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"content": "\u003cp>Unless you've been blissfully unplugged, you must have come across the term \"blackout\" lately. And you may have thought it means inebriated to the point of unconsciousness. Falling-down drunk. Blotto.[contextly_sidebar id=\"UNiHL8eB1QjUnbIxSw8VWUrjWiq8mQov\"]\u003c/p>\n\u003cp>Supreme Court nominee Brett Kavanaugh appears to think so, based on \u003ca href=\"https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.953b6f43eb3c\" target=\"_blank\" rel=\"noopener\">this exchange\u003c/a> last Thursday during his fiery self-defense before the Senate Judiciary Committee:\u003c/p>\n\u003cblockquote>\u003cp>\"Have you ever passed out from drinking?\" queried Rachel Mitchell, a sex crimes prosecutor from Phoenix retained by Republicans to ask question at the hearing.\u003c/p>\n\u003cp>\"Passed out would be — no. But I've gone to sleep. But — but I've never blacked out,\" Kavanaugh replied. \"That's the — allegation, and that — that's wrong.\"\u003c/p>\u003c/blockquote>\n\u003cp>But that notion of an alcohol-induced blackout is wrong.\u003c/p>\n\u003cp>A less confusing term might be \"alcohol-induced amnesia.\" It can be total. Hours of experience and events can be totally missing from memory. Or it can be spotty. Either way, it can be hard to impossible for a bystander, or even the inebriated person, to know when it has happened.\u003c/p>\n\u003cp>Misunderstanding blackouts has big implications. The phenomenon could reconcile the disconnect between what psychologist Christine Blasey Ford says she remembers so indelibly about an alleged sexual assault by Kavanaugh one summer evening 36 years ago and Kavanaugh's categorical denial that it ever happened.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To understand the phenomenon, I talked with Dr. \u003ca href=\"https://www.bu.edu/sph/profile/richard-saitz/\" target=\"_blank\" rel=\"noopener\">Richard Saitz\u003c/a>, chair of Boston University School of Public Health's Department of Community Health Sciences, a veteran researcher of alcohol abuse and an addiction medicine specialist. Our conversation, edited:\u003c/p>\n\u003cp>\u003cstrong>There's been recent confusion about alcohol-related blackouts — what they are and what they aren't. What's been your reaction to the use of the term lately?\u003c/strong>\u003c/p>\n\u003cp>Many people confuse the idea of a blackout with someone who's had so much to drink that they are unarousable — they're not awake and they don't know what's going on. That's not at all the case. A blackout is when you don't remember what happened. You can appear to be completely awake. An observer can't tell when someone is in the midst of not forming a memory.\u003c/p>\n\u003cp>The second common misconception is that having a blackout is characteristic of an alcohol use disorder more commonly called alcoholism — that you only have blackouts if you have an alcohol use disorder. And that's just not true.\u003c/p>\n\u003cp>\u003cstrong>It's a curious phenomenon — a very selective kind of temporary memory impairment. What's going on in there?\u003c/strong>\u003c/p>\n\u003cp>It involves those parts of the brain that are required to take in what's happening and allow you to remember it later. You might remember it two or three minutes later but not 10 hours later or two days later or ever again, because it didn't get permanently encoded by the brain. It probably happens in the hippocampus and it involves the frontal lobes of the brain as well.[contextly_sidebar id=\"nWd7zNE3xlJLE0K0o8Op2Mrh7FV5jCXX\"]\u003c/p>\n\u003cp>\u003cstrong>What touches it off?\u003c/strong>\u003c/p>\n\u003cp>If you drink a substantial amount quickly, you might experience a blackout. Drinking games would be an example of that because that's the point of the game.\u003c/p>\n\u003cp>\u003cstrong>How common are blackouts?\u003c/strong>\u003c/p>\n\u003cp>We don't have great epidemiologic data about this. I've seen the prevalence of blackouts ranging anywhere from 10 percent to up to 50 percent of young people who drink. It's fair to say it's not rare.\u003c/p>\n\u003cp>\u003cstrong>Does blackout seem to explain, at least potentially, the great divergence we heard last week in the testimony of Ford and Kavanaugh?\u003c/strong>\u003c/p>\n\u003cp>It's plausible that if he were drinking heavily and rapidly that he might have a blackout. So it's possible he might have no recollection of what happened.\u003c/p>\n\u003cp>\u003cstrong>What do you think when you hear Kavanaugh say, in response to a question about whether he's ever \"passed out from drinking,\" that he's \"gone to sleep, but ... never blacked out\"?\u003c/strong>\u003c/p>\n\u003cp>I have no knowledge of what Judge Kavanaugh knows about the definition of \"blackout\" versus \"passing out\" versus \"falling asleep after drinking.\" Passed out is not a clinical term and usually people use it to mean that they drank so much that they ended up falling asleep. I'm not sure if he could say that he had a blackout or not. The only way he would know is if somebody later told him that something happened while he was intoxicated and he didn't remember it, and then he believed they were telling the truth. So it's not a particularly easy question to answer unless you know the definition of blackout and your memory has been questioned, or somebody told you about it.[contextly_sidebar id=\"cOFlriGvdakmZZ3kgLOVmpocMiXNOj0A\"]\u003c/p>\n\u003cp>\u003cstrong>Ford placed Kavanaugh's companion, Mark Judge, in the room where the alleged assault occurred. If he also was drinking heavily and also had a blackout, neither of them would remember and nobody else would be in a position to call their attention to it.\u003c/strong>\u003c/p>\n\u003cp>Sure. It's conceivable they both could have had a blackout about the same event, although that begins to get a little bit less likely. If there was someone there to say that something happened, that's the only way you could come close to knowing.\u003c/p>\n\u003cp>\u003cstrong>If you were consulted by the FBI, which is trying to unravel all this, what would you advise them to consider in light of the blackout phenomenon? What should they be alert to?\u003c/strong>\u003c/p>\n\u003cp>They need to be aware that it's certainly possible there could have been something that happened that [Kavanaugh] might have no memory of. So if he says something didn't happen and it was supposed to have happened during a heavy drinking episode, then it's possible he has no memory of it. And so therefore they need to find other evidence or ask someone else, because his denial is questionable.\u003c/p>\n\u003cp>I would also tell them that it's unlikely, at that age and in that context, that this would have happened only once. It's likely he'd have had a blackout on some other occasion. And so there might be evidence of that.\u003c/p>\n\u003cp>\u003cstrong>It seems as though this whole phenomenon of blackouts is a really big public health issue. Because people may do things in that state, such as committing sexual assault, that they don't feel personally responsible for later.\u003c/strong>\u003c/p>\n\u003cp>The real problem with blackouts is that you don't remember. And so you can't learn from your behavior unless someone tells you that you did something terrible.\u003c/p>\n\u003cp>\u003cstrong>Shouldn't public health educators and message-makers address blackouts? Don't teens and young adults need to understand more about this phenomenon? That it's not simply a question of moral failure but it's the way the brain acts in some people, in certain situations?\u003c/strong>\u003c/p>\n\u003cp>You're absolutely right. This is not a moral judgment about whether people are drinking too much or not. This is a toxic biological effect of something that you're taking in that affects your brain in this way and makes it so that you can't remember what happened.\u003c/p>\n\u003cp>This afternoon our school of public health is having a conversation with students and faculty about sexual assault. So it's a teaching opportunity for that. And more broadly, it's a teaching opportunity around alcohol use and heavy drinking.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>A version of this story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\">CommonHealth\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Don%27t+Have+To+Pass+Out+To+Be+Blackout+Drunk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Unless you've been blissfully unplugged, you must have come across the term \"blackout\" lately. And you may have thought it means inebriated to the point of unconsciousness. Falling-down drunk. Blotto.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Supreme Court nominee Brett Kavanaugh appears to think so, based on \u003ca href=\"https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.953b6f43eb3c\" target=\"_blank\" rel=\"noopener\">this exchange\u003c/a> last Thursday during his fiery self-defense before the Senate Judiciary Committee:\u003c/p>\n\u003cblockquote>\u003cp>\"Have you ever passed out from drinking?\" queried Rachel Mitchell, a sex crimes prosecutor from Phoenix retained by Republicans to ask question at the hearing.\u003c/p>\n\u003cp>\"Passed out would be — no. But I've gone to sleep. But — but I've never blacked out,\" Kavanaugh replied. \"That's the — allegation, and that — that's wrong.\"\u003c/p>\u003c/blockquote>\n\u003cp>But that notion of an alcohol-induced blackout is wrong.\u003c/p>\n\u003cp>A less confusing term might be \"alcohol-induced amnesia.\" It can be total. Hours of experience and events can be totally missing from memory. Or it can be spotty. Either way, it can be hard to impossible for a bystander, or even the inebriated person, to know when it has happened.\u003c/p>\n\u003cp>Misunderstanding blackouts has big implications. The phenomenon could reconcile the disconnect between what psychologist Christine Blasey Ford says she remembers so indelibly about an alleged sexual assault by Kavanaugh one summer evening 36 years ago and Kavanaugh's categorical denial that it ever happened.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To understand the phenomenon, I talked with Dr. \u003ca href=\"https://www.bu.edu/sph/profile/richard-saitz/\" target=\"_blank\" rel=\"noopener\">Richard Saitz\u003c/a>, chair of Boston University School of Public Health's Department of Community Health Sciences, a veteran researcher of alcohol abuse and an addiction medicine specialist. Our conversation, edited:\u003c/p>\n\u003cp>\u003cstrong>There's been recent confusion about alcohol-related blackouts — what they are and what they aren't. What's been your reaction to the use of the term lately?\u003c/strong>\u003c/p>\n\u003cp>Many people confuse the idea of a blackout with someone who's had so much to drink that they are unarousable — they're not awake and they don't know what's going on. That's not at all the case. A blackout is when you don't remember what happened. You can appear to be completely awake. An observer can't tell when someone is in the midst of not forming a memory.\u003c/p>\n\u003cp>The second common misconception is that having a blackout is characteristic of an alcohol use disorder more commonly called alcoholism — that you only have blackouts if you have an alcohol use disorder. And that's just not true.\u003c/p>\n\u003cp>\u003cstrong>It's a curious phenomenon — a very selective kind of temporary memory impairment. What's going on in there?\u003c/strong>\u003c/p>\n\u003cp>It involves those parts of the brain that are required to take in what's happening and allow you to remember it later. You might remember it two or three minutes later but not 10 hours later or two days later or ever again, because it didn't get permanently encoded by the brain. It probably happens in the hippocampus and it involves the frontal lobes of the brain as well.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What touches it off?\u003c/strong>\u003c/p>\n\u003cp>If you drink a substantial amount quickly, you might experience a blackout. Drinking games would be an example of that because that's the point of the game.\u003c/p>\n\u003cp>\u003cstrong>How common are blackouts?\u003c/strong>\u003c/p>\n\u003cp>We don't have great epidemiologic data about this. I've seen the prevalence of blackouts ranging anywhere from 10 percent to up to 50 percent of young people who drink. It's fair to say it's not rare.\u003c/p>\n\u003cp>\u003cstrong>Does blackout seem to explain, at least potentially, the great divergence we heard last week in the testimony of Ford and Kavanaugh?\u003c/strong>\u003c/p>\n\u003cp>It's plausible that if he were drinking heavily and rapidly that he might have a blackout. So it's possible he might have no recollection of what happened.\u003c/p>\n\u003cp>\u003cstrong>What do you think when you hear Kavanaugh say, in response to a question about whether he's ever \"passed out from drinking,\" that he's \"gone to sleep, but ... never blacked out\"?\u003c/strong>\u003c/p>\n\u003cp>I have no knowledge of what Judge Kavanaugh knows about the definition of \"blackout\" versus \"passing out\" versus \"falling asleep after drinking.\" Passed out is not a clinical term and usually people use it to mean that they drank so much that they ended up falling asleep. I'm not sure if he could say that he had a blackout or not. The only way he would know is if somebody later told him that something happened while he was intoxicated and he didn't remember it, and then he believed they were telling the truth. So it's not a particularly easy question to answer unless you know the definition of blackout and your memory has been questioned, or somebody told you about it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Ford placed Kavanaugh's companion, Mark Judge, in the room where the alleged assault occurred. If he also was drinking heavily and also had a blackout, neither of them would remember and nobody else would be in a position to call their attention to it.\u003c/strong>\u003c/p>\n\u003cp>Sure. It's conceivable they both could have had a blackout about the same event, although that begins to get a little bit less likely. If there was someone there to say that something happened, that's the only way you could come close to knowing.\u003c/p>\n\u003cp>\u003cstrong>If you were consulted by the FBI, which is trying to unravel all this, what would you advise them to consider in light of the blackout phenomenon? What should they be alert to?\u003c/strong>\u003c/p>\n\u003cp>They need to be aware that it's certainly possible there could have been something that happened that [Kavanaugh] might have no memory of. So if he says something didn't happen and it was supposed to have happened during a heavy drinking episode, then it's possible he has no memory of it. And so therefore they need to find other evidence or ask someone else, because his denial is questionable.\u003c/p>\n\u003cp>I would also tell them that it's unlikely, at that age and in that context, that this would have happened only once. It's likely he'd have had a blackout on some other occasion. And so there might be evidence of that.\u003c/p>\n\u003cp>\u003cstrong>It seems as though this whole phenomenon of blackouts is a really big public health issue. Because people may do things in that state, such as committing sexual assault, that they don't feel personally responsible for later.\u003c/strong>\u003c/p>\n\u003cp>The real problem with blackouts is that you don't remember. And so you can't learn from your behavior unless someone tells you that you did something terrible.\u003c/p>\n\u003cp>\u003cstrong>Shouldn't public health educators and message-makers address blackouts? Don't teens and young adults need to understand more about this phenomenon? That it's not simply a question of moral failure but it's the way the brain acts in some people, in certain situations?\u003c/strong>\u003c/p>\n\u003cp>You're absolutely right. This is not a moral judgment about whether people are drinking too much or not. This is a toxic biological effect of something that you're taking in that affects your brain in this way and makes it so that you can't remember what happened.\u003c/p>\n\u003cp>This afternoon our school of public health is having a conversation with students and faculty about sexual assault. So it's a teaching opportunity for that. And more broadly, it's a teaching opportunity around alcohol use and heavy drinking.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>A version of this story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\">CommonHealth\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Don%27t+Have+To+Pass+Out+To+Be+Blackout+Drunk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sexual Assault And Harassment May Have Lasting Health Repercussions For Women",
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"content": "\u003cp>The trauma of sexual assault or harassment is not only hard to forget; it may also leave lasting effects on a woman's health. This finding of a study \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886\" target=\"_blank\" rel=\"noopener\">published Wednesday\u003c/a> adds support to a growing body of evidence suggesting the link.[contextly_sidebar id=\"HEpAUbCt2g19YW7Y7Rht6rrTaYElddh0\"]\u003c/p>\n\u003cp>In the study of roughly 300 middle-aged women, an experience of sexual assault was associated with anxiety, depression and poor sleep. A history of workplace sexual harassment was also associated with poor sleep and with an increased risk of developing high blood pressure.\u003c/p>\n\u003cp>\"These are experiences that [a woman] could have had long ago ... and it can have this long arm of influence throughout a woman's life,\" says \u003ca href=\"https://www.publichealth.pitt.edu/home/directory/rebecca-thurston\">Rebecca Thurston\u003c/a>, lead author of the study, and a research psychologist and director of the Women's Behavioral Health Laboratory at the University of Pittsburgh.\u003c/p>\n\u003cp>The study data come from a survey of healthy women between ages 40 and 60 who had been recruited for a study on menopause and cardiovascular disease — not sexual harassment or assault. They all had their blood pressure checked at study visits, as well as height and weight.\u003c/p>\n\u003cp>Among other questions, the survey asked the women if they had ever experienced sexual harassment at work. Participants were also asked if they had ever \"been made or pressured into having some type of unwanted sexual contact.\" The women were not asked when those events occurred.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Twenty-two percent reported a history of sexual assault, and 19 percent said they'd experienced workplace sexual harassment.\u003c/p>\n\u003cp>Though the sample size was small, the results are statistically significant. Women who had experienced sexual assault had on average an almost threefold increased risk of developing depressive symptoms, compared to women who hadn't. They also had a greater incidence of clinically significant anxiety.[contextly_sidebar id=\"IsNCC9ByhjKnhi0QhEGUW78GbGlaWQIA\"]\u003c/p>\n\u003cp>About 1 in 4 women who had been sexually assaulted met criteria for depression, while approximately 1 in 10 who had not were depressed.\u003c/p>\n\u003cp>Those who experienced sexual harassment at work had a twofold increased risk compared to women who hadn't of developing high blood pressure. Poor sleep was more common, too.\u003c/p>\n\u003cp>\"These [traumatic experiences] are clearly critical things that happen to people early on, that have these really long-lasting effects,\" says \u003ca href=\"https://directory.sph.umn.edu/bio/sph-a-z/susan-mason\" target=\"_blank\" rel=\"noopener\">Susan Mason\u003c/a>, an assistant professor of epidemiology at the University of Minnesota who studies the effects of trauma. \"These really shape people's life trajectories.\"\u003c/p>\n\u003cp>Mason was not involved in this study, but says the findings dovetail with other research on the relationship between trauma and physical or mental health later in life. Intimate partner violence, for example, has been associated with the development of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23248189\" target=\"_blank\" rel=\"noopener\">diabetes\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22717307\" target=\"_blank\" rel=\"noopener\">high blood pressure\u003c/a>.\u003c/p>\n\u003cp>Wednesday's study is particularly noteworthy, Mason says, because it includes clinical data — in-office blood pressure checks, for example, and validated diagnostic tools for depression and anxiety — rather than depending exclusively on self-reported diagnoses.\u003c/p>\n\u003cp>Clinicians don't have the ability to corroborate women's memories of sexual assault or harassment, however. Thurston points to literature on the way traumatic memories are processed that demonstrates that discrete events like a sexual assault often remain vivid in a way other memories don't. This is why, she says, she trusts the study participants who say they've been through these experiences.[contextly_sidebar id=\"aop33xdUj0MLT7LwmTHbeoNCW1mJ7lyp\"]\u003c/p>\n\u003cp>\"If the patient thinks it's important, it's important,\" says Dr. Valerie Gilchrist, chair of the department of family medicine at the University of Wisconsin who has written about screening for sexual violence in primary care.\u003c/p>\n\u003cp>She recommends that clinicians ask patients if they've experienced sexual assault, particularly patients who are experiencing significant stress or have difficulty with pelvic exams. Authors note that sexual assault and harassment seemed to be less common in this group of women than in national estimates.\u003c/p>\n\u003cp>The prevalence in their cohort was significantly lower than a \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm\" target=\"_blank\" rel=\"noopener\">2014 estimate from the Centers for Disease Control and Prevention\u003c/a>, which found that 19 percent of American women had been raped, and almost 44 percent had experienced another form of sexual violence.\u003c/p>\n\u003cp>Thurston thinks this is because the study excluded a fair number of women for reasons related to its original intent of researching menopause and cardiovascular disease. Women taking medications for depression were not included, for example, as well as those with serious medical problems.\u003c/p>\n\u003cp>\"Sexual assault and sexual abuse are much more common than people think,\" Thurston says. These are \"key toxic stressors for women.\"\u003c/p>\n\u003cp>While researchers weren't surprised that sexual assault and harassment seemed to be related to the development of mood disorders and poor sleep, they were impressed by the strength of the association.\u003c/p>\n\u003cp>\"These should be urgent public health priorities,\" Mason says. \"How do we address the fundamental ways that our social structure affects health?\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Sexual+Assault+And+Harassment+May+Have+Lasting+Health+Repercussions+For+Women&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The trauma of sexual assault or harassment is not only hard to forget; it may also leave lasting effects on a woman's health. This finding of a study \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886\" target=\"_blank\" rel=\"noopener\">published Wednesday\u003c/a> adds support to a growing body of evidence suggesting the link.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In the study of roughly 300 middle-aged women, an experience of sexual assault was associated with anxiety, depression and poor sleep. A history of workplace sexual harassment was also associated with poor sleep and with an increased risk of developing high blood pressure.\u003c/p>\n\u003cp>\"These are experiences that [a woman] could have had long ago ... and it can have this long arm of influence throughout a woman's life,\" says \u003ca href=\"https://www.publichealth.pitt.edu/home/directory/rebecca-thurston\">Rebecca Thurston\u003c/a>, lead author of the study, and a research psychologist and director of the Women's Behavioral Health Laboratory at the University of Pittsburgh.\u003c/p>\n\u003cp>The study data come from a survey of healthy women between ages 40 and 60 who had been recruited for a study on menopause and cardiovascular disease — not sexual harassment or assault. They all had their blood pressure checked at study visits, as well as height and weight.\u003c/p>\n\u003cp>Among other questions, the survey asked the women if they had ever experienced sexual harassment at work. Participants were also asked if they had ever \"been made or pressured into having some type of unwanted sexual contact.\" The women were not asked when those events occurred.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Twenty-two percent reported a history of sexual assault, and 19 percent said they'd experienced workplace sexual harassment.\u003c/p>\n\u003cp>Though the sample size was small, the results are statistically significant. Women who had experienced sexual assault had on average an almost threefold increased risk of developing depressive symptoms, compared to women who hadn't. They also had a greater incidence of clinically significant anxiety.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>About 1 in 4 women who had been sexually assaulted met criteria for depression, while approximately 1 in 10 who had not were depressed.\u003c/p>\n\u003cp>Those who experienced sexual harassment at work had a twofold increased risk compared to women who hadn't of developing high blood pressure. Poor sleep was more common, too.\u003c/p>\n\u003cp>\"These [traumatic experiences] are clearly critical things that happen to people early on, that have these really long-lasting effects,\" says \u003ca href=\"https://directory.sph.umn.edu/bio/sph-a-z/susan-mason\" target=\"_blank\" rel=\"noopener\">Susan Mason\u003c/a>, an assistant professor of epidemiology at the University of Minnesota who studies the effects of trauma. \"These really shape people's life trajectories.\"\u003c/p>\n\u003cp>Mason was not involved in this study, but says the findings dovetail with other research on the relationship between trauma and physical or mental health later in life. Intimate partner violence, for example, has been associated with the development of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23248189\" target=\"_blank\" rel=\"noopener\">diabetes\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22717307\" target=\"_blank\" rel=\"noopener\">high blood pressure\u003c/a>.\u003c/p>\n\u003cp>Wednesday's study is particularly noteworthy, Mason says, because it includes clinical data — in-office blood pressure checks, for example, and validated diagnostic tools for depression and anxiety — rather than depending exclusively on self-reported diagnoses.\u003c/p>\n\u003cp>Clinicians don't have the ability to corroborate women's memories of sexual assault or harassment, however. Thurston points to literature on the way traumatic memories are processed that demonstrates that discrete events like a sexual assault often remain vivid in a way other memories don't. This is why, she says, she trusts the study participants who say they've been through these experiences.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If the patient thinks it's important, it's important,\" says Dr. Valerie Gilchrist, chair of the department of family medicine at the University of Wisconsin who has written about screening for sexual violence in primary care.\u003c/p>\n\u003cp>She recommends that clinicians ask patients if they've experienced sexual assault, particularly patients who are experiencing significant stress or have difficulty with pelvic exams. Authors note that sexual assault and harassment seemed to be less common in this group of women than in national estimates.\u003c/p>\n\u003cp>The prevalence in their cohort was significantly lower than a \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm\" target=\"_blank\" rel=\"noopener\">2014 estimate from the Centers for Disease Control and Prevention\u003c/a>, which found that 19 percent of American women had been raped, and almost 44 percent had experienced another form of sexual violence.\u003c/p>\n\u003cp>Thurston thinks this is because the study excluded a fair number of women for reasons related to its original intent of researching menopause and cardiovascular disease. Women taking medications for depression were not included, for example, as well as those with serious medical problems.\u003c/p>\n\u003cp>\"Sexual assault and sexual abuse are much more common than people think,\" Thurston says. These are \"key toxic stressors for women.\"\u003c/p>\n\u003cp>While researchers weren't surprised that sexual assault and harassment seemed to be related to the development of mood disorders and poor sleep, they were impressed by the strength of the association.\u003c/p>\n\u003cp>\"These should be urgent public health priorities,\" Mason says. \"How do we address the fundamental ways that our social structure affects health?\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Sexual+Assault+And+Harassment+May+Have+Lasting+Health+Repercussions+For+Women&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.[contextly_sidebar id=\"KMLJnak6yPOdRS3TfVoiDTc6a7Cm51Xf\"]\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.[contextly_sidebar id=\"Kw9tNYwAAP3TxDDlzs24FDdim0qufSVP\"]\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)[contextly_sidebar id=\"XHhLlvPBCoPTlN54jyme2G0wpse1GITN\"]\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.[contextly_sidebar id=\"KGoxoWR6m8MUKnLishPvyacpod0HWpt7\"]\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.[contextly_sidebar id=\"8bFNH4xsL9O8lTSDRHnxnqtYwxOF2Z5k\"]\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Think You Don't Need A Flu Shot? Here Are 5 Reasons To Change Your Mind",
"title": "Think You Don't Need A Flu Shot? Here Are 5 Reasons To Change Your Mind",
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"content": "\u003cp>There are a lot of misconceptions out there about the flu shot.\u003c/p>\n\u003cp>But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.[contextly_sidebar id=\"d8sAsPjwUq9P6K71Bm4vRaAmUWmUHYSs\"]\u003c/p>\n\u003cp>\"Flu vaccinations save lives,\" Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. \"That's why it's so important for everyone 6 months and older to get a flu vaccine every year.\"\u003c/p>\n\u003cp>But many Americans ignore this advice. The U.S. \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/reportshtml/trends/index.html\">vaccination rate\u003c/a> hovers at about 47 percent a year. This is far below the \u003ca href=\"https://www.healthypeople.gov/sites/default/files/HP2020_IID_and_GH_Progress_Review_Slides.pdf\">70 percent target\u003c/a>. And college students are among the least vaccinated.\u003c/p>\n\u003cp>\"We have long known that college students are at a particularly high risk of getting and spreading flu viruses,\" says \u003ca href=\"https://weillcornell.org/lisaipp\">Lisa Ipp\u003c/a>, an adolescent medicine specialist at Weill Cornell Medicine. \"Yet, on U.S. college campuses, flu vaccination rates remain strikingly low,\" \u003ca href=\"https://nfid.wordpress.com/2017/12/06/why-arent-college-students-getting-flu-shots/\">she writes in a 2017 post\u003c/a> published by the National Foundation for Infectious Disease. The group sponsored a \u003ca href=\"http://www.nfid.org/publications/reports/college-flu-summit-report.pdf\">survey\u003c/a> of college students and found that only between 8 and 39 percent of students get the vaccine.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So why aren't people getting the vaccine? The college survey data point to a mix of misperception and fear.[contextly_sidebar id=\"1GYhiWSWE3AU14flVCzzeer5d84YkhaR\"]\u003c/p>\n\u003cp>For instance, among students who don't get the vaccine, 36 percent say that they are healthy and don't need it, and 30 percent say they don't think the vaccine is effective. Then, there's the fear: 31 percent say they don't like needles.\u003c/p>\n\u003cp>So, let's do a reality check. If you're on the fence about a flu shot, here are five arguments to twist your arm.\u003c/p>\n\u003cp>\u003cstrong>1. You are vulnerable.\u003c/strong>\u003c/p>\n\u003cp>People 65 and older are at higher risk of flu-related complications, but the flu can knock young, healthy people off their feet, too. It does every year.\u003c/p>\n\u003cp>\"The flu can, on occasion, take a young, healthy person and put them in the intensive care unit,\" says \u003ca href=\"http://www.nfid.org/newsroom/press-releases/2015-press-releases/nfid-selects-william-schaffner-as-new-medical-director.pdf\">William Schaffner\u003c/a>, medical director at the NFID.\u003c/p>\n\u003cp>And, even when it's not that severe, it's still bad. \"If you get the flu, you're [down] for the count for about a week,\" Ipp tells her college-age patients.\u003c/p>\n\u003cp>Here's a sobering thought: Healthy children die from flu, too. According to the CDC, \u003ca href=\"https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm\">172 American children and teens\u003c/a> (under the age of 18) died from the flu last winter. Eighty percent of them had not received a flu vaccine. And about half had no underlying illnesses before getting the flu. In other words, they'd been healthy children.[contextly_sidebar id=\"uR6a8xg4qkSfioEgDzzDZvzsgwhTq8sS\"]\u003c/p>\n\u003cp>And there's this: The flu doesn't just make you feel lousy. It can \u003ca href=\"https://www.npr.org/sections/health-shots/2018/01/24/579997381/aw-seriously-the-flu-can-trigger-a-heart-attack-too\">increase the risk of having a heart attack\u003c/a>, according to a study published this year.\u003c/p>\n\u003cp>\u003cstrong>2. Getting a flu shot is your civic duty.\u003c/strong>\u003c/p>\n\u003cp>\"Nobody wants to be the dreaded spreader,\" says Schaffner. But everybody gets the flu from somebody else. According to the Centers for Disease Control and Prevention, people who have caught the flu virus are contagious one day before they start to feel sick and for up to seven days after. (Check out our \u003ca href=\"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu\">video on flu contagion \u003c/a>if you really need to be convinced!)\u003c/p>\n\u003cp>So getting the flu shot will help protect your family, friends and co-workers. \"It's the socially correct thing to do,\" Schaffner says.\u003c/p>\n\u003cp>\u003cstrong>3. You can still get the flu, but you won't be as sick.\u003c/strong>\u003c/p>\n\u003cp>After last winter's severe season, some people are skeptical. They say: \"I got the flu shot, but I still caught the flu.\"\u003c/p>\n\u003cp>In fact, the 2017-18 season was the deadliest in more than 40 years. \"We had a very vicious virus, the so-called H3N2 influenza strain,\" says Schaffner.[contextly_sidebar id=\"TFcjOHNAbBl7nUaIFKyNSb1xwI4w06NI\"]\u003c/p>\n\u003cp>And yes, it's true that the vaccine does not offer complete protection. The CDC estimates that flu vaccination \u003ca href=\"https://www.cdc.gov/flu/about/qa/vaccineeffect.htm\">reduces the risk of the virus\u003c/a> by about 40 to 60 percent. Think of it this way: If you catch the flu, the vaccine does still offer some protection. It cushions the blow. \"Your illness is likely to be milder\" if you've had a flu shot, says Schaffner. You're less likely to get pneumonia, which is a major complication of the flu, and less likely to be hospitalized.\u003c/p>\n\u003cp>\u003cstrong>4. Pregnant women who get the flu shot protect their babies from flu.\u003c/strong>\u003c/p>\n\u003cp>Women who are pregnant should be vaccinated to protect themselves. The vaccine also offers protection after babies are born. \"[Women] can pass the protection on, across the placenta,\" Schaffner explains. And this will protect their baby during the first six months of life, until the baby is old enough to be vaccinated.\u003c/p>\n\u003cp>\u003cstrong>5. You\u003c/strong>\u003cem>\u003cstrong> cannot\u003c/strong>\u003c/em>\u003cstrong> get flu from the flu vaccine.\u003c/strong>\u003c/p>\n\u003cp>It's still a common misperception: the idea that you can get the flu from the flu shot.\u003c/p>\n\u003cp>The NFID-sponsored survey of college students found that close to 60 percent of students seem to think that the flu vaccine can cause flu. \"That's, of course, incorrect,\" says Schaffner.\u003c/p>\n\u003cp>The most common side effects are a sore arm, and perhaps a little swelling. \"A very small proportion of people, 1 to 2 percent, get a degree of fever,\" Schaffner says. That's not the flu, he explains. \"That's the body reacting to the vaccine.\"\u003c/p>\n\u003cp>Because the flu is unpredictable, it's too soon to know what to expect this winter. But Schaffner has this advice: Don't wait. \"The time to get vaccinated is right now,\" he says.\u003c/p>\n\u003cp>If that doesn't move you, maybe a little reward will. The survey data of college students found that incentives are a good idea. Think: free food, free entertainment or a gift card for a free coffee. Ipp found about 60 percent of students said these types of incentives would increase the likelihood of their getting the flu vaccine.\u003c/p>\n\u003cp>Another way to nudge people? Make it super convenient. On the campus of George Washington University, the medical director of the student health center has organized flu-clinic pop-ups in venues where students hang out, such as the library. \"We don't wait for them to come to us,\" \u003ca href=\"https://healthcenter.gwu.edu/isabel-goldenberg-md\">Isabel Goldenberg\u003c/a> told us\u003cem>.\u003c/em>\u003c/p>\n\u003cp>For workers in offices, flu clinics at the workplace can be an effective way to encourage vaccination, too.\u003c/p>\n\u003cp>What about the use of social media to motivate people? \"I've had the flu, which was horrible,\" Max Webb, a student at George Washington University, told me. He thinks if people shared their flu stories, it could help nudge people in their social networks to get the flu shot.\u003c/p>\n\u003cp>And what would you name this campaign, I asked Webb? \"Say boo to the flu,\" Web replied. Or simply, #boo2flu.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Kinda catchy.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Think+You+Don%27t+Need+A+Flu+Shot%3F+Here+Are+5+Reasons+To+Change+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There are a lot of misconceptions out there about the flu shot.\u003c/p>\n\u003cp>But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Flu vaccinations save lives,\" Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. \"That's why it's so important for everyone 6 months and older to get a flu vaccine every year.\"\u003c/p>\n\u003cp>But many Americans ignore this advice. The U.S. \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/reportshtml/trends/index.html\">vaccination rate\u003c/a> hovers at about 47 percent a year. This is far below the \u003ca href=\"https://www.healthypeople.gov/sites/default/files/HP2020_IID_and_GH_Progress_Review_Slides.pdf\">70 percent target\u003c/a>. And college students are among the least vaccinated.\u003c/p>\n\u003cp>\"We have long known that college students are at a particularly high risk of getting and spreading flu viruses,\" says \u003ca href=\"https://weillcornell.org/lisaipp\">Lisa Ipp\u003c/a>, an adolescent medicine specialist at Weill Cornell Medicine. \"Yet, on U.S. college campuses, flu vaccination rates remain strikingly low,\" \u003ca href=\"https://nfid.wordpress.com/2017/12/06/why-arent-college-students-getting-flu-shots/\">she writes in a 2017 post\u003c/a> published by the National Foundation for Infectious Disease. The group sponsored a \u003ca href=\"http://www.nfid.org/publications/reports/college-flu-summit-report.pdf\">survey\u003c/a> of college students and found that only between 8 and 39 percent of students get the vaccine.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So why aren't people getting the vaccine? The college survey data point to a mix of misperception and fear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For instance, among students who don't get the vaccine, 36 percent say that they are healthy and don't need it, and 30 percent say they don't think the vaccine is effective. Then, there's the fear: 31 percent say they don't like needles.\u003c/p>\n\u003cp>So, let's do a reality check. If you're on the fence about a flu shot, here are five arguments to twist your arm.\u003c/p>\n\u003cp>\u003cstrong>1. You are vulnerable.\u003c/strong>\u003c/p>\n\u003cp>People 65 and older are at higher risk of flu-related complications, but the flu can knock young, healthy people off their feet, too. It does every year.\u003c/p>\n\u003cp>\"The flu can, on occasion, take a young, healthy person and put them in the intensive care unit,\" says \u003ca href=\"http://www.nfid.org/newsroom/press-releases/2015-press-releases/nfid-selects-william-schaffner-as-new-medical-director.pdf\">William Schaffner\u003c/a>, medical director at the NFID.\u003c/p>\n\u003cp>And, even when it's not that severe, it's still bad. \"If you get the flu, you're [down] for the count for about a week,\" Ipp tells her college-age patients.\u003c/p>\n\u003cp>Here's a sobering thought: Healthy children die from flu, too. According to the CDC, \u003ca href=\"https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm\">172 American children and teens\u003c/a> (under the age of 18) died from the flu last winter. Eighty percent of them had not received a flu vaccine. And about half had no underlying illnesses before getting the flu. In other words, they'd been healthy children.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And there's this: The flu doesn't just make you feel lousy. It can \u003ca href=\"https://www.npr.org/sections/health-shots/2018/01/24/579997381/aw-seriously-the-flu-can-trigger-a-heart-attack-too\">increase the risk of having a heart attack\u003c/a>, according to a study published this year.\u003c/p>\n\u003cp>\u003cstrong>2. Getting a flu shot is your civic duty.\u003c/strong>\u003c/p>\n\u003cp>\"Nobody wants to be the dreaded spreader,\" says Schaffner. But everybody gets the flu from somebody else. According to the Centers for Disease Control and Prevention, people who have caught the flu virus are contagious one day before they start to feel sick and for up to seven days after. (Check out our \u003ca href=\"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu\">video on flu contagion \u003c/a>if you really need to be convinced!)\u003c/p>\n\u003cp>So getting the flu shot will help protect your family, friends and co-workers. \"It's the socially correct thing to do,\" Schaffner says.\u003c/p>\n\u003cp>\u003cstrong>3. You can still get the flu, but you won't be as sick.\u003c/strong>\u003c/p>\n\u003cp>After last winter's severe season, some people are skeptical. They say: \"I got the flu shot, but I still caught the flu.\"\u003c/p>\n\u003cp>In fact, the 2017-18 season was the deadliest in more than 40 years. \"We had a very vicious virus, the so-called H3N2 influenza strain,\" says Schaffner.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And yes, it's true that the vaccine does not offer complete protection. The CDC estimates that flu vaccination \u003ca href=\"https://www.cdc.gov/flu/about/qa/vaccineeffect.htm\">reduces the risk of the virus\u003c/a> by about 40 to 60 percent. Think of it this way: If you catch the flu, the vaccine does still offer some protection. It cushions the blow. \"Your illness is likely to be milder\" if you've had a flu shot, says Schaffner. You're less likely to get pneumonia, which is a major complication of the flu, and less likely to be hospitalized.\u003c/p>\n\u003cp>\u003cstrong>4. Pregnant women who get the flu shot protect their babies from flu.\u003c/strong>\u003c/p>\n\u003cp>Women who are pregnant should be vaccinated to protect themselves. The vaccine also offers protection after babies are born. \"[Women] can pass the protection on, across the placenta,\" Schaffner explains. And this will protect their baby during the first six months of life, until the baby is old enough to be vaccinated.\u003c/p>\n\u003cp>\u003cstrong>5. You\u003c/strong>\u003cem>\u003cstrong> cannot\u003c/strong>\u003c/em>\u003cstrong> get flu from the flu vaccine.\u003c/strong>\u003c/p>\n\u003cp>It's still a common misperception: the idea that you can get the flu from the flu shot.\u003c/p>\n\u003cp>The NFID-sponsored survey of college students found that close to 60 percent of students seem to think that the flu vaccine can cause flu. \"That's, of course, incorrect,\" says Schaffner.\u003c/p>\n\u003cp>The most common side effects are a sore arm, and perhaps a little swelling. \"A very small proportion of people, 1 to 2 percent, get a degree of fever,\" Schaffner says. That's not the flu, he explains. \"That's the body reacting to the vaccine.\"\u003c/p>\n\u003cp>Because the flu is unpredictable, it's too soon to know what to expect this winter. But Schaffner has this advice: Don't wait. \"The time to get vaccinated is right now,\" he says.\u003c/p>\n\u003cp>If that doesn't move you, maybe a little reward will. The survey data of college students found that incentives are a good idea. Think: free food, free entertainment or a gift card for a free coffee. Ipp found about 60 percent of students said these types of incentives would increase the likelihood of their getting the flu vaccine.\u003c/p>\n\u003cp>Another way to nudge people? Make it super convenient. On the campus of George Washington University, the medical director of the student health center has organized flu-clinic pop-ups in venues where students hang out, such as the library. \"We don't wait for them to come to us,\" \u003ca href=\"https://healthcenter.gwu.edu/isabel-goldenberg-md\">Isabel Goldenberg\u003c/a> told us\u003cem>.\u003c/em>\u003c/p>\n\u003cp>For workers in offices, flu clinics at the workplace can be an effective way to encourage vaccination, too.\u003c/p>\n\u003cp>What about the use of social media to motivate people? \"I've had the flu, which was horrible,\" Max Webb, a student at George Washington University, told me. He thinks if people shared their flu stories, it could help nudge people in their social networks to get the flu shot.\u003c/p>\n\u003cp>And what would you name this campaign, I asked Webb? \"Say boo to the flu,\" Web replied. Or simply, #boo2flu.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kinda catchy.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Think+You+Don%27t+Need+A+Flu+Shot%3F+Here+Are+5+Reasons+To+Change+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study",
"title": "Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study",
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"content": "\u003cp>Artificial sweeteners, widely regarded as a healthy alternative to sugar, may be sabotaging your gut biome.[contextly_sidebar id=\"yjhBwHasobhXnJ18NYXbIYtjXOq70PwF\"]\u003c/p>\n\u003cp>A new study published \u003ca href=\"https://www.mdpi.com/1420-3049/23/10/2454\" target=\"_blank\" rel=\"noopener\">in the journal\u003c/a> \u003cem>Molecule\u003c/em> found that \u003cem>E. coli\u003c/em> bacteria in the intestinal tract became damaged when exposed to several different kinds of artificial sweeteners.\u003c/p>\n\u003cp>The study zeroed in on six artificial sweeteners to determine their toxicity to the healthy bacteria present: aspartame, sucralose, saccharine, neotame, advantame, and acesulfame potassium-k.\u003c/p>\n\u003cp>The researchers used as markers special light-producing bacteria known as bioluminescent \u003cem>E. coli\u003c/em> that light up when toxicity is detected, according to the collaborative study by researchers at Israel’s Ben-Gurion University of the Negev and Singapore’s Nanyang Technological University.\u003c/p>\n\u003cp>Sucralose displayed the most significant effects, with as little as 1 milligram affecting a strain of the \u003cem>E. coli.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This is further evidence that consumption of artificial sweeteners adversely affects gut \u003ca href=\"https://www.sciencedaily.com/releases/2018/10/181001101932.htm\" target=\"_blank\" rel=\"noopener\">microbial activity\u003c/a> which can cause a wide range of health issues,\" co-author Ariel Kushmaro, a professor of biotechnology engineering at Ben-Gurion, said in a statement.[contextly_sidebar id=\"zlhu2orfRNf238Xnhya1R1LkDBb9jMGv\"]\u003c/p>\n\u003cp>Disturbances in the gut ecosystem can seriously harm human health with previous studies showing that pathogenic\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/\"> bacteria\u003c/a> can cause many chronic diseases, including inflammatory bowel disease, obesity, diabetes, and cancer.\u003c/p>\n\u003cp>The presence of these chemicals is not always obvious, with many popular foods, such as microwave popcorn and fruit juice, labeling the ingredient as a \"natural sweetener.\" That's because the Food and Drug Administration has \u003ca href=\"https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm\" target=\"_blank\" rel=\"noopener\">yet to define\u003c/a> the term “natural” for use in food labeling.\u003c/p>\n\u003cp>Along with possible adverse health effects, the study warns that artificial sweeteners have become so ubiquitous that they're increasingly turning up in drinking water and groundwater basins.\u003c/p>\n\u003cp>\"They are resistant to wastewater treatment processes, therefore they are continuously introduced into the water environments,\" write the authors. \"Such concentrations [of artificial sweeteners] are among the highest known for anthropogenic trace pollutants.\"\u003c/p>\n\u003cp>\u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">Calorie Control Council\u003c/a>, the trade group for the artificial sweetener industry, criticized the study for relying solely on \u003cem>E. coli \u003c/em>bacterium, which they argue is not directly comparable to the human microbiome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\"More specifically, it is unknown whether the changes to the bacterium noted in the study, or any changes in microbiome bacteria, are indicative of negative health outcomes in humans,\" the \u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">group \u003c/a>said in a statement emailed to KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">Moreover, the group says that all the sweeteners included in the study have been approved for use by several scientific and regulatory authorities, including the FDA.\u003c/p>\n\u003cp>To determine toxicity, researchers modified different types of \u003ci>E.coli \u003c/i>bacteria to emit light when experiencing distress. Researchers then could see what type of damage occurred, depending on which type of modified \u003cem>E. coli\u003c/em> glowed. Researchers found that each sweetener produced a specific fingerprint using three stripes of bacteria, with each stripe representing a different type of damage. From \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">Live Science\u003c/a>, quoting senior author Evgeni Eltzov:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">The pattern of colors was unique for each sweetener; one might've caused more DNA damage than protein damage, for example. However, all sweeteners damaged the bacteria in some way, Eltzov said. But Eltzov noted that these findings don't mean the chemicals are \"toxic\" to humans. More research is needed to make that determination.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">One cited shortcoming of the study is that the concentrations of artificial sweetener used were higher than what's typically consumed in a can of diet soda. The \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">findings do\u003c/a> not\u003cspan class=\"Apple-converted-space\"> \u003c/span>\"tell us what happens in real life. It tells us what happens in a test tube,\" Dr. Kristina Rother, a senior research physician at the National Institutes of Health, told Live Science.\u003c/p>\n\u003cp class=\"p1\">\"Real life is just more complicated,\" Rother, who was not involved in the study, told Live Science.\u003c/p>\n\u003cp class=\"p1\">Still, she recommends avoiding artificial sweeteners.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\"I haven't seen a study that says any of these six FDA-approved sweeteners make the gut microbiome better,” she says. \"So, my recommendation is very simple and very difficult to achieve: Live a healthy life, eat little processed food.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Artificial sweeteners, widely regarded as a healthy alternative to sugar, may be sabotaging your gut biome.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A new study published \u003ca href=\"https://www.mdpi.com/1420-3049/23/10/2454\" target=\"_blank\" rel=\"noopener\">in the journal\u003c/a> \u003cem>Molecule\u003c/em> found that \u003cem>E. coli\u003c/em> bacteria in the intestinal tract became damaged when exposed to several different kinds of artificial sweeteners.\u003c/p>\n\u003cp>The study zeroed in on six artificial sweeteners to determine their toxicity to the healthy bacteria present: aspartame, sucralose, saccharine, neotame, advantame, and acesulfame potassium-k.\u003c/p>\n\u003cp>The researchers used as markers special light-producing bacteria known as bioluminescent \u003cem>E. coli\u003c/em> that light up when toxicity is detected, according to the collaborative study by researchers at Israel’s Ben-Gurion University of the Negev and Singapore’s Nanyang Technological University.\u003c/p>\n\u003cp>Sucralose displayed the most significant effects, with as little as 1 milligram affecting a strain of the \u003cem>E. coli.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This is further evidence that consumption of artificial sweeteners adversely affects gut \u003ca href=\"https://www.sciencedaily.com/releases/2018/10/181001101932.htm\" target=\"_blank\" rel=\"noopener\">microbial activity\u003c/a> which can cause a wide range of health issues,\" co-author Ariel Kushmaro, a professor of biotechnology engineering at Ben-Gurion, said in a statement.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Disturbances in the gut ecosystem can seriously harm human health with previous studies showing that pathogenic\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/\"> bacteria\u003c/a> can cause many chronic diseases, including inflammatory bowel disease, obesity, diabetes, and cancer.\u003c/p>\n\u003cp>The presence of these chemicals is not always obvious, with many popular foods, such as microwave popcorn and fruit juice, labeling the ingredient as a \"natural sweetener.\" That's because the Food and Drug Administration has \u003ca href=\"https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm\" target=\"_blank\" rel=\"noopener\">yet to define\u003c/a> the term “natural” for use in food labeling.\u003c/p>\n\u003cp>Along with possible adverse health effects, the study warns that artificial sweeteners have become so ubiquitous that they're increasingly turning up in drinking water and groundwater basins.\u003c/p>\n\u003cp>\"They are resistant to wastewater treatment processes, therefore they are continuously introduced into the water environments,\" write the authors. \"Such concentrations [of artificial sweeteners] are among the highest known for anthropogenic trace pollutants.\"\u003c/p>\n\u003cp>\u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">Calorie Control Council\u003c/a>, the trade group for the artificial sweetener industry, criticized the study for relying solely on \u003cem>E. coli \u003c/em>bacterium, which they argue is not directly comparable to the human microbiome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\"More specifically, it is unknown whether the changes to the bacterium noted in the study, or any changes in microbiome bacteria, are indicative of negative health outcomes in humans,\" the \u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">group \u003c/a>said in a statement emailed to KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">Moreover, the group says that all the sweeteners included in the study have been approved for use by several scientific and regulatory authorities, including the FDA.\u003c/p>\n\u003cp>To determine toxicity, researchers modified different types of \u003ci>E.coli \u003c/i>bacteria to emit light when experiencing distress. Researchers then could see what type of damage occurred, depending on which type of modified \u003cem>E. coli\u003c/em> glowed. Researchers found that each sweetener produced a specific fingerprint using three stripes of bacteria, with each stripe representing a different type of damage. From \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">Live Science\u003c/a>, quoting senior author Evgeni Eltzov:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">The pattern of colors was unique for each sweetener; one might've caused more DNA damage than protein damage, for example. However, all sweeteners damaged the bacteria in some way, Eltzov said. But Eltzov noted that these findings don't mean the chemicals are \"toxic\" to humans. More research is needed to make that determination.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">One cited shortcoming of the study is that the concentrations of artificial sweetener used were higher than what's typically consumed in a can of diet soda. The \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">findings do\u003c/a> not\u003cspan class=\"Apple-converted-space\"> \u003c/span>\"tell us what happens in real life. It tells us what happens in a test tube,\" Dr. Kristina Rother, a senior research physician at the National Institutes of Health, told Live Science.\u003c/p>\n\u003cp class=\"p1\">\"Real life is just more complicated,\" Rother, who was not involved in the study, told Live Science.\u003c/p>\n\u003cp class=\"p1\">Still, she recommends avoiding artificial sweeteners.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\"I haven't seen a study that says any of these six FDA-approved sweeteners make the gut microbiome better,” she says. \"So, my recommendation is very simple and very difficult to achieve: Live a healthy life, eat little processed food.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Rush Against Time: Decades Old Chemicals, New Angst Over Drinking Water",
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"content": "\u003cp>In some parts of the country people are learning their drinking water contains pollution from a group of chemicals called \u003ca href=\"https://www.epa.gov/pfas\" target=\"_blank\" rel=\"noopener\">Per- and Polyfluoroalkyl Substances\u003c/a> (PFAS). These chemicals have been linked to illnesses, including cancer. But a lot of questions remain including how exactly they affect people's health and in what doses.[contextly_sidebar id=\"6zIBNiaB7i0Hof1u8JCSiwQIZioEoqoi\"]\u003c/p>\n\u003cp>These chemicals have been around for decades but the issue gained urgency in recent years as water suppliers tested for and found PFAS pollution as part of an Environmental Protection Agency program.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS but members of Congress are \u003ca href=\"https://apnews.com/9f387f98e705432e9278001687fe99aa\" target=\"_blank\" rel=\"noopener\">pushing the EPA to move faster\u003c/a>. A few states already have established strict new standards to limit the compounds in drinking water. And in some places, \u003ca href=\"http://www.wbur.org/hereandnow/2018/09/25/water-pollution-pennsylvania-gop-midterms\" target=\"_blank\" rel=\"noopener\">such as the Philadelphia suburbs\u003c/a>, PFAS pollution has become an issue in mid-term election races.\u003c/p>\n\u003cp>As scientists and policy-makers work to limit human exposure to the compounds here are a few key points that are worth knowing.\u003c/p>\n\u003cp>\u003cstrong>1. PFAS Chemicals Useful But May Be Dangerous \u003c/strong>\u003c/p>\n\u003cp>PFAS chemicals are good at repelling oil and water. That makes them useful in a lot of products including non-stick cookware, fast food wrappers, pizza boxes, water-repellent fabrics and fire-fighting foam.\u003c/p>\n\u003cp>It's difficult to pin down exactly how harmful these chemicals are because research is limited. There was a \u003ca href=\"http://www.c8sciencepanel.org/\" target=\"_blank\" rel=\"noopener\">big health study\u003c/a> involving one form of PFAS in the Mid-Ohio Valley. From that and other studies scientists are comfortable saying certain diseases are linked to PFAS exposure but they won't be more definitive than that.[contextly_sidebar id=\"q4qiZYcFYSHVK4Y9xGlLpSQ7zRpqCqtg\"]\u003c/p>\n\u003cp>\"PFAS chemicals have been linked to a wide range of health effects, including cancer, low birth weight, thyroid disease, elevated cholesterol and effects on the immune system,\" says Laurel Schaider, research scientist at \u003ca href=\"https://www.silentspring.org/research-area/highly-fluorinated-chemicals-pfass\" target=\"_blank\" rel=\"noopener\">Silent Spring Institute\u003c/a>.\u003c/p>\n\u003cp>Manufacturers have agreed to stop using two forms of PFAS in the U.S. These chemicals take a long time to break down in the environment, which is why they remain a problem now. And Schaider says newer forms of PFAS chemicals are still being used, though some people believe they are safer because they remain in the environment and in our bodies for shorter periods.\u003c/p>\n\u003cp>\u003cstrong>2. PFAS Pollution Affects Communities Around the Country\u003c/strong>\u003c/p>\n\u003cp>In some communities PFAS pollution may be known by another name if a specific compound is to blame for problems there. Some of the most common are PFOS, PFOA and Gen-X. PFAS is the overall name for this group of several thousand chemicals.\u003c/p>\n\u003cp>Among the places with PFAS pollution is \u003ca href=\"http://www.michiganradio.org/post/parchment-residents-can-drink-their-tap-water-again\" target=\"_blank\" rel=\"noopener\">Michigan\u003c/a> where the some residents were warned not to drink the water for a month. In \u003ca href=\"http://www.nhpr.org/post/coakley-landfill-site-government-assurances-meet-public-fear\" target=\"_blank\" rel=\"noopener\">New Hampshire\u003c/a> there are concerns a landfill may be polluting water. A case in \u003ca href=\"https://www.npr.org/2016/03/31/472501029/elevated-levels-of-suspected-carcinogen-found-in-states-drinking-water\" target=\"_blank\" rel=\"noopener\">New York\u003c/a> came to regulators' attention after a resident tested his own water. And in \u003ca href=\"http://www.starnewsonline.com/news/20180608/whats-happened-since-we-first-learned-of-genx-year-ago-lot\" target=\"_blank\" rel=\"noopener\">North Carolina\u003c/a> high levels of a PFAS chemical were found in drinking water downstream from a manufacturing plant.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ewg.org/interactive-maps/2017_pfa\">map\u003c/a> of contaminated sites and communities where PFAS has been detected in drinking water has been compiled by Northeastern University and Environmental Working Group.\u003c/p>\n\u003cp>Lawsuits have been filed against companies believed to be responsible for the pollution. For example, Minnesota sued 3M over PFAS pollution and \u003ca href=\"https://www.mprnews.org/story/2018/02/20/3m-pfc-groundwater-pollution-trial-announcement\" target=\"_blank\" rel=\"noopener\">settled for $850 million\u003c/a> in February 2018\u003c/p>\n\u003cp>\u003cstrong>3. State and Federal Agencies Not Responding Fast Enough \u003c/strong>\u003c/p>\n\u003cp>The EPA requires most water utilities to test for a list of PFAS chemicals. In 2016 the agency lowered a \u003ca href=\"https://www.epa.gov/sites/production/files/2016-06/documents/drinkingwaterhealthadvisories_pfoa_pfos_updated_5.31.16.pdf\" target=\"_blank\" rel=\"noopener\">non-binding health advisory limit\u003c/a> for some PFAS compounds to 70 parts per trillion (ppt). That's about 70 grains of sand in an Olympic-size swimming pool, says Christopher Crockett, chief environmental officer for the water utility Aqua America.[contextly_sidebar id=\"K3FQ2vxkI9zPMDIwttZqKDOlOkz9sSst\"]\u003c/p>\n\u003cp>But environmentalists argue that a \u003ca href=\"https://www.propublica.org/article/suppressed-study-the-epa-underestimated-dangers-of-widespread-chemicals\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention study\u003c/a> indicates the numbers should be much lower. \u003ca href=\"https://news.bloombergenvironment.com/environment-and-energy/glass-half-full-on-state-solutions-to-chemicals-in-water/\">A few states\u003c/a> have set lower standards on their own.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS chemicals and expects to release it by the end of this year.\u003c/p>\n\u003cp>\"We need actions to come out of those plans that lead to clear direction for water suppliers,\" says Crockett. He wants to know what level of PFAS chemicals in water is safe and when should his company install filters to remove the chemicals.\u003c/p>\n\u003cp>The Department of Defense also has a big role to play in cleaning up PFAS pollution. The agency uses fire-fighting foam for training at air bases around the country. In places like \u003ca href=\"https://whyy.org/segments/pfas-chemicals-showing-up-in-montco-water-beyond-military-bases/\">Pennsylvania\u003c/a> PFAS chemicals from that foam have made their way into local drinking water.\u003c/p>\n\u003cp>\u003cstrong>4. Steps to Protect Yourself \u003c/strong>\u003c/p>\n\u003cp>When utility company Aqua America learns it needs to treat water polluted with PFAS it installs big carbon filters. If you're worried about this issue and want to be extra cautious, you can essentially do the same in your home.\u003c/p>\n\u003cp>Christopher Crockett with Aqua says filters on refrigerators that dispense water or pitchers with carbon filters work pretty well—just make sure you change the filters regularly as manufacturers recommend.\u003c/p>\n\u003cp>If you want to also limit exposure from taking showers or brushing your teeth then a whole-house filtration system might be necessary. When asked if he filters his water, Crockett says he does not. He's comfortable that water under the current EPA health advisory level of 70 ppt is safe to drink.[contextly_sidebar id=\"Q6TlIH5KCT6cF2EoLBgJP95hLDZvlPwV\"]\u003c/p>\n\u003cp>Water is not the only concern though. Laurel Schaider with Silent Spring Institute says it could make sense to avoid things like fast food wrappers and microwave popcorn bags that can have PFAS chemicals in them. The problem is you never know which ones to avoid because there are no labeling requirements.\u003c/p>\n\u003cp>The state of Washington will eventually \u003ca href=\"https://www.opb.org/news/article/food-packaging-chemical-perfluorinated-ban-washington/\" target=\"_blank\" rel=\"noopener\">ban PFAS use for food packaging\u003c/a> and \u003ca href=\"http://www.spokesman.com/stories/2018/mar/27/washington-bans-fire-fighting-chemicals-that-may-c/\">fire-fighting foam\u003c/a>.\u003c/p>\n\u003cp>Finally, eating a lot of fish also can be a concern in some places. New Jersey is among states that have warned people to \u003ca href=\"https://stateimpact.npr.org/pennsylvania/2018/07/20/new-jersey-issues-first-advisories-for-consumption-of-fish-containing-pfas-chemicals/\" target=\"_blank\" rel=\"noopener\">limit how much fish they eat\u003c/a> from certain bodies of water\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Decades+Old+Chemicals%2C+New+Angst+Over+Drinking+Water&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" />\u003c/div>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In some parts of the country people are learning their drinking water contains pollution from a group of chemicals called \u003ca href=\"https://www.epa.gov/pfas\" target=\"_blank\" rel=\"noopener\">Per- and Polyfluoroalkyl Substances\u003c/a> (PFAS). These chemicals have been linked to illnesses, including cancer. But a lot of questions remain including how exactly they affect people's health and in what doses.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These chemicals have been around for decades but the issue gained urgency in recent years as water suppliers tested for and found PFAS pollution as part of an Environmental Protection Agency program.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS but members of Congress are \u003ca href=\"https://apnews.com/9f387f98e705432e9278001687fe99aa\" target=\"_blank\" rel=\"noopener\">pushing the EPA to move faster\u003c/a>. A few states already have established strict new standards to limit the compounds in drinking water. And in some places, \u003ca href=\"http://www.wbur.org/hereandnow/2018/09/25/water-pollution-pennsylvania-gop-midterms\" target=\"_blank\" rel=\"noopener\">such as the Philadelphia suburbs\u003c/a>, PFAS pollution has become an issue in mid-term election races.\u003c/p>\n\u003cp>As scientists and policy-makers work to limit human exposure to the compounds here are a few key points that are worth knowing.\u003c/p>\n\u003cp>\u003cstrong>1. PFAS Chemicals Useful But May Be Dangerous \u003c/strong>\u003c/p>\n\u003cp>PFAS chemicals are good at repelling oil and water. That makes them useful in a lot of products including non-stick cookware, fast food wrappers, pizza boxes, water-repellent fabrics and fire-fighting foam.\u003c/p>\n\u003cp>It's difficult to pin down exactly how harmful these chemicals are because research is limited. There was a \u003ca href=\"http://www.c8sciencepanel.org/\" target=\"_blank\" rel=\"noopener\">big health study\u003c/a> involving one form of PFAS in the Mid-Ohio Valley. From that and other studies scientists are comfortable saying certain diseases are linked to PFAS exposure but they won't be more definitive than that.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"PFAS chemicals have been linked to a wide range of health effects, including cancer, low birth weight, thyroid disease, elevated cholesterol and effects on the immune system,\" says Laurel Schaider, research scientist at \u003ca href=\"https://www.silentspring.org/research-area/highly-fluorinated-chemicals-pfass\" target=\"_blank\" rel=\"noopener\">Silent Spring Institute\u003c/a>.\u003c/p>\n\u003cp>Manufacturers have agreed to stop using two forms of PFAS in the U.S. These chemicals take a long time to break down in the environment, which is why they remain a problem now. And Schaider says newer forms of PFAS chemicals are still being used, though some people believe they are safer because they remain in the environment and in our bodies for shorter periods.\u003c/p>\n\u003cp>\u003cstrong>2. PFAS Pollution Affects Communities Around the Country\u003c/strong>\u003c/p>\n\u003cp>In some communities PFAS pollution may be known by another name if a specific compound is to blame for problems there. Some of the most common are PFOS, PFOA and Gen-X. PFAS is the overall name for this group of several thousand chemicals.\u003c/p>\n\u003cp>Among the places with PFAS pollution is \u003ca href=\"http://www.michiganradio.org/post/parchment-residents-can-drink-their-tap-water-again\" target=\"_blank\" rel=\"noopener\">Michigan\u003c/a> where the some residents were warned not to drink the water for a month. In \u003ca href=\"http://www.nhpr.org/post/coakley-landfill-site-government-assurances-meet-public-fear\" target=\"_blank\" rel=\"noopener\">New Hampshire\u003c/a> there are concerns a landfill may be polluting water. A case in \u003ca href=\"https://www.npr.org/2016/03/31/472501029/elevated-levels-of-suspected-carcinogen-found-in-states-drinking-water\" target=\"_blank\" rel=\"noopener\">New York\u003c/a> came to regulators' attention after a resident tested his own water. And in \u003ca href=\"http://www.starnewsonline.com/news/20180608/whats-happened-since-we-first-learned-of-genx-year-ago-lot\" target=\"_blank\" rel=\"noopener\">North Carolina\u003c/a> high levels of a PFAS chemical were found in drinking water downstream from a manufacturing plant.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ewg.org/interactive-maps/2017_pfa\">map\u003c/a> of contaminated sites and communities where PFAS has been detected in drinking water has been compiled by Northeastern University and Environmental Working Group.\u003c/p>\n\u003cp>Lawsuits have been filed against companies believed to be responsible for the pollution. For example, Minnesota sued 3M over PFAS pollution and \u003ca href=\"https://www.mprnews.org/story/2018/02/20/3m-pfc-groundwater-pollution-trial-announcement\" target=\"_blank\" rel=\"noopener\">settled for $850 million\u003c/a> in February 2018\u003c/p>\n\u003cp>\u003cstrong>3. State and Federal Agencies Not Responding Fast Enough \u003c/strong>\u003c/p>\n\u003cp>The EPA requires most water utilities to test for a list of PFAS chemicals. In 2016 the agency lowered a \u003ca href=\"https://www.epa.gov/sites/production/files/2016-06/documents/drinkingwaterhealthadvisories_pfoa_pfos_updated_5.31.16.pdf\" target=\"_blank\" rel=\"noopener\">non-binding health advisory limit\u003c/a> for some PFAS compounds to 70 parts per trillion (ppt). That's about 70 grains of sand in an Olympic-size swimming pool, says Christopher Crockett, chief environmental officer for the water utility Aqua America.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But environmentalists argue that a \u003ca href=\"https://www.propublica.org/article/suppressed-study-the-epa-underestimated-dangers-of-widespread-chemicals\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention study\u003c/a> indicates the numbers should be much lower. \u003ca href=\"https://news.bloombergenvironment.com/environment-and-energy/glass-half-full-on-state-solutions-to-chemicals-in-water/\">A few states\u003c/a> have set lower standards on their own.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS chemicals and expects to release it by the end of this year.\u003c/p>\n\u003cp>\"We need actions to come out of those plans that lead to clear direction for water suppliers,\" says Crockett. He wants to know what level of PFAS chemicals in water is safe and when should his company install filters to remove the chemicals.\u003c/p>\n\u003cp>The Department of Defense also has a big role to play in cleaning up PFAS pollution. The agency uses fire-fighting foam for training at air bases around the country. In places like \u003ca href=\"https://whyy.org/segments/pfas-chemicals-showing-up-in-montco-water-beyond-military-bases/\">Pennsylvania\u003c/a> PFAS chemicals from that foam have made their way into local drinking water.\u003c/p>\n\u003cp>\u003cstrong>4. Steps to Protect Yourself \u003c/strong>\u003c/p>\n\u003cp>When utility company Aqua America learns it needs to treat water polluted with PFAS it installs big carbon filters. If you're worried about this issue and want to be extra cautious, you can essentially do the same in your home.\u003c/p>\n\u003cp>Christopher Crockett with Aqua says filters on refrigerators that dispense water or pitchers with carbon filters work pretty well—just make sure you change the filters regularly as manufacturers recommend.\u003c/p>\n\u003cp>If you want to also limit exposure from taking showers or brushing your teeth then a whole-house filtration system might be necessary. When asked if he filters his water, Crockett says he does not. He's comfortable that water under the current EPA health advisory level of 70 ppt is safe to drink.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Water is not the only concern though. Laurel Schaider with Silent Spring Institute says it could make sense to avoid things like fast food wrappers and microwave popcorn bags that can have PFAS chemicals in them. The problem is you never know which ones to avoid because there are no labeling requirements.\u003c/p>\n\u003cp>The state of Washington will eventually \u003ca href=\"https://www.opb.org/news/article/food-packaging-chemical-perfluorinated-ban-washington/\" target=\"_blank\" rel=\"noopener\">ban PFAS use for food packaging\u003c/a> and \u003ca href=\"http://www.spokesman.com/stories/2018/mar/27/washington-bans-fire-fighting-chemicals-that-may-c/\">fire-fighting foam\u003c/a>.\u003c/p>\n\u003cp>Finally, eating a lot of fish also can be a concern in some places. New Jersey is among states that have warned people to \u003ca href=\"https://stateimpact.npr.org/pennsylvania/2018/07/20/new-jersey-issues-first-advisories-for-consumption-of-fish-containing-pfas-chemicals/\" target=\"_blank\" rel=\"noopener\">limit how much fish they eat\u003c/a> from certain bodies of water\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Decades+Old+Chemicals%2C+New+Angst+Over+Drinking+Water&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" />\u003c/div>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In her testimony to a Senate committee, the woman who accused Brett Kavanaugh of sexually assaulting her when they were teenagers dipped briefly into the mechanics of memory. Experts say she got it pretty much right.[contextly_sidebar id=\"MgBzvQhdBHjEstqurrr3K1yckpneYUdI\"]\u003c/p>\n\u003cp>When asked Thursday how she could be sure it was Kavanaugh who put a hand over her mouth to keep her quiet, psychologist Christine Blasey Ford cited levels of chemical messengers called norepinephrine and epinephrine in her brain at the time of the alleged attack.\u003c/p>\n\u003cp>She said those chemicals helped encode memories in a brain region called the hippocampus, so that the main memory was “locked there” while other details “kind of drift.”\u003c/p>\n\u003cp>Later, she said a memory of Kavanaugh and another teen laughing during the assault was “indelible in the hippocampus.”\u003c/p>\n\u003cp>Memories are not highly detailed recordings of events retrieved with perfect accuracy. They are shaped by beliefs and expectations. For that reason, experts told The Associated Press last week that both Ford and Kavanaugh, who denies that any assault happened, may both firmly believe what they say.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Which one believes his or her version more strongly is no tipoff to what really happened, experts say.\u003c/p>\n\u003cp>“Confidence is not a good guide to whether or not someone is telling the truth,” said Nora Newcombe, a psychology professor at Temple University in Philadelphia. “If they think they’re telling the truth, they could plausibly both be confident about it.”[contextly_sidebar id=\"amJ6lQEUSDSPlTWgnGoBA7CSFAZGM5RJ\"]\u003c/p>\n\u003cp>In a situation where a woman fears being raped by a man, her memories might be shaped by that fear into a recollection that overestimates the threat, whereas the man might consider it “just playing around” and forget it, said David Rubin, a professor of psychology and neuroscience at Duke University.\u003c/p>\n\u003cp>And both people could be completely honest about their recollections, he said.\u003c/p>\n\u003cp>Rubin noted the obvious fact that people can forget things they did while drunk. But he said the man in that scenario could forget about the event even if he had been sober.\u003c/p>\n\u003cp>Experts in memory and the brain said Ford’s quick tour of memory machinery was generally correct. Levels of the brain substances she cited go up when a person is alarmed, and they help memories become laid down more strongly in the hippocampus, said Elizabeth Phelps, a Harvard University psychologist.\u003c/p>\n\u003cp>That helps people vividly recall central parts of an emotional experience, while details are typically lost, said Lila Davachi of Columbia University.\u003c/p>\n\u003cp>While it’s clear the hippocampus is key to the initial laying down of memory, there’s some debate about its role in long-term memory, Phelps said. Various pieces of an experience — sounds, sights and thoughts — are perceived in different parts of the brain. And initially the hippocampus serves as sort of the center of a web that holds those perceptions together as a memory, she said.\u003c/p>\n\u003cp>After years pass and the memory becomes consolidated, it’s not clear whether the hippocampus continues to play that central role, or whether the various parts of a memory are connected by other means, she said.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"http://bit.ly/2G0n9w6\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In her testimony to a Senate committee, the woman who accused Brett Kavanaugh of sexually assaulting her when they were teenagers dipped briefly into the mechanics of memory. Experts say she got it pretty much right.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>When asked Thursday how she could be sure it was Kavanaugh who put a hand over her mouth to keep her quiet, psychologist Christine Blasey Ford cited levels of chemical messengers called norepinephrine and epinephrine in her brain at the time of the alleged attack.\u003c/p>\n\u003cp>She said those chemicals helped encode memories in a brain region called the hippocampus, so that the main memory was “locked there” while other details “kind of drift.”\u003c/p>\n\u003cp>Later, she said a memory of Kavanaugh and another teen laughing during the assault was “indelible in the hippocampus.”\u003c/p>\n\u003cp>Memories are not highly detailed recordings of events retrieved with perfect accuracy. They are shaped by beliefs and expectations. For that reason, experts told The Associated Press last week that both Ford and Kavanaugh, who denies that any assault happened, may both firmly believe what they say.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Which one believes his or her version more strongly is no tipoff to what really happened, experts say.\u003c/p>\n\u003cp>“Confidence is not a good guide to whether or not someone is telling the truth,” said Nora Newcombe, a psychology professor at Temple University in Philadelphia. “If they think they’re telling the truth, they could plausibly both be confident about it.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In a situation where a woman fears being raped by a man, her memories might be shaped by that fear into a recollection that overestimates the threat, whereas the man might consider it “just playing around” and forget it, said David Rubin, a professor of psychology and neuroscience at Duke University.\u003c/p>\n\u003cp>And both people could be completely honest about their recollections, he said.\u003c/p>\n\u003cp>Rubin noted the obvious fact that people can forget things they did while drunk. But he said the man in that scenario could forget about the event even if he had been sober.\u003c/p>\n\u003cp>Experts in memory and the brain said Ford’s quick tour of memory machinery was generally correct. Levels of the brain substances she cited go up when a person is alarmed, and they help memories become laid down more strongly in the hippocampus, said Elizabeth Phelps, a Harvard University psychologist.\u003c/p>\n\u003cp>That helps people vividly recall central parts of an emotional experience, while details are typically lost, said Lila Davachi of Columbia University.\u003c/p>\n\u003cp>While it’s clear the hippocampus is key to the initial laying down of memory, there’s some debate about its role in long-term memory, Phelps said. Various pieces of an experience — sounds, sights and thoughts — are perceived in different parts of the brain. And initially the hippocampus serves as sort of the center of a web that holds those perceptions together as a memory, she said.\u003c/p>\n\u003cp>After years pass and the memory becomes consolidated, it’s not clear whether the hippocampus continues to play that central role, or whether the various parts of a memory are connected by other means, she said.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"http://bit.ly/2G0n9w6\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Within three days of starting high school this year, my ninth-grader could not get into bed before 11 p.m. or wake up by 6 a.m. He complained he couldn’t fall asleep but felt foggy during the school day and had to reread lessons a few times at night to finish his homework. And forget morning activities on the weekends — he was in bed.\u003c/p>\n\u003cp>We’re not the only family struggling to get restful shut-eye.\u003c/p>\n\u003cp>“What parents are sharing with us is that the ‘normal life’ of a typical American high schooler is interfering with sleep,” says \u003ca href=\"https://chear.org/people/faculty-investigators/sarah-clark\">Sarah Clark\u003c/a>, co-director of C.S. Mott Children’s Hospital \u003ca href=\"http://mottnpch.org/\">National Poll on Children’s Health\u003c/a> at the University of Michigan.\u003c/p>\n\u003cp>In the \u003ca href=\"https://mottpoll.org/sites/default/files/documents/091718_Sleep.pdf\">poll\u003c/a> of 2,000 parents from various ethnic groups and backgrounds that Clark and her team published this month, 1 in 6 parents say their teen experiences frequent sleep problems — “having trouble falling asleep or staying asleep 3 or more nights per week.”\u003c/p>\n\u003cp>More than half the parents say it’s because their teens won’t get off their electronic devices, and 43 percent blame irregular schedules with homework and activities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A significant percentage of parents say their kids worry about school (31 percent), and 23 percent say their teens stay up worrying about their social lives.\u003c/p>\n\u003cp>It’s likely that the numbers of teens who have trouble sleeping is even higher than the poll of parents suggests, Clark says, because kids can hide their nighttime electronics use and parents may not frequently check in on older children.\u003c/p>\n\u003cp>How can parents help? Start with knowing what kids need.\u003c/p>\n\u003cp>The average American teenager gets \u003ca href=\"https://www.nationwidechildrens.org/specialties/sleep-disorder-center/sleep-in-adolescents\">seven hours\u003c/a> of sleep a night, wedging it in between homework, outside activities, dinner and maybe a job. But research \u003ca href=\"https://www.npr.org/sections/health-shots/2012/02/14/146881838/how-much-sleep-do-kids-need-not-such-a-mystery-after-all\">suggests\u003c/a> teens need more like nine hours.\u003c/p>\n\u003cp>Unfortunately, even their bodies work against them, says \u003ca href=\"https://vivo.brown.edu/display/mcarskad\">Mary Carskadon\u003c/a>, a longtime sleep researcher and professor of psychiatry and human behavior at Brown University. As children grow into the middle and teen years, they are naturally inclined to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130594/\">go to bed later\u003c/a> and sleep later in the morning. But an early school start time doesn’t allow it.\u003c/p>\n\u003cp>“If kids’ body clocks are shifting later and the school is starting earlier, there’s no time left to recover,” Carskadon says.\u003c/p>\n\u003cp>She and Clark have evidence-based tips for weary teens and their parents:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Put electronics away and out of reach.\u003c/strong> Research has long shown that screen time interferes with good sleep because \u003ca href=\"https://www.npr.org/sections/health-shots/2016/11/19/502610055/heavy-screen-time-rewires-young-brains-for-better-and-worse\">it’s stimulating\u003c/a>, and those “\u003ca href=\"https://www.npr.org/2017/12/03/568133027/encore-blue-light-and-sleep\">blue light filters\u003c/a>” that minimize the most troublesome part of the spectrum won’t help much if you’re stressed out. So do whatever it takes to make sleep hours electronics-free. “If I were an entrepreneur, my get-rich-quick scheme would be the family tech lockbox,” says Carskadon. (There are already a few \u003ca href=\"http://www.distractagone.com/\">phone lockers\u003c/a> in the works or \u003ca href=\"https://www.amazon.com/Mounted-Phone-Locker-Storage-Acrylic/dp/B0765C89CY\">on the market\u003c/a> that may do the trick.)\u003c/li>\n\u003cli>\u003cstrong>Instill a regular bedtime routine.\u003c/strong> Try to turn the lights out at around the same time and wake up at the same time, even on weekends, because the evidence shows you can’t really “make up” missed sleep \u003ca href=\"https://www.npr.org/2018/07/20/630792401/sleep-scientist-warns-against-walking-through-life-in-an-underslept-state\">on the weekends\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>Sleep masks are useful, but avoid long naps. \u003c/strong>Sleep masks can help create an environment conducive to sleep, says Carskadon, as can trying to prevent sleepy kids from taking long,\u003cstrong> \u003c/strong>late afternoon naps. A 20-minute nap \u003ca href=\"https://www.npr.org/sections/health-shots/2017/05/15/527952956/stressed-out-high-schoolers-advised-to-take-a-nap-pod\">might be refreshing\u003c/a>, but longer sleep sessions during the day can make it harder to get good rest at night. “The kids who struggle most at night are the ones who will be falling asleep in school, going to the nurse’s office, and pouring a bowl of Cheerios and falling asleep in them,” Carskadon says.\u003c/li>\n\u003cli>\u003cstrong>Limit caffeine — even more than you already do.\u003c/strong> After school, many teens grab a soda or an energy drink to power through the rest of the afternoon. But this just makes going to bed on time more difficult, which, in turn, makes the next day harder. The disruptions add up. In the Mott survey, 54 percent of parents had their teens limit caffeine in the evening, notes Clark, although she suggests cutting it back earlier in the day or even completely.\u003c/li>\n\u003cli>\u003cstrong>Pull back on the crammed schedule.\u003c/strong> This is antithetical to what many parents of high school students and some students themselves think they should do to get into college. But does your teen really need to star in the school play, run for student council and be the starting quarterback for the high school football team? “Pick one,” says Carskadon.\u003c/li>\n\u003cli>\u003cstrong>Teach time management.\u003c/strong> If you don’t have four hours straight to get homework done at night, break it up into chunks. “If you have 45 minutes before your activity, go to the library and get one or two subjects out of the way,” Clark suggests.\u003c/li>\n\u003cli>\u003cstrong>Before trying a drugstore sleep aid, talk to your doctor.\u003c/strong> The Mott survey suggests parents frequently turn to remedies like melatonin and over-the-counter drugs like Tylenol PM or NyQuil. But Clark encourages parents and teens to discuss these with a physician first. Melatonin isn’t always gentle or effective, and scientists still \u003ca href=\"https://nccih.nih.gov/health/melatonin\">don’t know much\u003c/a> about its long-term effects, according to the National Institutes of Health. And the heavy use of OTC drugs can be habit-forming and \u003ca href=\"https://www.npr.org/templates/story/story.php?storyId=106167255\">hard on the liver\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>Pursue policy changes.\u003c/strong> Most sleep scientists say it would be healthier for older children to \u003ca href=\"https://www.nytimes.com/2018/09/20/opinion/sunday/sleep-school-start-time-screens-teenagers.html?action=click&module=MoreInSection&pgtype=Article®ion=Footer&contentCollection=Opinion\">start school later\u003c/a> in the morning than most U.S. school districts do. The California Legislature \u003ca href=\"http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-may-2018-tired-teens-could-get-to-sleep-in-after-1535779353-htmlstory.html\">passed a bill\u003c/a> last month requiring most middle schools and high schools to start no earlier than 8:30 a.m. by 2021, but Gov. Jerry Brown vetoed it on Thursday. Such a change nationally won’t come easily. “The school start time issue is very fraught,” Carskadon notes. Many teachers are fighting it, and working parents may not be able to shift their schedules and other child care obligations.\u003c/li>\n\u003c/ul>\n\u003cp>Meanwhile, Clark and Carskadon say, the most effective thing we parents can do is listen to our kids — talk with them about their sleep challenges and help them set a regular sleep schedule. It’s never to early (or too late) to find healthy ways to relieve \u003ca href=\"https://www.npr.org/sections/health-shots/2014/07/17/332058265/skimping-on-sleep-can-stress-body-and-brain\">daytime stresses\u003c/a> that can disrupt sleep at night, whatever your age.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Best idea yet, parents: We can set a good example, by putting our own electronics away — really away — at bedtime. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teens+Sleeping+Too+Much%2C+Or+Not+Enough%3F+Parents+Can+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Within three days of starting high school this year, my ninth-grader could not get into bed before 11 p.m. or wake up by 6 a.m. He complained he couldn’t fall asleep but felt foggy during the school day and had to reread lessons a few times at night to finish his homework. And forget morning activities on the weekends — he was in bed.\u003c/p>\n\u003cp>We’re not the only family struggling to get restful shut-eye.\u003c/p>\n\u003cp>“What parents are sharing with us is that the ‘normal life’ of a typical American high schooler is interfering with sleep,” says \u003ca href=\"https://chear.org/people/faculty-investigators/sarah-clark\">Sarah Clark\u003c/a>, co-director of C.S. Mott Children’s Hospital \u003ca href=\"http://mottnpch.org/\">National Poll on Children’s Health\u003c/a> at the University of Michigan.\u003c/p>\n\u003cp>In the \u003ca href=\"https://mottpoll.org/sites/default/files/documents/091718_Sleep.pdf\">poll\u003c/a> of 2,000 parents from various ethnic groups and backgrounds that Clark and her team published this month, 1 in 6 parents say their teen experiences frequent sleep problems — “having trouble falling asleep or staying asleep 3 or more nights per week.”\u003c/p>\n\u003cp>More than half the parents say it’s because their teens won’t get off their electronic devices, and 43 percent blame irregular schedules with homework and activities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A significant percentage of parents say their kids worry about school (31 percent), and 23 percent say their teens stay up worrying about their social lives.\u003c/p>\n\u003cp>It’s likely that the numbers of teens who have trouble sleeping is even higher than the poll of parents suggests, Clark says, because kids can hide their nighttime electronics use and parents may not frequently check in on older children.\u003c/p>\n\u003cp>How can parents help? Start with knowing what kids need.\u003c/p>\n\u003cp>The average American teenager gets \u003ca href=\"https://www.nationwidechildrens.org/specialties/sleep-disorder-center/sleep-in-adolescents\">seven hours\u003c/a> of sleep a night, wedging it in between homework, outside activities, dinner and maybe a job. But research \u003ca href=\"https://www.npr.org/sections/health-shots/2012/02/14/146881838/how-much-sleep-do-kids-need-not-such-a-mystery-after-all\">suggests\u003c/a> teens need more like nine hours.\u003c/p>\n\u003cp>Unfortunately, even their bodies work against them, says \u003ca href=\"https://vivo.brown.edu/display/mcarskad\">Mary Carskadon\u003c/a>, a longtime sleep researcher and professor of psychiatry and human behavior at Brown University. As children grow into the middle and teen years, they are naturally inclined to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130594/\">go to bed later\u003c/a> and sleep later in the morning. But an early school start time doesn’t allow it.\u003c/p>\n\u003cp>“If kids’ body clocks are shifting later and the school is starting earlier, there’s no time left to recover,” Carskadon says.\u003c/p>\n\u003cp>She and Clark have evidence-based tips for weary teens and their parents:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Put electronics away and out of reach.\u003c/strong> Research has long shown that screen time interferes with good sleep because \u003ca href=\"https://www.npr.org/sections/health-shots/2016/11/19/502610055/heavy-screen-time-rewires-young-brains-for-better-and-worse\">it’s stimulating\u003c/a>, and those “\u003ca href=\"https://www.npr.org/2017/12/03/568133027/encore-blue-light-and-sleep\">blue light filters\u003c/a>” that minimize the most troublesome part of the spectrum won’t help much if you’re stressed out. So do whatever it takes to make sleep hours electronics-free. “If I were an entrepreneur, my get-rich-quick scheme would be the family tech lockbox,” says Carskadon. (There are already a few \u003ca href=\"http://www.distractagone.com/\">phone lockers\u003c/a> in the works or \u003ca href=\"https://www.amazon.com/Mounted-Phone-Locker-Storage-Acrylic/dp/B0765C89CY\">on the market\u003c/a> that may do the trick.)\u003c/li>\n\u003cli>\u003cstrong>Instill a regular bedtime routine.\u003c/strong> Try to turn the lights out at around the same time and wake up at the same time, even on weekends, because the evidence shows you can’t really “make up” missed sleep \u003ca href=\"https://www.npr.org/2018/07/20/630792401/sleep-scientist-warns-against-walking-through-life-in-an-underslept-state\">on the weekends\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>Sleep masks are useful, but avoid long naps. \u003c/strong>Sleep masks can help create an environment conducive to sleep, says Carskadon, as can trying to prevent sleepy kids from taking long,\u003cstrong> \u003c/strong>late afternoon naps. A 20-minute nap \u003ca href=\"https://www.npr.org/sections/health-shots/2017/05/15/527952956/stressed-out-high-schoolers-advised-to-take-a-nap-pod\">might be refreshing\u003c/a>, but longer sleep sessions during the day can make it harder to get good rest at night. “The kids who struggle most at night are the ones who will be falling asleep in school, going to the nurse’s office, and pouring a bowl of Cheerios and falling asleep in them,” Carskadon says.\u003c/li>\n\u003cli>\u003cstrong>Limit caffeine — even more than you already do.\u003c/strong> After school, many teens grab a soda or an energy drink to power through the rest of the afternoon. But this just makes going to bed on time more difficult, which, in turn, makes the next day harder. The disruptions add up. In the Mott survey, 54 percent of parents had their teens limit caffeine in the evening, notes Clark, although she suggests cutting it back earlier in the day or even completely.\u003c/li>\n\u003cli>\u003cstrong>Pull back on the crammed schedule.\u003c/strong> This is antithetical to what many parents of high school students and some students themselves think they should do to get into college. But does your teen really need to star in the school play, run for student council and be the starting quarterback for the high school football team? “Pick one,” says Carskadon.\u003c/li>\n\u003cli>\u003cstrong>Teach time management.\u003c/strong> If you don’t have four hours straight to get homework done at night, break it up into chunks. “If you have 45 minutes before your activity, go to the library and get one or two subjects out of the way,” Clark suggests.\u003c/li>\n\u003cli>\u003cstrong>Before trying a drugstore sleep aid, talk to your doctor.\u003c/strong> The Mott survey suggests parents frequently turn to remedies like melatonin and over-the-counter drugs like Tylenol PM or NyQuil. But Clark encourages parents and teens to discuss these with a physician first. Melatonin isn’t always gentle or effective, and scientists still \u003ca href=\"https://nccih.nih.gov/health/melatonin\">don’t know much\u003c/a> about its long-term effects, according to the National Institutes of Health. And the heavy use of OTC drugs can be habit-forming and \u003ca href=\"https://www.npr.org/templates/story/story.php?storyId=106167255\">hard on the liver\u003c/a>.\u003c/li>\n\u003cli>\u003cstrong>Pursue policy changes.\u003c/strong> Most sleep scientists say it would be healthier for older children to \u003ca href=\"https://www.nytimes.com/2018/09/20/opinion/sunday/sleep-school-start-time-screens-teenagers.html?action=click&module=MoreInSection&pgtype=Article®ion=Footer&contentCollection=Opinion\">start school later\u003c/a> in the morning than most U.S. school districts do. The California Legislature \u003ca href=\"http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-may-2018-tired-teens-could-get-to-sleep-in-after-1535779353-htmlstory.html\">passed a bill\u003c/a> last month requiring most middle schools and high schools to start no earlier than 8:30 a.m. by 2021, but Gov. Jerry Brown vetoed it on Thursday. Such a change nationally won’t come easily. “The school start time issue is very fraught,” Carskadon notes. Many teachers are fighting it, and working parents may not be able to shift their schedules and other child care obligations.\u003c/li>\n\u003c/ul>\n\u003cp>Meanwhile, Clark and Carskadon say, the most effective thing we parents can do is listen to our kids — talk with them about their sleep challenges and help them set a regular sleep schedule. It’s never to early (or too late) to find healthy ways to relieve \u003ca href=\"https://www.npr.org/sections/health-shots/2014/07/17/332058265/skimping-on-sleep-can-stress-body-and-brain\">daytime stresses\u003c/a> that can disrupt sleep at night, whatever your age.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Best idea yet, parents: We can set a good example, by putting our own electronics away — really away — at bedtime. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teens+Sleeping+Too+Much%2C+Or+Not+Enough%3F+Parents+Can+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>She says he sexually assaulted her; he denies it. Is somebody deliberately lying?\u003c/p>\n\u003cp>Not necessarily.\u003c/p>\n\u003cp>Experts say that because of how memory works, it’s possible that both Supreme Court nominee Brett Kavanaugh and Christine Blasey Ford — the woman who says a drunken Kavanaugh pinned her to a bed and groped her at a party when they were teenagers in the early 1980s — believe what they say.[contextly_sidebar id=\"aGFI2U13RVFON4GWTLLls7lLOiR2jou1\"]\u003c/p>\n\u003cp>And which one of them believes his or her version more strongly is no tipoff to what really happened.\u003c/p>\n\u003cp>“Confidence is not a good guide to whether or not someone is telling the truth,” said Nora Newcombe, a psychology professor at Temple University in Philadelphia. “If they think they’re telling the truth, they could plausibly both be confident about it.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As the nation ponders the accusations from Ford that could derail Kavanaugh’s nomination, the possibility that one of them simply got it wrong has been floated on Capitol Hill. Ford’s lawyers have said some senators appear to have made up their mind that she is “mistaken” and confused. Republican Sen. Orrin Hatch of Utah told CNN, “Somebody’s mixed up.”\u003c/p>\n\u003cp>Experts say a person’s memory is not like a video recorder, perfectly capturing an objective record of everything that happens for later retrieval.\u003c/p>\n\u003cp>“Memory is mostly true but sometimes unreliable,” said psychologist Jennifer Talarico of Lafayette College in Easton, Pennsylvania. Generally, “we get the gist mostly right.”\u003c/p>\n\u003cp>Your beliefs and expectations shape what you perceive in your life and how you later remember those events, researchers say.\u003c/p>\n\u003cp>“You are constructing the reality out there as it happens, and therefore you get stuck with that ... as the most accurate you can have for your memory,” said David Rubin, a professor of psychology and neuroscience at Duke University. “That’s all you have to base your memory on.”[contextly_sidebar id=\"whv9WgAL0RAIu9Kk3FDpIVBBXEXkxLjZ\"]\u003c/p>\n\u003cp>So in a situation where a woman fears being raped by a man, her memories might be shaped by that fear into a recollection that overestimates the threat, whereas the man might consider it “just playing around” and simply forget it later on, Rubin said. And both could be completely honest about their recollections.\u003c/p>\n\u003cp>Typically, when people make mistakes in recalling an event, they unknowingly slip in details that would be typical on such occasions, Talarico said. (She would not speculate on particular memories at issue in the Kavanaugh matter.)\u003c/p>\n\u003cp>When it comes to emotionally charged events, it’s typical to remember a central person or an item such as a gun but forget the context and details, Newcombe said. “You have this vivid central thing and everything else is fuzzy,” she said. “Emotion makes one thing go up and the other go down.”\u003c/p>\n\u003cp>So it would be wrong to challenge Ford’s memory of the alleged incident over inability to recall details, Newcombe said.\u003c/p>\n\u003cp>Ford, a 51-year-old California psychology professor, told The Washington Post that she told nobody about the alleged incident in any detail until 2012, while in couples therapy. Her husband said he recalled her using Kavanaugh’s last name at that time.[contextly_sidebar id=\"JPgu1jHhQDzw6C74gfXRYE1kGCDVjvC4\"]\u003c/p>\n\u003cp>Some experts cited a classic case of how memory can fail: the 1973 Senate committee testimony of John Dean, former counsel to President Richard Nixon, regarding the Watergate affair. He testified about conversations that, it later turned out, had been recorded.\u003c/p>\n\u003cp>In 1981, a psychologist published a comparison of his testimony to the tapes and found that even though Dean was basically right about the existence of a cover-up, his accounts of conversations were often wrong.\u003c/p>\n\u003cp>As for the Kavanaugh matter, Rubin said, “We don’t have the tapes for what happened at the party.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>She says he sexually assaulted her; he denies it. Is somebody deliberately lying?\u003c/p>\n\u003cp>Not necessarily.\u003c/p>\n\u003cp>Experts say that because of how memory works, it’s possible that both Supreme Court nominee Brett Kavanaugh and Christine Blasey Ford — the woman who says a drunken Kavanaugh pinned her to a bed and groped her at a party when they were teenagers in the early 1980s — believe what they say.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And which one of them believes his or her version more strongly is no tipoff to what really happened.\u003c/p>\n\u003cp>“Confidence is not a good guide to whether or not someone is telling the truth,” said Nora Newcombe, a psychology professor at Temple University in Philadelphia. “If they think they’re telling the truth, they could plausibly both be confident about it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As the nation ponders the accusations from Ford that could derail Kavanaugh’s nomination, the possibility that one of them simply got it wrong has been floated on Capitol Hill. Ford’s lawyers have said some senators appear to have made up their mind that she is “mistaken” and confused. Republican Sen. Orrin Hatch of Utah told CNN, “Somebody’s mixed up.”\u003c/p>\n\u003cp>Experts say a person’s memory is not like a video recorder, perfectly capturing an objective record of everything that happens for later retrieval.\u003c/p>\n\u003cp>“Memory is mostly true but sometimes unreliable,” said psychologist Jennifer Talarico of Lafayette College in Easton, Pennsylvania. Generally, “we get the gist mostly right.”\u003c/p>\n\u003cp>Your beliefs and expectations shape what you perceive in your life and how you later remember those events, researchers say.\u003c/p>\n\u003cp>“You are constructing the reality out there as it happens, and therefore you get stuck with that ... as the most accurate you can have for your memory,” said David Rubin, a professor of psychology and neuroscience at Duke University. “That’s all you have to base your memory on.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>So in a situation where a woman fears being raped by a man, her memories might be shaped by that fear into a recollection that overestimates the threat, whereas the man might consider it “just playing around” and simply forget it later on, Rubin said. And both could be completely honest about their recollections.\u003c/p>\n\u003cp>Typically, when people make mistakes in recalling an event, they unknowingly slip in details that would be typical on such occasions, Talarico said. (She would not speculate on particular memories at issue in the Kavanaugh matter.)\u003c/p>\n\u003cp>When it comes to emotionally charged events, it’s typical to remember a central person or an item such as a gun but forget the context and details, Newcombe said. “You have this vivid central thing and everything else is fuzzy,” she said. “Emotion makes one thing go up and the other go down.”\u003c/p>\n\u003cp>So it would be wrong to challenge Ford’s memory of the alleged incident over inability to recall details, Newcombe said.\u003c/p>\n\u003cp>Ford, a 51-year-old California psychology professor, told The Washington Post that she told nobody about the alleged incident in any detail until 2012, while in couples therapy. Her husband said he recalled her using Kavanaugh’s last name at that time.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Some experts cited a classic case of how memory can fail: the 1973 Senate committee testimony of John Dean, former counsel to President Richard Nixon, regarding the Watergate affair. He testified about conversations that, it later turned out, had been recorded.\u003c/p>\n\u003cp>In 1981, a psychologist published a comparison of his testimony to the tapes and found that even though Dean was basically right about the existence of a cover-up, his accounts of conversations were often wrong.\u003c/p>\n\u003cp>As for the Kavanaugh matter, Rubin said, “We don’t have the tapes for what happened at the party.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "IVF And Infertility Tech May Lead To Health Risks For The Baby",
"title": "IVF And Infertility Tech May Lead To Health Risks For The Baby",
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"content": "\u003cp>When patients come to Dr. Molly Quinn for infertility treatments, they usually aren't too interested in hearing about the possible downsides, she says. They just want to get pregnant.[contextly_sidebar id=\"ey0hWotixUsdyo0wQnYUMCoyOptxLTRK\"]\u003c/p>\n\u003cp>Still, she always discusses the risks. For example, there's an increased likelihood of twins or triplets — which increases the chances of \u003ca href=\"https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P08021\" target=\"_blank\" rel=\"noopener\">medical complications\u003c/a> for both moms and babies. And stimulating the ovaries to ripen extra eggs can, in a small number of cases, cause the ovaries to rupture.\u003c/p>\n\u003cp>\u003ca href=\"https://www.uclahealth.org/molly-quinn\" target=\"_blank\" rel=\"noopener\">Quinn\u003c/a>, an infertility specialist and assistant professor of obstetrics and gynecology at the University of California, Los Angeles, now has a new hazard to consider. According to \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0735109718354809?via%3Dihub\" target=\"_blank\" rel=\"noopener\">research\u003c/a> published this month in the \u003cem>Journal of the American College of Cardiology\u003c/em>, children conceived through certain infertility treatments may be at a higher risk for cardiovascular disease.\u003c/p>\n\u003cp>Parents shouldn't panic, the study's authors say: The findings are preliminary, and the study cohort was fairly small. Still, they say, it means that families who used infertility treatments should be particularly vigilant about screening for high blood pressure in their children and help them avoid other cardiovascular risk factors, such as smoking, obesity and a sedentary lifestyle.\u003c/p>\n\u003cp>\"Fertility clinics should really ... counsel about potential risks for their kids,\" says \u003ca href=\"http://www.dbmr.unibe.ch/research/research_groups/personenpool/cardiology/prof_dr_med_scherrer_urs/index_eng.html\" target=\"_blank\" rel=\"noopener\">Dr. Urs Scherrer\u003c/a>, a visiting professor at the University of Bern in Switzerland and a senior author of the study.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Scherrer and his colleagues followed the health of children conceived through assisted reproductive technology for more than a decade. \u003ca href=\"https://medlineplus.gov/assistedreproductivetechnology.html\" target=\"_blank\" rel=\"noopener\">ART\u003c/a> is an umbrella term that covers a number of different types of procedures, including in vitro fertilization, in which sperm and eggs are mixed in a lab dish, and intracytoplasmic sperm injection, in which sperm are inserted directly into eggs. Today, roughly 2 percent of all births in the U.S are conceived via ART.[contextly_sidebar id=\"QmmfxSiEfwbF2B1GB9guL21XilL52eqX\"]\u003c/p>\n\u003cp>In 2012, the same team of scientists published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22434595\" target=\"_blank\" rel=\"noopener\">major paper\u003c/a> showing that 65 healthy kids born with the help of ART were more likely than their peers to have early signs of problematic blood vessels. The current study, comparing 54 of those original children with 43 age- and sex-matched peers, shows those early irregularities — signs of \"premature vascular aging\", the scientists say — persist into adolescence and young adulthood.\u003c/p>\n\u003cp>Kids in the study who were conceived via ART are now 16 years old, on average, but have blood vessels resembling those of middle-aged adults, the scientists found.\u003c/p>\n\u003cp>And those differences seemed to be enough to boost the teens' blood pressure. Everyone in the study underwent round-the-clock blood pressure monitoring for 24 hours, and the differences between a group conceived by ART and teens in the control group were significant. The ART group had markedly higher blood pressure; about 15 percent met the criteria for hypertension.\u003c/p>\n\u003cp>The study adds to a small but \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24270419\" target=\"_blank\" rel=\"noopener\">growing\u003c/a> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27420642\">body\u003c/a> of research suggesting that children conceived this way may have an elevated risk of hypertension and its health complications.\u003c/p>\n\u003cp>Scientists say they don't yet know why that would be true, but they hypothesize that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256/\" target=\"_blank\" rel=\"noopener\">epigenetics\u003c/a> — the interplay of environment and genes — plays a role. Something about the manipulation of the eggs and sperm in the lab might affect which genes are turned on or off as embryos develop.\u003c/p>\n\u003cp>Medical specialists who study high blood pressure in kids called the research striking.\u003c/p>\n\u003cp>\"The fact that these kids already have abnormal vasculature is quite concerning,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/joseph-t-flynn/\" target=\"_blank\" rel=\"noopener\">Dr. Joseph Flynn\u003c/a>, a pediatrician who helped write the American Academy of Pediatrics' guidelines about blood pressure management. \"I think the fact that they saw these changes at an early age and that they're still persisting into adolescence is worrisome for these kids.\"[contextly_sidebar id=\"85O7WjzrUHwoOFYBW2OgPx9FMGcZx2CI\"]\u003c/p>\n\u003cp>Still, he says, it's unclear what the long-term effects on their cardiovascular health will be. Conception through ART, Flynn says, may confer the same amount of risk as, say, teenage smoking or alcohol use.\u003c/p>\n\u003cp>Quinn says she would like to see more longitudinal research that tracks long-term consequences of infertility treatments.\u003c/p>\n\u003cp>\"We need to connect these kinds of studies,\" she says. Such research can be more difficult to do in the United States, she notes, because there is no unified medical record, so it's hard to track the babies who are conceived through ART.\u003c/p>\n\u003cp>Still, she says, it's important for all doctors working in the infertility field to acknowledge that the techniques they use are still evolving.\u003c/p>\n\u003cp>\"We appreciate that there is quite a bit unknown about we do on a day-to-day basis,\" says Quinn. \"We have to be humble.\"\u003c/p>\n\u003cp>For now, \u003ca href=\"http://pediatrics.aappublications.org/content/early/2017/08/21/peds.2017-1904\" target=\"_blank\" rel=\"noopener\">the American Academy of Pediatrics recommends\u003c/a> that every child over the age of 3 get a yearly blood pressure test at the doctor's office — whether or not their parents underwent infertility treatments.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Do+IVF+And+Other+Infertility+Tech+Lead+To+Health+Risks+For+The+Baby%3F+Maybe&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"description": "A small study of teens who were conceived via assisted reproductive technology finds a significant number already have hypertension and premature "age-related changes" in their blood vessels.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When patients come to Dr. Molly Quinn for infertility treatments, they usually aren't too interested in hearing about the possible downsides, she says. They just want to get pregnant.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Still, she always discusses the risks. For example, there's an increased likelihood of twins or triplets — which increases the chances of \u003ca href=\"https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P08021\" target=\"_blank\" rel=\"noopener\">medical complications\u003c/a> for both moms and babies. And stimulating the ovaries to ripen extra eggs can, in a small number of cases, cause the ovaries to rupture.\u003c/p>\n\u003cp>\u003ca href=\"https://www.uclahealth.org/molly-quinn\" target=\"_blank\" rel=\"noopener\">Quinn\u003c/a>, an infertility specialist and assistant professor of obstetrics and gynecology at the University of California, Los Angeles, now has a new hazard to consider. According to \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0735109718354809?via%3Dihub\" target=\"_blank\" rel=\"noopener\">research\u003c/a> published this month in the \u003cem>Journal of the American College of Cardiology\u003c/em>, children conceived through certain infertility treatments may be at a higher risk for cardiovascular disease.\u003c/p>\n\u003cp>Parents shouldn't panic, the study's authors say: The findings are preliminary, and the study cohort was fairly small. Still, they say, it means that families who used infertility treatments should be particularly vigilant about screening for high blood pressure in their children and help them avoid other cardiovascular risk factors, such as smoking, obesity and a sedentary lifestyle.\u003c/p>\n\u003cp>\"Fertility clinics should really ... counsel about potential risks for their kids,\" says \u003ca href=\"http://www.dbmr.unibe.ch/research/research_groups/personenpool/cardiology/prof_dr_med_scherrer_urs/index_eng.html\" target=\"_blank\" rel=\"noopener\">Dr. Urs Scherrer\u003c/a>, a visiting professor at the University of Bern in Switzerland and a senior author of the study.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Scherrer and his colleagues followed the health of children conceived through assisted reproductive technology for more than a decade. \u003ca href=\"https://medlineplus.gov/assistedreproductivetechnology.html\" target=\"_blank\" rel=\"noopener\">ART\u003c/a> is an umbrella term that covers a number of different types of procedures, including in vitro fertilization, in which sperm and eggs are mixed in a lab dish, and intracytoplasmic sperm injection, in which sperm are inserted directly into eggs. Today, roughly 2 percent of all births in the U.S are conceived via ART.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In 2012, the same team of scientists published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22434595\" target=\"_blank\" rel=\"noopener\">major paper\u003c/a> showing that 65 healthy kids born with the help of ART were more likely than their peers to have early signs of problematic blood vessels. The current study, comparing 54 of those original children with 43 age- and sex-matched peers, shows those early irregularities — signs of \"premature vascular aging\", the scientists say — persist into adolescence and young adulthood.\u003c/p>\n\u003cp>Kids in the study who were conceived via ART are now 16 years old, on average, but have blood vessels resembling those of middle-aged adults, the scientists found.\u003c/p>\n\u003cp>And those differences seemed to be enough to boost the teens' blood pressure. Everyone in the study underwent round-the-clock blood pressure monitoring for 24 hours, and the differences between a group conceived by ART and teens in the control group were significant. The ART group had markedly higher blood pressure; about 15 percent met the criteria for hypertension.\u003c/p>\n\u003cp>The study adds to a small but \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24270419\" target=\"_blank\" rel=\"noopener\">growing\u003c/a> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27420642\">body\u003c/a> of research suggesting that children conceived this way may have an elevated risk of hypertension and its health complications.\u003c/p>\n\u003cp>Scientists say they don't yet know why that would be true, but they hypothesize that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256/\" target=\"_blank\" rel=\"noopener\">epigenetics\u003c/a> — the interplay of environment and genes — plays a role. Something about the manipulation of the eggs and sperm in the lab might affect which genes are turned on or off as embryos develop.\u003c/p>\n\u003cp>Medical specialists who study high blood pressure in kids called the research striking.\u003c/p>\n\u003cp>\"The fact that these kids already have abnormal vasculature is quite concerning,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/joseph-t-flynn/\" target=\"_blank\" rel=\"noopener\">Dr. Joseph Flynn\u003c/a>, a pediatrician who helped write the American Academy of Pediatrics' guidelines about blood pressure management. \"I think the fact that they saw these changes at an early age and that they're still persisting into adolescence is worrisome for these kids.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Still, he says, it's unclear what the long-term effects on their cardiovascular health will be. Conception through ART, Flynn says, may confer the same amount of risk as, say, teenage smoking or alcohol use.\u003c/p>\n\u003cp>Quinn says she would like to see more longitudinal research that tracks long-term consequences of infertility treatments.\u003c/p>\n\u003cp>\"We need to connect these kinds of studies,\" she says. Such research can be more difficult to do in the United States, she notes, because there is no unified medical record, so it's hard to track the babies who are conceived through ART.\u003c/p>\n\u003cp>Still, she says, it's important for all doctors working in the infertility field to acknowledge that the techniques they use are still evolving.\u003c/p>\n\u003cp>\"We appreciate that there is quite a bit unknown about we do on a day-to-day basis,\" says Quinn. \"We have to be humble.\"\u003c/p>\n\u003cp>For now, \u003ca href=\"http://pediatrics.aappublications.org/content/early/2017/08/21/peds.2017-1904\" target=\"_blank\" rel=\"noopener\">the American Academy of Pediatrics recommends\u003c/a> that every child over the age of 3 get a yearly blood pressure test at the doctor's office — whether or not their parents underwent infertility treatments.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Do+IVF+And+Other+Infertility+Tech+Lead+To+Health+Risks+For+The+Baby%3F+Maybe&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Day-Tripping to the Dispensary: Seniors Hop Aboard the Canna-Bus",
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"content": "\u003cp>Shirley Avedon, 90, had never been a cannabis user. But carpal tunnel syndrome that sends shooting pains into both of her hands and an aversion to conventional steroid and surgical treatments is prompting her to consider some new options.[contextly_sidebar id=\"5ee5PAwSPV305kcHFGTk8K3BJPlD6Byj\"]\u003c/p>\n\u003cp>“It’s very painful, sometimes I can’t even open my hand,” Avedon said.\u003c/p>\n\u003cp>So for the second time in two months, she’s climbed on board a bus that provides seniors at the Laguna Woods Village retirement community in Orange County, with a free shuttle to a nearby marijuana dispensary.\u003c/p>\n\u003cp>The retired manager of an oncology office says she’s seeking the same relief she saw cancer patients get from smoking marijuana 25 years ago.\u003c/p>\n\u003cp>“At that time [marijuana] wasn’t legal, so they used to get it off their children,” she said with a laugh. “It was fantastic what it did for them.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Avedon, who doesn’t want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol, or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana’s psychoactive ingredient.\u003c/p>\n\u003cp>“It helped a little,” she said. “Now I’m going back for the second time hoping they have something better.”\u003c/p>\n\u003cp>As more states legalize marijuana for medical or recreational use — 30 states plus the District of Columbia to date — the cannabis industry is booming. Among the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300687/\" target=\"_blank\" rel=\"noopener\">fastest growing group\u003c/a> of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternative treatments for their aches, pains and other medical conditions.[contextly_sidebar id=\"yVY8GMNy1scMP5h4RfGXepXWi4YTpexN\"]\u003c/p>\n\u003cp>On this particular morning, about 35 seniors climb on board the free shuttle — paid for by Bud and Bloom, a licensed cannabis dispensary in Santa Ana. After about a half-hour drive, the large white bus pulls up to the parking lot of the dispensary.\u003c/p>\n\u003cp>About half of the seniors on board today are repeat customers; the other half are cannabis newbies who’ve never tried it before, said Kandice Hawes, director of community outreach for Bud and Bloom.\u003c/p>\n\u003cfigure id=\"attachment_444512\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-444512\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/canna-bus_01_1350-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Residents of Laguna Woods Village, a retirement community in Orange County, Calif., ride a free shuttle to a marijuana dispensary in August.(STEPHANIE O’NEILL FOR KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>“Not everybody is coming to be a customer,” Hawes said. “A lot are just coming to be educated.”\u003c/p>\n\u003cp>Among them, Layla Sabet, 72, a first-timer seeking relief from back pain that keeps her awake at night, she said.\u003c/p>\n\u003cp>“I’m taking so much medication to sleep and still I can’t sleep,” she said. “So I’m trying it for the back pain and the sleep.”\u003c/p>\n\u003cp>Hawes invited the seniors into a large room with chairs and a table set up with free sandwiches and drinks. As they ate, she gave a presentation focused on the potential benefits of cannabis as a reliever of anxiety, insomnia and chronic pain and the various ways people can consume it.\u003c/p>\n\u003cp>Several vendors on site took turns speaking to the group about the goods they sell. Then, the seniors entered the dispensary for the chance to buy everything from old-school rolled joints and high-tech vaporizer pens to liquid sublingual tinctures, topical creams and an assortment of sweet, cannabis-infused edibles.[contextly_sidebar id=\"GecDtFoNYBPsmX1oCAw267dH2NyqP03S\"]\u003c/p>\n\u003cp>Jim Lebowitz, 75, is a return customer who suffers pain from back surgery two years ago.\u003c/p>\n\u003cp>He prefers to eat his cannabis, he said.\u003c/p>\n\u003cp>“I got chocolate and I got gummies,” he told a visitor. “Never had the chocolate before, but I’ve had the gummies and they worked pretty good.”\u003c/p>\n\u003cp>“Gummies” are cannabis-infused chewy candies. His contain both the CBD and THC, two active ingredients in marijuana.\u003c/p>\n\u003cp>Derek Tauchman rings up sales at one of several Bud and Bloom registers in the dispensary. Fear of getting high is the biggest concern expressed by senior consumers, who make up the bulk of the dispensary’s new business, he said.\u003c/p>\n\u003cp>“What they don’t realize is there’s so many different ways to medicate now that you don’t have to actually get high to relieve all your aches and pains,” he said.\u003c/p>\n\u003cp>But despite such enthusiasm, marijuana isn’t well researched, said Dr. David Reuben, the Archstone Foundation professor of medicine and geriatrics at UCLA’s David Geffen School of Medicine.\u003c/p>\n\u003cp>While cannabis is legal both medically and recreationally in California, it remains a Schedule 1 substance — meaning it’s illegal under federal law. And that makes it harder to study.\u003c/p>\n\u003cp>The limited research that exists suggests that marijuana may be helpful in treating pain and nausea, according to a research overview published last year by the National Academies of Sciences, Engineering and Medicine. Less conclusive research points to it helping with sleep problems and anxiety.[contextly_sidebar id=\"O0pnvY7nsyO04cAtYDrpqvAEjxhmliPb\"]\u003c/p>\n\u003cp>Reuben said he sees a growing number of patients interested in using it for things like anxiety, chronic pain and depression.\u003c/p>\n\u003cp>“I am, in general, fairly supportive of this because these are conditions [for which] there aren’t good alternatives,” he said.\u003c/p>\n\u003cp>But Reuben cautions his patients that products bought at marijuana dispensaries aren’t FDA-regulated, as are prescription drugs. That means dose and consistency can vary.\u003c/p>\n\u003cp>“There’s still so much left to learn about how to package, how to ensure quality and standards,” he said. “So the question is how to make sure the people are getting high-quality product and then testing its effectiveness.”\u003c/p>\n\u003cp>And there are risks associated with cannabis use too, said \u003ca href=\"https://www.samhsa.gov/about-us/who-we-are/leadership/biographies/elinore-mccance-katz\" target=\"_blank\" rel=\"noopener\">Dr. Elinore McCance-Katz\u003c/a>, who directs the Substance Abuse and Mental Health Services Administration.\u003c/p>\n\u003cp>“When you have an industry that does nothing but blanket our society with messages about the medicinal value of marijuana, people get the idea this is a safe substance to use. And that’s not true,” she said.\u003c/p>\n\u003cp>Side effects can include increased heart rate, nausea and vomiting, and with long-term use, there’s a potential for addiction, some studies say. \u003ca href=\"https://www.drugabuse.gov/publications/drugfacts/marijuana#ref\" target=\"_blank\" rel=\"noopener\">Research suggests\u003c/a> that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder.[contextly_sidebar id=\"6j0KZXlPn7yaSYGjVSehNhYUNN3fBDa4\"]\u003c/p>\n\u003cp>Still, Reuben said, if it gets patients off more addictive and potentially dangerous prescription drugs — like opioids — all the better.\u003c/p>\n\u003cp>Jim Levy, 71, suffers a pinched nerve that shoots pain down both his legs. He uses a topical cream and ingests cannabis gelatin capsules and lozenges.\u003c/p>\n\u003cp>“I have no way to measure, but I’d say it gets rid of 90 percent of the pain,” said Levy, who — like other seniors here — pays for these products out-of-pocket, as Medicare doesn’t cover cannabis.\u003c/p>\n\u003cp>“I got something they say is wonderful and I hope it works,” said Shirley Avedon. “It’s a cream.”\u003c/p>\n\u003cp>The price tag: $90. Avedon said if it helps ease the carpal tunnel pain she suffers, it’ll be worth it.\u003c/p>\n\u003cp>“It’s better than having surgery,” she said.\u003c/p>\n\u003cp>\u003cstrong>Precautions To Keep In Mind\u003c/strong>\u003c/p>\n\u003cp>Though marijuana use remains illegal under federal law, it’s legal in some form in 30 states and the District of Columbia. And a growing number of Americans are considering trying it for health reasons. For people who are, doctors advise the following cautions.\u003c/p>\n\u003cp>\u003cstrong>Talk to your doctor.\u003c/strong> Tell your doctor you’re thinking about trying medical marijuana. Although he or she may have some concerns, most doctors won’t judge you for seeking out alternative treatments.\u003c/p>\n\u003cp>Make sure your prescriber is aware of all the medications you take. Marijuana might have dangerous interactions with prescription medications, particularly medicines that can be sedating, said Dr. Benjamin Han, a geriatrician at New York University School of Medicine who studies marijuana use in the elderly.[contextly_sidebar id=\"ALEswggsqFbUQfgVlASKJNkpkpppsnzm\"]\u003c/p>\n\u003cp>\u003cstrong>Watch out for dosing.\u003c/strong> Older adults metabolize drugs differently than young people. If your doctor gives you the go-ahead, try the lowest possible dose first to avoid feeling intoxicated. And be especially careful with edibles. They can have very concentrated doses that don’t take effect right away.\u003c/p>\n\u003cp>Elderly people are also more sensitive to side effects. If you start to feel unwell, talk to your doctor right away. “When you’re older, you’re more vulnerable to the side effects of everything,” Han said. “I’m cautious about everything.”\u003c/p>\n\u003cp>\u003cstrong>Look for licensed providers.\u003c/strong> In some states like California, licensed dispensaries must test for contaminants. Be especially careful with marijuana bought illegally. “If you’re just buying marijuana down the street … you don’t really know what’s in that,” said Dr. Joshua Briscoe, a palliative care doctor at Duke University School of Medicine who has studied the use of marijuana for pain and nausea in older patients. “Buyer, beware.”\u003c/p>\n\u003cp>\u003cstrong>Bottom line:\u003c/strong> The research on medical marijuana is limited. There’s even less we know about marijuana use in older people. Proceed with caution.\u003c/p>\n\u003cp>\u003cem>Jenny Gold and Mara Gordon contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story is part of a partnership that includes \u003ca href=\"http://www.npr.org/sections/news/\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a> and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"credits\">\u003cem>KHN’s coverage of these topics is supported by \u003ca href=\"http://www.jhartfound.org/\" target=\"_blank\" rel=\"noopener\">John A. Hartford Foundation\u003c/a> and\u003ca href=\"http://www.thescanfoundation.org/\" target=\"_blank\" rel=\"noopener\">The SCAN Foundation\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Avedon, who doesn’t want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol, or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana’s psychoactive ingredient.\u003c/p>\n\u003cp>“It helped a little,” she said. “Now I’m going back for the second time hoping they have something better.”\u003c/p>\n\u003cp>As more states legalize marijuana for medical or recreational use — 30 states plus the District of Columbia to date — the cannabis industry is booming. Among the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300687/\" target=\"_blank\" rel=\"noopener\">fastest growing group\u003c/a> of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternative treatments for their aches, pains and other medical conditions.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>On this particular morning, about 35 seniors climb on board the free shuttle — paid for by Bud and Bloom, a licensed cannabis dispensary in Santa Ana. After about a half-hour drive, the large white bus pulls up to the parking lot of the dispensary.\u003c/p>\n\u003cp>About half of the seniors on board today are repeat customers; the other half are cannabis newbies who’ve never tried it before, said Kandice Hawes, director of community outreach for Bud and Bloom.\u003c/p>\n\u003cfigure id=\"attachment_444512\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-444512\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/canna-bus_01_1350-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/canna-bus_01_1350.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Residents of Laguna Woods Village, a retirement community in Orange County, Calif., ride a free shuttle to a marijuana dispensary in August.(STEPHANIE O’NEILL FOR KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>“Not everybody is coming to be a customer,” Hawes said. “A lot are just coming to be educated.”\u003c/p>\n\u003cp>Among them, Layla Sabet, 72, a first-timer seeking relief from back pain that keeps her awake at night, she said.\u003c/p>\n\u003cp>“I’m taking so much medication to sleep and still I can’t sleep,” she said. “So I’m trying it for the back pain and the sleep.”\u003c/p>\n\u003cp>Hawes invited the seniors into a large room with chairs and a table set up with free sandwiches and drinks. As they ate, she gave a presentation focused on the potential benefits of cannabis as a reliever of anxiety, insomnia and chronic pain and the various ways people can consume it.\u003c/p>\n\u003cp>Several vendors on site took turns speaking to the group about the goods they sell. Then, the seniors entered the dispensary for the chance to buy everything from old-school rolled joints and high-tech vaporizer pens to liquid sublingual tinctures, topical creams and an assortment of sweet, cannabis-infused edibles.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Jim Lebowitz, 75, is a return customer who suffers pain from back surgery two years ago.\u003c/p>\n\u003cp>He prefers to eat his cannabis, he said.\u003c/p>\n\u003cp>“I got chocolate and I got gummies,” he told a visitor. “Never had the chocolate before, but I’ve had the gummies and they worked pretty good.”\u003c/p>\n\u003cp>“Gummies” are cannabis-infused chewy candies. His contain both the CBD and THC, two active ingredients in marijuana.\u003c/p>\n\u003cp>Derek Tauchman rings up sales at one of several Bud and Bloom registers in the dispensary. Fear of getting high is the biggest concern expressed by senior consumers, who make up the bulk of the dispensary’s new business, he said.\u003c/p>\n\u003cp>“What they don’t realize is there’s so many different ways to medicate now that you don’t have to actually get high to relieve all your aches and pains,” he said.\u003c/p>\n\u003cp>But despite such enthusiasm, marijuana isn’t well researched, said Dr. David Reuben, the Archstone Foundation professor of medicine and geriatrics at UCLA’s David Geffen School of Medicine.\u003c/p>\n\u003cp>While cannabis is legal both medically and recreationally in California, it remains a Schedule 1 substance — meaning it’s illegal under federal law. And that makes it harder to study.\u003c/p>\n\u003cp>The limited research that exists suggests that marijuana may be helpful in treating pain and nausea, according to a research overview published last year by the National Academies of Sciences, Engineering and Medicine. Less conclusive research points to it helping with sleep problems and anxiety.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Reuben said he sees a growing number of patients interested in using it for things like anxiety, chronic pain and depression.\u003c/p>\n\u003cp>“I am, in general, fairly supportive of this because these are conditions [for which] there aren’t good alternatives,” he said.\u003c/p>\n\u003cp>But Reuben cautions his patients that products bought at marijuana dispensaries aren’t FDA-regulated, as are prescription drugs. That means dose and consistency can vary.\u003c/p>\n\u003cp>“There’s still so much left to learn about how to package, how to ensure quality and standards,” he said. “So the question is how to make sure the people are getting high-quality product and then testing its effectiveness.”\u003c/p>\n\u003cp>And there are risks associated with cannabis use too, said \u003ca href=\"https://www.samhsa.gov/about-us/who-we-are/leadership/biographies/elinore-mccance-katz\" target=\"_blank\" rel=\"noopener\">Dr. Elinore McCance-Katz\u003c/a>, who directs the Substance Abuse and Mental Health Services Administration.\u003c/p>\n\u003cp>“When you have an industry that does nothing but blanket our society with messages about the medicinal value of marijuana, people get the idea this is a safe substance to use. And that’s not true,” she said.\u003c/p>\n\u003cp>Side effects can include increased heart rate, nausea and vomiting, and with long-term use, there’s a potential for addiction, some studies say. \u003ca href=\"https://www.drugabuse.gov/publications/drugfacts/marijuana#ref\" target=\"_blank\" rel=\"noopener\">Research suggests\u003c/a> that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Still, Reuben said, if it gets patients off more addictive and potentially dangerous prescription drugs — like opioids — all the better.\u003c/p>\n\u003cp>Jim Levy, 71, suffers a pinched nerve that shoots pain down both his legs. He uses a topical cream and ingests cannabis gelatin capsules and lozenges.\u003c/p>\n\u003cp>“I have no way to measure, but I’d say it gets rid of 90 percent of the pain,” said Levy, who — like other seniors here — pays for these products out-of-pocket, as Medicare doesn’t cover cannabis.\u003c/p>\n\u003cp>“I got something they say is wonderful and I hope it works,” said Shirley Avedon. “It’s a cream.”\u003c/p>\n\u003cp>The price tag: $90. Avedon said if it helps ease the carpal tunnel pain she suffers, it’ll be worth it.\u003c/p>\n\u003cp>“It’s better than having surgery,” she said.\u003c/p>\n\u003cp>\u003cstrong>Precautions To Keep In Mind\u003c/strong>\u003c/p>\n\u003cp>Though marijuana use remains illegal under federal law, it’s legal in some form in 30 states and the District of Columbia. And a growing number of Americans are considering trying it for health reasons. For people who are, doctors advise the following cautions.\u003c/p>\n\u003cp>\u003cstrong>Talk to your doctor.\u003c/strong> Tell your doctor you’re thinking about trying medical marijuana. Although he or she may have some concerns, most doctors won’t judge you for seeking out alternative treatments.\u003c/p>\n\u003cp>Make sure your prescriber is aware of all the medications you take. Marijuana might have dangerous interactions with prescription medications, particularly medicines that can be sedating, said Dr. Benjamin Han, a geriatrician at New York University School of Medicine who studies marijuana use in the elderly.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Watch out for dosing.\u003c/strong> Older adults metabolize drugs differently than young people. If your doctor gives you the go-ahead, try the lowest possible dose first to avoid feeling intoxicated. And be especially careful with edibles. They can have very concentrated doses that don’t take effect right away.\u003c/p>\n\u003cp>Elderly people are also more sensitive to side effects. If you start to feel unwell, talk to your doctor right away. “When you’re older, you’re more vulnerable to the side effects of everything,” Han said. “I’m cautious about everything.”\u003c/p>\n\u003cp>\u003cstrong>Look for licensed providers.\u003c/strong> In some states like California, licensed dispensaries must test for contaminants. Be especially careful with marijuana bought illegally. “If you’re just buying marijuana down the street … you don’t really know what’s in that,” said Dr. Joshua Briscoe, a palliative care doctor at Duke University School of Medicine who has studied the use of marijuana for pain and nausea in older patients. “Buyer, beware.”\u003c/p>\n\u003cp>\u003cstrong>Bottom line:\u003c/strong> The research on medical marijuana is limited. There’s even less we know about marijuana use in older people. Proceed with caution.\u003c/p>\n\u003cp>\u003cem>Jenny Gold and Mara Gordon contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story is part of a partnership that includes \u003ca href=\"http://www.npr.org/sections/news/\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a> and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "WATCH: This Rapper Used Neuroscience To Get Over Her Ex",
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"content": "\u003cp>https://youtu.be/_zptWlAxYk0\u003c/p>\n\u003cp>When a relationship ends but love remains, it can be both frustrating and embarrassing.\u003c/p>\n\u003cp>Dessa, \u003ca href=\"http://www.doomtree.net/dessa/\" target=\"_blank\" rel=\"noopener\">a well-known rapper, singer and writer from Minneapolis,\u003c/a> knows the feeling well. She'd spent years trying to get over an ex-boyfriend, but she was still stuck on him.[contextly_sidebar id=\"mlbMdLIlSsXEMYXBPWlqFIXoZNq8obvy\"]\u003c/p>\n\u003cp>\"You're not only suffering,\" she says, \"you're just sort of ridiculous. Discipline and dedication are my strong suits — it really bothered me that, no matter how much effort I tried to expend in trying to solve this problem, I was stuck.\"\u003c/p>\n\u003cp>But things changed when Dessa turned to the frontiers of neuroscience for help. She came across a \u003ca href=\"https://www.ted.com/talks/helen_fisher_studies_the_brain_in_love\" target=\"_blank\" rel=\"noopener\">TED Talk by Helen Fisher\u003c/a>, a biological anthropologist and visiting research associate at Rutgers University. Using a type of brain scan called functional MRI, or fMRI, Fisher had looked into the brains of love-struck people and noticed that certain parts of their brains were unusually active.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"That you could objectively measure and observe 'love' — that had never occurred to me before,\" Dessa says.\u003c/p>\n\u003cp>She wondered: If science could map the sources of love in her brain, could it somehow make that love go away?\u003c/p>\n\u003cp>The question led her to a controversial therapy technique called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892319/\" target=\"_blank\" rel=\"noopener\">neurofeedback\u003c/a>.\u003c/p>\n\u003cp>The idea is simple: If you want to learn to lower your heart rate, it helps to be able to hear your pulse. And if you want to change patterns of brain activity, it might be helpful to be able to see what your brain is up to.\u003c/p>\n\u003cp>One flavor of neurofeedback therapy uses a technology called electroencephalography (EEG). A cap full of electrical leads picks up brain waves and translates them into visual or audio cues — like shifting colors on a screen or a series of dings.[contextly_sidebar id=\"1fHutBtcW68QYfMP3EG9cUp4qyVAiRXb\"]\u003c/p>\n\u003cp>The idea is that people can use this feedback to retrain those brain waves, changing underlying patterns in the process — turning down unwanted brain activity or turning up regions that are too quiet.\u003c/p>\n\u003cp>Clinicians have used neurofeedback to try and treat all kinds of mental health issues: anxiety, depression, autism, and ADHD. And they say they've \u003ca href=\"https://www.isnr.org/in-defense-of-neurofeedback\" target=\"_blank\" rel=\"noopener\">seen some positive results\u003c/a>. Patients say they feel better.\u003c/p>\n\u003cp>The growing popularity of EEG-neurofeedback has been met with skepticism. Some scientists say the power of this therapy \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_AMP_2017.pdf\" target=\"_blank\" rel=\"noopener\">may stem from the placebo effect\u003c/a>. (They also point out that a lot of neurofeedback research is done by \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_Brain_Climate_2018.pdf\" target=\"_blank\" rel=\"noopener\">people who have a financial stake in the industry\u003c/a>.)\u003c/p>\n\u003cp>But more rigorous research from the past couple of years supports the idea that, at least in some cases, neurofeedback can be used to train the brain. Most of this research uses fMRI brain scans — not EEG — to peek inside the skull.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.cell.com/neuron/abstract/S0896-6273(16)00095-7\" target=\"_blank\" rel=\"noopener\">one study\u003c/a>, participants learned to turn up a brain region linked to motivation and focus. In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28407727\" target=\"_blank\" rel=\"noopener\">another\u003c/a>, patients with depression were able to alleviate some of their symptoms. But scientists doing this research say there's a lot of work to be done before it can be applied clinically.[contextly_sidebar id=\"ZTOJcPBkTbqiXR1MSox5O57wZuSuzU4T\"]\u003c/p>\n\u003cp>Could neurofeedback provide a balm for broken hearts? No research has been done in this area. But that didn't stop Dessa from trying a sort of experiment on herself: nine EEG-neurofeedback sessions aimed at helping her brain escape the rut of romantic obsession.\u003c/p>\n\u003cp>She says she felt different when she was done.\u003c/p>\n\u003cp>\"Before, I felt that I was really under the thumb of a fixation and a compulsion,\" she says. \"And now it feels like those feelings have been scaled down.\"\u003c/p>\n\u003cp>Now, maybe the neurofeedback had worked as practitioners suggest it does. Or maybe, alternatively, Dessa got the therapy she wanted in other ways — by talking through her experiment, by writing about it, by composing songs for her new album.\u003c/p>\n\u003cp>Or maybe, her neurofeedback sessions helped her via the placebo effect. They suggested that her emotions are grounded in a physical organ \u003cem> — \u003c/em>one that she might be able to influence. Maybe simply believing that she wasn't helpless helped her change her mind and heal her heartbreak.\u003c/p>\n\u003cp>Whatever the reason, Dessa is happy to begin to move on and to start a new chapter with her music.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I've written a bunch of sad rap bangers — I'd like to write other kinds of songs,\" she says.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=This+Rapper+Tried+To+Use+Neuroscience+To+Get+Over+Her+Ex&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\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/_zptWlAxYk0'\n title='//www.youtube.com/embed/_zptWlAxYk0'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>When a relationship ends but love remains, it can be both frustrating and embarrassing.\u003c/p>\n\u003cp>Dessa, \u003ca href=\"http://www.doomtree.net/dessa/\" target=\"_blank\" rel=\"noopener\">a well-known rapper, singer and writer from Minneapolis,\u003c/a> knows the feeling well. She'd spent years trying to get over an ex-boyfriend, but she was still stuck on him.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"You're not only suffering,\" she says, \"you're just sort of ridiculous. Discipline and dedication are my strong suits — it really bothered me that, no matter how much effort I tried to expend in trying to solve this problem, I was stuck.\"\u003c/p>\n\u003cp>But things changed when Dessa turned to the frontiers of neuroscience for help. She came across a \u003ca href=\"https://www.ted.com/talks/helen_fisher_studies_the_brain_in_love\" target=\"_blank\" rel=\"noopener\">TED Talk by Helen Fisher\u003c/a>, a biological anthropologist and visiting research associate at Rutgers University. Using a type of brain scan called functional MRI, or fMRI, Fisher had looked into the brains of love-struck people and noticed that certain parts of their brains were unusually active.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"That you could objectively measure and observe 'love' — that had never occurred to me before,\" Dessa says.\u003c/p>\n\u003cp>She wondered: If science could map the sources of love in her brain, could it somehow make that love go away?\u003c/p>\n\u003cp>The question led her to a controversial therapy technique called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892319/\" target=\"_blank\" rel=\"noopener\">neurofeedback\u003c/a>.\u003c/p>\n\u003cp>The idea is simple: If you want to learn to lower your heart rate, it helps to be able to hear your pulse. And if you want to change patterns of brain activity, it might be helpful to be able to see what your brain is up to.\u003c/p>\n\u003cp>One flavor of neurofeedback therapy uses a technology called electroencephalography (EEG). A cap full of electrical leads picks up brain waves and translates them into visual or audio cues — like shifting colors on a screen or a series of dings.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The idea is that people can use this feedback to retrain those brain waves, changing underlying patterns in the process — turning down unwanted brain activity or turning up regions that are too quiet.\u003c/p>\n\u003cp>Clinicians have used neurofeedback to try and treat all kinds of mental health issues: anxiety, depression, autism, and ADHD. And they say they've \u003ca href=\"https://www.isnr.org/in-defense-of-neurofeedback\" target=\"_blank\" rel=\"noopener\">seen some positive results\u003c/a>. Patients say they feel better.\u003c/p>\n\u003cp>The growing popularity of EEG-neurofeedback has been met with skepticism. Some scientists say the power of this therapy \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_AMP_2017.pdf\" target=\"_blank\" rel=\"noopener\">may stem from the placebo effect\u003c/a>. (They also point out that a lot of neurofeedback research is done by \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_Brain_Climate_2018.pdf\" target=\"_blank\" rel=\"noopener\">people who have a financial stake in the industry\u003c/a>.)\u003c/p>\n\u003cp>But more rigorous research from the past couple of years supports the idea that, at least in some cases, neurofeedback can be used to train the brain. Most of this research uses fMRI brain scans — not EEG — to peek inside the skull.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.cell.com/neuron/abstract/S0896-6273(16)00095-7\" target=\"_blank\" rel=\"noopener\">one study\u003c/a>, participants learned to turn up a brain region linked to motivation and focus. In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28407727\" target=\"_blank\" rel=\"noopener\">another\u003c/a>, patients with depression were able to alleviate some of their symptoms. But scientists doing this research say there's a lot of work to be done before it can be applied clinically.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Could neurofeedback provide a balm for broken hearts? No research has been done in this area. But that didn't stop Dessa from trying a sort of experiment on herself: nine EEG-neurofeedback sessions aimed at helping her brain escape the rut of romantic obsession.\u003c/p>\n\u003cp>She says she felt different when she was done.\u003c/p>\n\u003cp>\"Before, I felt that I was really under the thumb of a fixation and a compulsion,\" she says. \"And now it feels like those feelings have been scaled down.\"\u003c/p>\n\u003cp>Now, maybe the neurofeedback had worked as practitioners suggest it does. Or maybe, alternatively, Dessa got the therapy she wanted in other ways — by talking through her experiment, by writing about it, by composing songs for her new album.\u003c/p>\n\u003cp>Or maybe, her neurofeedback sessions helped her via the placebo effect. They suggested that her emotions are grounded in a physical organ \u003cem> — \u003c/em>one that she might be able to influence. Maybe simply believing that she wasn't helpless helped her change her mind and heal her heartbreak.\u003c/p>\n\u003cp>Whatever the reason, Dessa is happy to begin to move on and to start a new chapter with her music.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I've written a bunch of sad rap bangers — I'd like to write other kinds of songs,\" she says.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=This+Rapper+Tried+To+Use+Neuroscience+To+Get+Over+Her+Ex&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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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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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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"info": "",
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