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"content": "\u003cp class=\"danger-zone\">The genetic testing company 23andMe received \u003ca href=\"https://www.statnews.com/2017/04/06/genetic-test-alzheimers/\">approval\u003c/a> this week from regulators to sell genetic reports on an individual’s risk for 10 diseases, most prominently Alzheimer’s and Parkinson’s. Before you send in your saliva sample and $199, here’s what you should know:\u003c/p>\n\u003ch2 class=\"danger-zone\">What will a genetic test actually tell me?\u003c/h2>\n\u003cp class=\"danger-zone\">At most, that you carry a DNA variant that, according to research, is associated with a higher risk of a disease. For the rare clotting disorder hereditary thrombophilia, for instance, the report will say that you do or do not carry a variant called Factor V Leiden in the F5 gene and a variant called Prothrombin G20210A in the F2 gene.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s important for people to know that even if they have a mutation in the genes [associated with Parkinson’s that 23andMe will test for], by and large they won’t get Parkinson’s disease.'\u003c/aside>\n\u003cp>23and me is still fine-tuning the reports, but its tests will also tell you how the presence (or absence) of variants affects risk. If there’s enough science to quantify that, the report will specify a percentage, like “your risk is 3 percent.” If not, it will just say there’s an (unspecified) increased risk. Of course, you can also look it up. For Alzheimer’s, carrying two copies of the Apoe4 variant (one from each parent), as \u003ca href=\"https://science.education.nih.gov/supplements/nih9/bioethics/guide/pdf/Master_4-2.pdf\">1 to 2 percent\u003c/a> of the population does, raises the risk of the disease to as much as 87 percent, for instance, compared to about \u003ca href=\"https://www.statnews.com/2016/11/21/dementia-rate-decline/\">9 percent\u003c/a> in the general population.\u003c/p>\n\u003ch2 class=\"danger-zone\">What diseases can 23andMe tell me about?\u003c/h2>\n\u003cp class=\"danger-zone\">This month, late-onset Alzheimer’s disease, Parkinson’s disease, the clotting disorder alpha-1 antitrypsin deficiency, and Gaucher disease. Soon — the company hasn’t said exactly when — it will also test for genetic variants linked to factor XI deficiency (excessive bleeding), celiac disease, anemia-causing G6PD deficiency, the movement disorder early-onset primary dystonia, and the blood illness hereditary hemochromatosis.\u003c/p>\n\u003ch2>Will the test tell me if I’m doomed to get one of these terrible disorders?\u003c/h2>\n\u003cp>No. None of the genetic variants that 23andMe tests for is what’s called “fully penetrant,” meaning that 100 percent of those who carry the variant develop the disease. By not “fully,” we mean \u003cem>really\u003c/em> not fully, as in the risk might be measured in the single-digit percentages. “It’s important for people to know that even if they have a mutation in the genes [associated with Parkinson’s that 23andMe will test for], by and large they won’t get Parkinson’s disease,” said James Beck, chief scientific officer of the Parkinson’s Foundation. The N370S variant in the GBA gene, for instance, triples the risk of Parkinson’s, Beck said, but with a baseline risk of 0.3 percent that means about a 1 percent risk.\u003c/p>\n\u003ch2>Do these tests work better for some ethnic groups than others?\u003c/h2>\n\u003cp>Geneticists have studied more people of European descent than other groups, so they have more data on white people. 23andMe knows this, so its reports will include warnings such as that the test results are “most relevant for people of European descent” (for Alzheimer’s), “. . . for people of European, Ashkenazi Jewish, and North African Berber descent” (for Parkinson’s), and “. . . for people of Ashkenazi Jewish descent” (Factor XI Deficiency). With Alzheimer’s, the effect of the ApoE4 variant is weaker in African-Americans, for instance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/04/07/genetic-analysis-need-to-know/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">The genetic testing company 23andMe received \u003ca href=\"https://www.statnews.com/2017/04/06/genetic-test-alzheimers/\">approval\u003c/a> this week from regulators to sell genetic reports on an individual’s risk for 10 diseases, most prominently Alzheimer’s and Parkinson’s. Before you send in your saliva sample and $199, here’s what you should know:\u003c/p>\n\u003ch2 class=\"danger-zone\">What will a genetic test actually tell me?\u003c/h2>\n\u003cp class=\"danger-zone\">At most, that you carry a DNA variant that, according to research, is associated with a higher risk of a disease. For the rare clotting disorder hereditary thrombophilia, for instance, the report will say that you do or do not carry a variant called Factor V Leiden in the F5 gene and a variant called Prothrombin G20210A in the F2 gene.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s important for people to know that even if they have a mutation in the genes [associated with Parkinson’s that 23andMe will test for], by and large they won’t get Parkinson’s disease.'\u003c/aside>\n\u003cp>23and me is still fine-tuning the reports, but its tests will also tell you how the presence (or absence) of variants affects risk. If there’s enough science to quantify that, the report will specify a percentage, like “your risk is 3 percent.” If not, it will just say there’s an (unspecified) increased risk. Of course, you can also look it up. For Alzheimer’s, carrying two copies of the Apoe4 variant (one from each parent), as \u003ca href=\"https://science.education.nih.gov/supplements/nih9/bioethics/guide/pdf/Master_4-2.pdf\">1 to 2 percent\u003c/a> of the population does, raises the risk of the disease to as much as 87 percent, for instance, compared to about \u003ca href=\"https://www.statnews.com/2016/11/21/dementia-rate-decline/\">9 percent\u003c/a> in the general population.\u003c/p>\n\u003ch2 class=\"danger-zone\">What diseases can 23andMe tell me about?\u003c/h2>\n\u003cp class=\"danger-zone\">This month, late-onset Alzheimer’s disease, Parkinson’s disease, the clotting disorder alpha-1 antitrypsin deficiency, and Gaucher disease. Soon — the company hasn’t said exactly when — it will also test for genetic variants linked to factor XI deficiency (excessive bleeding), celiac disease, anemia-causing G6PD deficiency, the movement disorder early-onset primary dystonia, and the blood illness hereditary hemochromatosis.\u003c/p>\n\u003ch2>Will the test tell me if I’m doomed to get one of these terrible disorders?\u003c/h2>\n\u003cp>No. None of the genetic variants that 23andMe tests for is what’s called “fully penetrant,” meaning that 100 percent of those who carry the variant develop the disease. By not “fully,” we mean \u003cem>really\u003c/em> not fully, as in the risk might be measured in the single-digit percentages. “It’s important for people to know that even if they have a mutation in the genes [associated with Parkinson’s that 23andMe will test for], by and large they won’t get Parkinson’s disease,” said James Beck, chief scientific officer of the Parkinson’s Foundation. The N370S variant in the GBA gene, for instance, triples the risk of Parkinson’s, Beck said, but with a baseline risk of 0.3 percent that means about a 1 percent risk.\u003c/p>\n\u003ch2>Do these tests work better for some ethnic groups than others?\u003c/h2>\n\u003cp>Geneticists have studied more people of European descent than other groups, so they have more data on white people. 23andMe knows this, so its reports will include warnings such as that the test results are “most relevant for people of European descent” (for Alzheimer’s), “. . . for people of European, Ashkenazi Jewish, and North African Berber descent” (for Parkinson’s), and “. . . for people of Ashkenazi Jewish descent” (Factor XI Deficiency). With Alzheimer’s, the effect of the ApoE4 variant is weaker in African-Americans, for instance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Katherine Stevenson was 8 when she joined a UCSF study to test the effects of a video game on kids like her with \u003ca href=\"https://www.spdstar.org/basic/about-spd\" target=\"_blank\">sensory processing dysfunction\u003c/a>, or SPD, a collection of symptoms where the brain has trouble filtering incoming information -- like sounds and instructions -- in organized, focused ways.\u003c/p>\n\u003cp>Katherine is a happy, outgoing child with a high overall IQ, but her cognitive speed (relating to response and performance) is low in comparison to her critical thinking. Her main challenge is an auditory processing disorder that makes it hard for her to screen out certain sounds, because she hears them all at once.\u003c/p>\n\u003cp>\"It's almost like having a 500 horsepower engine that gets flooded,\" says her mom, Kori Stevenson.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost like having a 500 horsepower engine that gets flooded.'\u003ccite>Parent Kori Stevenson on her daughter's sensory processing dysfunction, or SPD\u003c/cite>\u003c/aside>\n\u003cp>The UCSF study, spearheaded in 2014 by two Department of Neurology professors, brought Katherine and 62 other elementary school kids (38 with SPD and 25 with typical development patterns) into a lab where an EEG machine tracked their brain activity while they followed computer prompts designed to measure their ability to focus and multitask.\u003c/p>\n\u003cp>Then the real work began. The kids brought home iPads loaded with a special software designed to target and improve problems with thinking, reacting, and performing tasks. Twice a day, five days a week for a month, the kids spent 30 minutes maneuvering a cartoonish 3-D figure along a moving pathway without hitting the walls -- tilting, swiping and jabbing the iPad as the game made all kinds of sounds and other potential distractions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There were times that it was really hard to for her,\" says Stevenson. \"There were some days when she breezed through and other days, she was in tears.\"\u003c/p>\n\u003cp>But when the month was over, and the kids were retested, Katherine's performance had improved.\u003c/p>\n\u003cp>\"Her ability to focus was a little bit better. And she wasn’t as fatigued at the end of the day. Her ability to multitask improved,\" says Stevenson.\u003c/p>\n\u003cp>Katherine's experience was not unique. The UCSF study, \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172616\" target=\"_blank\">published \u003c/a>Wednesday in the journal PLOS ONE, showed that while the iPad home training program benefited all the kids who participated to some extent, the results were even better for seven children (including Katherine), a subset of the 38 SPD children with symptoms of ADHD. This group dramatically overcame these issues, at least temporarily, after just a month of video play. Nine months later, those children had so improved (based on their parents' feedback) that they would no longer meet the clinical standard for symptoms of ADHD.\u003c/p>\n\u003cp>\u003cstrong>An Underserved Group\u003c/strong>\u003c/p>\n\u003cp>Video games designed for kids with ADHD have received the most press. But for this study, UCSF Neurology professors Joaquin Anguera and Elyse Marco wanted to focus on an underserved group that doesn't get as much attention.\u003c/p>\n\u003cp>Some brain training studies specifically target people with ADHD with \u003ca href=\"http://www.cnbc.com/2015/05/21/a-tech-start-up-making-a-play-for-billions-in-adhd-drug-market.html\">gaming products\u003c/a> -- a market ripe for profit, if it can be shown that such products really work. But \u003ca href=\"http://profiles.ucsf.edu/joaquin.anguera\">Anguera\u003c/a> and \u003ca href=\"http://anp.ucsf.edu/aboutus/faculty/emarco\">Marco\u003c/a> wanted to work with children with sensory processing dysfunction, a group Marco got to know through her pediatric clinical practice at UCSF. If you're not familiar with SPD, you're not alone. The disorder is thought to affect 5 percent of all U.S. children, but it's a poorly studied group. Symptoms vary widely, from children like Katherine Stevenson with auditory processing issues to something closer to autism spectrum disorder and ADHD. As such, it is often misdiagnosed.\u003c/p>\n\u003cfigure id=\"attachment_366979\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-366979\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/04/Project-EVO-800x564.jpg\" alt=\"A child plays with Project: EVO, a video game software.\" width=\"800\" height=\"564\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-800x564.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-160x113.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-768x541.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-1020x719.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-960x677.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-240x169.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-375x264.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-520x366.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO.jpg 1084w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A child plays with Project: EVO, a video game software. \u003ccite>(Akili Interactive Labs)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The results\u003cem> \u003c/em>of the UCSF study challenge the notion that prolonged exposure to video games, iPads and other interactive technology turns toddlers into strung-out youngsters with an \u003ca href=\"http://www.psychiatrictimes.com/adhd/adhd-associated-video-game-addiction\">ADHD-like inability to focus on tasks\u003c/a> and get things done to completion.\u003c/p>\n\u003cp>A preponderance of studies suggest that all that screen time \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/19/502610055/heavy-screen-time-rewires-young-brains-for-better-and-worse\">\u003cem>does\u003c/em> re-wire the brain\u003c/a>. But that may not be a bad thing -- especially for kids like Katherine, who can benefit from learning how to focus on a single goal-based task and block out any other distractions.\u003c/p>\n\u003cp>\"The fact that these parents reported persistent amounts of improvement for nine months – I think that’s really remarkable,\" says Anguera, lead author of the study. The results showed some parallels to his\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24005416\"> much-publicized 2013 \u003c/a>study where a different 3-D video game called Neuroracer trained seniors to multitask better than a group of 20-year-olds.\u003c/p>\n\u003cp>\u003cstrong>Beyond the Hype\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Since the new study only included 63 kids, it was meant as more of a proof of concept experiment than a study meant to offer clinical conclusions.\u003c/p>\n\u003cp>Cognitive scientists bristle at suggestions that any of the newfangled cognitive training programs on the market can work for everyone. \u003ca href=\"http://www.cogmed.com/who-is-cogmed-for\">Cogmed \u003c/a>and \u003ca href=\"https://www.lumosity.com/\">Lumosity\u003c/a>, for example, target both children and adults with claims of improving attention and processing speed. The most common word experts use to describe them is \"exaggerated.\"\u003c/p>\n\u003cp>Dr. Laura Carstensen, founding director of the \u003ca href=\"http://longevity3.stanford.edu/\" target=\"_blank\">Stanford Center on Longevity\u003c/a>, is one of the skeptics. “Can you improve your brain so that it’s faster, more adept, more vital?,\" she told KQED in 2010. \"That’s what the claims are, and I don’t think there’s really any evidence for that.\" In 2014, 73 experts signed an open letter (since taken offline) \u003ca href=\"https://www.theguardian.com/science/2014/oct/23/brain-games-memory-loss-open-letter\">warning about\u003c/a> companies exploiting consumers with such claims.\u003c/p>\n\u003cp>Anguera is the first to agree. \"You have all these problematic 'brain training' things, and it's fraught with snake oil,\" he says. \"There haven’t been very many studies that have shown any kind of difference, that it does work.\" [contextly_sidebar id=\"8fVx8JR3VjF4j4i929dImiQCARfor4l2\"]\u003c/p>\n\u003cp>The main takeaway from this study, according to Anguera, is how well it demonstrates the need for personalized assessment before offering kids the brain-training programs of tomorrow. One size does not fit all; look at the fact that only a small subset of the study participants with SPD -- the cohort of SPD kids with hyperactivity or attention struggles -- showed long-term benefit from the video game training.\u003c/p>\n\u003cp>\"It really gives us a perspective. If you’re going to use these types of technologies to improve people's attention, you need to be putting thought into it. Not everyone needs the same type of intervention, and the same types of intervention won't work for everyone.\"\u003c/p>\n\u003cp>That said, Anguera has confidence that the improvements his team observed were genuine, based on the fact that they were assessed with three different metrics: behavioral testing in the lab, parent surveys, and the use of EEG devices to measure brain waves.\u003c/p>\n\u003cp>Anguera's team was particularly intrigued to watch a part of the pre-frontal lobe \"light up\" during EEG scans. It's the part of the brain that drives goal-directed activities, and researchers saw how much more responsive it became after kids had spent a month playing with the iPad. Scientists suspect that in kids with ADHD-like symptoms, the cognitive circuits at the front of the brain are not firing at the right time or they’re not firing enough, according to Anguera.\u003c/p>\n\u003cp>Researchers don't know exactly how, but it appears that \"pushing\" on, or repeatedly using, these circuits of attention strengthens them, like bicep training at the gym.\u003c/p>\n\u003cp>\"There’s very few of these cognitive training studies – maybe none – that show a signature that correlates with behavior on some test of attention and shows what’s happening,\" says Anguera. \"That's what makes this unique.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'The fact that these parents reported persistent amounts of improvement for nine months – I think that’s really remarkable.'\u003ccite>Dr. Joaquin Anguera, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The UCSF study used an iPad game called Project: EVO. In 2015, \u003ca href=\"http://www.akiliinteractive.com/\">Akili Interactive Labs\u003c/a>, the software developer, used it to \u003ca href=\"https://well.blogs.nytimes.com/2015/11/23/video-game-is-built-to-be-prescribed-to-children-with-a-d-h-d/?_r=0\">measure the effects on a small group of children\u003c/a> with ADHD and a control group. The study found that, after playing the game five days a week for a month, the children with ADHD showed significant improvement and the control group did not.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Akili Interactive is now \u003ca href=\"http://nationaladhdstudy.com/\">testing their software \u003c/a>on hundreds of ADHD children at 13 study sites across the U.S. and aims to be first FDA-approved ADHD videogame\u003ca href=\"http://www.npr.org/sections/health-shots/2015/08/10/430149726/will-doctors-soon-be-prescribing-video-games-for-mental-health\"> doctors prescribe to parents\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Katherine Stevenson was 8 when she joined a UCSF study to test the effects of a video game on kids like her with \u003ca href=\"https://www.spdstar.org/basic/about-spd\" target=\"_blank\">sensory processing dysfunction\u003c/a>, or SPD, a collection of symptoms where the brain has trouble filtering incoming information -- like sounds and instructions -- in organized, focused ways.\u003c/p>\n\u003cp>Katherine is a happy, outgoing child with a high overall IQ, but her cognitive speed (relating to response and performance) is low in comparison to her critical thinking. Her main challenge is an auditory processing disorder that makes it hard for her to screen out certain sounds, because she hears them all at once.\u003c/p>\n\u003cp>\"It's almost like having a 500 horsepower engine that gets flooded,\" says her mom, Kori Stevenson.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost like having a 500 horsepower engine that gets flooded.'\u003ccite>Parent Kori Stevenson on her daughter's sensory processing dysfunction, or SPD\u003c/cite>\u003c/aside>\n\u003cp>The UCSF study, spearheaded in 2014 by two Department of Neurology professors, brought Katherine and 62 other elementary school kids (38 with SPD and 25 with typical development patterns) into a lab where an EEG machine tracked their brain activity while they followed computer prompts designed to measure their ability to focus and multitask.\u003c/p>\n\u003cp>Then the real work began. The kids brought home iPads loaded with a special software designed to target and improve problems with thinking, reacting, and performing tasks. Twice a day, five days a week for a month, the kids spent 30 minutes maneuvering a cartoonish 3-D figure along a moving pathway without hitting the walls -- tilting, swiping and jabbing the iPad as the game made all kinds of sounds and other potential distractions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There were times that it was really hard to for her,\" says Stevenson. \"There were some days when she breezed through and other days, she was in tears.\"\u003c/p>\n\u003cp>But when the month was over, and the kids were retested, Katherine's performance had improved.\u003c/p>\n\u003cp>\"Her ability to focus was a little bit better. And she wasn’t as fatigued at the end of the day. Her ability to multitask improved,\" says Stevenson.\u003c/p>\n\u003cp>Katherine's experience was not unique. The UCSF study, \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172616\" target=\"_blank\">published \u003c/a>Wednesday in the journal PLOS ONE, showed that while the iPad home training program benefited all the kids who participated to some extent, the results were even better for seven children (including Katherine), a subset of the 38 SPD children with symptoms of ADHD. This group dramatically overcame these issues, at least temporarily, after just a month of video play. Nine months later, those children had so improved (based on their parents' feedback) that they would no longer meet the clinical standard for symptoms of ADHD.\u003c/p>\n\u003cp>\u003cstrong>An Underserved Group\u003c/strong>\u003c/p>\n\u003cp>Video games designed for kids with ADHD have received the most press. But for this study, UCSF Neurology professors Joaquin Anguera and Elyse Marco wanted to focus on an underserved group that doesn't get as much attention.\u003c/p>\n\u003cp>Some brain training studies specifically target people with ADHD with \u003ca href=\"http://www.cnbc.com/2015/05/21/a-tech-start-up-making-a-play-for-billions-in-adhd-drug-market.html\">gaming products\u003c/a> -- a market ripe for profit, if it can be shown that such products really work. But \u003ca href=\"http://profiles.ucsf.edu/joaquin.anguera\">Anguera\u003c/a> and \u003ca href=\"http://anp.ucsf.edu/aboutus/faculty/emarco\">Marco\u003c/a> wanted to work with children with sensory processing dysfunction, a group Marco got to know through her pediatric clinical practice at UCSF. If you're not familiar with SPD, you're not alone. The disorder is thought to affect 5 percent of all U.S. children, but it's a poorly studied group. Symptoms vary widely, from children like Katherine Stevenson with auditory processing issues to something closer to autism spectrum disorder and ADHD. As such, it is often misdiagnosed.\u003c/p>\n\u003cfigure id=\"attachment_366979\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-366979\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/04/Project-EVO-800x564.jpg\" alt=\"A child plays with Project: EVO, a video game software.\" width=\"800\" height=\"564\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-800x564.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-160x113.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-768x541.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-1020x719.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-960x677.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-240x169.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-375x264.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO-520x366.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Project-EVO.jpg 1084w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A child plays with Project: EVO, a video game software. \u003ccite>(Akili Interactive Labs)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The results\u003cem> \u003c/em>of the UCSF study challenge the notion that prolonged exposure to video games, iPads and other interactive technology turns toddlers into strung-out youngsters with an \u003ca href=\"http://www.psychiatrictimes.com/adhd/adhd-associated-video-game-addiction\">ADHD-like inability to focus on tasks\u003c/a> and get things done to completion.\u003c/p>\n\u003cp>A preponderance of studies suggest that all that screen time \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/19/502610055/heavy-screen-time-rewires-young-brains-for-better-and-worse\">\u003cem>does\u003c/em> re-wire the brain\u003c/a>. But that may not be a bad thing -- especially for kids like Katherine, who can benefit from learning how to focus on a single goal-based task and block out any other distractions.\u003c/p>\n\u003cp>\"The fact that these parents reported persistent amounts of improvement for nine months – I think that’s really remarkable,\" says Anguera, lead author of the study. The results showed some parallels to his\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24005416\"> much-publicized 2013 \u003c/a>study where a different 3-D video game called Neuroracer trained seniors to multitask better than a group of 20-year-olds.\u003c/p>\n\u003cp>\u003cstrong>Beyond the Hype\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Since the new study only included 63 kids, it was meant as more of a proof of concept experiment than a study meant to offer clinical conclusions.\u003c/p>\n\u003cp>Cognitive scientists bristle at suggestions that any of the newfangled cognitive training programs on the market can work for everyone. \u003ca href=\"http://www.cogmed.com/who-is-cogmed-for\">Cogmed \u003c/a>and \u003ca href=\"https://www.lumosity.com/\">Lumosity\u003c/a>, for example, target both children and adults with claims of improving attention and processing speed. The most common word experts use to describe them is \"exaggerated.\"\u003c/p>\n\u003cp>Dr. Laura Carstensen, founding director of the \u003ca href=\"http://longevity3.stanford.edu/\" target=\"_blank\">Stanford Center on Longevity\u003c/a>, is one of the skeptics. “Can you improve your brain so that it’s faster, more adept, more vital?,\" she told KQED in 2010. \"That’s what the claims are, and I don’t think there’s really any evidence for that.\" In 2014, 73 experts signed an open letter (since taken offline) \u003ca href=\"https://www.theguardian.com/science/2014/oct/23/brain-games-memory-loss-open-letter\">warning about\u003c/a> companies exploiting consumers with such claims.\u003c/p>\n\u003cp>Anguera is the first to agree. \"You have all these problematic 'brain training' things, and it's fraught with snake oil,\" he says. \"There haven’t been very many studies that have shown any kind of difference, that it does work.\" \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The main takeaway from this study, according to Anguera, is how well it demonstrates the need for personalized assessment before offering kids the brain-training programs of tomorrow. One size does not fit all; look at the fact that only a small subset of the study participants with SPD -- the cohort of SPD kids with hyperactivity or attention struggles -- showed long-term benefit from the video game training.\u003c/p>\n\u003cp>\"It really gives us a perspective. If you’re going to use these types of technologies to improve people's attention, you need to be putting thought into it. Not everyone needs the same type of intervention, and the same types of intervention won't work for everyone.\"\u003c/p>\n\u003cp>That said, Anguera has confidence that the improvements his team observed were genuine, based on the fact that they were assessed with three different metrics: behavioral testing in the lab, parent surveys, and the use of EEG devices to measure brain waves.\u003c/p>\n\u003cp>Anguera's team was particularly intrigued to watch a part of the pre-frontal lobe \"light up\" during EEG scans. It's the part of the brain that drives goal-directed activities, and researchers saw how much more responsive it became after kids had spent a month playing with the iPad. Scientists suspect that in kids with ADHD-like symptoms, the cognitive circuits at the front of the brain are not firing at the right time or they’re not firing enough, according to Anguera.\u003c/p>\n\u003cp>Researchers don't know exactly how, but it appears that \"pushing\" on, or repeatedly using, these circuits of attention strengthens them, like bicep training at the gym.\u003c/p>\n\u003cp>\"There’s very few of these cognitive training studies – maybe none – that show a signature that correlates with behavior on some test of attention and shows what’s happening,\" says Anguera. \"That's what makes this unique.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'The fact that these parents reported persistent amounts of improvement for nine months – I think that’s really remarkable.'\u003ccite>Dr. Joaquin Anguera, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The UCSF study used an iPad game called Project: EVO. In 2015, \u003ca href=\"http://www.akiliinteractive.com/\">Akili Interactive Labs\u003c/a>, the software developer, used it to \u003ca href=\"https://well.blogs.nytimes.com/2015/11/23/video-game-is-built-to-be-prescribed-to-children-with-a-d-h-d/?_r=0\">measure the effects on a small group of children\u003c/a> with ADHD and a control group. The study found that, after playing the game five days a week for a month, the children with ADHD showed significant improvement and the control group did not.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Akili Interactive is now \u003ca href=\"http://nationaladhdstudy.com/\">testing their software \u003c/a>on hundreds of ADHD children at 13 study sites across the U.S. and aims to be first FDA-approved ADHD videogame\u003ca href=\"http://www.npr.org/sections/health-shots/2015/08/10/430149726/will-doctors-soon-be-prescribing-video-games-for-mental-health\"> doctors prescribe to parents\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Yes, Stress Really Can Cause Disease. But Don’t Stress! You Can Do Something About It",
"title": "Yes, Stress Really Can Cause Disease. But Don’t Stress! You Can Do Something About It",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Have you ever envied a friend who looks 20 years younger than their age?\u003c/p>\n\u003cp>How do they do it?\u003c/p>\n\u003caside class=\"pullquote alignright\">'You can do a lot to improve your DNA without having to buy expensive genetic tests, like changing the way you eat, relax and sleep.'\u003c/aside>\n\u003cp>The secret could lie in their telomeres, the tiny caps on the ends of their chromosomes\u003cspan style=\"font-weight: 400\">—\u003c/span>kind of like the plastic wraps at the end of shoelaces. Nobel Laureate Elizabeth Blackburn, \u003cspan class=\"guests\">\u003cspan class=\"guest\">the\u003c/span> \u003cspan class=\"guest-bio\">president of the \u003ca href=\"http://www.salk.edu/\" target=\"_blank\">Salk Institute for Biological Studies\u003c/a>, \u003c/span>\u003c/span>used this metaphor recently when she was a guest on KQED's \u003ca href=\"https://ww2.kqed.org/forum/2017/03/06/using-the-telomere-effect-to-protect-your-dna-and-stave-off-disease/\" target=\"_blank\">Forum\u003c/a>, along with UCSF psychologist Elissa Epel. The two, who have researched telomeres, discussed their new book, \"The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer.\"\u003c/p>\n\u003cp>\"Picture a shoelace and remember the little plastic tips at the end,\" said Blackburn. \"If you don't have those at the end of your shoelace, they will start fraying away, and the shoelaces will stop working well. Now imagine the shoelaces are actually the chromosomes that carry our genetic material. ... When those telomeres wear down, which they do over the many, many decades of human life, then the consequences are severe. Cells will stop in their tracks and start malfunctioning, and they start becoming inflammatory. \"\u003c/p>\n\u003cp>The good news, Blackburn says, is that minimizing stress will keep your shoelace tips (telomeres) in better shape, helping to prevent disease and maybe even the effects of aging.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Below are excerpts from the conversation, edited for length and clarity. Answers from both authors are combined.\u003c/p>\n\u003cfigure id=\"attachment_360074\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-360074 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/03/EPEL-And-Blackburn-800x617.jpg\" alt=\"Psychologist Elissa Epel, PhD (left) and Nobel Laureate Elizabeth Blackburn, PhD (right) in a lab at the University of California San Francisco.\" width=\"800\" height=\"617\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-800x617.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-160x123.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-768x593.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-1020x787.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-1920x1482.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-1180x911.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-960x741.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-240x185.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-375x289.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-520x401.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Psychologist Elissa Epel, PhD (left) and Nobel Laureate Elizabeth Blackburn, PhD (right) in a lab at the University of California San Francisco. \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Telomeres Connected to the Big Killers\u003c/strong>\u003c/p>\n\u003cp>When telomeres fray at the tips, the DNA inside a cell is no longer able to protect its genetic material, because the telomeres don't work well. Again, think of shoelaces. When the tips are frayed, it's difficult to thread them through your shoes. The same is true if your telomeres wear down.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>When chromosomes are no longer protected by the telomeres, it sets off alarm signals inside the cells. Over the years, this process of deterioration is what leads to the major diseases of aging like cardiovascular disease, dementia and cancer, because the body isn't protecting itself well.\u003c/p>\n\u003cp>Telomere attrition—causing negative damage to the cells\u003cspan style=\"font-weight: 400\">—\u003c/span>is one of the contributors that lead to these major killers. So the more we stave off attrition of telomeres, the more we extend both our lifespan and our healthspan (the years in which we enjoy a high quality of life where our health is concerned.)\u003c/p>\n\u003cp>\u003cstrong>A Mystery Solved\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>We knew that telomeres gradually wear down over the years. We also knew these protective tips build back up, but we didn't know how.\u003c/p>\n\u003cp>Then we discovered a biological indicator, an enzyme called telomerase, which protects our genetic heritage. The enzyme is one of many factors that helps the telomeres build back up again and pass DNA successfully from generation to generation.\u003c/p>\n\u003cp>\u003cstrong>Telomere Length Depends on Mind-Body Connection\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>There is a well-established correlation between chronic stress and our health, not only in accelerating chronic diseases but also the short-term effects on the immune system. We wanted to find out how stress affects telomeres, and the results surprised us.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>We found a strong relationship between perceived stress\u003cspan style=\"font-weight: 400\">—\u003c/span>the feeling that you can't cope with all that's on your plate\u003cspan style=\"font-weight: 400\">—\u003c/span>and shorter telomeres, and in turn we found lower levels of telomerase in patients who were in a state of overwhelm.\u003c/p>\n\u003cp>Active exercise, good nutrition and deep sleep all play a role in helping to lower stress, but we also found that our community, our neighborhood and our social and psychological lives are also shaping our telomere length throughout our lifespan. For example, the trust we feel or don't feel in our neighbors are all related to telomeres.\u003c/p>\n\u003cp>Any time you get a group of people together, you have social connection and support, which is powerful. And, we are starting to see that emotional support groups can reduce stress just as well as meditation and mindfulness training. For example, the research on knitting , Christian prayer and other repetitive behaviors like chanting look pretty darn good when you study their mind-body effects.\u003c/p>\n\u003cp>So what's very interesting about telomeres is how much control one has over the net attrition rate, which is the sum of many, many \u003cstrong>i\u003c/strong>nfluences. You can quantify it and then say, \"Wow this statistically relates to a lot of these things.\"\u003c/p>\n\u003cp>\u003cstrong>Telomeres: A Key Pathway in Aging\u003c/strong>\u003c/p>\n\u003cp>Part of the reason we know so much about telomeres is that we can now study human DNA so easily. The number of studies that have been done on large populations all over the world is phenomenal. Granted, telomere research is only one factor of aging, but it is a pathway that is illuminated and that we know a lot about.\u003c/p>\n\u003cp>There are other discoveries that are gaining scientists' attention, like the epigenetic clock, which is another predictor of our longevity and our health. But it's a totally different, independent pathway. Our goal in focusing on telomeres is to empower people to see all the ways they can improve their health on their own. You can do a lot to improve your DNA without having to buy expensive genetic tests, like changing the way you eat, relax and sleep.\u003c/p>\n\u003cp>\u003cstrong>Don't Fall For Pills that Make Big Promises\u003c/strong>\u003c/p>\n\u003cp>Don't take supplements promising to improve your telomeres. They are completely unproven. The creams you put on the outside of the body are really not going to seep down to the deeper layers and change the cell aging system. We suggest changes in small daily habits that add up over time. For example, nutrition is a powerful way to reduce oxidative stress, reduce inflammation and possibly boost telomerase. New studies will likely show that changes in diet eventually affect the skin and beyond.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Blackburn and Epel offer a \u003ca href=\"http://www.hachettebookgroup.com/features/the-telomere-effect/resources.html\" target=\"_blank\">list of practices\u003c/a> to strengthen the health of your telomeres.\u003c/em>\u003c/p>\n\n",
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"excerpt": "A Nobel laureate and a UCSF psychologist team up to discuss how the health of your chromosome tips are affected by stress and is one key to a healthy life as you age.",
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"title": "Yes, Stress Really Can Cause Disease. But Don’t Stress! You Can Do Something About It | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Have you ever envied a friend who looks 20 years younger than their age?\u003c/p>\n\u003cp>How do they do it?\u003c/p>\n\u003caside class=\"pullquote alignright\">'You can do a lot to improve your DNA without having to buy expensive genetic tests, like changing the way you eat, relax and sleep.'\u003c/aside>\n\u003cp>The secret could lie in their telomeres, the tiny caps on the ends of their chromosomes\u003cspan style=\"font-weight: 400\">—\u003c/span>kind of like the plastic wraps at the end of shoelaces. Nobel Laureate Elizabeth Blackburn, \u003cspan class=\"guests\">\u003cspan class=\"guest\">the\u003c/span> \u003cspan class=\"guest-bio\">president of the \u003ca href=\"http://www.salk.edu/\" target=\"_blank\">Salk Institute for Biological Studies\u003c/a>, \u003c/span>\u003c/span>used this metaphor recently when she was a guest on KQED's \u003ca href=\"https://ww2.kqed.org/forum/2017/03/06/using-the-telomere-effect-to-protect-your-dna-and-stave-off-disease/\" target=\"_blank\">Forum\u003c/a>, along with UCSF psychologist Elissa Epel. The two, who have researched telomeres, discussed their new book, \"The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer.\"\u003c/p>\n\u003cp>\"Picture a shoelace and remember the little plastic tips at the end,\" said Blackburn. \"If you don't have those at the end of your shoelace, they will start fraying away, and the shoelaces will stop working well. Now imagine the shoelaces are actually the chromosomes that carry our genetic material. ... When those telomeres wear down, which they do over the many, many decades of human life, then the consequences are severe. Cells will stop in their tracks and start malfunctioning, and they start becoming inflammatory. \"\u003c/p>\n\u003cp>The good news, Blackburn says, is that minimizing stress will keep your shoelace tips (telomeres) in better shape, helping to prevent disease and maybe even the effects of aging.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Below are excerpts from the conversation, edited for length and clarity. Answers from both authors are combined.\u003c/p>\n\u003cfigure id=\"attachment_360074\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-360074 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/03/EPEL-And-Blackburn-800x617.jpg\" alt=\"Psychologist Elissa Epel, PhD (left) and Nobel Laureate Elizabeth Blackburn, PhD (right) in a lab at the University of California San Francisco.\" width=\"800\" height=\"617\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-800x617.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-160x123.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-768x593.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-1020x787.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-1920x1482.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-1180x911.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-960x741.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-240x185.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-375x289.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/EPEL-And-Blackburn-520x401.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Psychologist Elissa Epel, PhD (left) and Nobel Laureate Elizabeth Blackburn, PhD (right) in a lab at the University of California San Francisco. \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Telomeres Connected to the Big Killers\u003c/strong>\u003c/p>\n\u003cp>When telomeres fray at the tips, the DNA inside a cell is no longer able to protect its genetic material, because the telomeres don't work well. Again, think of shoelaces. When the tips are frayed, it's difficult to thread them through your shoes. The same is true if your telomeres wear down.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>When chromosomes are no longer protected by the telomeres, it sets off alarm signals inside the cells. Over the years, this process of deterioration is what leads to the major diseases of aging like cardiovascular disease, dementia and cancer, because the body isn't protecting itself well.\u003c/p>\n\u003cp>Telomere attrition—causing negative damage to the cells\u003cspan style=\"font-weight: 400\">—\u003c/span>is one of the contributors that lead to these major killers. So the more we stave off attrition of telomeres, the more we extend both our lifespan and our healthspan (the years in which we enjoy a high quality of life where our health is concerned.)\u003c/p>\n\u003cp>\u003cstrong>A Mystery Solved\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>We knew that telomeres gradually wear down over the years. We also knew these protective tips build back up, but we didn't know how.\u003c/p>\n\u003cp>Then we discovered a biological indicator, an enzyme called telomerase, which protects our genetic heritage. The enzyme is one of many factors that helps the telomeres build back up again and pass DNA successfully from generation to generation.\u003c/p>\n\u003cp>\u003cstrong>Telomere Length Depends on Mind-Body Connection\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>There is a well-established correlation between chronic stress and our health, not only in accelerating chronic diseases but also the short-term effects on the immune system. We wanted to find out how stress affects telomeres, and the results surprised us.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>We found a strong relationship between perceived stress\u003cspan style=\"font-weight: 400\">—\u003c/span>the feeling that you can't cope with all that's on your plate\u003cspan style=\"font-weight: 400\">—\u003c/span>and shorter telomeres, and in turn we found lower levels of telomerase in patients who were in a state of overwhelm.\u003c/p>\n\u003cp>Active exercise, good nutrition and deep sleep all play a role in helping to lower stress, but we also found that our community, our neighborhood and our social and psychological lives are also shaping our telomere length throughout our lifespan. For example, the trust we feel or don't feel in our neighbors are all related to telomeres.\u003c/p>\n\u003cp>Any time you get a group of people together, you have social connection and support, which is powerful. And, we are starting to see that emotional support groups can reduce stress just as well as meditation and mindfulness training. For example, the research on knitting , Christian prayer and other repetitive behaviors like chanting look pretty darn good when you study their mind-body effects.\u003c/p>\n\u003cp>So what's very interesting about telomeres is how much control one has over the net attrition rate, which is the sum of many, many \u003cstrong>i\u003c/strong>nfluences. You can quantify it and then say, \"Wow this statistically relates to a lot of these things.\"\u003c/p>\n\u003cp>\u003cstrong>Telomeres: A Key Pathway in Aging\u003c/strong>\u003c/p>\n\u003cp>Part of the reason we know so much about telomeres is that we can now study human DNA so easily. The number of studies that have been done on large populations all over the world is phenomenal. Granted, telomere research is only one factor of aging, but it is a pathway that is illuminated and that we know a lot about.\u003c/p>\n\u003cp>There are other discoveries that are gaining scientists' attention, like the epigenetic clock, which is another predictor of our longevity and our health. But it's a totally different, independent pathway. Our goal in focusing on telomeres is to empower people to see all the ways they can improve their health on their own. You can do a lot to improve your DNA without having to buy expensive genetic tests, like changing the way you eat, relax and sleep.\u003c/p>\n\u003cp>\u003cstrong>Don't Fall For Pills that Make Big Promises\u003c/strong>\u003c/p>\n\u003cp>Don't take supplements promising to improve your telomeres. They are completely unproven. The creams you put on the outside of the body are really not going to seep down to the deeper layers and change the cell aging system. We suggest changes in small daily habits that add up over time. For example, nutrition is a powerful way to reduce oxidative stress, reduce inflammation and possibly boost telomerase. New studies will likely show that changes in diet eventually affect the skin and beyond.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Blackburn and Epel offer a \u003ca href=\"http://www.hachettebookgroup.com/features/the-telomere-effect/resources.html\" target=\"_blank\">list of practices\u003c/a> to strengthen the health of your telomeres.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Strong Progress for Paralyzed Patients After Stem Cell Therapy, Company Says",
"title": "Strong Progress for Paralyzed Patients After Stem Cell Therapy, Company Says",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>A small stem cell trial in which patients with severe spinal injuries appeared to make remarkable progress is still showing excellent results, according to the company conducting the research.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This is as good as you could hope at this point.' \u003ccite>Charles Liu, director of the USC Neurorestoration Center\u003c/cite>\u003c/aside>\n\u003cp>\u003cspan style=\"font-weight: 400\">One of the patients in the trial is 21-year-old Kris Boesen, from Bakersfield, California, whose \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/12/stem-cells-may-have-restored-use-of-hands-and-arms-in-paralyzed-man/\" target=\"_blank\" rel=\"noopener\">story \u003c/a>we reported on last year. A car crash had left the Bakersfield, California native with \u003c/span>\u003cspan style=\"font-weight: 400\">three crushed vertebrae, almost no feeling below his neck, and a grim\u003c/span>\u003cspan style=\"font-weight: 400\"> prognosis. Doctors believed he would live the rest of his life as a paraplegic.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"font-weight: 400\">Enter stem cell therapy. Most treatments for serious spinal injuries concentrate on physical therapy to expand the range of the patient's remaining motor skills and to limit further injury, not to reverse the actual damage. But last April, as part of an experimental phase 2 clinical trial called \u003c/span>\u003ca href=\"http://www.scistar-study.com/\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">SCiStar\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, researchers injected Boesen with 10 million stem cells. By July, he had recovered use of his hands to the point where he could use a wheelchair, a computer and a cellphone, and could take care of most of his daily living needs.\u003c/span> In recent months his progress has continued, says his father.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s certainly interesting, but it’s still early.'\u003ccite>Paul Knoepfler, UC Davis stem cell researcher\u003c/cite>\u003c/aside>\n\u003cp>Boesen is not the only patient to have improved in the trial, according to Asterias Biotherapeutics, which is conducting the research. Boesen is part of a cohort of six patients who were experiencing various levels of paralysis and were injected with the 10 million stem cell dose. In a Jan. 24 \u003ca href=\"http://asteriasbiotherapeutics.com/presentations/Asterias-Biotherapeutics_Investor_Presentation_January-2017.pdf\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">update\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, the company said\u003c/span>\u003cspan style=\"font-weight: 400\"> five of those patients had improved either one or two levels on a widely used scale to measure \u003c/span>motor function in spinal injury patients.\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"font-weight: 400\">On Tuesday, Asterias issued a new \u003c/span>\u003ca href=\"https://finance.yahoo.com/news/full-six-patient-cohort-confirms-110000936.html\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">update\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">,\u003c/span> \u003cspan style=\"font-weight: 400\">announcing\u003c/span> \u003cspan style=\"font-weight: 400\"> that the sixth patient in the cohort has experienced a similar improvement. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">While spontaneous recovery for spinal injury patients does occur, the likelihood of all six patients recovering to the degree they have is less likely, researchers say.\u003c/p>\n\u003cp class=\"p1\">“This is as good as you could hope at this point,” said Charles Liu, Boesen’s neurosurgeon and director of the USC Neurorestoration Center. “So far all the evidence is pointing in the right direction.”\u003c/p>\n\u003cp class=\"p1\">To measure improvement in spinal injury patients, researchers use two yardsticks: the Upper Extremity Motor Scale, or UEMS, and the International Standards for Neurological Classification of Spinal Cord Injury, or ISNCSCI. On the UEMS scale, patients are scored from 0 to 5 on their ability to use \u003ca href=\"http://www.nature.com/sc/journal/v45/n3/fig_tab/3102008t1.html\" target=\"_blank\" rel=\"noopener\">five key muscles\u003c/a> in the wrists, elbows and fingers. The \u003ca href=\"http://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabilitation/spinal_cord_injury_85,P01180/\" target=\"_blank\" rel=\"noopener\">ISNCSCI scale\u003c/a> assesses where damage has occurred along the different levels of the cervical vertebrae, which generally determines the scope of impairment to the body and the\u003ca href=\"http://www.spinalinjury101.org/details/levels-of-injury\" target=\"_blank\" rel=\"noopener\"> level of care needed\u003c/a>.\u003c/p>\n\u003cp>For instance, if a patient has sustained damage at the fourth cervical vertebra down, known as C-4, at the base of the neck, it generally means that person is paralyzed from the neck down, requiring round-the-clock care and a ventilator to breathe. A patient with a C-5 injury may not be able to move her arms or hands, requiring about 6 to 12 hours per day of assisted care; and at the C-6 level, better motor function may allow a patient to take care of most of her daily living needs on her own.\u003c/p>\n\u003cfigure id=\"attachment_243385\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-243385 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Neurosurgery-Stem-Cell-spine-patient-Kris-Boesen_04-800x526.jpg\" alt=\"Lifting weights is part of Kris Boesen’s regular program of physical therapy. \" width=\"800\" height=\"526\">\u003cfigcaption class=\"wp-caption-text\">Lifting weights is part of Kris Boesen’s regular program of physical therapy. \u003ccite>(Greg Iger/Keck Medicine of USC))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Which is all to say that even one level of recovery could substantially improve the daily life of a spinal injury patient.\u003c/p>\n\u003cp class=\"p1\">According to Asterias, all six patients in the 10 million-cell cohort have improved their general UEMS scores, and jumped at least one motor level on the ISNCSCI scale on one or both sides of their body.\u003c/p>\n\u003cp class=\"p1\">Two patients have improved two motor levels on one side; and one patient, Boesen, has improved two motor levels on both sides\u003cb>. \u003c/b>\u003c/p>\n\u003cp>Steve Cartt, president and CEO of Asterias, said another patient, Jake Javier of Danville, California, has gone from partial paralysis to being able to use his hands well enough to consider pursuing a computer science career.\u003c/p>\n\u003cp>\u003cstrong>'Throws Like a Regular Throw'\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In September, Boesen’s father, Rod Boesen, told us how excited he was that his son had regained some feeling in one of his feet. Last week, at 11 months post-injection, the elder Boesen said Kris has continued to improve.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Now he can move his toe and his knee together at the same time,” Boesen said. “They’re about to give him a manual wheelchair now [instead of a motorized one]. He can grip with his hands enough to use a manual one.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Boesen said the movement in his son’s arms and hands has greatly improved since September. \u003c/span>\u003cspan style=\"font-weight: 400\">Kris, a former high school pitcher, had been flinging a ball to his dog “like people throw hand grenades,” Boesen said. “They kind of cradle them – and that’s how Kris would do it. … But now he throws like a regular throw, tosses that ball down the hall, has that release point down, and just wings it.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Asterias is currently recruiting patients for a trial in which they'll receive 20 million stem cells, the optimal dose, according to company researchers. T\u003c/span>\u003cspan style=\"font-weight: 400\">wo patients have already started the 20 million stem cell therapy, and six-month results from those patients will be released in the fall, Cartt said.\u003c/span>\u003c/p>\n\u003cp>Patients who received 2 million stem cells in an earlier phase of the study have not shown much change in their condition, according to the Jan. 24 update.\u003c/p>\n\u003cp>\u003cstrong>Guarded Optimism\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">While Boesen’s father is impressed with the results, the optimism of researchers inside and outside the study has been guarded. \u003c/span>The trial is still in its early stages, and the sample size is small, said Paul Knoepfler, a cell biology professor and stem cell researcher at UC Davis, who is not involved in the SCiStar study.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"As a scientist, I still would want to wait for more data,” Knoepfler said. “It’s certainly interesting, but it’s still early. It’s a phase 2 trial.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"font-weight: 400\">To address the issue of small sample size, Asterias is looking at historical data to determine the level of improvement for patients in similar circumstances who did not receive stem cell therapy. The company has said it found \"a meaningful difference\" in the recovery of its study patients compared to the norm. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">Liu said one of the most important results is the lack of significant side effects or other negative outcomes resulting from the treatment to date.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"That’s very significant to me,” Liu said. “That’s the first thing you look for, is anyone hurt from this therapy.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">There was also a concern, he said, that some patients might regress over time, once the initial injection of stem cells wore off. That has yet to occur.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“No one has lost anything they’ve gained,” Liu said. “We were very happy to see that. This is all very promising.\"\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The next step for the SCiStar trial will be to establish a control group, Cartt said.\u003c/span>\u003c/p>\n\n",
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"excerpt": "Among the patients injected with 10 million stem cells is Kris Boesen, who suffered three crushed vertebrae in a car accident last year and was thought by doctors to have little hope of recovery.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A small stem cell trial in which patients with severe spinal injuries appeared to make remarkable progress is still showing excellent results, according to the company conducting the research.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This is as good as you could hope at this point.' \u003ccite>Charles Liu, director of the USC Neurorestoration Center\u003c/cite>\u003c/aside>\n\u003cp>\u003cspan style=\"font-weight: 400\">One of the patients in the trial is 21-year-old Kris Boesen, from Bakersfield, California, whose \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/12/stem-cells-may-have-restored-use-of-hands-and-arms-in-paralyzed-man/\" target=\"_blank\" rel=\"noopener\">story \u003c/a>we reported on last year. A car crash had left the Bakersfield, California native with \u003c/span>\u003cspan style=\"font-weight: 400\">three crushed vertebrae, almost no feeling below his neck, and a grim\u003c/span>\u003cspan style=\"font-weight: 400\"> prognosis. Doctors believed he would live the rest of his life as a paraplegic.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"font-weight: 400\">Enter stem cell therapy. Most treatments for serious spinal injuries concentrate on physical therapy to expand the range of the patient's remaining motor skills and to limit further injury, not to reverse the actual damage. But last April, as part of an experimental phase 2 clinical trial called \u003c/span>\u003ca href=\"http://www.scistar-study.com/\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">SCiStar\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, researchers injected Boesen with 10 million stem cells. By July, he had recovered use of his hands to the point where he could use a wheelchair, a computer and a cellphone, and could take care of most of his daily living needs.\u003c/span> In recent months his progress has continued, says his father.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s certainly interesting, but it’s still early.'\u003ccite>Paul Knoepfler, UC Davis stem cell researcher\u003c/cite>\u003c/aside>\n\u003cp>Boesen is not the only patient to have improved in the trial, according to Asterias Biotherapeutics, which is conducting the research. Boesen is part of a cohort of six patients who were experiencing various levels of paralysis and were injected with the 10 million stem cell dose. In a Jan. 24 \u003ca href=\"http://asteriasbiotherapeutics.com/presentations/Asterias-Biotherapeutics_Investor_Presentation_January-2017.pdf\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">update\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, the company said\u003c/span>\u003cspan style=\"font-weight: 400\"> five of those patients had improved either one or two levels on a widely used scale to measure \u003c/span>motor function in spinal injury patients.\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"font-weight: 400\">On Tuesday, Asterias issued a new \u003c/span>\u003ca href=\"https://finance.yahoo.com/news/full-six-patient-cohort-confirms-110000936.html\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">update\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">,\u003c/span> \u003cspan style=\"font-weight: 400\">announcing\u003c/span> \u003cspan style=\"font-weight: 400\"> that the sixth patient in the cohort has experienced a similar improvement. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">While spontaneous recovery for spinal injury patients does occur, the likelihood of all six patients recovering to the degree they have is less likely, researchers say.\u003c/p>\n\u003cp class=\"p1\">“This is as good as you could hope at this point,” said Charles Liu, Boesen’s neurosurgeon and director of the USC Neurorestoration Center. “So far all the evidence is pointing in the right direction.”\u003c/p>\n\u003cp class=\"p1\">To measure improvement in spinal injury patients, researchers use two yardsticks: the Upper Extremity Motor Scale, or UEMS, and the International Standards for Neurological Classification of Spinal Cord Injury, or ISNCSCI. On the UEMS scale, patients are scored from 0 to 5 on their ability to use \u003ca href=\"http://www.nature.com/sc/journal/v45/n3/fig_tab/3102008t1.html\" target=\"_blank\" rel=\"noopener\">five key muscles\u003c/a> in the wrists, elbows and fingers. The \u003ca href=\"http://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabilitation/spinal_cord_injury_85,P01180/\" target=\"_blank\" rel=\"noopener\">ISNCSCI scale\u003c/a> assesses where damage has occurred along the different levels of the cervical vertebrae, which generally determines the scope of impairment to the body and the\u003ca href=\"http://www.spinalinjury101.org/details/levels-of-injury\" target=\"_blank\" rel=\"noopener\"> level of care needed\u003c/a>.\u003c/p>\n\u003cp>For instance, if a patient has sustained damage at the fourth cervical vertebra down, known as C-4, at the base of the neck, it generally means that person is paralyzed from the neck down, requiring round-the-clock care and a ventilator to breathe. A patient with a C-5 injury may not be able to move her arms or hands, requiring about 6 to 12 hours per day of assisted care; and at the C-6 level, better motor function may allow a patient to take care of most of her daily living needs on her own.\u003c/p>\n\u003cfigure id=\"attachment_243385\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-243385 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Neurosurgery-Stem-Cell-spine-patient-Kris-Boesen_04-800x526.jpg\" alt=\"Lifting weights is part of Kris Boesen’s regular program of physical therapy. \" width=\"800\" height=\"526\">\u003cfigcaption class=\"wp-caption-text\">Lifting weights is part of Kris Boesen’s regular program of physical therapy. \u003ccite>(Greg Iger/Keck Medicine of USC))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Which is all to say that even one level of recovery could substantially improve the daily life of a spinal injury patient.\u003c/p>\n\u003cp class=\"p1\">According to Asterias, all six patients in the 10 million-cell cohort have improved their general UEMS scores, and jumped at least one motor level on the ISNCSCI scale on one or both sides of their body.\u003c/p>\n\u003cp class=\"p1\">Two patients have improved two motor levels on one side; and one patient, Boesen, has improved two motor levels on both sides\u003cb>. \u003c/b>\u003c/p>\n\u003cp>Steve Cartt, president and CEO of Asterias, said another patient, Jake Javier of Danville, California, has gone from partial paralysis to being able to use his hands well enough to consider pursuing a computer science career.\u003c/p>\n\u003cp>\u003cstrong>'Throws Like a Regular Throw'\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In September, Boesen’s father, Rod Boesen, told us how excited he was that his son had regained some feeling in one of his feet. Last week, at 11 months post-injection, the elder Boesen said Kris has continued to improve.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Now he can move his toe and his knee together at the same time,” Boesen said. “They’re about to give him a manual wheelchair now [instead of a motorized one]. He can grip with his hands enough to use a manual one.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Boesen said the movement in his son’s arms and hands has greatly improved since September. \u003c/span>\u003cspan style=\"font-weight: 400\">Kris, a former high school pitcher, had been flinging a ball to his dog “like people throw hand grenades,” Boesen said. “They kind of cradle them – and that’s how Kris would do it. … But now he throws like a regular throw, tosses that ball down the hall, has that release point down, and just wings it.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Asterias is currently recruiting patients for a trial in which they'll receive 20 million stem cells, the optimal dose, according to company researchers. T\u003c/span>\u003cspan style=\"font-weight: 400\">wo patients have already started the 20 million stem cell therapy, and six-month results from those patients will be released in the fall, Cartt said.\u003c/span>\u003c/p>\n\u003cp>Patients who received 2 million stem cells in an earlier phase of the study have not shown much change in their condition, according to the Jan. 24 update.\u003c/p>\n\u003cp>\u003cstrong>Guarded Optimism\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">While Boesen’s father is impressed with the results, the optimism of researchers inside and outside the study has been guarded. \u003c/span>The trial is still in its early stages, and the sample size is small, said Paul Knoepfler, a cell biology professor and stem cell researcher at UC Davis, who is not involved in the SCiStar study.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"As a scientist, I still would want to wait for more data,” Knoepfler said. “It’s certainly interesting, but it’s still early. It’s a phase 2 trial.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"font-weight: 400\">To address the issue of small sample size, Asterias is looking at historical data to determine the level of improvement for patients in similar circumstances who did not receive stem cell therapy. The company has said it found \"a meaningful difference\" in the recovery of its study patients compared to the norm. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">Liu said one of the most important results is the lack of significant side effects or other negative outcomes resulting from the treatment to date.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"That’s very significant to me,” Liu said. “That’s the first thing you look for, is anyone hurt from this therapy.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">There was also a concern, he said, that some patients might regress over time, once the initial injection of stem cells wore off. That has yet to occur.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“No one has lost anything they’ve gained,” Liu said. “We were very happy to see that. This is all very promising.\"\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The next step for the SCiStar trial will be to establish a control group, Cartt said.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Electronic Program Reduces Wait Times for Specialty Care in L.A. County",
"title": "Electronic Program Reduces Wait Times for Specialty Care in L.A. County",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>An electronic program launched in 2012 by Los Angeles County’s health care system has reduced wait times for specialty care and eliminated the need for some safety-net patients to see specialists at all, according to a new \u003ca href=\"http://content.healthaffairs.org/content/36/3/492.abstract\" target=\"_blank\">study\u003c/a> in the journal Health Affairs.\u003c/p>\n\u003cp>The program, eConsult, allows primary care doctors to get specialists’ advice for their patients and expedite referrals for those who need in-person appointments. About a quarter of the requests included in the study were resolved without patients needing to see an advanced-care doctor, though there was variation among the specialties.\u003c/p>\n\u003cp>“It completely changed how specialty care was delivered in a safety net system,” said Michael Barnett, an assistant professor of health policy and management at Harvard T.H. Chan School of Public Health and lead author of the study.\u003c/p>\n\u003cp>The Los Angeles County Department of Health Services provides care for about 670,000 patients each year in a system that includes four hospitals, 19 health centers and dozens of community providers. The system serves a low-income population — mostly uninsured or covered by Medi-Cal — who traditionally have had difficulty getting access to specialty care.\u003c/p>\n\u003cp>The eConsult system handles over 17,000 requests each month. About 4,500 providers from more than 400 clinics use the system, according to the county. In 2016, the program served about 130,000 patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One of the major benefits of the eConsult system is that it centralizes requests for care from specialists such as cardiologists, neurologists or gynecologists, Barnett said.\u003c/p>\n\u003cp>Primary care doctors using eConsult have access to a secure, web-based portal to make requests for assistance from specialists. A specialist “reviewer” responds and helps the primary care physician decide how best to manage the patient’s condition.\u003c/p>\n\u003cp>That may mean giving advice, suggesting a specific treatment or recommending the patient see a specialist. If a patient needs a visit right away, the system allows for an expedited appointment.\u003c/p>\n\u003cp>In many cases, primary care doctors can resolve clinical issues with their patients simply by having a conversation, Barnett said. “Many referrals are for issues that could be resolved pretty easily if a primary care doctor could get a specialist’s attention,” he said.\u003c/p>\n\u003cp>That means those patients wouldn’t need to take another day off work, figure out transportation across town and wait to see a specialist, said Paul Giboney, director of specialty care for the Los Angeles County Department of Health Services. Instead, the care could be delivered in the offices of their primary care doctors.\u003c/p>\n\u003cp>About 30 percent of patients who needed a face-to-face visit with a specialist in 2015 were able to get one within 30 days, up from 24 percent in 2014.\u003c/p>\n\u003cp>Difficulty getting appointments with specialists is a challenge for low-income patients across the United States. Without timely access, patients may get sicker and turn to the emergency room for care.\u003c/p>\n\u003cp>That was happening on a large scale in L.A. County before the implementation of the eConsult program. Some patients had to wait more than nine months for an appointment with a urologist or a gastroenterologist, for example, the study said.\u003c/p>\n\u003cp>The eConsult program started as an experiment to reduce the backlog, but Giboney said the county’s public health care system is now using it “day in and day out.”\u003c/p>\n\u003cp>Despite the size and complexity of the Los Angeles County health care system, the eConsult program works efficiently, suggesting that “specialty access is not an intractable problem,” the study said.\u003c/p>\n\u003cp>Giboney said the results show that electronic conversations between primary care doctors and specialists can improve the way business is done.\u003c/p>\n\u003cp>“Within a day, the specialist is already engaged and adding something to the patient’s care,” he said. “We are a public system that is delivering a speed of specialty care that is really unmatched.”\u003c/p>\n\u003cp>Since eConsult was rolled out in L.A. County, Giboney said he has talked to providers from Colorado, Illinois and Connecticut about starting similar programs.\u003c/p>\n\u003cp>Despite the efficiency of the system, Barnett said, there is still room for improvement on the wait times. The average amount of time it took for a patient to see a specialist in 2015 was still 52 days, though it had dropped about 17 percent from 63 days in 2014.\u003c/p>\n\u003cp>Patients who needed ear, nose and throat doctors and those who had kidney problems, cancer or blood diseases saw the most dramatic reductions in waiting time. The wait to see an ear, nose and throat specialist, for example, dropped from 72 to 44 days.\u003c/p>\n\u003cp>Wait times increased in only one of the dozen specialties examined: Patients had to wait on average 75 days in 2015 to see a podiatrist, up from 65 the previous year.\u003c/p>\n\u003cp>Barnett said the next step is to study the impact of the program on quality of care.\u003c/p>\n\u003cp>Giboney said he isn’t satisfied with the wait times either, despite the reduction, but he noted that sometimes doctors want patients to wait a few weeks to see if a treatment is working before going to see a specialist.\u003c/p>\n\u003cp>“It is not always about reducing the wait time,” Giboney said. “It’s about delivering the right specialty care at the right time.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage in California is funded in part by \u003ca href=\"http://www.blueshieldcafoundation.org/\" target=\"_blank\">Blue Shield of California Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>An electronic program launched in 2012 by Los Angeles County’s health care system has reduced wait times for specialty care and eliminated the need for some safety-net patients to see specialists at all, according to a new \u003ca href=\"http://content.healthaffairs.org/content/36/3/492.abstract\" target=\"_blank\">study\u003c/a> in the journal Health Affairs.\u003c/p>\n\u003cp>The program, eConsult, allows primary care doctors to get specialists’ advice for their patients and expedite referrals for those who need in-person appointments. About a quarter of the requests included in the study were resolved without patients needing to see an advanced-care doctor, though there was variation among the specialties.\u003c/p>\n\u003cp>“It completely changed how specialty care was delivered in a safety net system,” said Michael Barnett, an assistant professor of health policy and management at Harvard T.H. Chan School of Public Health and lead author of the study.\u003c/p>\n\u003cp>The Los Angeles County Department of Health Services provides care for about 670,000 patients each year in a system that includes four hospitals, 19 health centers and dozens of community providers. The system serves a low-income population — mostly uninsured or covered by Medi-Cal — who traditionally have had difficulty getting access to specialty care.\u003c/p>\n\u003cp>The eConsult system handles over 17,000 requests each month. About 4,500 providers from more than 400 clinics use the system, according to the county. In 2016, the program served about 130,000 patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of the major benefits of the eConsult system is that it centralizes requests for care from specialists such as cardiologists, neurologists or gynecologists, Barnett said.\u003c/p>\n\u003cp>Primary care doctors using eConsult have access to a secure, web-based portal to make requests for assistance from specialists. A specialist “reviewer” responds and helps the primary care physician decide how best to manage the patient’s condition.\u003c/p>\n\u003cp>That may mean giving advice, suggesting a specific treatment or recommending the patient see a specialist. If a patient needs a visit right away, the system allows for an expedited appointment.\u003c/p>\n\u003cp>In many cases, primary care doctors can resolve clinical issues with their patients simply by having a conversation, Barnett said. “Many referrals are for issues that could be resolved pretty easily if a primary care doctor could get a specialist’s attention,” he said.\u003c/p>\n\u003cp>That means those patients wouldn’t need to take another day off work, figure out transportation across town and wait to see a specialist, said Paul Giboney, director of specialty care for the Los Angeles County Department of Health Services. Instead, the care could be delivered in the offices of their primary care doctors.\u003c/p>\n\u003cp>About 30 percent of patients who needed a face-to-face visit with a specialist in 2015 were able to get one within 30 days, up from 24 percent in 2014.\u003c/p>\n\u003cp>Difficulty getting appointments with specialists is a challenge for low-income patients across the United States. Without timely access, patients may get sicker and turn to the emergency room for care.\u003c/p>\n\u003cp>That was happening on a large scale in L.A. County before the implementation of the eConsult program. Some patients had to wait more than nine months for an appointment with a urologist or a gastroenterologist, for example, the study said.\u003c/p>\n\u003cp>The eConsult program started as an experiment to reduce the backlog, but Giboney said the county’s public health care system is now using it “day in and day out.”\u003c/p>\n\u003cp>Despite the size and complexity of the Los Angeles County health care system, the eConsult program works efficiently, suggesting that “specialty access is not an intractable problem,” the study said.\u003c/p>\n\u003cp>Giboney said the results show that electronic conversations between primary care doctors and specialists can improve the way business is done.\u003c/p>\n\u003cp>“Within a day, the specialist is already engaged and adding something to the patient’s care,” he said. “We are a public system that is delivering a speed of specialty care that is really unmatched.”\u003c/p>\n\u003cp>Since eConsult was rolled out in L.A. County, Giboney said he has talked to providers from Colorado, Illinois and Connecticut about starting similar programs.\u003c/p>\n\u003cp>Despite the efficiency of the system, Barnett said, there is still room for improvement on the wait times. The average amount of time it took for a patient to see a specialist in 2015 was still 52 days, though it had dropped about 17 percent from 63 days in 2014.\u003c/p>\n\u003cp>Patients who needed ear, nose and throat doctors and those who had kidney problems, cancer or blood diseases saw the most dramatic reductions in waiting time. The wait to see an ear, nose and throat specialist, for example, dropped from 72 to 44 days.\u003c/p>\n\u003cp>Wait times increased in only one of the dozen specialties examined: Patients had to wait on average 75 days in 2015 to see a podiatrist, up from 65 the previous year.\u003c/p>\n\u003cp>Barnett said the next step is to study the impact of the program on quality of care.\u003c/p>\n\u003cp>Giboney said he isn’t satisfied with the wait times either, despite the reduction, but he noted that sometimes doctors want patients to wait a few weeks to see if a treatment is working before going to see a specialist.\u003c/p>\n\u003cp>“It is not always about reducing the wait time,” Giboney said. “It’s about delivering the right specialty care at the right time.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage in California is funded in part by \u003ca href=\"http://www.blueshieldcafoundation.org/\" target=\"_blank\">Blue Shield of California Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sesame Street to Introduce Muppet With Autism (Video)",
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"content": "\u003cp>https://www.youtube.com/watch?v=1FeuSdL61MY\u003c/p>\n\u003cp>Folks on Sesame Street have a way of making everyone feel accepted.\u003c/p>\n\u003cp>That certainly goes for Julia, a Muppet youngster with blazing red hair, bright green eyes — and autism. Rather than being treated like an outsider, which too often is the plight of kids on the spectrum, Julia is one of the gang.\u003c/p>\n\u003cp>Look: On this friendliest of streets (actually Studio J at New York's Kaufman Astoria Studios, where \"Sesame Street\" lives) Julia is about to play a game with Oscar, Abby and Grover. In this scene being taped for airing next season, these Muppet chums have been challenged to spot objects shaped like squares or circles or triangles.\u003c/p>\n\u003cp>\"You're lucky,\" says Abby to Grover. \"You have Julia on your team, and she is really good at finding shapes!\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>With that, they skedaddle, an exit that calls for the six Muppeteers squatted out of sight below them to scramble accordingly. Joining her pals, Julia (performed by Stacey Gordon) takes off hunting.\u003c/p>\n\u003cp>For more than a year, Julia has existed in print and digital illustrations as the centerpiece of a multifaceted initiative by Sesame Workshop called \"Sesame Street and Autism: See Amazing in All Children.\"\u003c/p>\n\u003cp>She has been the subject of a storybook released along with videos, e-books, an app and website. The goal is to promote a better understanding of what the Autism Speaks advocacy group describes as \"a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences.\"\u003c/p>\n\u003cp>But now Julia has been brought to life in fine Muppet fettle. She makes her TV debut on \"Sesame Street\" in the \"Meet Julia\" episode airing April 10 on both PBS and HBO. Additional videos featuring Julia will be available online.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=M8QQRtA0hVA\u003c/p>\n\u003cp>Developing Julia and all the other components of this campaign has required years of consultation with organizations, experts and families within the autism community, according to Jeanette Betancourt, Sesame Workshop's senior vice president of U.S. Social Impact.\u003c/p>\n\u003cp>\"In the U.S., one in 68 children is diagnosed with autism spectrum disorder,\" she says. \"We wanted to promote a better understanding and reduce the stigma often found around these children. We're modeling the way both children and adults can look at autism from a strength-based perspective: finding things that all children share.\"\u003c/p>\n\u003cp>Julia is at the heart of this effort. But while she represents the full range of children on the spectrum, she isn't meant to typify each one of them: \"Just as we look at all children as being unique, we should do the same thing when we're looking at children with autism,\" Betancourt says.\u003c/p>\n\u003cp>It was with keen interest that Stacey Gordon first learned of Julia more than a year ago. \"I said, 'If she's ever a puppet, I want to BE Julia!'\"\u003c/p>\n\u003cp>No wonder. Gordon is a Phoenix-based puppeteer who performs, conducts classes and workshops, and creates whimsical puppets for sale to the public.\u003c/p>\n\u003cp>She also has a son with autism, and, before she started her family, was a therapist to youngsters on the spectrum.\u003c/p>\n\u003cp>Although she figured her chances of landing the dream role of Julia were nil, her contacts in the puppet world paid off: Two friends who worked as Muppeteers on \"Sesame Street\" dropped her name to the producers. After submitting tapes, then coming to New York for an audition, she was hired.\u003c/p>\n\u003cp>In the introductory segment, Julia is having fun with Abby and Elmo when Big Bird walks up. He wants to be her new friend, but she doesn't speak to him. He thinks she doesn't like him.\u003c/p>\n\u003cp>\"She does things just a little differently, in a Julia sort of way,\" Abby informs him.\u003c/p>\n\u003cp>Julia, chuckling, then displays a different-but-fun way of playing tag, and everyone joins in. But when a siren wails, she covers her ears and looks stricken.\u003c/p>\n\u003cp>\"She needs to take a break,\" Big Bird's human friend Alan calmly explains. Soon, all is well and play resumes.\u003c/p>\n\u003cp>\"The 'Meet Julia' episode is something that I wish my son's friends had been able to see when they were small,\" says Gordon. \"I remember him having meltdowns and his classmates not understanding how to react.\"\u003c/p>\n\u003cp>Gordon says her son, now 13, isn't drawn to puppetry. \"He's more interested in math and science, and plays the piano brilliantly,\" she says with pride.\u003c/p>\n\u003cp>But she's having a blast being part of the show that helped hook her, as a child, on puppeteering.\u003c/p>\n\u003cp>\"It is so much fun to be on set with everyone, and get to play up all the positive things I've seen with the kids that I've worked with,\" Gordon says. \"At the same time, I come at this with a reverence. I don't want to let the autism community down.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"338\" src=\"https://www.npr.org/player/embed/520577117/520788209\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>With that, they skedaddle, an exit that calls for the six Muppeteers squatted out of sight below them to scramble accordingly. Joining her pals, Julia (performed by Stacey Gordon) takes off hunting.\u003c/p>\n\u003cp>For more than a year, Julia has existed in print and digital illustrations as the centerpiece of a multifaceted initiative by Sesame Workshop called \"Sesame Street and Autism: See Amazing in All Children.\"\u003c/p>\n\u003cp>She has been the subject of a storybook released along with videos, e-books, an app and website. The goal is to promote a better understanding of what the Autism Speaks advocacy group describes as \"a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences.\"\u003c/p>\n\u003cp>But now Julia has been brought to life in fine Muppet fettle. She makes her TV debut on \"Sesame Street\" in the \"Meet Julia\" episode airing April 10 on both PBS and HBO. Additional videos featuring Julia will be available online.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/M8QQRtA0hVA'\n title='//www.youtube.com/embed/M8QQRtA0hVA'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Developing Julia and all the other components of this campaign has required years of consultation with organizations, experts and families within the autism community, according to Jeanette Betancourt, Sesame Workshop's senior vice president of U.S. Social Impact.\u003c/p>\n\u003cp>\"In the U.S., one in 68 children is diagnosed with autism spectrum disorder,\" she says. \"We wanted to promote a better understanding and reduce the stigma often found around these children. We're modeling the way both children and adults can look at autism from a strength-based perspective: finding things that all children share.\"\u003c/p>\n\u003cp>Julia is at the heart of this effort. But while she represents the full range of children on the spectrum, she isn't meant to typify each one of them: \"Just as we look at all children as being unique, we should do the same thing when we're looking at children with autism,\" Betancourt says.\u003c/p>\n\u003cp>It was with keen interest that Stacey Gordon first learned of Julia more than a year ago. \"I said, 'If she's ever a puppet, I want to BE Julia!'\"\u003c/p>\n\u003cp>No wonder. Gordon is a Phoenix-based puppeteer who performs, conducts classes and workshops, and creates whimsical puppets for sale to the public.\u003c/p>\n\u003cp>She also has a son with autism, and, before she started her family, was a therapist to youngsters on the spectrum.\u003c/p>\n\u003cp>Although she figured her chances of landing the dream role of Julia were nil, her contacts in the puppet world paid off: Two friends who worked as Muppeteers on \"Sesame Street\" dropped her name to the producers. After submitting tapes, then coming to New York for an audition, she was hired.\u003c/p>\n\u003cp>In the introductory segment, Julia is having fun with Abby and Elmo when Big Bird walks up. He wants to be her new friend, but she doesn't speak to him. He thinks she doesn't like him.\u003c/p>\n\u003cp>\"She does things just a little differently, in a Julia sort of way,\" Abby informs him.\u003c/p>\n\u003cp>Julia, chuckling, then displays a different-but-fun way of playing tag, and everyone joins in. But when a siren wails, she covers her ears and looks stricken.\u003c/p>\n\u003cp>\"She needs to take a break,\" Big Bird's human friend Alan calmly explains. 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"disqusTitle": "For Some Republicans, NIH Cuts Are a Nonstarter",
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"content": "\u003cp>What goes on the chopping block: Research into cancer or Alzheimer's? A Zika vaccine or a treatment for superbugs?\u003c/p>\n\u003cp>In his budget blueprint Thursday, President Donald Trump called for cutting $5.8 billion from the National Institutes of Health. That's a staggering 18 percent drop for the $32 billion agency that funds much of the nation's research into what causes different diseases and what it will take to treat them.\u003c/p>\n\u003cp>Trump's proposal would roll back NIH's 2018 budget to about what it was in 2003. The president called for a \"major reorganization\" of NIH to stress the \"highest priority research,\" but only specifically targeted for elimination the $69 million Fogarty International Center that focuses on global health and has played a big role in HIV research abroad.\u003c/p>\n\u003cp>But it's far from clear if Congress will agree to the cuts. The NIH has long experienced bipartisan support among lawmakers, who awarded the agency an extra $2 billion in 2016.\u003c/p>\n\u003cp>Here is coverage from around the web, pointing to Republican and other opposition to the proposed cuts. ...\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://www.mcclatchydc.com/news/politics-government/congress/article138974053.html\">Republicans queasy about Trump’s cuts to medical research\u003c/a> (McClatchy)\u003c/p>\n\u003cblockquote>\u003cp>President Donald Trump’s budget would slash funding for the National Institutes of Health by nearly $6 billion, or 19 percent, a proposal that’s likely to run into staunch opposition from conservatives within Trump’s own party.\u003c/p>\n\u003cp>Two years ago, Republicans helped secure the largest budget increase for NIH in more than a decade. Led by Missouri Sen. Roy Blunt and Rep. Kevin Yoder and Sen. Jerry Moran of Kansas, the effort resulted in a $2 billion jump in funding and enabled the NIH to give out 1,147 more grants nationwide.\u003c/p>\n\u003cp>The GOP lawmakers again worked across the aisle in November to pass the bipartisan Cures Act, which would allocate more money to the NIH. It had less than Blunt, Yoder and Moran had wanted, but more than President Barack Obama had requested in his budget.\u003c/p>\n\u003cp>So when Trump released his budget on Thursday, proposing an NIH budget of about $26 billion, it quickly became apparent that the cuts to medical research were one of the few proposals that Republicans would be willing to criticize openly.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://theweek.com/speedreads/686585/gop-congressman-slams-trumps-proposed-cuts-nih-cdc-youre-much-more-likely-die-pandemic-than-terrorist-attack\">GOP congressman on Trump's proposed cuts to NIH, CDC: 'You're much more likely to die in a pandemic than a terrorist attack'\u003c/a> (The Week)\u003c/p>\n\u003cblockquote>\u003cp>(Rep. Tom) Cole argued that defense spending — which Trump's budget blueprint calls for ratcheting up by $54 billion — is no more important than investing in health research. \"You're much more likely to die in a pandemic than a terrorist attack, and so that's part of the defense of the country as well,\" Cole said. \"The CDC is what protects you from things like Ebola and Zika. The NIH, we have 1.6 million Americans a year that contract cancer. About 600,000 die. That is more people than died in the Civil War, the bloodiest war in American history.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"https://www.theatlantic.com/politics/archive/2017/03/trumps-budget-cuts-nih-funding-by-20-percent/519771/\" target=\"_blank\">Trump's Budget Proposal Cuts NIH Funding by 20 Percent\u003c/a> (The Atlantic)\u003c/p>\n\u003cblockquote>\u003cp>The agency, which distributes funding to some 300,000 scientists worldwide, has seen its funding wax and wane over the last 20-odd years. In the late 1990s and early 2000s, Congress doubled its funding each year, infusing the agency with cash. But for years afterward, the budgets stayed stagnant. Funding advocates explain that NIH didn’t lose its bipartisan support—other issues, like national defense, simply became more pressing. This hurt the agency’s ability to fund scientists’ research grants and labs’ ability to retain young researchers, and made planning for multi-year projects extremely difficult.\u003c/p>\n\u003cp>Scientists and NIH officials alike were encouraged by the recent enthusiasm around NIH. In an interview last year, agency Director Francis Collins said he hoped Congress would begin “a trend to get us back on a stable, predictable, upward trajectory.” At the time, lawmakers seemed mostly on board with that plan, as the Republican chairs of the relevant funding panels both supported future budget bumps. Congress hasn’t settled on funding for the 2017 fiscal year, but legislators planned for another NIH increase of up to $2 billion.\u003c/p>\n\u003cp>The question now is how closely congressional Republicans will conform to the president’s proposal as they craft their own budgets, and how strongly the president’s staff will push for this particular cut.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"https://www.forbes.com/sites/matthewherper/2017/03/16/trump-nih-cuts-would-be-catastrophic-event-says-bush-era-nih-chief/#f055a74789c6\">Trump NIH Cuts Would Be 'Catastrophic Event,' Says Bush-Era NIH Chief\u003c/a> (Forbes)\u003c/p>\n\u003cblockquote>\u003cp>Elias Zerhouni was nominated as director of the National Institutes of Health by George W. Bush in 2002, a role in which he served until 2008. Since 2011, he has run research and development at Sanofi, the world's fifth-largest drug company by sales. He says he's disturbed by the budget proposal of President Donald Trump. ...\u003c/p>\n\u003cp>\"It will be a catastrophic event because the NIH funds grants over four or five years and therefore only has 20% of its budget to give at any one year,\" Zerhouni says. \"Therefore, if you cut it by $6 billion it means next year there will be no grants. It’s really ill-advised, I think, to change budgets so drastically so quickly. It will be very detrimental, especially on young investigators or new investigators, new science. It will set back the NIH significantly after years of stagnation, but recent support from Congress. I find it disturbing, to be honest with you.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://www.latimes.com/science/sciencenow/la-sci-sn-trump-budget-nih-20170316-story.html\">20% cut to NIH budget would leave Americans more vulnerable to cancer and other diseases, experts warn\u003c/a> (L.A. Times)\u003c/p>\n\u003cblockquote>\u003cp>Even scientists that have been critical of the NIH rallied to its defense.\u003c/p>\n\u003cp>J. Craig Venter, a genetics pioneer and chief executive of the J. Craig Venter Institute in La Jolla, said the proposed cuts would forfeit American primacy in a sector where the United States enjoys “absolutely dominant leadership in the world.”\u003c/p>\n\u003cp>“This is an engine that drives our entire economy,” he said. “Our federal money can be better spent. But cutting these budgets will only make it 10 times worse.”\u003c/p>\n\u003cp>Faced with bare-bones budgets, Venter said, the NIH will put an end to any high-risk research. Like a drug company whose new CEO cuts costs by axing research and development, the U.S. could soon see its pipeline of innovative therapies has gone dry.\u003c/p>\n\u003cp>“The ones that suffer most are new investigators with new ideas,” he said. “It’ll just be a disaster for the U.S. economy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://www.vox.com/policy-and-politics/2017/3/16/14940444/2018-budget-trump-science-nih\">Trump’s budget is everything scientists have been fearing\u003c/a> (Vox)\u003c/p>\n\u003cblockquote>\u003cp>Already, competition for NIH grants is intense. Its funding has basically plateaued over the past decade. At the same time, the cost of research keeps increasing, and an ever-growing pool of PhDs is competing for a relatively smaller pile of grant money.\u003c/p>\n\u003cp>Consider this: In 2000, more than 30 percent of NIH grant applications got approved. Today, it’s closer to 17 percent. It’s not crazy math: The less money there is to go around, the fewer projects get funded.\u003c/p>\n\u003cp>According to Hourihan, when the NIH’s budget dropped 5 percent from sequestration cuts, they had to cut around 700 individual grants (out of about 9,000). With a 20 percent cut, “we’re likely talking about [grant] cuts in the hundreds, if not the thousands,” he says.\u003c/p>\u003c/blockquote>\n\u003cp>The first hearing by the subcommittee that oversees NIH is scheduled for Tuesday.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>What goes on the chopping block: Research into cancer or Alzheimer's? A Zika vaccine or a treatment for superbugs?\u003c/p>\n\u003cp>In his budget blueprint Thursday, President Donald Trump called for cutting $5.8 billion from the National Institutes of Health. That's a staggering 18 percent drop for the $32 billion agency that funds much of the nation's research into what causes different diseases and what it will take to treat them.\u003c/p>\n\u003cp>Trump's proposal would roll back NIH's 2018 budget to about what it was in 2003. The president called for a \"major reorganization\" of NIH to stress the \"highest priority research,\" but only specifically targeted for elimination the $69 million Fogarty International Center that focuses on global health and has played a big role in HIV research abroad.\u003c/p>\n\u003cp>But it's far from clear if Congress will agree to the cuts. The NIH has long experienced bipartisan support among lawmakers, who awarded the agency an extra $2 billion in 2016.\u003c/p>\n\u003cp>Here is coverage from around the web, pointing to Republican and other opposition to the proposed cuts. ...\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.mcclatchydc.com/news/politics-government/congress/article138974053.html\">Republicans queasy about Trump’s cuts to medical research\u003c/a> (McClatchy)\u003c/p>\n\u003cblockquote>\u003cp>President Donald Trump’s budget would slash funding for the National Institutes of Health by nearly $6 billion, or 19 percent, a proposal that’s likely to run into staunch opposition from conservatives within Trump’s own party.\u003c/p>\n\u003cp>Two years ago, Republicans helped secure the largest budget increase for NIH in more than a decade. Led by Missouri Sen. Roy Blunt and Rep. Kevin Yoder and Sen. Jerry Moran of Kansas, the effort resulted in a $2 billion jump in funding and enabled the NIH to give out 1,147 more grants nationwide.\u003c/p>\n\u003cp>The GOP lawmakers again worked across the aisle in November to pass the bipartisan Cures Act, which would allocate more money to the NIH. It had less than Blunt, Yoder and Moran had wanted, but more than President Barack Obama had requested in his budget.\u003c/p>\n\u003cp>So when Trump released his budget on Thursday, proposing an NIH budget of about $26 billion, it quickly became apparent that the cuts to medical research were one of the few proposals that Republicans would be willing to criticize openly.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://theweek.com/speedreads/686585/gop-congressman-slams-trumps-proposed-cuts-nih-cdc-youre-much-more-likely-die-pandemic-than-terrorist-attack\">GOP congressman on Trump's proposed cuts to NIH, CDC: 'You're much more likely to die in a pandemic than a terrorist attack'\u003c/a> (The Week)\u003c/p>\n\u003cblockquote>\u003cp>(Rep. Tom) Cole argued that defense spending — which Trump's budget blueprint calls for ratcheting up by $54 billion — is no more important than investing in health research. \"You're much more likely to die in a pandemic than a terrorist attack, and so that's part of the defense of the country as well,\" Cole said. \"The CDC is what protects you from things like Ebola and Zika. The NIH, we have 1.6 million Americans a year that contract cancer. About 600,000 die. That is more people than died in the Civil War, the bloodiest war in American history.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"https://www.theatlantic.com/politics/archive/2017/03/trumps-budget-cuts-nih-funding-by-20-percent/519771/\" target=\"_blank\">Trump's Budget Proposal Cuts NIH Funding by 20 Percent\u003c/a> (The Atlantic)\u003c/p>\n\u003cblockquote>\u003cp>The agency, which distributes funding to some 300,000 scientists worldwide, has seen its funding wax and wane over the last 20-odd years. In the late 1990s and early 2000s, Congress doubled its funding each year, infusing the agency with cash. But for years afterward, the budgets stayed stagnant. Funding advocates explain that NIH didn’t lose its bipartisan support—other issues, like national defense, simply became more pressing. This hurt the agency’s ability to fund scientists’ research grants and labs’ ability to retain young researchers, and made planning for multi-year projects extremely difficult.\u003c/p>\n\u003cp>Scientists and NIH officials alike were encouraged by the recent enthusiasm around NIH. In an interview last year, agency Director Francis Collins said he hoped Congress would begin “a trend to get us back on a stable, predictable, upward trajectory.” At the time, lawmakers seemed mostly on board with that plan, as the Republican chairs of the relevant funding panels both supported future budget bumps. Congress hasn’t settled on funding for the 2017 fiscal year, but legislators planned for another NIH increase of up to $2 billion.\u003c/p>\n\u003cp>The question now is how closely congressional Republicans will conform to the president’s proposal as they craft their own budgets, and how strongly the president’s staff will push for this particular cut.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"https://www.forbes.com/sites/matthewherper/2017/03/16/trump-nih-cuts-would-be-catastrophic-event-says-bush-era-nih-chief/#f055a74789c6\">Trump NIH Cuts Would Be 'Catastrophic Event,' Says Bush-Era NIH Chief\u003c/a> (Forbes)\u003c/p>\n\u003cblockquote>\u003cp>Elias Zerhouni was nominated as director of the National Institutes of Health by George W. Bush in 2002, a role in which he served until 2008. Since 2011, he has run research and development at Sanofi, the world's fifth-largest drug company by sales. He says he's disturbed by the budget proposal of President Donald Trump. ...\u003c/p>\n\u003cp>\"It will be a catastrophic event because the NIH funds grants over four or five years and therefore only has 20% of its budget to give at any one year,\" Zerhouni says. \"Therefore, if you cut it by $6 billion it means next year there will be no grants. It’s really ill-advised, I think, to change budgets so drastically so quickly. It will be very detrimental, especially on young investigators or new investigators, new science. It will set back the NIH significantly after years of stagnation, but recent support from Congress. I find it disturbing, to be honest with you.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://www.latimes.com/science/sciencenow/la-sci-sn-trump-budget-nih-20170316-story.html\">20% cut to NIH budget would leave Americans more vulnerable to cancer and other diseases, experts warn\u003c/a> (L.A. Times)\u003c/p>\n\u003cblockquote>\u003cp>Even scientists that have been critical of the NIH rallied to its defense.\u003c/p>\n\u003cp>J. Craig Venter, a genetics pioneer and chief executive of the J. Craig Venter Institute in La Jolla, said the proposed cuts would forfeit American primacy in a sector where the United States enjoys “absolutely dominant leadership in the world.”\u003c/p>\n\u003cp>“This is an engine that drives our entire economy,” he said. “Our federal money can be better spent. But cutting these budgets will only make it 10 times worse.”\u003c/p>\n\u003cp>Faced with bare-bones budgets, Venter said, the NIH will put an end to any high-risk research. Like a drug company whose new CEO cuts costs by axing research and development, the U.S. could soon see its pipeline of innovative therapies has gone dry.\u003c/p>\n\u003cp>“The ones that suffer most are new investigators with new ideas,” he said. “It’ll just be a disaster for the U.S. economy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://www.vox.com/policy-and-politics/2017/3/16/14940444/2018-budget-trump-science-nih\">Trump’s budget is everything scientists have been fearing\u003c/a> (Vox)\u003c/p>\n\u003cblockquote>\u003cp>Already, competition for NIH grants is intense. Its funding has basically plateaued over the past decade. At the same time, the cost of research keeps increasing, and an ever-growing pool of PhDs is competing for a relatively smaller pile of grant money.\u003c/p>\n\u003cp>Consider this: In 2000, more than 30 percent of NIH grant applications got approved. Today, it’s closer to 17 percent. It’s not crazy math: The less money there is to go around, the fewer projects get funded.\u003c/p>\n\u003cp>According to Hourihan, when the NIH’s budget dropped 5 percent from sequestration cuts, they had to cut around 700 individual grants (out of about 9,000). With a 20 percent cut, “we’re likely talking about [grant] cuts in the hundreds, if not the thousands,” he says.\u003c/p>\u003c/blockquote>\n\u003cp>The first hearing by the subcommittee that oversees NIH is scheduled for Tuesday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Biomedical research and public health are among the big losers in the Trump administration's proposed budget.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.npr.org/2017/03/16/520379061/read-president-trumps-budget-blueprint\">proposal\u003c/a> promises:\u003c/p>\n\u003cul>\n\u003cli>A \"major reorganization\" in the National Institutes of Health, which supports most of the nation's research on diseases and treatments. That includes a cut of $5.8 billion, about 20 percent of NIH's $30 billion budget.\u003c/li>\n\u003cli>\"Reform\" of funding for the Centers for Disease and Prevention, which works to prevent, monitor and combat disease outbreaks. The budget mentions a $500 million block grant to states.\u003c/li>\n\u003cli>An additional $500 million for the Department of Health and Human Services to \"expand opioid misuse prevention efforts and to increase access to treatment and recovery services to help Americans who are misusing opioids get the help they need.\"\u003c/li>\n\u003cli>Investment in \"mental health activities that are awarded to high-performing entities and focus on high priority areas, such as suicide prevention, serious mental illness, and children's mental health.\" No specifics are provided.\u003c/li>\n\u003c/ul>\n\u003cp>Funding from the National Institutes of Health flows to more than 2,600 institutions around the country and creates more than 313,000 full- and part-time jobs, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750411/\">2016 study\u003c/a>. So it's not obvious how slashing billions from the NIH budget, as the Trump administration proposes, will bring more jobs to America.\u003c/p>\n\u003cp>That $5.8 billion cut represents a 20 percent reduction in the NIH budget, which is about $30 billion. The federal government hands out most of this funding rather than spending it on its own employees, but the budget proposal is not clear on how much of the spending cuts target grants to university scientists.\u003c/p>\n\u003cp>Federal research grant money flows primarily to universities, and they in turn spend billions to buy equipment and services from local companies. Economist Bruce Weinberg and colleagues at Ohio State University \u003ca href=\"http://science.sciencemag.org/content/344/6179/41.full\">looked at\u003c/a> what happened to federal research dollars that flowed to nine major Midwestern universities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2012, these nine institutions received about $7 billion for research, more than half of which came from the NIH, the National Science Foundation and other funding agencies. Of that, the universities spent almost $1 billion on goods and services from U.S. vendors and subcontractors, the study found.\u003c/p>\n\u003cp>Of that, 16 percent went to vendors in the university's home county, over 16 percent was spent elsewhere in the state, and the balance was spread to companies across the United States.\u003c/p>\n\u003cp>University researchers buy chemicals and other ingredients needed for experiments and purchase laboratory equipment. There are entire industries devoted to supporting biomedical research.\u003c/p>\n\u003cp>\"We were surprised by how many were small, niche high-technology companies,\" Weinberg and his colleagues wrote.\u003c/p>\n\u003cp>\"Of course, science funding is not primarily a jobs or economic stimulus program,\" they added. After all, research is a long-term investment in knowledge and the driving force for economic growth.\u003c/p>\n\u003cp>The budget proposal doesn't include a specific funding figure for the Centers for Disease Control and Prevention, which had a budget of $7 billion in 2016. But the proposed budget says it \"reforms\" the CDC through a new $500 million block grant that would \"increase state flexibility and focus on the leading public health challenges to each state.\"\u003c/p>\n\u003cp>No additional details are included, but that could mean diverting those funds from the CDC's core budget to provide block grants to individual states.\u003c/p>\n\u003cp>\"We are encouraged to see that state health agency priorities, such as flexible funding to meet state and territorial public health needs and the public health Emergency Fund, are in the President's Budget,\" said Michael Fraser, executive director of the \u003ca href=\"http://www.astho.org/\">Association of State and Territorial Health Officials\u003c/a>, in an email.\u003c/p>\n\u003cp>\"Those are things we really do want to see,\" Fraser continued. \"However, the fact is that support for those priorities comes at what looks like a very significant cost to existing programs. The proposed reductions to HHS may have serious negative impacts on both federal and state responses to public health needs and that leaves many of us extremely concerned.\"\u003c/p>\n\u003cp>The budget also calls for the creation of a new \"Federal Emergency Response Fund\" that would be designed to \"rapidly respond to public health outbreaks,\" such as Zika. This is an idea that has been gaining support recently, especially in the wake of the Ebola outbreak in West Africa and the emergence of Zika as a threat to pregnant women and their babies.\u003c/p>\n\u003cp>President Obama's emergency funding request to respond to Zika got mired in politics in Congress. The budget doesn't specify how big this new fund would be.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The proposed budget is silent on the National Science Foundation, which provides about $7 billion a year in grants to researchers in many fields.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trump+Administration+Proposes+Big+Cuts+In+Medical+Research&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Biomedical research and public health are among the big losers in the Trump administration's proposed budget.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.npr.org/2017/03/16/520379061/read-president-trumps-budget-blueprint\">proposal\u003c/a> promises:\u003c/p>\n\u003cul>\n\u003cli>A \"major reorganization\" in the National Institutes of Health, which supports most of the nation's research on diseases and treatments. That includes a cut of $5.8 billion, about 20 percent of NIH's $30 billion budget.\u003c/li>\n\u003cli>\"Reform\" of funding for the Centers for Disease and Prevention, which works to prevent, monitor and combat disease outbreaks. The budget mentions a $500 million block grant to states.\u003c/li>\n\u003cli>An additional $500 million for the Department of Health and Human Services to \"expand opioid misuse prevention efforts and to increase access to treatment and recovery services to help Americans who are misusing opioids get the help they need.\"\u003c/li>\n\u003cli>Investment in \"mental health activities that are awarded to high-performing entities and focus on high priority areas, such as suicide prevention, serious mental illness, and children's mental health.\" No specifics are provided.\u003c/li>\n\u003c/ul>\n\u003cp>Funding from the National Institutes of Health flows to more than 2,600 institutions around the country and creates more than 313,000 full- and part-time jobs, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750411/\">2016 study\u003c/a>. So it's not obvious how slashing billions from the NIH budget, as the Trump administration proposes, will bring more jobs to America.\u003c/p>\n\u003cp>That $5.8 billion cut represents a 20 percent reduction in the NIH budget, which is about $30 billion. The federal government hands out most of this funding rather than spending it on its own employees, but the budget proposal is not clear on how much of the spending cuts target grants to university scientists.\u003c/p>\n\u003cp>Federal research grant money flows primarily to universities, and they in turn spend billions to buy equipment and services from local companies. Economist Bruce Weinberg and colleagues at Ohio State University \u003ca href=\"http://science.sciencemag.org/content/344/6179/41.full\">looked at\u003c/a> what happened to federal research dollars that flowed to nine major Midwestern universities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2012, these nine institutions received about $7 billion for research, more than half of which came from the NIH, the National Science Foundation and other funding agencies. Of that, the universities spent almost $1 billion on goods and services from U.S. vendors and subcontractors, the study found.\u003c/p>\n\u003cp>Of that, 16 percent went to vendors in the university's home county, over 16 percent was spent elsewhere in the state, and the balance was spread to companies across the United States.\u003c/p>\n\u003cp>University researchers buy chemicals and other ingredients needed for experiments and purchase laboratory equipment. There are entire industries devoted to supporting biomedical research.\u003c/p>\n\u003cp>\"We were surprised by how many were small, niche high-technology companies,\" Weinberg and his colleagues wrote.\u003c/p>\n\u003cp>\"Of course, science funding is not primarily a jobs or economic stimulus program,\" they added. After all, research is a long-term investment in knowledge and the driving force for economic growth.\u003c/p>\n\u003cp>The budget proposal doesn't include a specific funding figure for the Centers for Disease Control and Prevention, which had a budget of $7 billion in 2016. But the proposed budget says it \"reforms\" the CDC through a new $500 million block grant that would \"increase state flexibility and focus on the leading public health challenges to each state.\"\u003c/p>\n\u003cp>No additional details are included, but that could mean diverting those funds from the CDC's core budget to provide block grants to individual states.\u003c/p>\n\u003cp>\"We are encouraged to see that state health agency priorities, such as flexible funding to meet state and territorial public health needs and the public health Emergency Fund, are in the President's Budget,\" said Michael Fraser, executive director of the \u003ca href=\"http://www.astho.org/\">Association of State and Territorial Health Officials\u003c/a>, in an email.\u003c/p>\n\u003cp>\"Those are things we really do want to see,\" Fraser continued. \"However, the fact is that support for those priorities comes at what looks like a very significant cost to existing programs. The proposed reductions to HHS may have serious negative impacts on both federal and state responses to public health needs and that leaves many of us extremely concerned.\"\u003c/p>\n\u003cp>The budget also calls for the creation of a new \"Federal Emergency Response Fund\" that would be designed to \"rapidly respond to public health outbreaks,\" such as Zika. This is an idea that has been gaining support recently, especially in the wake of the Ebola outbreak in West Africa and the emergence of Zika as a threat to pregnant women and their babies.\u003c/p>\n\u003cp>President Obama's emergency funding request to respond to Zika got mired in politics in Congress. The budget doesn't specify how big this new fund would be.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The proposed budget is silent on the National Science Foundation, which provides about $7 billion a year in grants to researchers in many fields.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trump+Administration+Proposes+Big+Cuts+In+Medical+Research&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Video Replay of Joe Biden's SXSW Speech on Cancer Research",
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"content": "\u003cp>https://www.youtube.com/watch?v=IykG7_zHXoo\u003c/p>\n\u003cp>Joe Biden spoke at the South by Southwest conference in Austin on Sunday, talking about continuing the work of the \"\u003ca href=\"https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative\" target=\"_blank\">cancer moonshot\u003c/a>\" initiative, first announced by President Obama during the 2016 State of the Union address. At the time, Obama put Biden “in charge of mission control” for a national initiative to cure cancer, which kills \u003ca href=\"https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2016.html\">hundreds of thousands of Americans\u003c/a> each year. Biden's son, former Delaware Attorney General Beau Biden, died of brain cancer in 2015.\u003c/p>\n\u003cp>At South by Southwest, Biden gave a wide-ranging and at times emotional presentation, citing treatment advances like immunotherapy and particle beam therapy. He also said that cancer data from the Veterans Administration could be analyzed by Dept. of Energy supercomputers to find \"new patterns\" to help with research, one of the suggestions in the \u003ca href=\"https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative/blue-ribbon-panel\" target=\"_blank\">Cancer Moonshot Blue Ribbon Panel Report\u003c/a>, released last year.\u003c/p>\n\u003cp>In January, Biden said he had offered to help the Trump administration carry on the mission to end cancer. But he also said he would create the Biden Cancer Initiative, where the primary focus would be on working on community collaboration between scientists, so that research would be widely shared across specialties.\u003c/p>\n\u003cp>On Sunday, Biden again mentioned working with the new administration. From a \u003ca href=\"https://www.texastribune.org/2017/03/12/biden-talks-cancer-sxsw/\" target=\"_blank\">Texas Tribune\u003c/a> report:\u003c/p>\n\u003cblockquote>\u003cp>\"It is my hope that this new administration, once it gets organized — and I’m not being facetious — will be able to focus on and be as committed and as enthusiastic as we were in the goal of ending cancer as we know it,\" Biden said. \"I will do everything in my power to work with the new administration.\"\u003c/p>\u003c/blockquote>\n\u003cp>And more from the \u003ca href=\"http://www.latimes.com/entertainment/movies/la-et-mn-joe-biden-cancer-sxsw-trump-2017-story.html\" target=\"_blank\">LA Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Biden had come to SXSW to recruit talent. Addressing an audience that included techies and innovators, he pointed out how easy websites and apps had made it to buy movie tickets or cash checks at the swipe of a finger on a smartphone, then wondered why cancer patients like his son couldn’t just as easily send test results from one hospital to another.\u003c/p>\n\u003cp>“Many of you are developing technologies and innovations for purposes large and small, fun and serious, entertaining and lifesaving, that have nothing to do with cancer — but you could make a gigantic impact,” he said, his voice booming. “We need you to help us reach people who need to change their behavior and avoid cancer. You’re doing it to help them figure out how to buy a product… We need to reach people.”\u003c/p>\u003c/blockquote>\n\u003cp>And \u003ca href=\"http://www.usatoday.com/story/tech/news/2017/03/12/joe-biden-cancer-sxsw/99095456/\" target=\"_blank\">USA Today\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Biden said the idea for the White House Moonshot Cancer initiative came as he and Obama headed to the White House Rose Garden in October 2015 to announce that Biden would not be running for president. Asked by Obama if he had any regrets, Biden said he had one: \"I would have loved to be the president who presided over the end of cancer, as we know it.\" Three months later, Obama announced the creation of the initiative in his final State of the Union address -- to the surprise of Biden, he said.\u003c/p>\u003c/blockquote>\n\u003cp>Biden also mentioned during his presentation that Amazon.com had contacted him to offer free cloud computing space for the project.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/IykG7_zHXoo'\n title='//www.youtube.com/embed/IykG7_zHXoo'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Joe Biden spoke at the South by Southwest conference in Austin on Sunday, talking about continuing the work of the \"\u003ca href=\"https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative\" target=\"_blank\">cancer moonshot\u003c/a>\" initiative, first announced by President Obama during the 2016 State of the Union address. At the time, Obama put Biden “in charge of mission control” for a national initiative to cure cancer, which kills \u003ca href=\"https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2016.html\">hundreds of thousands of Americans\u003c/a> each year. Biden's son, former Delaware Attorney General Beau Biden, died of brain cancer in 2015.\u003c/p>\n\u003cp>At South by Southwest, Biden gave a wide-ranging and at times emotional presentation, citing treatment advances like immunotherapy and particle beam therapy. He also said that cancer data from the Veterans Administration could be analyzed by Dept. of Energy supercomputers to find \"new patterns\" to help with research, one of the suggestions in the \u003ca href=\"https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative/blue-ribbon-panel\" target=\"_blank\">Cancer Moonshot Blue Ribbon Panel Report\u003c/a>, released last year.\u003c/p>\n\u003cp>In January, Biden said he had offered to help the Trump administration carry on the mission to end cancer. But he also said he would create the Biden Cancer Initiative, where the primary focus would be on working on community collaboration between scientists, so that research would be widely shared across specialties.\u003c/p>\n\u003cp>On Sunday, Biden again mentioned working with the new administration. From a \u003ca href=\"https://www.texastribune.org/2017/03/12/biden-talks-cancer-sxsw/\" target=\"_blank\">Texas Tribune\u003c/a> report:\u003c/p>\n\u003cblockquote>\u003cp>\"It is my hope that this new administration, once it gets organized — and I’m not being facetious — will be able to focus on and be as committed and as enthusiastic as we were in the goal of ending cancer as we know it,\" Biden said. \"I will do everything in my power to work with the new administration.\"\u003c/p>\u003c/blockquote>\n\u003cp>And more from the \u003ca href=\"http://www.latimes.com/entertainment/movies/la-et-mn-joe-biden-cancer-sxsw-trump-2017-story.html\" target=\"_blank\">LA Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Biden had come to SXSW to recruit talent. Addressing an audience that included techies and innovators, he pointed out how easy websites and apps had made it to buy movie tickets or cash checks at the swipe of a finger on a smartphone, then wondered why cancer patients like his son couldn’t just as easily send test results from one hospital to another.\u003c/p>\n\u003cp>“Many of you are developing technologies and innovations for purposes large and small, fun and serious, entertaining and lifesaving, that have nothing to do with cancer — but you could make a gigantic impact,” he said, his voice booming. “We need you to help us reach people who need to change their behavior and avoid cancer. You’re doing it to help them figure out how to buy a product… We need to reach people.”\u003c/p>\u003c/blockquote>\n\u003cp>And \u003ca href=\"http://www.usatoday.com/story/tech/news/2017/03/12/joe-biden-cancer-sxsw/99095456/\" target=\"_blank\">USA Today\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Biden said the idea for the White House Moonshot Cancer initiative came as he and Obama headed to the White House Rose Garden in October 2015 to announce that Biden would not be running for president. Asked by Obama if he had any regrets, Biden said he had one: \"I would have loved to be the president who presided over the end of cancer, as we know it.\" Three months later, Obama announced the creation of the initiative in his final State of the Union address -- to the surprise of Biden, he said.\u003c/p>\u003c/blockquote>\n\u003cp>Biden also mentioned during his presentation that Amazon.com had contacted him to offer free cloud computing space for the project.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Can Probiotics Help Your Depression? What We Know, What We Don’t",
"title": "Can Probiotics Help Your Depression? What We Know, What We Don’t",
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"content": "\u003cp>What if your psychiatrist prescribed yogurt and vegetables as an antidepressant?\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s the first controlled experiment, to our knowledge, to show that dietary intervention can curb mood disorders.'\u003c/aside>\n\u003cp>It may sound like alternative medicine, but researchers at the intersection of psychiatry and biochemistry think that adding certain beneficial bacteria to a person's intestines could be the future for treating anxiety and depression.\u003c/p>\n\u003cp>\u003cstrong>Diet and Depression\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Studies have found that a diet high in vegetables and low in processed foods correlates with \u003ca href=\"https://www.researchgate.net/publication/265517050_Relationship_Between_Diet_and_Mental_Health_in_Children_and_Adolescents_A_Systematic_Review\" target=\"_blank\">lower\u003c/a> rates of depression.\u003c/span>\u003cspan style=\"font-weight: 400\"> But showing that what you eat actually \u003cem>affects\u003c/em> your mental health has been more complicated, because people who are depressed may be less likely to eat healthier, as opposed to the other way around.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But now, in a recent \u003c/span>\u003ca href=\"https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">study \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">out of Australia’s Deakin University\u003c/span>\u003cspan style=\"font-weight: 400\">,\u003c/span>\u003cspan style=\"font-weight: 400\"> scientists \u003c/span>\u003cspan style=\"font-weight: 400\">say they\u003c/span> \u003cspan style=\"font-weight: 400\">have used food to effectively treat depression.\u003c/span>\u003cb> \u003c/b>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s the first controlled experiment, to our knowledge, to show that dietary intervention can curb mood disorders,” says \u003c/span>\u003cspan style=\"font-weight: 400\">Dr. Felice Jacka\u003c/span>\u003cspan style=\"font-weight: 400\">, a psychiatrist at Deakin and the study’s lead researcher.\u003c/span>\u003c/p>\n\u003cp>[contextly_sidebar id=\"BR5La0DO2Pz0qD1n57PZ49OO77mTxy8A\"]Deakin and colleagues recruited 56 people, all of whom met two criteria: They were clinically diagnosed with moderate to severe depression, and they had consumed a lot of sweets and processed meats at the expense of healthier foods like fruit, vegetables and fish.\u003c/p>\n\u003cp>The participants were then randomly assigned to one of two treatments: diet counseling or “\u003ca href=\"https://www.psychologytoday.com/blog/the-friendship-doctor/201002/is-befriending-treatment-depression\" target=\"_blank\">befriending\u003c/a>.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Despite heavy marketing of probiotics, we still don't know which bacteria interact with which foods to help boost neurotransmitters that can help our mood.\u003c/aside>\n\u003cp>Over the course of the 12-week study, subjects in the diet intervention group regularly met with nutritionists who counseled them to increase their consumption of vegetables, whole grains and fish, and to decrease their intake of junk food.\u003c/p>\n\u003cp>The patients who were subject to befriending met \u003cspan style=\"font-weight: 400\">with trained research assistants to discuss topics like hobbies or board games; they did not receive any psychological therapy. \u003c/span>\u003cspan style=\"font-weight: 400\">This group served as a control to ensure that any improvement in the diet intervention group would not be due to positive social interaction with the nutritionist.\u003c/span>\u003c/p>\n\u003cp>At the end of the 12 weeks, all of the participants were re-evaluated, using the same depression measures as at the study's start. The results? While both groups showed fewer symptoms of depression, those who had received the diet intervention were significantly less depressed than those in the control group.\u003c/p>\n\u003cp>Furthermore, the more healthy changes that the subjects made to their diet, the less depressed they were at the end of the study.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was pretty remarkable,” Jacka says. “Their level of improvement correlated closely with the level of improvement to their diet.” \u003c/span>\u003c/p>\n\u003cp>\u003cb>How Can Food Affect Our Mood?\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">At the end of the study, the researchers found similar levels of biomarkers like glucose and cholesterol in the diet and control groups. The groups did not differ in the overall amount of exercise they had engaged in. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">So what happened to the group with the improved diet to make them less depressed? \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">While many people intuit that they are what they eat when it comes to mental health, Jacka and other researchers believe there is another factor at work: our \u003c/span>\u003cspan style=\"font-weight: 400\">intestines\u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">, \u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">and the signals they send to our brain\u003ci>s.\u003c/i>\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We are still only starting to tease all of this out,” says \u003c/span>\u003cspan style=\"font-weight: 400\">Melanie Gareau, \u003c/span>\u003cspan style=\"font-weight: 400\">a physiologist at UC Davis who specializes in understanding interactions between our brain and our gut. Given all that we know about that link, the Australian study results make sense, she says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’ve known for quite a while that over 95 percent of the serotonin in our bodies is produced in the intestines,” says Gareau. As serotonin is one of the primary neurotransmitters mediating depression, she thinks it's no surprise that what goes into our intestines can affect our emotions.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But it’s not just about the food we are eating, she says. It's how that food interacts with the trillions of bacterial cells that live in our guts, collectively called our microbiome.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Gareau points to\u003c/span>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839572/\" target=\"_blank\"> \u003cspan style=\"font-weight: 400\">a small study \u003c/span>\u003c/a>out of \u003cspan style=\"font-weight: 400\">UCLA that shows \u003c/span>\u003cspan style=\"font-weight: 400\">the effect of probiotics — micro-organisms believed to be beneficial to humans — on brain activity. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the study, 12 women over the course of a month were given yogurt containing Bifidobacteria and Lactobacillus.\u003c/span>\u003cspan style=\"font-weight: 400\"> Both of these have been associated with \u003c/span>\u003ca href=\"https://www.researchgate.net/profile/Lieve_Desbonnet/publication/45582675_Desbonnet_L_Garrett_L_Clarke_G_Kiely_B_Cryan_JF_Dinan_TG_Effects_of_the_probiotic_Bifidobacterium_infantis_in_the_maternal_separation_model_of_depression_Neuroscience_170_1179-1188/links/552ce5fa0cf21acb09210214.pdf\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">decreased depression in rodents\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, and there have been suggestive \u003c/span>\u003cspan style=\"font-weight: 400\">links between those types of bacteria and mood in \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20974015\" target=\"_blank\">human studies\u003c/a> as well.\u003c/span>\u003cspan style=\"font-weight: 400\"> Although it’s not clear whether taking probiotics with these particular bacteria changes the overall profile of our microbiome for any extended length of time, ingesting them does increase their levels for shorter periods. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the UCLA study, after four weeks of consuming these probiotics, the women completed an emotional response task in which they viewed pictures of angry and fearful faces, while their brain activity was recorded through functional magnetic resonance imaging, or fMRI. The procedure, which measures changes in blood flow within the brain, showed which areas were activated while the subjects viewed the images\u003c/span>\u003cb>.\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The faces [we used] can trigger threat responses in people,” explains\u003c/span> \u003cspan style=\"font-weight: 400\">Dr. Kirsten Tillisch\u003c/span>\u003cspan style=\"font-weight: 400\">, the study's lead researcher and a gastroenterologist at UCLA. “And we know that people with anxiety show increased responses to them.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As it turned out, the women who took the probiotics showed less brain activity when viewing the emotional images than women who took a placebo. \u003c/span>\u003cspan style=\"font-weight: 400\">Dr. Emeran Mayer\u003c/span>\u003cspan style=\"font-weight: 400\">, a co-researcher in the study and the author of \"\u003c/span>\u003cspan style=\"font-weight: 400\">The Mind-Gut Connection\u003c/span>\u003cspan style=\"font-weight: 400\">,\" explains that this kind of dampened response resembles the pattern you might expect to see in someone who isn’t hyper-reactive to the environment. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The brain’s reactivity to threatening stimuli is reduced. So you could speculate that these people might be less prone to anxiety,” Mayer says. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Is it the Food or the Bacteria?\u003c/b>\u003c/p>\n\u003cp>But if our microbiome affects our mood, how so? Researchers think the process might occur \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S155041311400463X\" target=\"_blank\">through metabolites\u003c/a>, a byproduct released by bacteria that feeds on food our bodies cannot fully break down.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">These metabolites can enter into the bloodstream or nervous system, travel up to our brain, and influence how neurons talk to one another. Metabolites may also serve as messengers, signaling cells in the intestines to increase or decrease compounds like serotonin.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">C\u003c/span>\u003cspan style=\"font-weight: 400\">a\u003c/span>\u003cspan style=\"font-weight: 400\">rlito Lebrilla\u003c/span>\u003cspan style=\"font-weight: 400\">, a professor of biochemistry and molecular medicine at UC Davis, says you have to look at both the bacteria \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">and\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> the food to understand what’s happening. \u003c/span>\u003c/p>\n\u003cp>Although there has been an increase in the marketing of probiotic supplements in recent years, especially for improving physical health, \"probiotics are not doing all of the work here,” Lebrilla explains. Ingesting probiotics, whether through supplements or a food like yogurt, lays down some of that “good” intestinal bacteria, so that they are poised and ready to give off the right kind of metabolites. However, whether or not your gut bacteria produce those metabolites depends on the food you eat afterward.\u003c/p>\n\u003cp>So you can eat a probiotic food like yogurt all day and still not experience the potentially positive effects, Lebrilla says. That's because we still don't know which metabolites make our brains feel better, which bacteria give off those metabolites, and which kinds of foods \u003ci>feed\u003c/i> those bacteria.\u003c/p>\n\u003cp>“That's what we are trying to do right now,” Lebrilla says. He says that while scientists have identified a few types of bacteria that are likely to give off good metabolites, there are hundreds and possibly thousands of bacterial strains in our intestines. If we could map out the specific bacteria-metabolite combinations that reduce anxiety and depression, we would be a step closer to creating customized diets for our brains. It’s something that could take a couple of decades to accomplish, Lebrilla says, “but it’s not that far-fetched.”\u003c/p>\n\u003cp class=\"x_gmail-m_-2829810840648309428gmail-m_-7153094449839385370MsoListParagraph\">In the meantime, both Jacka and Mayer point out that over tens of thousands of years, our bodies have evolved in concert with the microbiota in our intestines to function optimally with the foods we have been eating\u003cb>. \u003c/b>\u003cspan style=\"line-height: 1.5\">For millennia we fed off of a mostly plant-based and lean-meat diet. But in recent years there have been “profound changes to the kinds of foods we eat,” Jacka says, particularly in the reduced amount of vegetables and increased amount of sugar.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It's wildly different from what we were eating even a generation ago.” \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Taking that into consideration, what the findings from her study might really show is not a \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">new\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> diet to curb mood disorders, but rather how we might look back to the foods our ancestors ate in order to restore balance to our bodies and brains.\u003c/span>\u003c/p>\n\n",
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"excerpt": "Researchers at the intersection of psychiatry and biochemistry think adding beneficial bacteria to our diet could be a treatment for anxiety and depression. But there are still many unknowns about which foods can help.\r\n",
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"description": "Researchers at the intersection of psychiatry and biochemistry think adding beneficial bacteria to our diet could be a treatment for anxiety and depression. But there are still many unknowns about which foods can help.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>What if your psychiatrist prescribed yogurt and vegetables as an antidepressant?\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s the first controlled experiment, to our knowledge, to show that dietary intervention can curb mood disorders.'\u003c/aside>\n\u003cp>It may sound like alternative medicine, but researchers at the intersection of psychiatry and biochemistry think that adding certain beneficial bacteria to a person's intestines could be the future for treating anxiety and depression.\u003c/p>\n\u003cp>\u003cstrong>Diet and Depression\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Studies have found that a diet high in vegetables and low in processed foods correlates with \u003ca href=\"https://www.researchgate.net/publication/265517050_Relationship_Between_Diet_and_Mental_Health_in_Children_and_Adolescents_A_Systematic_Review\" target=\"_blank\">lower\u003c/a> rates of depression.\u003c/span>\u003cspan style=\"font-weight: 400\"> But showing that what you eat actually \u003cem>affects\u003c/em> your mental health has been more complicated, because people who are depressed may be less likely to eat healthier, as opposed to the other way around.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But now, in a recent \u003c/span>\u003ca href=\"https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">study \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">out of Australia’s Deakin University\u003c/span>\u003cspan style=\"font-weight: 400\">,\u003c/span>\u003cspan style=\"font-weight: 400\"> scientists \u003c/span>\u003cspan style=\"font-weight: 400\">say they\u003c/span> \u003cspan style=\"font-weight: 400\">have used food to effectively treat depression.\u003c/span>\u003cb> \u003c/b>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s the first controlled experiment, to our knowledge, to show that dietary intervention can curb mood disorders,” says \u003c/span>\u003cspan style=\"font-weight: 400\">Dr. Felice Jacka\u003c/span>\u003cspan style=\"font-weight: 400\">, a psychiatrist at Deakin and the study’s lead researcher.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Deakin and colleagues recruited 56 people, all of whom met two criteria: They were clinically diagnosed with moderate to severe depression, and they had consumed a lot of sweets and processed meats at the expense of healthier foods like fruit, vegetables and fish.\u003c/p>\n\u003cp>The participants were then randomly assigned to one of two treatments: diet counseling or “\u003ca href=\"https://www.psychologytoday.com/blog/the-friendship-doctor/201002/is-befriending-treatment-depression\" target=\"_blank\">befriending\u003c/a>.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Despite heavy marketing of probiotics, we still don't know which bacteria interact with which foods to help boost neurotransmitters that can help our mood.\u003c/aside>\n\u003cp>Over the course of the 12-week study, subjects in the diet intervention group regularly met with nutritionists who counseled them to increase their consumption of vegetables, whole grains and fish, and to decrease their intake of junk food.\u003c/p>\n\u003cp>The patients who were subject to befriending met \u003cspan style=\"font-weight: 400\">with trained research assistants to discuss topics like hobbies or board games; they did not receive any psychological therapy. \u003c/span>\u003cspan style=\"font-weight: 400\">This group served as a control to ensure that any improvement in the diet intervention group would not be due to positive social interaction with the nutritionist.\u003c/span>\u003c/p>\n\u003cp>At the end of the 12 weeks, all of the participants were re-evaluated, using the same depression measures as at the study's start. The results? While both groups showed fewer symptoms of depression, those who had received the diet intervention were significantly less depressed than those in the control group.\u003c/p>\n\u003cp>Furthermore, the more healthy changes that the subjects made to their diet, the less depressed they were at the end of the study.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was pretty remarkable,” Jacka says. “Their level of improvement correlated closely with the level of improvement to their diet.” \u003c/span>\u003c/p>\n\u003cp>\u003cb>How Can Food Affect Our Mood?\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">At the end of the study, the researchers found similar levels of biomarkers like glucose and cholesterol in the diet and control groups. The groups did not differ in the overall amount of exercise they had engaged in. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">So what happened to the group with the improved diet to make them less depressed? \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">While many people intuit that they are what they eat when it comes to mental health, Jacka and other researchers believe there is another factor at work: our \u003c/span>\u003cspan style=\"font-weight: 400\">intestines\u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">, \u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">and the signals they send to our brain\u003ci>s.\u003c/i>\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We are still only starting to tease all of this out,” says \u003c/span>\u003cspan style=\"font-weight: 400\">Melanie Gareau, \u003c/span>\u003cspan style=\"font-weight: 400\">a physiologist at UC Davis who specializes in understanding interactions between our brain and our gut. Given all that we know about that link, the Australian study results make sense, she says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’ve known for quite a while that over 95 percent of the serotonin in our bodies is produced in the intestines,” says Gareau. As serotonin is one of the primary neurotransmitters mediating depression, she thinks it's no surprise that what goes into our intestines can affect our emotions.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But it’s not just about the food we are eating, she says. It's how that food interacts with the trillions of bacterial cells that live in our guts, collectively called our microbiome.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Gareau points to\u003c/span>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839572/\" target=\"_blank\"> \u003cspan style=\"font-weight: 400\">a small study \u003c/span>\u003c/a>out of \u003cspan style=\"font-weight: 400\">UCLA that shows \u003c/span>\u003cspan style=\"font-weight: 400\">the effect of probiotics — micro-organisms believed to be beneficial to humans — on brain activity. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the study, 12 women over the course of a month were given yogurt containing Bifidobacteria and Lactobacillus.\u003c/span>\u003cspan style=\"font-weight: 400\"> Both of these have been associated with \u003c/span>\u003ca href=\"https://www.researchgate.net/profile/Lieve_Desbonnet/publication/45582675_Desbonnet_L_Garrett_L_Clarke_G_Kiely_B_Cryan_JF_Dinan_TG_Effects_of_the_probiotic_Bifidobacterium_infantis_in_the_maternal_separation_model_of_depression_Neuroscience_170_1179-1188/links/552ce5fa0cf21acb09210214.pdf\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">decreased depression in rodents\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, and there have been suggestive \u003c/span>\u003cspan style=\"font-weight: 400\">links between those types of bacteria and mood in \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20974015\" target=\"_blank\">human studies\u003c/a> as well.\u003c/span>\u003cspan style=\"font-weight: 400\"> Although it’s not clear whether taking probiotics with these particular bacteria changes the overall profile of our microbiome for any extended length of time, ingesting them does increase their levels for shorter periods. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the UCLA study, after four weeks of consuming these probiotics, the women completed an emotional response task in which they viewed pictures of angry and fearful faces, while their brain activity was recorded through functional magnetic resonance imaging, or fMRI. The procedure, which measures changes in blood flow within the brain, showed which areas were activated while the subjects viewed the images\u003c/span>\u003cb>.\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The faces [we used] can trigger threat responses in people,” explains\u003c/span> \u003cspan style=\"font-weight: 400\">Dr. Kirsten Tillisch\u003c/span>\u003cspan style=\"font-weight: 400\">, the study's lead researcher and a gastroenterologist at UCLA. “And we know that people with anxiety show increased responses to them.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As it turned out, the women who took the probiotics showed less brain activity when viewing the emotional images than women who took a placebo. \u003c/span>\u003cspan style=\"font-weight: 400\">Dr. Emeran Mayer\u003c/span>\u003cspan style=\"font-weight: 400\">, a co-researcher in the study and the author of \"\u003c/span>\u003cspan style=\"font-weight: 400\">The Mind-Gut Connection\u003c/span>\u003cspan style=\"font-weight: 400\">,\" explains that this kind of dampened response resembles the pattern you might expect to see in someone who isn’t hyper-reactive to the environment. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The brain’s reactivity to threatening stimuli is reduced. So you could speculate that these people might be less prone to anxiety,” Mayer says. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Is it the Food or the Bacteria?\u003c/b>\u003c/p>\n\u003cp>But if our microbiome affects our mood, how so? Researchers think the process might occur \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S155041311400463X\" target=\"_blank\">through metabolites\u003c/a>, a byproduct released by bacteria that feeds on food our bodies cannot fully break down.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">These metabolites can enter into the bloodstream or nervous system, travel up to our brain, and influence how neurons talk to one another. Metabolites may also serve as messengers, signaling cells in the intestines to increase or decrease compounds like serotonin.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">C\u003c/span>\u003cspan style=\"font-weight: 400\">a\u003c/span>\u003cspan style=\"font-weight: 400\">rlito Lebrilla\u003c/span>\u003cspan style=\"font-weight: 400\">, a professor of biochemistry and molecular medicine at UC Davis, says you have to look at both the bacteria \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">and\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> the food to understand what’s happening. \u003c/span>\u003c/p>\n\u003cp>Although there has been an increase in the marketing of probiotic supplements in recent years, especially for improving physical health, \"probiotics are not doing all of the work here,” Lebrilla explains. Ingesting probiotics, whether through supplements or a food like yogurt, lays down some of that “good” intestinal bacteria, so that they are poised and ready to give off the right kind of metabolites. However, whether or not your gut bacteria produce those metabolites depends on the food you eat afterward.\u003c/p>\n\u003cp>So you can eat a probiotic food like yogurt all day and still not experience the potentially positive effects, Lebrilla says. That's because we still don't know which metabolites make our brains feel better, which bacteria give off those metabolites, and which kinds of foods \u003ci>feed\u003c/i> those bacteria.\u003c/p>\n\u003cp>“That's what we are trying to do right now,” Lebrilla says. He says that while scientists have identified a few types of bacteria that are likely to give off good metabolites, there are hundreds and possibly thousands of bacterial strains in our intestines. If we could map out the specific bacteria-metabolite combinations that reduce anxiety and depression, we would be a step closer to creating customized diets for our brains. It’s something that could take a couple of decades to accomplish, Lebrilla says, “but it’s not that far-fetched.”\u003c/p>\n\u003cp class=\"x_gmail-m_-2829810840648309428gmail-m_-7153094449839385370MsoListParagraph\">In the meantime, both Jacka and Mayer point out that over tens of thousands of years, our bodies have evolved in concert with the microbiota in our intestines to function optimally with the foods we have been eating\u003cb>. \u003c/b>\u003cspan style=\"line-height: 1.5\">For millennia we fed off of a mostly plant-based and lean-meat diet. But in recent years there have been “profound changes to the kinds of foods we eat,” Jacka says, particularly in the reduced amount of vegetables and increased amount of sugar.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It's wildly different from what we were eating even a generation ago.” \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Taking that into consideration, what the findings from her study might really show is not a \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">new\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> diet to curb mood disorders, but rather how we might look back to the foods our ancestors ate in order to restore balance to our bodies and brains.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Telehealth takes a lot of forms these days\u003cspan style=\"font-weight: 400\">—\u003c/span>consultations with a doctor by video, phone or text; an appointment through the web or a mobile app. The one commonality: You get to interact with a health care provider from anywhere\u003cspan style=\"font-weight: 400\">—\u003c/span>your home, the office, Starbucks. Virtual consultations can mean you don’t have to schlep across town, sit in the waiting room, and leaf through a year-old Time magazine article as prelude to a short visit with your doc.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you make services that are convenient, it’s an ‘If you build it, they will come' kind of thing.'\u003ccite> Lori Uscher-Pines,\u003cbr>\nRAND Corporation\u003c/cite>\u003c/aside>\n\u003cp>Telehealth appointments are less expensive because the companies offering these services contract with doctors who are paid by the visit, and the companies themselves have little of the overhead necessary in a typical medical office, says Lori Uscher-Pines, a health policy researcher with the RAND Corporation. That means telehealth should theoretically save money for patients, employers and insurance companies -- the entire health care ecosystem. At least this is what telehealth companies claim. But now a \u003ca href=\"http://content.healthaffairs.org/content/36/3/485.abstract\" target=\"_blank\">study\u003c/a> from RAND, published Monday in \u003cem>Health Affairs\u003c/em>, says this isn't the case.\u003c/p>\n\u003cp>The study found that using telehealth for treatment of acute respiratory illnesses increased total annual spending, which the researchers defined as costs to insurers and out-of-pocket payments by patients, by $45 per telehealth user.\u003c/p>\n\u003cp>That's because 88 percent of the telehealth visits represented people who would not have gone to a doctor otherwise -- what the industry calls new utilization. Just 12 percent of the telehealth sessions, the researchers concluded, amounted to a \u003cem>substitute\u003c/em> for going to see the doc.\u003c/p>\n\u003cp>Uscher-Pines, a co-author of the study, says she's not surprised.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“When you make services that are convenient, it’s an ‘If you build it, they will come' kind of thing.”\u003c/p>\n\u003cp>Uscher-Pines says patients using telehealth for respiratory infections would likely not have gone to a doctor if the service had not been available. Rather, they would self-treat.\u003c/p>\n\u003cp>\"You sit at home, you watch Netflix, you take Tylenol,\" Pines says. \"But now because of these kind of services that are so easy to access, you have a visit that would not have otherwise occurred.”\u003c/p>\n\u003cp>The study is the fourth on telehealth funded by the California Health Care Foundation. Researchers examined claims data from more than 300,000 enrollees in the Blue Shield of California HMO offered by CalPERS, the California Public Employees' Retirement System. In 2012, CalPERS began offering the telehealth appointments to selected members through Teladoc, a Texas-based public company that provides virtual appointments with licensed physicians 24 hours a day, 365 days a year.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You have to use [telehealth] as a more precise tool with particular populations in order to serve their needs. Don’t just go into it blindly.'\u003ccite>Melissa Buckley,\u003cbr>\nCalifornia Health Care Foundation\u003c/cite>\u003c/aside>\n\u003cp>The current study looked at 981 people who used the Teladoc service over 18 months in 2012-13, seeking help for acute respiratory infections like bronchitis, pneumonia or sinusitis. The researchers compared these users with patients who had their acute respiratory infections treated by a doctor in-person. The focus was on this type of illness because it is the most commonly treated by direct-to-consumer telehealth providers, the researchers said.\u003c/p>\n\u003cp>Teladoc, which \u003ca href=\"https://www.teladoc.com/businesses/save-money/\" target=\"_blank\">markets\u003c/a> its service as a cost reduction, says patient information it gathered at the time of care contradicts the findings. Courtney McLeod, the company’s director of public relations, said in an email that just 13 percent of appointments for more than 400,000 acute respiratory infection patients represented new health care utilization.\u003c/p>\n\u003cp>That is pretty much the reverse of the 88 percent new utilization that the RAND researchers found. The RAND study asserts that the discrepancies between its numbers and those of the telehealth companies on new-versus-replacement health care could be due to the companies' use of surveys, as opposed to actual utilization data. The surveyed telehealth patients, the researchers wrote, may have overestimated the likelihood of going to see a doctor as opposed to not acting at all.\u003c/p>\n\u003cp>The researchers did acknowledge that use of telehealth for different conditions might produce better results. One of the study’s limitations was that respiratory infections often resolve on their own. “In contrast, an increase in utilization for patients with diabetes or mental illness might be perceived as a net positive,\" the study reads. \"These are conditions that are often undertreated and for which there is clearer evidence that receiving treatment improves health.\"\u003c/p>\n\u003cp>Uscher-Pines also said there could be economic benefits from telehealth that the study didn’t capture. \"These services can be offering patients reassurance,” she said, which can positively impact employee productivity. Telehealth visits initiated from a patient's work site might also reduce absenteeism,\u003c/p>\n\u003cp>But, she said, “You have to take this with a grain of salt when a company says we’re going to prevent emergency department visits. It’s unclear whether that’s likely to happen given the fact that the literature on innovations in health care delivery frequently tells us that when you increase convenience you increase utilization.\"\u003c/p>\n\u003cp>David Cowling, a co-author of the paper and a research scientist at CalPERS, said the study revealed the tradeoff that telehealth presents.\u003c/p>\n\u003cp>\"We have increased access to our members, which is a good thing. Eighty-eight percent were new utilization, so they wouldn’t have gotten care previously. Our members were seeking care and I’m sure their satisfaction with their health plan was higher.\"\u003c/p>\n\u003cp>But Cowling said the issue could prompt a change in the benefit when CalPERS re-examines its benefit package. He said the organization could potentially limit telehealth access to rural areas, one of the original aims of introducing the service, or tailor it to specific conditions.\u003c/p>\n\u003cp>Melissa Buckley, the director of the California Health Care Foundation’s Innovation Fund, said that sort of strategic thinking may be the best bet when it comes to telehealth.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“If you use it naively you can drive up utilization,\" she said. \"You have to use it as a more precise tool with particular populations in order to serve their needs. Don’t just go into it blindly.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Telehealth takes a lot of forms these days\u003cspan style=\"font-weight: 400\">—\u003c/span>consultations with a doctor by video, phone or text; an appointment through the web or a mobile app. The one commonality: You get to interact with a health care provider from anywhere\u003cspan style=\"font-weight: 400\">—\u003c/span>your home, the office, Starbucks. Virtual consultations can mean you don’t have to schlep across town, sit in the waiting room, and leaf through a year-old Time magazine article as prelude to a short visit with your doc.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you make services that are convenient, it’s an ‘If you build it, they will come' kind of thing.'\u003ccite> Lori Uscher-Pines,\u003cbr>\nRAND Corporation\u003c/cite>\u003c/aside>\n\u003cp>Telehealth appointments are less expensive because the companies offering these services contract with doctors who are paid by the visit, and the companies themselves have little of the overhead necessary in a typical medical office, says Lori Uscher-Pines, a health policy researcher with the RAND Corporation. That means telehealth should theoretically save money for patients, employers and insurance companies -- the entire health care ecosystem. At least this is what telehealth companies claim. But now a \u003ca href=\"http://content.healthaffairs.org/content/36/3/485.abstract\" target=\"_blank\">study\u003c/a> from RAND, published Monday in \u003cem>Health Affairs\u003c/em>, says this isn't the case.\u003c/p>\n\u003cp>The study found that using telehealth for treatment of acute respiratory illnesses increased total annual spending, which the researchers defined as costs to insurers and out-of-pocket payments by patients, by $45 per telehealth user.\u003c/p>\n\u003cp>That's because 88 percent of the telehealth visits represented people who would not have gone to a doctor otherwise -- what the industry calls new utilization. Just 12 percent of the telehealth sessions, the researchers concluded, amounted to a \u003cem>substitute\u003c/em> for going to see the doc.\u003c/p>\n\u003cp>Uscher-Pines, a co-author of the study, says she's not surprised.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When you make services that are convenient, it’s an ‘If you build it, they will come' kind of thing.”\u003c/p>\n\u003cp>Uscher-Pines says patients using telehealth for respiratory infections would likely not have gone to a doctor if the service had not been available. Rather, they would self-treat.\u003c/p>\n\u003cp>\"You sit at home, you watch Netflix, you take Tylenol,\" Pines says. \"But now because of these kind of services that are so easy to access, you have a visit that would not have otherwise occurred.”\u003c/p>\n\u003cp>The study is the fourth on telehealth funded by the California Health Care Foundation. Researchers examined claims data from more than 300,000 enrollees in the Blue Shield of California HMO offered by CalPERS, the California Public Employees' Retirement System. In 2012, CalPERS began offering the telehealth appointments to selected members through Teladoc, a Texas-based public company that provides virtual appointments with licensed physicians 24 hours a day, 365 days a year.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You have to use [telehealth] as a more precise tool with particular populations in order to serve their needs. Don’t just go into it blindly.'\u003ccite>Melissa Buckley,\u003cbr>\nCalifornia Health Care Foundation\u003c/cite>\u003c/aside>\n\u003cp>The current study looked at 981 people who used the Teladoc service over 18 months in 2012-13, seeking help for acute respiratory infections like bronchitis, pneumonia or sinusitis. The researchers compared these users with patients who had their acute respiratory infections treated by a doctor in-person. The focus was on this type of illness because it is the most commonly treated by direct-to-consumer telehealth providers, the researchers said.\u003c/p>\n\u003cp>Teladoc, which \u003ca href=\"https://www.teladoc.com/businesses/save-money/\" target=\"_blank\">markets\u003c/a> its service as a cost reduction, says patient information it gathered at the time of care contradicts the findings. Courtney McLeod, the company’s director of public relations, said in an email that just 13 percent of appointments for more than 400,000 acute respiratory infection patients represented new health care utilization.\u003c/p>\n\u003cp>That is pretty much the reverse of the 88 percent new utilization that the RAND researchers found. The RAND study asserts that the discrepancies between its numbers and those of the telehealth companies on new-versus-replacement health care could be due to the companies' use of surveys, as opposed to actual utilization data. The surveyed telehealth patients, the researchers wrote, may have overestimated the likelihood of going to see a doctor as opposed to not acting at all.\u003c/p>\n\u003cp>The researchers did acknowledge that use of telehealth for different conditions might produce better results. One of the study’s limitations was that respiratory infections often resolve on their own. “In contrast, an increase in utilization for patients with diabetes or mental illness might be perceived as a net positive,\" the study reads. \"These are conditions that are often undertreated and for which there is clearer evidence that receiving treatment improves health.\"\u003c/p>\n\u003cp>Uscher-Pines also said there could be economic benefits from telehealth that the study didn’t capture. \"These services can be offering patients reassurance,” she said, which can positively impact employee productivity. Telehealth visits initiated from a patient's work site might also reduce absenteeism,\u003c/p>\n\u003cp>But, she said, “You have to take this with a grain of salt when a company says we’re going to prevent emergency department visits. It’s unclear whether that’s likely to happen given the fact that the literature on innovations in health care delivery frequently tells us that when you increase convenience you increase utilization.\"\u003c/p>\n\u003cp>David Cowling, a co-author of the paper and a research scientist at CalPERS, said the study revealed the tradeoff that telehealth presents.\u003c/p>\n\u003cp>\"We have increased access to our members, which is a good thing. Eighty-eight percent were new utilization, so they wouldn’t have gotten care previously. Our members were seeking care and I’m sure their satisfaction with their health plan was higher.\"\u003c/p>\n\u003cp>But Cowling said the issue could prompt a change in the benefit when CalPERS re-examines its benefit package. He said the organization could potentially limit telehealth access to rural areas, one of the original aims of introducing the service, or tailor it to specific conditions.\u003c/p>\n\u003cp>Melissa Buckley, the director of the California Health Care Foundation’s Innovation Fund, said that sort of strategic thinking may be the best bet when it comes to telehealth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If you use it naively you can drive up utilization,\" she said. \"You have to use it as a more precise tool with particular populations in order to serve their needs. Don’t just go into it blindly.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Premier U.S. Hospitals Are Selling Unproven Alternative Therapies",
"title": "Premier U.S. Hospitals Are Selling Unproven Alternative Therapies",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>They’re among the nation’s premier medical centers, at the leading edge of scientific research.\u003c/p>\n\u003cp>Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing. They offer “energy healing” to help treat multiple sclerosis, acupuncture for infertility, and homeopathic bee venom for fibromyalgia. A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)\u003c/p>\n\u003cp>This embrace of alternative medicine has been building for years. But a STAT examination of 15 academic research centers across the U.S. underscores just how deeply these therapies have become embedded in prestigious hospitals and medical schools.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We've become witch doctors ... [forfeiting] any claim that we had to be a science-based profession.'\u003ccite>Dr. Steven Novella, Yale School of Medicine \u003c/cite>\u003c/aside>\n\u003cp>Some hospitals have built luxurious, spa-like wellness centers to draw patients for spiritual healing, homeopathy and more. And they’re promoting such treatments for a wide array of conditions, including depression, heart disease, cancer, and chronic pain. Duke even markets a pediatric program that suggests on its website that alternative medicine, including “detoxification programs” and “botanical medicines,” can help children with conditions ranging from autism to asthma to ADHD.\u003c/p>\n\u003cp>“We’ve become witch doctors,” said Dr. Steven Novella, a professor of neurology at the Yale School of Medicine and a longtime critic of alternative medicine.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>STAT’s examination found a booming market for such therapies: The clinic at the University of California, San Francisco, is growing so fast, it’s bursting out of its space.\u003c/p>\n\u003cp>Just in the past year, the teaching hospital connected to the University of Florida began offering cancer patients consultations in homeopathy and traditional Chinese herbal medicine. Thomas Jefferson University in Philadelphia launched an institute whose offerings include \u003ca href=\"https://www.statnews.com/2017/02/23/vitamin-iv-infusion/\" target=\"_blank\">intravenous vitamin and mineral therapies\u003c/a>. And the University of Arizona, a pioneer in the field, received a $1 million gift to boost practitioner training in natural and spiritual healing techniques.\u003c/p>\n\u003cp>Even as they count on these programs to bring in patients and revenue, several hospitals were reluctant to talk to STAT about why they’re lending their distinguished names to unproven therapies.\u003c/p>\n\u003cp>Duke Health declined repeated requests for interviews about its rapidly growing integrative medicine center, which \u003ca href=\"https://www.dukeintegrativemedicine.org/wp-content/uploads/2016/02/primarycare-brochure-web.pdf\" target=\"_blank\">charges patients $1,800 a year\u003c/a> just for a basic membership, with acupuncture and other treatments billed separately.\u003c/p>\n\u003cp>MedStar Georgetown quietly edited its website, citing changes to its clinical offerings, after a reporter asked why it listed the energy healing practice of reiki as a therapy for blood cancer. Cleveland Clinic struggled to find anyone on its staff to defend the hospital’s energy medicine program, ultimately issuing a statement that it’s “responding to the needs of our patients and patient demand.”\u003c/p>\n\u003cp>And the director of an alternative medicine program at another prestigious hospital declined to speak on the record — out of fear, he said, that his remarks would be construed as “fake news” and stir a backlash.\u003c/p>\n\u003cp>The rise of alternative therapies has sparked tension in some hospitals, with doctors openly accusing their peers of peddling snake oil and undermining the credibility of their institutions.\u003c/p>\n\u003cp>By promoting such therapies, Novella said, physicians are forfeiting “any claim that we had to being a science-based profession.”\u003c/p>\n\u003cp>As for patients? They’re “being snookered,” he said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what's best for a patient. Who am I to say that's hogwash?' \u003ccite>Dr. Linda Lee, Johns Hopkins gastroenterologist\u003c/cite>\u003c/aside>\n\u003cp>The counterargument: Modern medicine clearly can’t cure everyone. It fails a great many patients. So why not encourage them to try an ancient Indian remedy or a spiritual healing technique that’s unlikely to cause harm — and may provide some relief, if only from the placebo effect?\u003c/p>\n\u003cp>“Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what’s best for a patient. Who am I to say that’s hogwash?” said Dr. Linda Lee.\u003c/p>\n\u003cp>A gastroenterologist, Lee runs the Johns Hopkins Integrative Medicine and Digestive Center, which offers acupuncture, massage therapy, and reiki — a therapy that the center’s website describes as laying on hands \u003ca href=\"http://www.hopkinsmedicine.org/integrative_medicine_digestive_center/services/reiki.html\" target=\"_blank\">“to transmit Universal Life Energy”\u003c/a> to the patient.\u003c/p>\n\u003cp>Lee and others who promote alternative therapies are careful to say that they can supplement — but can’t replace — conventional treatments. And they make a point of coordinating care with other doctors so that, for instance, patients don’t get prescribed herbal supplements that might interact badly with their chemotherapy.\u003c/p>\n\u003cp>“Here at UF, we do not have alternative medicine. We do not have complementary medicine. We have integrative medicine,” said Dr. Irene Estores, medical director of the integrative medicine program at the University of Florida Shands Hospital in Gainesville, Fla.\u003c/p>\n\u003cp>\u003cstrong>Online Promotions Offer Scant Evidence\u003c/strong>\u003c/p>\n\u003cp>But while those cautions may come through in the clinic, the hospitals also promote alternative medicine online — often, without any nuance.\u003c/p>\n\u003cp>Duke’s Integrative Medicine store, for instance, sells \u003ca href=\"https://shopprovisions.dukestores.duke.edu/index.php?main_page=product_info&cPath=37_1&products_id=196\" target=\"_blank\">“Po Chai Pills”\u003c/a> that are touted on the hospital’s website as a cure for everything from belching to hangovers to headaches. The site explains that taking a pill “harmonizes the stomach, stems counterflow ascent of stomach qi, dispels damp, dispels pathogenic factors, subdues yang, relieves pain.” None of that makes sense in modern biomedical terms.\u003c/p>\n\u003cp>Thomas Jefferson University Hospital’s website touts \u003ca href=\"http://hospitals.jefferson.edu/tests-and-treatments/homeopathic-medicine.html\" target=\"_blank\">homeopathic bee venom\u003c/a> as useful to relieve symptoms for arthritis, nerve pain, and other conditions. The site does tell patients that the biological mechanism for the treatment is “unexplained” but asserts that studies “have been published in medical journals showing homeopathic medicines may provide clinical benefit.”\u003c/p>\n\u003cp>Asked about the therapy, Dr. Daniel Monti, who directs the integrative health center, acknowledged that the data is “largely anecdotal,” and said the hospital offers the treatment only rarely, “when there are few other options.” But those caveats don’t come through on the website.\u003c/p>\n\u003cp>Novella gets alarmed when he sees top-tier hospitals backing therapies with scant evidence behind them. “Patients only want [alternative medicine] because they’re being told they should want it. They see a prestigious hospital is offering it, so they think it’s legitimate,” said Novella.\u003c/p>\n\u003cp>“The perpetuation of these practices is a victory of marketing over truth,” said Steven Salzberg, a biomedical engineer at Johns Hopkins who lectures in the medical school. If a hospital is “offering treatment that’s based on fantasy, it undermines the credibility of the institution.”\u003c/p>\n\u003cp>The debate burst into the public view earlier this year when the medical director of the Cleveland Clinic’s Wellness Institute — which markets a variety of alternative therapies — \u003ca href=\"https://www.statnews.com/2017/01/07/anti-vaccine-claims-cleveland-clinic/\" target=\"_blank\">published an article\u003c/a> raising discredited theories linking vaccines to autism.\u003c/p>\n\u003cp>Cleveland Clinic’s chief executive, Dr. Toby Cosgrove, disavowed the article. And the clinic told STAT last week that it will take down its online wellness store and stop selling homeopathy kits.\u003c/p>\n\u003cp>But Cosgrove has stood up for the general principle of offering alternative treatments.\u003c/p>\n\u003cp>“The old way of combating chronic disease hasn’t worked,” Cosgrove wrote in a column posted on the hospital’s website. “… We have heard from our patients that they want more than conventional medicine can offer.”\u003c/p>\n\u003cfigure id=\"attachment_351821\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/03/bee-venom-800x530.jpg\">\u003cfigcaption class=\"wp-caption-text\">Thomas Jefferson University Hospital’s website touts homeopathic bee venom as useful to relieve symptoms for arthritis, nerve pain, and other conditions. The site tells patients that the biological mechanism for the treatment is “unexplained.” \u003ccite>(erierika/iStock)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Booming Market for ‘Natural’ Therapies\u003c/strong>\u003c/p>\n\u003cp>There’s no question that patients want alternative medicine. It’s a $37 billion-a-year business.\u003c/p>\n\u003cp>The typical American adult spent about $800 out of pocket in 2012 on dietary supplements and visits to alternative providers, such as naturopaths and acupuncturists, according to the federal Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Hospitals have taken note. A national consortium to promote integrative health now counts more than 70 academic centers and health systems as members, up from eight in 1999. Each year, four or five new programs join, said Dr. Leslie Mendoza Temple, the chair of the consortium’s policy working group.\u003c/p>\n\u003cp>In most cases, insurers won’t cover alternative therapies — there’s simply not enough evidence that they actually work — so patients pay out of pocket: $85 for acupuncture, $100 for reiki, $38 for pills made from thyme and oregano oils that promise to “harmonize digestive and respiratory function.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'The people running the hospitals are doctors, but they also have MBAs. They talk of patients as customers. ... Your job is to sell them what they want.' \u003ccite>Arthur Caplan, New York University bioethicist\u003c/cite>\u003c/aside>\n\u003cp>To be sure, not all such integrative medicine clinics are big profit centers. Many are funded by philanthropists, and some hospitals say their programs operate at a loss — but are nonetheless essential to woo patients in a highly competitive marketplace. If they failed to offer “natural” therapies, some hospital executives fear they would lose a chance to attract patients who need more lucrative care, such as orthopedic surgeries or cancer treatments.\u003c/p>\n\u003cp>The integrative medicine center at Thomas Jefferson, for instance, is part of an “enterprise strategy for growth and development,” Monti said.\u003c/p>\n\u003cp>“The people running the hospitals are doctors, but they also have MBAs. They talk of patients as customers. Customers have demands. Your job is to sell them what they want,” said Arthur Caplan, a bioethicist at New York University’s medical school. Too often, he said, the attitude is, “We’re damn well going to do it if the guys down the street are doing it.”\u003c/p>\n\u003cp>While most hospitals declined to give specific revenue figures, STAT found indications of rapid growth.\u003c/p>\n\u003cp>“We’re literally bursting. We have to convert office space to clinic exam rooms,” said Shelley Adler, who runs the Osher Center for Integrative Medicine at the University of California, San Francisco. It offers a wide range of services, including Chinese herbal medicine, massage therapy, and Ayurveda, an ancient healing system from India based on the belief that health results from a balance between the mind, body, and spirit.\u003c/p>\n\u003cp>The center is on pace to get more than 10,300 patient visits this fiscal year, up 37 percent from 2012. It’s expanding its clinical staff by a third.\u003c/p>\n\u003cp>Duke University’s integrative medicine clinic, a stunning space with arching wood ceilings and an indoor garden, has seen strong growth: Total visits jumped 50 percent in 2015, to more than 14,000, Dr. Adam Perlman, the executive director, told IntegrativePractitioner.com. (He declined to talk to STAT.)\u003c/p>\n\u003cp>The center’s membership count also jumped, up 25 percent to 885, Perlman said. If all members paid the list price, that would bring in more than $1 million a year just for primary care.\u003c/p>\n\u003cp>At the University of Pittsburgh’s Center for Integrative Medicine, meanwhile, “our volume pretty much has increased steadily, even when we’ve had recessions and financial downturns,” said Dr. Ronald Glick, the medical director. The center now treats about 8,000 patients a year.\u003c/p>\n\u003cp>Many hospitals have also expanded into more general “wellness” offerings, with classes in healthy cooking, tai chi, meditation, and art therapy. UCSF offers a $375 class on “cultivating emotional balance” (and a free class on “laughter yoga”). Mayo Clinic sells a $2,900 “signature experience,” which includes consultations with a wellness coach.\u003c/p>\n\u003cp>And the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital offers specialized stress management services to help patients deal with conditions including cancer, infertility, and menopause. John Henry, the owner of STAT, has contributed funding to the Benson-Henry Institute.\u003c/p>\n\u003cp>Wellness programs — which are designed to ease stress and encourage healthy behaviors — are seen by many clinicians and hospitals as key to slowing America’s epidemic of chronic disease. They don’t tend to draw sharp criticism, except for their cost.\u003c/p>\n\u003cp>It’s the alternative therapies promoted as a way to treat disease that raise eyebrows.\u003c/p>\n\u003cp>\u003cstrong>‘Energy Healing’ Takes Root\u003c/strong>\u003c/p>\n\u003cp>Despite their deep wells of medical expertise, many top hospitals are offering to help treat serious medical problems with reiki — a practice based on the belief that lightly touching patients can unleash a cosmic energy flow that will heal them naturally.\u003c/p>\n\u003cp>STAT found that it is widely used by academic medical centers, including Johns Hopkins, Yale, the University of Pennsylvania, and Spaulding Rehabilitation Hospital, part of Partners HealthCare in Boston.\u003c/p>\n\u003cp>So, where’s the evidence supporting it?\u003c/p>\n\u003caside class=\"pullquote alignright\">'If it doesn't work, I don't know that you've lost anything. If it does, you do get to a better place.' \u003ccite>Dr. Richard Lang, Cleveland Clinic\u003c/cite>\u003c/aside>\n\u003cp>There is none, according to a division of the National Institutes of Health that funds research into alternative medicines. It says the practice has not been shown to be useful for “any health-related purpose” — and adds that there is no scientific evidence that the “natural healing energy” it’s based on even exists.\u003c/p>\n\u003cp>Asked about the Cleveland Clinic’s promotion of reiki, Dr. Richard Lang, the recently named interim director of the clinic’s Wellness Institute, said he hadn’t had a chance to think about it. “I don’t know that I could give you a plus or minus on that,” he said. Lang served as a vice chair of the Wellness Institute for nearly a decade before taking the top post.\u003c/p>\n\u003cp>Pressed for a more substantive answer, the clinic sent a statement saying it offers energy medicine as a complementary therapy, not as a replacement solution. But its website only briefly alludes to a patient’s broader “care team” in describing a “full range of emotional and physical issues” that can be treated with energy therapies, including autoimmune diseases, migraines, hormonal imbalances, and “cancer treatment support and recovery.”\u003c/p>\n\u003cp>Academic medical centers often boast that they’re more rigorous in evaluating alternative therapies — and weeding out scams — than a for-profit wellness center might be.\u003c/p>\n\u003cp>“The important thing about practicing in an academic center is that we must hold ourselves to certain standards,” said Estores, the medical director at the University of Florida’s integrative medicine clinic.\u003c/p>\n\u003cp>At the University of Pittsburgh, Glick echoed that sentiment: “We’re an academic institution … [so] we’re offering services that have greater evidence basis [and] scientific explanation.”\u003c/p>\n\u003cp>But that evidence isn’t always rigorous.\u003c/p>\n\u003cp>The University of Florida, for instance, is using Facebook to advertise an herbal medicine workshop for providers and the public that promises to answer questions including, “How can we stabilize or reverse Alzheimer’s disease?”\u003c/p>\n\u003cp>Asked about the evidence for that statement, Susan Marynowski, the herbalist presenting the workshop, cited several papers and a book chapter that she said showed herbs, in conjunction with lifestyle adjustments, could reverse Alzheimer’s-associated memory loss. However, at least two of those papers were small collections of case studies published in a journal with a reputation for less-than-rigorous review. (Marynowski said she knew the studies’ size and design limited the strength of their conclusions, but that she was not aware of the journal’s reputation.)\u003c/p>\n\u003cp>At Pittsburgh, the integrative medical center does take care to note on its website that alternative therapies “generally have not been subjected to the same level of research as standard medical approaches.”\u003c/p>\n\u003cp>But the site then goes on to promote dozens of treatments for everything from ADHD to whiplash, saying they have “appeared to be beneficial in this and other complementary medicine clinics.” (Glick noted that the body of research had grown since he wrote the caveat on the website in 2003.)\u003c/p>\n\u003cp>\u003cstrong>‘It’s not Black and White’\u003c/strong>\u003c/p>\n\u003cp>Perhaps the most prevalent alternative treatment STAT found on offer is acupuncture. It’s promoted for more than a dozen conditions, including high blood pressure, sinus problems, infertility, migraines, and digestive irregularities.\u003c/p>\n\u003cp>A 3,000-year-old Chinese therapy, acupuncture is based on the belief that by stimulating certain points on the body, most often with needles, practitioners can unlock a natural healing energy that flows through the body’s “meridians.” Research suggests it helps with certain pain conditions and might help prevent migraine headaches — but it also suggests that the placebo effect may play an important role.\u003c/p>\n\u003cp>Its value in treating other conditions is uncertain, according to the NIH’s center on integrative medicine.\u003c/p>\n\u003cp>Several major insurers, including Aetna, Anthem, and regional Blue Cross Blue Shield affiliates, cover acupuncture as a treatment for chronic pain and nausea. But the Centers for Medicare and Medicaid Services won’t pay for acupuncture, dismissing the scientific evidence as insufficient.\u003c/p>\n\u003cp>Still, it’s important for physicians to keep an open mind, said Lang, the interim director of the Cleveland Clinic Wellness Institute.\u003c/p>\n\u003cp>He said, for example, that he used to avoid referring patients for acupuncture, until he saw the benefit it provided to some of them. “I have seen it work in some chronic pain situations,” said Lang. “It can be very helpful. If it doesn’t work, I don’t know that you’ve lost anything. If it does, you do get to a better place.”\u003c/p>\n\u003cp>And while the evidence of its efficacy is not ironclad, neither is the evidence for various pharmaceutical therapies that are routinely provided by hospitals and covered by insurance. Some of those solutions, such as opioids to treat pain, have resulted in addiction and harm to patients.\u003c/p>\n\u003cp>Advocates of alternative medicine say it’s difficult to test some alternative therapies through rigorous clinical trials, primarily because treatment techniques vary from patient to patient. (The federal government does, however, spend roughly $120 million a year to fund research through the NIH National Center for Complementary and Integrative Health.)\u003c/p>\n\u003cp>They note, too, that traditional doctors sometimes stray from proven treatments, for instance when they prescribe medicines off-label for conditions the drugs have not been approved to treat.\u003c/p>\n\u003cp>“We do use things that aren’t necessarily 100 percent evidence-based, but I would argue that’s also true within all of medicine,” said Dr. Jill Schneiderhan, co-director of the University of Michigan’s integrative family medicine program. “I feel like it’s not black and white.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/03/07/alternative-medicine-hospitals-promote/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>They’re among the nation’s premier medical centers, at the leading edge of scientific research.\u003c/p>\n\u003cp>Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing. They offer “energy healing” to help treat multiple sclerosis, acupuncture for infertility, and homeopathic bee venom for fibromyalgia. A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)\u003c/p>\n\u003cp>This embrace of alternative medicine has been building for years. But a STAT examination of 15 academic research centers across the U.S. underscores just how deeply these therapies have become embedded in prestigious hospitals and medical schools.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We've become witch doctors ... [forfeiting] any claim that we had to be a science-based profession.'\u003ccite>Dr. Steven Novella, Yale School of Medicine \u003c/cite>\u003c/aside>\n\u003cp>Some hospitals have built luxurious, spa-like wellness centers to draw patients for spiritual healing, homeopathy and more. And they’re promoting such treatments for a wide array of conditions, including depression, heart disease, cancer, and chronic pain. Duke even markets a pediatric program that suggests on its website that alternative medicine, including “detoxification programs” and “botanical medicines,” can help children with conditions ranging from autism to asthma to ADHD.\u003c/p>\n\u003cp>“We’ve become witch doctors,” said Dr. Steven Novella, a professor of neurology at the Yale School of Medicine and a longtime critic of alternative medicine.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>STAT’s examination found a booming market for such therapies: The clinic at the University of California, San Francisco, is growing so fast, it’s bursting out of its space.\u003c/p>\n\u003cp>Just in the past year, the teaching hospital connected to the University of Florida began offering cancer patients consultations in homeopathy and traditional Chinese herbal medicine. Thomas Jefferson University in Philadelphia launched an institute whose offerings include \u003ca href=\"https://www.statnews.com/2017/02/23/vitamin-iv-infusion/\" target=\"_blank\">intravenous vitamin and mineral therapies\u003c/a>. And the University of Arizona, a pioneer in the field, received a $1 million gift to boost practitioner training in natural and spiritual healing techniques.\u003c/p>\n\u003cp>Even as they count on these programs to bring in patients and revenue, several hospitals were reluctant to talk to STAT about why they’re lending their distinguished names to unproven therapies.\u003c/p>\n\u003cp>Duke Health declined repeated requests for interviews about its rapidly growing integrative medicine center, which \u003ca href=\"https://www.dukeintegrativemedicine.org/wp-content/uploads/2016/02/primarycare-brochure-web.pdf\" target=\"_blank\">charges patients $1,800 a year\u003c/a> just for a basic membership, with acupuncture and other treatments billed separately.\u003c/p>\n\u003cp>MedStar Georgetown quietly edited its website, citing changes to its clinical offerings, after a reporter asked why it listed the energy healing practice of reiki as a therapy for blood cancer. Cleveland Clinic struggled to find anyone on its staff to defend the hospital’s energy medicine program, ultimately issuing a statement that it’s “responding to the needs of our patients and patient demand.”\u003c/p>\n\u003cp>And the director of an alternative medicine program at another prestigious hospital declined to speak on the record — out of fear, he said, that his remarks would be construed as “fake news” and stir a backlash.\u003c/p>\n\u003cp>The rise of alternative therapies has sparked tension in some hospitals, with doctors openly accusing their peers of peddling snake oil and undermining the credibility of their institutions.\u003c/p>\n\u003cp>By promoting such therapies, Novella said, physicians are forfeiting “any claim that we had to being a science-based profession.”\u003c/p>\n\u003cp>As for patients? They’re “being snookered,” he said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what's best for a patient. Who am I to say that's hogwash?' \u003ccite>Dr. Linda Lee, Johns Hopkins gastroenterologist\u003c/cite>\u003c/aside>\n\u003cp>The counterargument: Modern medicine clearly can’t cure everyone. It fails a great many patients. So why not encourage them to try an ancient Indian remedy or a spiritual healing technique that’s unlikely to cause harm — and may provide some relief, if only from the placebo effect?\u003c/p>\n\u003cp>“Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what’s best for a patient. Who am I to say that’s hogwash?” said Dr. Linda Lee.\u003c/p>\n\u003cp>A gastroenterologist, Lee runs the Johns Hopkins Integrative Medicine and Digestive Center, which offers acupuncture, massage therapy, and reiki — a therapy that the center’s website describes as laying on hands \u003ca href=\"http://www.hopkinsmedicine.org/integrative_medicine_digestive_center/services/reiki.html\" target=\"_blank\">“to transmit Universal Life Energy”\u003c/a> to the patient.\u003c/p>\n\u003cp>Lee and others who promote alternative therapies are careful to say that they can supplement — but can’t replace — conventional treatments. And they make a point of coordinating care with other doctors so that, for instance, patients don’t get prescribed herbal supplements that might interact badly with their chemotherapy.\u003c/p>\n\u003cp>“Here at UF, we do not have alternative medicine. We do not have complementary medicine. We have integrative medicine,” said Dr. Irene Estores, medical director of the integrative medicine program at the University of Florida Shands Hospital in Gainesville, Fla.\u003c/p>\n\u003cp>\u003cstrong>Online Promotions Offer Scant Evidence\u003c/strong>\u003c/p>\n\u003cp>But while those cautions may come through in the clinic, the hospitals also promote alternative medicine online — often, without any nuance.\u003c/p>\n\u003cp>Duke’s Integrative Medicine store, for instance, sells \u003ca href=\"https://shopprovisions.dukestores.duke.edu/index.php?main_page=product_info&cPath=37_1&products_id=196\" target=\"_blank\">“Po Chai Pills”\u003c/a> that are touted on the hospital’s website as a cure for everything from belching to hangovers to headaches. The site explains that taking a pill “harmonizes the stomach, stems counterflow ascent of stomach qi, dispels damp, dispels pathogenic factors, subdues yang, relieves pain.” None of that makes sense in modern biomedical terms.\u003c/p>\n\u003cp>Thomas Jefferson University Hospital’s website touts \u003ca href=\"http://hospitals.jefferson.edu/tests-and-treatments/homeopathic-medicine.html\" target=\"_blank\">homeopathic bee venom\u003c/a> as useful to relieve symptoms for arthritis, nerve pain, and other conditions. The site does tell patients that the biological mechanism for the treatment is “unexplained” but asserts that studies “have been published in medical journals showing homeopathic medicines may provide clinical benefit.”\u003c/p>\n\u003cp>Asked about the therapy, Dr. Daniel Monti, who directs the integrative health center, acknowledged that the data is “largely anecdotal,” and said the hospital offers the treatment only rarely, “when there are few other options.” But those caveats don’t come through on the website.\u003c/p>\n\u003cp>Novella gets alarmed when he sees top-tier hospitals backing therapies with scant evidence behind them. “Patients only want [alternative medicine] because they’re being told they should want it. They see a prestigious hospital is offering it, so they think it’s legitimate,” said Novella.\u003c/p>\n\u003cp>“The perpetuation of these practices is a victory of marketing over truth,” said Steven Salzberg, a biomedical engineer at Johns Hopkins who lectures in the medical school. If a hospital is “offering treatment that’s based on fantasy, it undermines the credibility of the institution.”\u003c/p>\n\u003cp>The debate burst into the public view earlier this year when the medical director of the Cleveland Clinic’s Wellness Institute — which markets a variety of alternative therapies — \u003ca href=\"https://www.statnews.com/2017/01/07/anti-vaccine-claims-cleveland-clinic/\" target=\"_blank\">published an article\u003c/a> raising discredited theories linking vaccines to autism.\u003c/p>\n\u003cp>Cleveland Clinic’s chief executive, Dr. Toby Cosgrove, disavowed the article. And the clinic told STAT last week that it will take down its online wellness store and stop selling homeopathy kits.\u003c/p>\n\u003cp>But Cosgrove has stood up for the general principle of offering alternative treatments.\u003c/p>\n\u003cp>“The old way of combating chronic disease hasn’t worked,” Cosgrove wrote in a column posted on the hospital’s website. “… We have heard from our patients that they want more than conventional medicine can offer.”\u003c/p>\n\u003cfigure id=\"attachment_351821\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/03/bee-venom-800x530.jpg\">\u003cfigcaption class=\"wp-caption-text\">Thomas Jefferson University Hospital’s website touts homeopathic bee venom as useful to relieve symptoms for arthritis, nerve pain, and other conditions. The site tells patients that the biological mechanism for the treatment is “unexplained.” \u003ccite>(erierika/iStock)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Booming Market for ‘Natural’ Therapies\u003c/strong>\u003c/p>\n\u003cp>There’s no question that patients want alternative medicine. It’s a $37 billion-a-year business.\u003c/p>\n\u003cp>The typical American adult spent about $800 out of pocket in 2012 on dietary supplements and visits to alternative providers, such as naturopaths and acupuncturists, according to the federal Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Hospitals have taken note. A national consortium to promote integrative health now counts more than 70 academic centers and health systems as members, up from eight in 1999. Each year, four or five new programs join, said Dr. Leslie Mendoza Temple, the chair of the consortium’s policy working group.\u003c/p>\n\u003cp>In most cases, insurers won’t cover alternative therapies — there’s simply not enough evidence that they actually work — so patients pay out of pocket: $85 for acupuncture, $100 for reiki, $38 for pills made from thyme and oregano oils that promise to “harmonize digestive and respiratory function.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'The people running the hospitals are doctors, but they also have MBAs. They talk of patients as customers. ... Your job is to sell them what they want.' \u003ccite>Arthur Caplan, New York University bioethicist\u003c/cite>\u003c/aside>\n\u003cp>To be sure, not all such integrative medicine clinics are big profit centers. Many are funded by philanthropists, and some hospitals say their programs operate at a loss — but are nonetheless essential to woo patients in a highly competitive marketplace. If they failed to offer “natural” therapies, some hospital executives fear they would lose a chance to attract patients who need more lucrative care, such as orthopedic surgeries or cancer treatments.\u003c/p>\n\u003cp>The integrative medicine center at Thomas Jefferson, for instance, is part of an “enterprise strategy for growth and development,” Monti said.\u003c/p>\n\u003cp>“The people running the hospitals are doctors, but they also have MBAs. They talk of patients as customers. Customers have demands. Your job is to sell them what they want,” said Arthur Caplan, a bioethicist at New York University’s medical school. Too often, he said, the attitude is, “We’re damn well going to do it if the guys down the street are doing it.”\u003c/p>\n\u003cp>While most hospitals declined to give specific revenue figures, STAT found indications of rapid growth.\u003c/p>\n\u003cp>“We’re literally bursting. We have to convert office space to clinic exam rooms,” said Shelley Adler, who runs the Osher Center for Integrative Medicine at the University of California, San Francisco. It offers a wide range of services, including Chinese herbal medicine, massage therapy, and Ayurveda, an ancient healing system from India based on the belief that health results from a balance between the mind, body, and spirit.\u003c/p>\n\u003cp>The center is on pace to get more than 10,300 patient visits this fiscal year, up 37 percent from 2012. It’s expanding its clinical staff by a third.\u003c/p>\n\u003cp>Duke University’s integrative medicine clinic, a stunning space with arching wood ceilings and an indoor garden, has seen strong growth: Total visits jumped 50 percent in 2015, to more than 14,000, Dr. Adam Perlman, the executive director, told IntegrativePractitioner.com. (He declined to talk to STAT.)\u003c/p>\n\u003cp>The center’s membership count also jumped, up 25 percent to 885, Perlman said. If all members paid the list price, that would bring in more than $1 million a year just for primary care.\u003c/p>\n\u003cp>At the University of Pittsburgh’s Center for Integrative Medicine, meanwhile, “our volume pretty much has increased steadily, even when we’ve had recessions and financial downturns,” said Dr. Ronald Glick, the medical director. The center now treats about 8,000 patients a year.\u003c/p>\n\u003cp>Many hospitals have also expanded into more general “wellness” offerings, with classes in healthy cooking, tai chi, meditation, and art therapy. UCSF offers a $375 class on “cultivating emotional balance” (and a free class on “laughter yoga”). Mayo Clinic sells a $2,900 “signature experience,” which includes consultations with a wellness coach.\u003c/p>\n\u003cp>And the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital offers specialized stress management services to help patients deal with conditions including cancer, infertility, and menopause. John Henry, the owner of STAT, has contributed funding to the Benson-Henry Institute.\u003c/p>\n\u003cp>Wellness programs — which are designed to ease stress and encourage healthy behaviors — are seen by many clinicians and hospitals as key to slowing America’s epidemic of chronic disease. They don’t tend to draw sharp criticism, except for their cost.\u003c/p>\n\u003cp>It’s the alternative therapies promoted as a way to treat disease that raise eyebrows.\u003c/p>\n\u003cp>\u003cstrong>‘Energy Healing’ Takes Root\u003c/strong>\u003c/p>\n\u003cp>Despite their deep wells of medical expertise, many top hospitals are offering to help treat serious medical problems with reiki — a practice based on the belief that lightly touching patients can unleash a cosmic energy flow that will heal them naturally.\u003c/p>\n\u003cp>STAT found that it is widely used by academic medical centers, including Johns Hopkins, Yale, the University of Pennsylvania, and Spaulding Rehabilitation Hospital, part of Partners HealthCare in Boston.\u003c/p>\n\u003cp>So, where’s the evidence supporting it?\u003c/p>\n\u003caside class=\"pullquote alignright\">'If it doesn't work, I don't know that you've lost anything. If it does, you do get to a better place.' \u003ccite>Dr. Richard Lang, Cleveland Clinic\u003c/cite>\u003c/aside>\n\u003cp>There is none, according to a division of the National Institutes of Health that funds research into alternative medicines. It says the practice has not been shown to be useful for “any health-related purpose” — and adds that there is no scientific evidence that the “natural healing energy” it’s based on even exists.\u003c/p>\n\u003cp>Asked about the Cleveland Clinic’s promotion of reiki, Dr. Richard Lang, the recently named interim director of the clinic’s Wellness Institute, said he hadn’t had a chance to think about it. “I don’t know that I could give you a plus or minus on that,” he said. Lang served as a vice chair of the Wellness Institute for nearly a decade before taking the top post.\u003c/p>\n\u003cp>Pressed for a more substantive answer, the clinic sent a statement saying it offers energy medicine as a complementary therapy, not as a replacement solution. But its website only briefly alludes to a patient’s broader “care team” in describing a “full range of emotional and physical issues” that can be treated with energy therapies, including autoimmune diseases, migraines, hormonal imbalances, and “cancer treatment support and recovery.”\u003c/p>\n\u003cp>Academic medical centers often boast that they’re more rigorous in evaluating alternative therapies — and weeding out scams — than a for-profit wellness center might be.\u003c/p>\n\u003cp>“The important thing about practicing in an academic center is that we must hold ourselves to certain standards,” said Estores, the medical director at the University of Florida’s integrative medicine clinic.\u003c/p>\n\u003cp>At the University of Pittsburgh, Glick echoed that sentiment: “We’re an academic institution … [so] we’re offering services that have greater evidence basis [and] scientific explanation.”\u003c/p>\n\u003cp>But that evidence isn’t always rigorous.\u003c/p>\n\u003cp>The University of Florida, for instance, is using Facebook to advertise an herbal medicine workshop for providers and the public that promises to answer questions including, “How can we stabilize or reverse Alzheimer’s disease?”\u003c/p>\n\u003cp>Asked about the evidence for that statement, Susan Marynowski, the herbalist presenting the workshop, cited several papers and a book chapter that she said showed herbs, in conjunction with lifestyle adjustments, could reverse Alzheimer’s-associated memory loss. However, at least two of those papers were small collections of case studies published in a journal with a reputation for less-than-rigorous review. (Marynowski said she knew the studies’ size and design limited the strength of their conclusions, but that she was not aware of the journal’s reputation.)\u003c/p>\n\u003cp>At Pittsburgh, the integrative medical center does take care to note on its website that alternative therapies “generally have not been subjected to the same level of research as standard medical approaches.”\u003c/p>\n\u003cp>But the site then goes on to promote dozens of treatments for everything from ADHD to whiplash, saying they have “appeared to be beneficial in this and other complementary medicine clinics.” (Glick noted that the body of research had grown since he wrote the caveat on the website in 2003.)\u003c/p>\n\u003cp>\u003cstrong>‘It’s not Black and White’\u003c/strong>\u003c/p>\n\u003cp>Perhaps the most prevalent alternative treatment STAT found on offer is acupuncture. It’s promoted for more than a dozen conditions, including high blood pressure, sinus problems, infertility, migraines, and digestive irregularities.\u003c/p>\n\u003cp>A 3,000-year-old Chinese therapy, acupuncture is based on the belief that by stimulating certain points on the body, most often with needles, practitioners can unlock a natural healing energy that flows through the body’s “meridians.” Research suggests it helps with certain pain conditions and might help prevent migraine headaches — but it also suggests that the placebo effect may play an important role.\u003c/p>\n\u003cp>Its value in treating other conditions is uncertain, according to the NIH’s center on integrative medicine.\u003c/p>\n\u003cp>Several major insurers, including Aetna, Anthem, and regional Blue Cross Blue Shield affiliates, cover acupuncture as a treatment for chronic pain and nausea. But the Centers for Medicare and Medicaid Services won’t pay for acupuncture, dismissing the scientific evidence as insufficient.\u003c/p>\n\u003cp>Still, it’s important for physicians to keep an open mind, said Lang, the interim director of the Cleveland Clinic Wellness Institute.\u003c/p>\n\u003cp>He said, for example, that he used to avoid referring patients for acupuncture, until he saw the benefit it provided to some of them. “I have seen it work in some chronic pain situations,” said Lang. “It can be very helpful. If it doesn’t work, I don’t know that you’ve lost anything. If it does, you do get to a better place.”\u003c/p>\n\u003cp>And while the evidence of its efficacy is not ironclad, neither is the evidence for various pharmaceutical therapies that are routinely provided by hospitals and covered by insurance. Some of those solutions, such as opioids to treat pain, have resulted in addiction and harm to patients.\u003c/p>\n\u003cp>Advocates of alternative medicine say it’s difficult to test some alternative therapies through rigorous clinical trials, primarily because treatment techniques vary from patient to patient. (The federal government does, however, spend roughly $120 million a year to fund research through the NIH National Center for Complementary and Integrative Health.)\u003c/p>\n\u003cp>They note, too, that traditional doctors sometimes stray from proven treatments, for instance when they prescribe medicines off-label for conditions the drugs have not been approved to treat.\u003c/p>\n\u003cp>“We do use things that aren’t necessarily 100 percent evidence-based, but I would argue that’s also true within all of medicine,” said Dr. Jill Schneiderhan, co-director of the University of Michigan’s integrative family medicine program. “I feel like it’s not black and white.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
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"title": "Rightnowish",
"tagline": "Art is where you find it",
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"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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