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"content": "\u003cp>Many healthy Americans take a baby aspirin every day to reduce their risk of having a heart attack, getting cancer and even possibly dementia. But is it really a good idea?[contextly_sidebar id=\"TeVgffLo8LYnxiLIJLovHnm2siFYHMFR\"]\u003c/p>\n\u003cp>Results released Sunday from a major \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1800722\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of low-dose aspirin contain a disappointing answer for older, otherwise healthy people.\u003c/p>\n\u003cp>\"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,\" says \u003ca href=\"https://www.hennepinhealthcare.org/provider/anne-m-murray-md/\" target=\"_blank\" rel=\"noopener\">Anne Murray\u003c/a>, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study.\u003c/p>\n\u003cp>The study involved more than 19,000 people ages 65 and older in the United States and Australia. The results were published in three papers in the \u003cem>New England Journal of Medicine.\u003c/em>\u003c/p>\n\u003cp>There is still strong evidence that a daily baby aspirin can \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer\" target=\"_blank\" rel=\"noopener\">reduce the risk\u003c/a> that many people who have already suffered a heart attack or stroke will suffer another attack.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And there is some evidence that daily low-dose aspirin may help people younger than 70 who have at least a 10 percent risk of having a heart attack avoid a heart attack or stroke, according to the latest \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/15/440337151/panel-says-aspirin-lowers-heart-attack-risk-for-some-but-not-all\" target=\"_blank\" rel=\"noopener\">recommendations\u003c/a> from the U.S. Preventive Services Task Force.\u003c/p>\n\u003cp>But for older, healthy people, \"the risks outweigh the benefits for taking low-dose aspirin,\" Murray says.[contextly_sidebar id=\"06i7Zbzq5DlgqfooOTFa4lgjt6Ui9wr1\"]\u003c/p>\n\u003cp>The primary risk is bleeding. The study \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1805819\" target=\"_blank\" rel=\"noopener\">confirmed\u003c/a> that a daily baby aspirin increases the risk for serious, potentially life-threatening bleeding.\u003c/p>\n\u003cp>Surprisingly, those who took daily aspirin also appeared to be \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1803955\" target=\"_blank\" rel=\"noopener\">more likely\u003c/a> to die overall, apparently from an increased risk of succumbing to cancer. That was especially unexpected given previous evidence that aspirin might reduce the risk for colorectal cancer.\u003c/p>\n\u003cp>The researchers stressed, however, that the cancer finding might have been a fluke. There's also a possibility that any colorectal cancer benefit wasn't seen because the subjects had only been followed for about five years.\u003c/p>\n\u003cp>Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin.\u003c/p>\n\u003cp>\"A lot of people read, 'Well, aspirin is good for people who have heart problems. Maybe I should take it, even if they haven't really had a heart attack,' \" Murray says. But \"for a long time there's been a need to establish appropriate criteria for when healthy people — elderly people — need aspirin.\"\u003c/p>\n\u003cp>That's why the researchers launched their study, called \u003ca href=\"https://www.aspree.org/\" target=\"_blank\" rel=\"noopener\">ASPREE\u003c/a>, in 2010. It involved 19,114 older people, with 16,703 in Australia and 2,411 in the United States. The U.S. portion included white volunteers ages 70 and older, and African-Americans and Hispanics subjects ages 65 and older.[contextly_sidebar id=\"lMIuMVSFXI9eLmCGzVINxi5SI7xGl6IV\"]\u003c/p>\n\u003cp>Participants took either 100 milligrams of aspirin every day or a placebo. People in the study were followed for an average of 4.7 years.\u003c/p>\n\u003cp>\"We were hoping that an inexpensive, very accessible medication might be something that we could recommend to elderly to maintain their independence but also decrease their risk of cardiovascular disease,\" Murray says.\u003c/p>\n\u003cp>But based on the findings, \u003ca href=\"https://www.nia.nih.gov/about/staff/hadley-evan\" target=\"_blank\" rel=\"noopener\">Dr. Evan Hadley\u003c/a> of the National Institute on Aging, which helped fund the study, says any elderly people taking aspirin or thinking about it should think twice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This gives pause and a reason for older people and their physician to think carefully about the decision whether to take low-dose aspirin regularly or not,\" Hadley says. \"And in many cases the right answer may be: Not.\"\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=Study%3A+A+Daily+Baby+Aspirin+Has+No+Benefit+For+Healthy+Older+People&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many healthy Americans take a baby aspirin every day to reduce their risk of having a heart attack, getting cancer and even possibly dementia. But is it really a good idea?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Results released Sunday from a major \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1800722\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of low-dose aspirin contain a disappointing answer for older, otherwise healthy people.\u003c/p>\n\u003cp>\"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,\" says \u003ca href=\"https://www.hennepinhealthcare.org/provider/anne-m-murray-md/\" target=\"_blank\" rel=\"noopener\">Anne Murray\u003c/a>, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study.\u003c/p>\n\u003cp>The study involved more than 19,000 people ages 65 and older in the United States and Australia. The results were published in three papers in the \u003cem>New England Journal of Medicine.\u003c/em>\u003c/p>\n\u003cp>There is still strong evidence that a daily baby aspirin can \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer\" target=\"_blank\" rel=\"noopener\">reduce the risk\u003c/a> that many people who have already suffered a heart attack or stroke will suffer another attack.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And there is some evidence that daily low-dose aspirin may help people younger than 70 who have at least a 10 percent risk of having a heart attack avoid a heart attack or stroke, according to the latest \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/15/440337151/panel-says-aspirin-lowers-heart-attack-risk-for-some-but-not-all\" target=\"_blank\" rel=\"noopener\">recommendations\u003c/a> from the U.S. Preventive Services Task Force.\u003c/p>\n\u003cp>But for older, healthy people, \"the risks outweigh the benefits for taking low-dose aspirin,\" Murray says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The primary risk is bleeding. The study \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1805819\" target=\"_blank\" rel=\"noopener\">confirmed\u003c/a> that a daily baby aspirin increases the risk for serious, potentially life-threatening bleeding.\u003c/p>\n\u003cp>Surprisingly, those who took daily aspirin also appeared to be \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1803955\" target=\"_blank\" rel=\"noopener\">more likely\u003c/a> to die overall, apparently from an increased risk of succumbing to cancer. That was especially unexpected given previous evidence that aspirin might reduce the risk for colorectal cancer.\u003c/p>\n\u003cp>The researchers stressed, however, that the cancer finding might have been a fluke. There's also a possibility that any colorectal cancer benefit wasn't seen because the subjects had only been followed for about five years.\u003c/p>\n\u003cp>Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin.\u003c/p>\n\u003cp>\"A lot of people read, 'Well, aspirin is good for people who have heart problems. Maybe I should take it, even if they haven't really had a heart attack,' \" Murray says. But \"for a long time there's been a need to establish appropriate criteria for when healthy people — elderly people — need aspirin.\"\u003c/p>\n\u003cp>That's why the researchers launched their study, called \u003ca href=\"https://www.aspree.org/\" target=\"_blank\" rel=\"noopener\">ASPREE\u003c/a>, in 2010. It involved 19,114 older people, with 16,703 in Australia and 2,411 in the United States. The U.S. portion included white volunteers ages 70 and older, and African-Americans and Hispanics subjects ages 65 and older.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Participants took either 100 milligrams of aspirin every day or a placebo. People in the study were followed for an average of 4.7 years.\u003c/p>\n\u003cp>\"We were hoping that an inexpensive, very accessible medication might be something that we could recommend to elderly to maintain their independence but also decrease their risk of cardiovascular disease,\" Murray says.\u003c/p>\n\u003cp>But based on the findings, \u003ca href=\"https://www.nia.nih.gov/about/staff/hadley-evan\" target=\"_blank\" rel=\"noopener\">Dr. Evan Hadley\u003c/a> of the National Institute on Aging, which helped fund the study, says any elderly people taking aspirin or thinking about it should think twice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This gives pause and a reason for older people and their physician to think carefully about the decision whether to take low-dose aspirin regularly or not,\" Hadley says. \"And in many cases the right answer may be: Not.\"\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=Study%3A+A+Daily+Baby+Aspirin+Has+No+Benefit+For+Healthy+Older+People&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Seven U.S. states now have adult obesity rates of 35 percent or higher, up from zero states just five years ago, according to federal data released Wednesday.[contextly_sidebar id=\"99npNiyEmtYPSxMeUr9ZC2OpxalF30tD\"]\u003c/p>\n\u003cp>The 2017 data, from the Centers for Disease Control and Prevention, highlight continuing discrepancies in adult obesity rates across geographic areas, race, and education levels.\u003c/p>\n\u003cp>The seven states with obesity rates of at least 35 percent in 2017 were Alabama, Arkansas, Iowa, Louisiana, Mississippi, Oklahoma, and West Virginia, which itself had the highest rate in the country at 38.1 percent. Colorado had the lowest obesity rate, at 22.6 percent.\u003c/p>\n\u003cp>Hawaii and Washington, D.C., were the only other places where fewer than 1 in 4 adults were obese.\u003c/p>\n\u003cp>Overall, the South and Midwest had the highest prevalence of adult obesity, the data showed.\u003c/p>\n\u003cfigure id=\"attachment_444430\" class=\"wp-caption alignnone\" style=\"max-width: 877px\">\u003cimg class=\"size-full wp-image-444430\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/brfss_2017_obesity-overall.jpg\" alt=\"\" width=\"877\" height=\"528\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall.jpg 877w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-160x96.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-800x482.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-768x462.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-240x144.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-375x226.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-520x313.jpg 520w\" sizes=\"(max-width: 877px) 100vw, 877px\">\u003cfigcaption class=\"wp-caption-text\">Prevalence of self-reported obesity among U.S. adults by state and territory. \u003ccite>(CDC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nationally, adults without a high school degree had obesity rates of 35.6 percent, compared with 32.9 percent for people with a high school degree, 31.9 percent of people with some college-level education, and 22.7 percent for college graduates.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The obesity rate for black adults was 39 percent, compared with 32.4 percent for Hispanics and 29.3 percent for whites.\u003c/p>\n\u003cp>In its report, the CDC called for \u003ca href=\"https://www.cdc.gov/obesity/strategies/index.html\" target=\"_blank\" rel=\"noopener\">a comprehensive strategy\u003c/a> to reduce obesity prevalence, with steps including healthy eating, better sleep, stress management, and physical activity.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/09/12/seven-u-s-states-now-have-adult-obesity-rates-of-35-percent-or-higher/\" 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>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Seven U.S. states now have adult obesity rates of 35 percent or higher, up from zero states just five years ago, according to federal data released Wednesday.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The 2017 data, from the Centers for Disease Control and Prevention, highlight continuing discrepancies in adult obesity rates across geographic areas, race, and education levels.\u003c/p>\n\u003cp>The seven states with obesity rates of at least 35 percent in 2017 were Alabama, Arkansas, Iowa, Louisiana, Mississippi, Oklahoma, and West Virginia, which itself had the highest rate in the country at 38.1 percent. Colorado had the lowest obesity rate, at 22.6 percent.\u003c/p>\n\u003cp>Hawaii and Washington, D.C., were the only other places where fewer than 1 in 4 adults were obese.\u003c/p>\n\u003cp>Overall, the South and Midwest had the highest prevalence of adult obesity, the data showed.\u003c/p>\n\u003cfigure id=\"attachment_444430\" class=\"wp-caption alignnone\" style=\"max-width: 877px\">\u003cimg class=\"size-full wp-image-444430\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/brfss_2017_obesity-overall.jpg\" alt=\"\" width=\"877\" height=\"528\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall.jpg 877w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-160x96.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-800x482.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-768x462.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-240x144.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-375x226.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/brfss_2017_obesity-overall-520x313.jpg 520w\" sizes=\"(max-width: 877px) 100vw, 877px\">\u003cfigcaption class=\"wp-caption-text\">Prevalence of self-reported obesity among U.S. adults by state and territory. \u003ccite>(CDC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nationally, adults without a high school degree had obesity rates of 35.6 percent, compared with 32.9 percent for people with a high school degree, 31.9 percent of people with some college-level education, and 22.7 percent for college graduates.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Members of the generation that came of age in the era of marijuana are reaching for weed in their golden years.\u003c/p>\n\u003cp>A\u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0376871618304538?via%3Dihub\" target=\"_blank\" rel=\"noopener\"> study\u003c/a> published in the journal \u003cem>Drug and Alcohol Dependence \u003c/em>this month suggests that increasing numbers of middle aged and older adults are using marijuana — and using it a lot.\u003c/p>\n\u003cp>The analysis comes from data gathered in the\u003ca href=\"https://nsduhweb.rti.org/respweb/homepage.cfm\" target=\"_blank\" rel=\"noopener\"> National Survey on Drug Use and Health\u003c/a> from 2015 and 2016. About 9 percent of U.S. adults between ages 50 and 64 used marijuana in the the previous year, according to survey results. About 3 percent of people over 65 used the drug in that time period.\u003c/p>\n\u003cp>This appears to be up from years past.\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300687/\" target=\"_blank\" rel=\"noopener\"> In 2013\u003c/a>, the same survey reported that 7 percent of middle-aged Americans used marijuana in the previous year, and only 1.4 percent of people over 65.\u003c/p>\n\u003cp>\u003ca href=\"https://med.nyu.edu/faculty/benjamin-han\" target=\"_blank\" rel=\"noopener\">Dr. Benjamin Han\u003c/a>, an assistant professor of internal medicine at New York University School of Medicine and lead author of the study, says he was surprised to learn that many of the older Americans turning to marijuana are new converts to its use. About 45 percent of those over 65 who use the drug said they got started after the age of 21.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And boomers who use marijuana also seem to be using it more often. Study authors found that 5.7 percent of middle-aged respondents said they'd tried it in the past month.\u003c/p>\n\u003cp>As laws surrounding marijuana use \u003ca href=\"http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx\" target=\"_blank\" rel=\"noopener\">become more permissive in many states nationwide\u003c/a>, more Americans of all ages seem to be giving the drug a try — some for recreation, and others in hopes of \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/15/620080148/lawmakers-in-illinois-embrace-medical-marijuana-as-an-opioid-alternative\" target=\"_blank\" rel=\"noopener\">easing medical ailments\u003c/a>.\u003c/p>\n\u003cp>Almost one quarter of Americans over 65 in the 2016 survey who had used marijuana in the previous year said they gotten the go-ahead from their doctors.\u003c/p>\n\u003cp>According to a \u003ca href=\"http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-chapter-highlights.pdf\" target=\"_blank\" rel=\"noopener\">research overview\u003c/a> published by the National Academies of Science, Engineering, and Medicine last year, a still small but growing number of studies suggest that marijuana may be helpful in treating pain, nausea, and spasticity.\u003c/p>\n\u003cp>\"For these conditions, the effects of cannabinoids are modest,\" the National Academies panel said.\u003c/p>\n\u003cp>But even modest benefits can be helpful for some patients, says\u003ca href=\"https://medicine.duke.edu/faculty/joshua-c-briscoe-md\" target=\"_blank\" rel=\"noopener\"> Dr. Joshua Briscoe\u003c/a>, a palliative care physician at Duke University School of Medicine who studies medical marijuana in the elderly.\u003c/p>\n\u003cp>\"We prescribe substances that are far more dangerous than cannabinoids,\" says Briscoe, noting that older people can be more likely to experience a medication's side effects.\u003c/p>\n\u003cp>And since marijuana's use is still tightly regulated by the federal government, he adds, it continues to be hard to study, so authoritative research on its harms and benefits is sparse.\u003c/p>\n\u003cp>Han sounds a note of caution for his patients turning to marijuana. He says he first became interested in studying drug and alcohol use in the elderly after doing house calls on his patients.\u003c/p>\n\u003cp>\"You see their home environment,\" Han says. \"I would see marijuana. I would see patients' family members engaged in drug use in the other room ... Open bottles of liquor everywhere.\"\u003c/p>\n\u003cp>He thinks marijuana use among older people who combine it with other drugs — like opioids or alcohol — might be a particular cause for concern.\u003c/p>\n\u003cp>Baby boomers who've had prior experience with marijuana shouldn't jump to using the same amount they did in their college days, Han says. The potency may be different, as well their ability to metabolize the drug.\u003c/p>\n\u003cp>\"A smaller amount is going to hit you a lot harder when you're older,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Han says his study highlights the need for more research on drug use in older adults. \"I get asked a lot, more and more, by my population, 'Hey, should I try marijuana for this? Should I try marijuana for that?'\" Han says. \"It's hard for me to know what to tell patients.\"\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=More+Older+Americans+Are+Turning+To+Marijuana&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "As marijuana gains popularity among people 65 and older, geriatricians call for more research on how it affects elderly patients. Shifts in metabolism as we age can intensify any drug's side effects.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Members of the generation that came of age in the era of marijuana are reaching for weed in their golden years.\u003c/p>\n\u003cp>A\u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0376871618304538?via%3Dihub\" target=\"_blank\" rel=\"noopener\"> study\u003c/a> published in the journal \u003cem>Drug and Alcohol Dependence \u003c/em>this month suggests that increasing numbers of middle aged and older adults are using marijuana — and using it a lot.\u003c/p>\n\u003cp>The analysis comes from data gathered in the\u003ca href=\"https://nsduhweb.rti.org/respweb/homepage.cfm\" target=\"_blank\" rel=\"noopener\"> National Survey on Drug Use and Health\u003c/a> from 2015 and 2016. About 9 percent of U.S. adults between ages 50 and 64 used marijuana in the the previous year, according to survey results. About 3 percent of people over 65 used the drug in that time period.\u003c/p>\n\u003cp>This appears to be up from years past.\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300687/\" target=\"_blank\" rel=\"noopener\"> In 2013\u003c/a>, the same survey reported that 7 percent of middle-aged Americans used marijuana in the previous year, and only 1.4 percent of people over 65.\u003c/p>\n\u003cp>\u003ca href=\"https://med.nyu.edu/faculty/benjamin-han\" target=\"_blank\" rel=\"noopener\">Dr. Benjamin Han\u003c/a>, an assistant professor of internal medicine at New York University School of Medicine and lead author of the study, says he was surprised to learn that many of the older Americans turning to marijuana are new converts to its use. About 45 percent of those over 65 who use the drug said they got started after the age of 21.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And boomers who use marijuana also seem to be using it more often. Study authors found that 5.7 percent of middle-aged respondents said they'd tried it in the past month.\u003c/p>\n\u003cp>As laws surrounding marijuana use \u003ca href=\"http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx\" target=\"_blank\" rel=\"noopener\">become more permissive in many states nationwide\u003c/a>, more Americans of all ages seem to be giving the drug a try — some for recreation, and others in hopes of \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/15/620080148/lawmakers-in-illinois-embrace-medical-marijuana-as-an-opioid-alternative\" target=\"_blank\" rel=\"noopener\">easing medical ailments\u003c/a>.\u003c/p>\n\u003cp>Almost one quarter of Americans over 65 in the 2016 survey who had used marijuana in the previous year said they gotten the go-ahead from their doctors.\u003c/p>\n\u003cp>According to a \u003ca href=\"http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-chapter-highlights.pdf\" target=\"_blank\" rel=\"noopener\">research overview\u003c/a> published by the National Academies of Science, Engineering, and Medicine last year, a still small but growing number of studies suggest that marijuana may be helpful in treating pain, nausea, and spasticity.\u003c/p>\n\u003cp>\"For these conditions, the effects of cannabinoids are modest,\" the National Academies panel said.\u003c/p>\n\u003cp>But even modest benefits can be helpful for some patients, says\u003ca href=\"https://medicine.duke.edu/faculty/joshua-c-briscoe-md\" target=\"_blank\" rel=\"noopener\"> Dr. Joshua Briscoe\u003c/a>, a palliative care physician at Duke University School of Medicine who studies medical marijuana in the elderly.\u003c/p>\n\u003cp>\"We prescribe substances that are far more dangerous than cannabinoids,\" says Briscoe, noting that older people can be more likely to experience a medication's side effects.\u003c/p>\n\u003cp>And since marijuana's use is still tightly regulated by the federal government, he adds, it continues to be hard to study, so authoritative research on its harms and benefits is sparse.\u003c/p>\n\u003cp>Han sounds a note of caution for his patients turning to marijuana. He says he first became interested in studying drug and alcohol use in the elderly after doing house calls on his patients.\u003c/p>\n\u003cp>\"You see their home environment,\" Han says. \"I would see marijuana. I would see patients' family members engaged in drug use in the other room ... Open bottles of liquor everywhere.\"\u003c/p>\n\u003cp>He thinks marijuana use among older people who combine it with other drugs — like opioids or alcohol — might be a particular cause for concern.\u003c/p>\n\u003cp>Baby boomers who've had prior experience with marijuana shouldn't jump to using the same amount they did in their college days, Han says. The potency may be different, as well their ability to metabolize the drug.\u003c/p>\n\u003cp>\"A smaller amount is going to hit you a lot harder when you're older,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Han says his study highlights the need for more research on drug use in older adults. \"I get asked a lot, more and more, by my population, 'Hey, should I try marijuana for this? Should I try marijuana for that?'\" Han says. \"It's hard for me to know what to tell patients.\"\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=More+Older+Americans+Are+Turning+To+Marijuana&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment",
"title": "'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Dr. Leslie Norins is willing to hand over $1 million of his own money to anyone who can clarify something: Is Alzheimer's disease, the most common form of dementia worldwide, caused by a germ?[contextly_sidebar id=\"MVU0oAlLJAOY5cRLFm8SgRXzH5ufmBIa\"]\u003c/p>\n\u003cp>By \"germ\" he means microbes like bacteria, viruses, fungi and parasites. In other words, Norins, a physician turned publisher, wants to know if Alzheimer's is infectious.\u003c/p>\n\u003cp>It's an idea that just a few years ago would've seemed to many an easy way to drain your research budget on bunk science. Money has poured into Alzheimer's research for years, but until very recently not much of it went toward investigating infection in causing dementia.\u003c/p>\n\u003cp>But this \"germ theory\" of Alzheimer's, as Norins calls it, has been fermenting in the literature for decades. Even early 20th century Czech physician Oskar Fischer — who, along with his German contemporary Dr. Alois Alzheimer, was integral in first describing the condition — noted a possible connection between the newly identified dementia and tuberculosis.\u003c/p>\n\u003cp>If the germ theory gets traction, even in some Alzheimer's patients, it could trigger a seismic shift in how doctors understand and treat the disease.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For instance, would we see a day when dementia is prevented with a vaccine, or treated with antibiotics and antiviral medications? Norins thinks it's worth looking into.\u003c/p>\n\u003cp>Norins received his medical degree from Duke in the early 1960s, and after a stint at the Centers for Disease Control and Prevention he fell into a lucrative career in medical publishing. He eventually settled in an admittedly aged community in Naples, Fla., where he took an interest in dementia and began reading up on the condition.[contextly_sidebar id=\"Xrb4XR0KXYySlI7ldjHh45GWXuqxKcIS\"]\u003c/p>\n\u003cp>After scouring the medical literature he noticed a pattern.\u003c/p>\n\u003cp>\"It appeared that many of the reported characteristics of Alzheimer's disease were compatible with an infectious process,\" Norins tells NPR. \"I thought for sure this must have already been investigated, because \u003ca href=\"http://act.alz.org/site/DocServer/2015_Appropriations_Fact_Sheet__FY16_.pdf?docID=3641\" target=\"_blank\" rel=\"noopener\">millions and millions of dollars\u003c/a> have been spent on Alzheimer's research.\"\u003c/p>\n\u003cp>But aside from scattered interest through the decades, this wasn't the case.\u003c/p>\n\u003cp>In 2017, Norins launched \u003ca href=\"https://alzgerm.org/about/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Germ Quest Inc.\u003c/a>, a public benefit corporation he hopes will drive interest into the germ theory of Alzheimer's, and through which his prize will be distributed. A white paper he penned for the site reads: \"From a two-year review of the scientific literature, I believe it's now clear that just one germ — identity not yet specified, and possibly not yet discovered — causes most AD. I'm calling it the 'Alzheimer's Germ.' \"\u003c/p>\n\u003cp>Norins is quick to cite sources and studies supporting his claim, among them a 2010 study published in the \u003cem>Journal of Neurosurgery\u003c/em> showing that \u003ca href=\"http://thejns.org/doi/pdf/10.3171/2010.1.JNS091740\" target=\"_blank\" rel=\"noopener\">neurosurgeons die from Alzheimer's at a seven-fold higher rate\u003c/a> than they do from other disorders.\u003c/p>\n\u003cp>Another study from that same year, published in The \u003cem>Journal of the American Geriatric Society,\u003c/em> found that people whose \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20722820/\" target=\"_blank\" rel=\"noopener\">spouses have dementia are at a six-times greater risk\u003c/a> for the condition themselves.\u003c/p>\n\u003cp>Contagion does come to mind. And Norins isn't alone in his thinking.\u003c/p>\n\u003cp>In 2016, 32 researchers from universities around the world signed an editorial in the \u003cem>Journal of Alzheimer's Disease\u003c/em> calling for \"further research on the role of infectious agents in [Alzheimer's] causation.\" Based on much of the same evidence Norins encountered, the authors concluded that clinical trials with antimicrobial drugs in Alzheimer's are now justified.[contextly_sidebar id=\"TlULmPwfIfLNT30W6fAdCGOQeBCymn7e\"]\u003c/p>\n\u003cp>NPR reported on an intriguing \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/21/621908340/researchers-find-herpes-viruses-in-brains-marked-by-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published in \u003cem>Neuron\u003c/em> in June that suggested that viral infection can influence the progression of Alzheimer's. Led by Mount Sinai genetics professor Joel Dudley, the work was intended to compare the genomes of healthy brain tissue with that affected by dementia.\u003c/p>\n\u003cp>But something kept getting in the way: herpes.\u003c/p>\n\u003cp>Dudley's team noticed an unexpectedly high level of viral DNA from two human herpes viruses, HHV-6 and HHV-7. The viruses are common and cause a rash called roseola in young children (not the sexually transmitted disease caused by other strains).\u003c/p>\n\u003cp>Some viruses have the ability to lie dormant in our neurons for decades by incorporating their genomes into our own. The classic example is chickenpox: A childhood viral infection resolves and lurks silently, returning years later as \u003ca href=\"https://www.cdc.gov/shingles/about/symptoms.html\" target=\"_blank\" rel=\"noopener\">shingles\u003c/a>, an excruciating rash. Like it or not, nearly all of us are chimeras with viral DNA speckling our genomes.\u003c/p>\n\u003cp>But having the herpes viruses alone doesn't mean inevitable brain decline. After all, up to 75 percent of us may \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11285567\" target=\"_blank\" rel=\"noopener\">harbor HHV-6\u003c/a> .\u003c/p>\n\u003cp>But Dudley also noticed that herpes appeared to interact with human genes known to increase Alzheimer's risk. Perhaps, he says, there is some toxic combination of genetic and infectious influence that results in the disease; a combination that sparks what some feel is the main contributor to the disease, an overactive immune system.\u003c/p>\n\u003cp>The hallmark pathology of Alzheimer's is accumulation of a protein called amyloid in the brain. Many researchers have assumed these aggregates, or plaques, are simply a byproduct of some other process at the core of the disease. Other scientists posit that the protein itself contributes to the condition in some way.\u003c/p>\n\u003cp>The theory that amyloid is the root cause of Alzheimer's is losing steam. But the protein may still contribute to the disease, even if it winds up being deemed infectious.[contextly_sidebar id=\"reNe9dG45Jm18II65oxyuE0ETmculfjN\"]\u003c/p>\n\u003cp>Work by Harvard neuroscientist Rudolph Tanzi suggests it might be a bit of both. Along with colleague Robert Moir, Tanzi has shown that amyloid is lethal to viruses and bacteria in the test tube, and also in mice. He now believes the protein is part of our ancient immune system that like antibodies, ramps up its activity to help fend off unwanted bugs.\u003c/p>\n\u003cp>So does that mean that the microbe is the cause of Alzheimer's, and amyloid a harmless reaction to it? According to Tanzi it's not that simple.\u003c/p>\n\u003cp>Tanzi believes that in many cases of Alzheimer's, microbes are probably the initial seed that sets off a toxic tumble of molecular dominoes. Early in the disease amyloid protein builds up to fight infection, yet too much of the protein begins to impair function of neurons in the brain. The excess amyloid then causes another protein, called tau, to form tangles, which further harm brain cells.\u003c/p>\n\u003cp>But as Tanzi explains, the ultimate neurological insult in Alzheimer's is the body's reaction to this neurotoxic mess. All the excess protein revs up the immune system, causing inflammation — and it's this inflammation that does the most damage to the Alzheimer's-afflicted brain.\u003c/p>\n\u003cp>So what does this say about the future of treatment? Possibly a lot. Tanzi envisions a day when people are screened at, say, 50 years old. \"If their brains are riddled with too much amyloid,\" he says, \"we knock it down a bit with antiviral medications. It's just like how you are prescribed preventative drugs if your cholesterol is too high.\"\u003c/p>\n\u003cp>Tanzi feels that microbes are just one possible seed for the complex pathology behind Alzheimer's. Genetics may also play a role, as certain genes produce a type of amyloid more prone to clumping up. He also feels environmental factors like pollution might contribute.\u003c/p>\n\u003cp>Dr. James Burke, professor of medicine and psychiatry at Duke University's Alzheimer's Disease Research Center, isn't willing to abandon the amyloid theory altogether, but agrees it's time for the field to move on. \"There may be many roads to developing Alzheimer's disease and it would be shortsighted to focus just on amyloid and tau,\" he says. \"A million-dollar prize is attention- getting, but the reward for identifying a treatable target to delay or prevent Alzheimer's disease is invaluable.\"[contextly_sidebar id=\"VDtvU3haNd1M74SuCUvVZuAz4hFEV5iO\"]\u003c/p>\n\u003cp>Any treatment that disrupts the cascade leading to amyloid, tau and inflammation could theoretically benefit an at-risk brain. The vast majority of Alzheimer's treatment trials have failed, including many targeting amyloid. But it could be that the patients included were too far along in their disease to reap any therapeutic benefit.\u003c/p>\n\u003cp>If a microbe is responsible for all or some cases of Alzheimer's, perhaps future treatments or preventive approaches will prevent toxin protein buildup in the first place. Both Tanzi and Norins believe Alzheimer's vaccines against viruses like herpes might one day become common practice.\u003c/p>\n\u003cp>In July of this year, in collaboration with Norins, the Infectious Diseases Society of America announced that they plan to offer two $50,000 grants supporting research into a microbial association with Alzheimer's. According to Norins, this is the first acknowledgement by a leading infectious disease group that Alzheimer's may be microbial in nature – or at least that it's worth exploring.\u003c/p>\n\u003cp>\"The important thing is not the amount of the money, which is a pittance compared with the $2 billion NIH spends on amyloid and tau research,\" says Norins, \"but rather the respectability and more mainstream status the grants confer on investigating of the infectious possibility. Remember when we thought ulcers were caused by stress?\"\u003c/p>\n\u003cp>Ulcers, we now know, are \u003ca href=\"https://www.nobelprize.org/prizes/medicine/2005/press-release/\" target=\"_blank\" rel=\"noopener\">caused by a germ\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired, Scientific American\u003cem> and on The Atlantic.com. He graduated from the University of Virginia School of Medicine. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\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=Infectious+Theory+Of+Alzheimer%27s+Disease+Draws+Fresh+Interest&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"description": "Money has poured into Alzheimer's research, but until very recently not much of it went toward investigating infection in causing dementia. A million dollar prize may lead more scientists to try.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Leslie Norins is willing to hand over $1 million of his own money to anyone who can clarify something: Is Alzheimer's disease, the most common form of dementia worldwide, caused by a germ?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>By \"germ\" he means microbes like bacteria, viruses, fungi and parasites. In other words, Norins, a physician turned publisher, wants to know if Alzheimer's is infectious.\u003c/p>\n\u003cp>It's an idea that just a few years ago would've seemed to many an easy way to drain your research budget on bunk science. Money has poured into Alzheimer's research for years, but until very recently not much of it went toward investigating infection in causing dementia.\u003c/p>\n\u003cp>But this \"germ theory\" of Alzheimer's, as Norins calls it, has been fermenting in the literature for decades. Even early 20th century Czech physician Oskar Fischer — who, along with his German contemporary Dr. Alois Alzheimer, was integral in first describing the condition — noted a possible connection between the newly identified dementia and tuberculosis.\u003c/p>\n\u003cp>If the germ theory gets traction, even in some Alzheimer's patients, it could trigger a seismic shift in how doctors understand and treat the disease.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For instance, would we see a day when dementia is prevented with a vaccine, or treated with antibiotics and antiviral medications? Norins thinks it's worth looking into.\u003c/p>\n\u003cp>Norins received his medical degree from Duke in the early 1960s, and after a stint at the Centers for Disease Control and Prevention he fell into a lucrative career in medical publishing. He eventually settled in an admittedly aged community in Naples, Fla., where he took an interest in dementia and began reading up on the condition.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After scouring the medical literature he noticed a pattern.\u003c/p>\n\u003cp>\"It appeared that many of the reported characteristics of Alzheimer's disease were compatible with an infectious process,\" Norins tells NPR. \"I thought for sure this must have already been investigated, because \u003ca href=\"http://act.alz.org/site/DocServer/2015_Appropriations_Fact_Sheet__FY16_.pdf?docID=3641\" target=\"_blank\" rel=\"noopener\">millions and millions of dollars\u003c/a> have been spent on Alzheimer's research.\"\u003c/p>\n\u003cp>But aside from scattered interest through the decades, this wasn't the case.\u003c/p>\n\u003cp>In 2017, Norins launched \u003ca href=\"https://alzgerm.org/about/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Germ Quest Inc.\u003c/a>, a public benefit corporation he hopes will drive interest into the germ theory of Alzheimer's, and through which his prize will be distributed. A white paper he penned for the site reads: \"From a two-year review of the scientific literature, I believe it's now clear that just one germ — identity not yet specified, and possibly not yet discovered — causes most AD. I'm calling it the 'Alzheimer's Germ.' \"\u003c/p>\n\u003cp>Norins is quick to cite sources and studies supporting his claim, among them a 2010 study published in the \u003cem>Journal of Neurosurgery\u003c/em> showing that \u003ca href=\"http://thejns.org/doi/pdf/10.3171/2010.1.JNS091740\" target=\"_blank\" rel=\"noopener\">neurosurgeons die from Alzheimer's at a seven-fold higher rate\u003c/a> than they do from other disorders.\u003c/p>\n\u003cp>Another study from that same year, published in The \u003cem>Journal of the American Geriatric Society,\u003c/em> found that people whose \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20722820/\" target=\"_blank\" rel=\"noopener\">spouses have dementia are at a six-times greater risk\u003c/a> for the condition themselves.\u003c/p>\n\u003cp>Contagion does come to mind. And Norins isn't alone in his thinking.\u003c/p>\n\u003cp>In 2016, 32 researchers from universities around the world signed an editorial in the \u003cem>Journal of Alzheimer's Disease\u003c/em> calling for \"further research on the role of infectious agents in [Alzheimer's] causation.\" Based on much of the same evidence Norins encountered, the authors concluded that clinical trials with antimicrobial drugs in Alzheimer's are now justified.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>NPR reported on an intriguing \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/21/621908340/researchers-find-herpes-viruses-in-brains-marked-by-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published in \u003cem>Neuron\u003c/em> in June that suggested that viral infection can influence the progression of Alzheimer's. Led by Mount Sinai genetics professor Joel Dudley, the work was intended to compare the genomes of healthy brain tissue with that affected by dementia.\u003c/p>\n\u003cp>But something kept getting in the way: herpes.\u003c/p>\n\u003cp>Dudley's team noticed an unexpectedly high level of viral DNA from two human herpes viruses, HHV-6 and HHV-7. The viruses are common and cause a rash called roseola in young children (not the sexually transmitted disease caused by other strains).\u003c/p>\n\u003cp>Some viruses have the ability to lie dormant in our neurons for decades by incorporating their genomes into our own. The classic example is chickenpox: A childhood viral infection resolves and lurks silently, returning years later as \u003ca href=\"https://www.cdc.gov/shingles/about/symptoms.html\" target=\"_blank\" rel=\"noopener\">shingles\u003c/a>, an excruciating rash. Like it or not, nearly all of us are chimeras with viral DNA speckling our genomes.\u003c/p>\n\u003cp>But having the herpes viruses alone doesn't mean inevitable brain decline. After all, up to 75 percent of us may \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11285567\" target=\"_blank\" rel=\"noopener\">harbor HHV-6\u003c/a> .\u003c/p>\n\u003cp>But Dudley also noticed that herpes appeared to interact with human genes known to increase Alzheimer's risk. Perhaps, he says, there is some toxic combination of genetic and infectious influence that results in the disease; a combination that sparks what some feel is the main contributor to the disease, an overactive immune system.\u003c/p>\n\u003cp>The hallmark pathology of Alzheimer's is accumulation of a protein called amyloid in the brain. Many researchers have assumed these aggregates, or plaques, are simply a byproduct of some other process at the core of the disease. Other scientists posit that the protein itself contributes to the condition in some way.\u003c/p>\n\u003cp>The theory that amyloid is the root cause of Alzheimer's is losing steam. But the protein may still contribute to the disease, even if it winds up being deemed infectious.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Work by Harvard neuroscientist Rudolph Tanzi suggests it might be a bit of both. Along with colleague Robert Moir, Tanzi has shown that amyloid is lethal to viruses and bacteria in the test tube, and also in mice. He now believes the protein is part of our ancient immune system that like antibodies, ramps up its activity to help fend off unwanted bugs.\u003c/p>\n\u003cp>So does that mean that the microbe is the cause of Alzheimer's, and amyloid a harmless reaction to it? According to Tanzi it's not that simple.\u003c/p>\n\u003cp>Tanzi believes that in many cases of Alzheimer's, microbes are probably the initial seed that sets off a toxic tumble of molecular dominoes. Early in the disease amyloid protein builds up to fight infection, yet too much of the protein begins to impair function of neurons in the brain. The excess amyloid then causes another protein, called tau, to form tangles, which further harm brain cells.\u003c/p>\n\u003cp>But as Tanzi explains, the ultimate neurological insult in Alzheimer's is the body's reaction to this neurotoxic mess. All the excess protein revs up the immune system, causing inflammation — and it's this inflammation that does the most damage to the Alzheimer's-afflicted brain.\u003c/p>\n\u003cp>So what does this say about the future of treatment? Possibly a lot. Tanzi envisions a day when people are screened at, say, 50 years old. \"If their brains are riddled with too much amyloid,\" he says, \"we knock it down a bit with antiviral medications. It's just like how you are prescribed preventative drugs if your cholesterol is too high.\"\u003c/p>\n\u003cp>Tanzi feels that microbes are just one possible seed for the complex pathology behind Alzheimer's. Genetics may also play a role, as certain genes produce a type of amyloid more prone to clumping up. He also feels environmental factors like pollution might contribute.\u003c/p>\n\u003cp>Dr. James Burke, professor of medicine and psychiatry at Duke University's Alzheimer's Disease Research Center, isn't willing to abandon the amyloid theory altogether, but agrees it's time for the field to move on. \"There may be many roads to developing Alzheimer's disease and it would be shortsighted to focus just on amyloid and tau,\" he says. \"A million-dollar prize is attention- getting, but the reward for identifying a treatable target to delay or prevent Alzheimer's disease is invaluable.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Any treatment that disrupts the cascade leading to amyloid, tau and inflammation could theoretically benefit an at-risk brain. The vast majority of Alzheimer's treatment trials have failed, including many targeting amyloid. But it could be that the patients included were too far along in their disease to reap any therapeutic benefit.\u003c/p>\n\u003cp>If a microbe is responsible for all or some cases of Alzheimer's, perhaps future treatments or preventive approaches will prevent toxin protein buildup in the first place. Both Tanzi and Norins believe Alzheimer's vaccines against viruses like herpes might one day become common practice.\u003c/p>\n\u003cp>In July of this year, in collaboration with Norins, the Infectious Diseases Society of America announced that they plan to offer two $50,000 grants supporting research into a microbial association with Alzheimer's. According to Norins, this is the first acknowledgement by a leading infectious disease group that Alzheimer's may be microbial in nature – or at least that it's worth exploring.\u003c/p>\n\u003cp>\"The important thing is not the amount of the money, which is a pittance compared with the $2 billion NIH spends on amyloid and tau research,\" says Norins, \"but rather the respectability and more mainstream status the grants confer on investigating of the infectious possibility. Remember when we thought ulcers were caused by stress?\"\u003c/p>\n\u003cp>Ulcers, we now know, are \u003ca href=\"https://www.nobelprize.org/prizes/medicine/2005/press-release/\" target=\"_blank\" rel=\"noopener\">caused by a germ\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired, Scientific American\u003cem> and on The Atlantic.com. He graduated from the University of Virginia School of Medicine. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\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=Infectious+Theory+Of+Alzheimer%27s+Disease+Draws+Fresh+Interest&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Researcher Battling Cancer Explores Alternatives To Opioid Treatments",
"title": "A Researcher Battling Cancer Explores Alternatives To Opioid Treatments",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>The explosion of deaths related to opioid misuse has underscored a pressing need for better ways of treating pain, especially chronic pain.[contextly_sidebar id=\"Lrxhc0PiaxvZNwtQRWNC315GUyNFIRBB\"]\u003c/p>\n\u003cp>Duquesne University pharmacology associate professor Jelena Janjic thinks she's on to one. It involves using a patient's own immune system to deliver non-opioid pain medication to places in the body where there's pain.\u003c/p>\n\u003cp>Janjic's idea, which draws from the field of cancer research, is to insert tiny amounts of over-the-counter pain medications into minute carriers called nanoparticles, and then inject these into pain patients. The medicines would then travel through the body to places where there is inflammation, and relieve the pain.\u003c/p>\n\u003cp>Janjic has a special reason for wanting to develop new medicines for chronic pain: She suffers from it herself.\u003c/p>\n\u003cp>\"As a patient, I want an answer,\" she says. \"I want to figure out this.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There's no question that the need for better, non-addictive medications is real and urgent. Researchers have come up with\u003ca href=\"https://www.painnewsnetwork.org/stories/2018/6/2/new-treatments-on-the-horizon-for-chronic-pain\"> some ideas\u003c/a>, but so far none has made it to market. Finding new treatments is difficult for any disease and it's proving especially difficult for chronic pain because the underlying causes are poorly understood.\u003c/p>\n\u003cp>Attempting to modulate inflammation as way to treat pain \"is an active area of research,\" says \u003ca href=\"https://www.ninds.nih.gov/node/8824\" target=\"_blank\" rel=\"noopener\">Michael L. Oshinsky\u003c/a>, Program Director, Pain and Migraine, at the National Institute of Neurological Disorders and Stroke.[contextly_sidebar id=\"wUYL0s18LxOkY4wdczUfG5sVi8cK5dSj\"]\u003c/p>\n\u003cp>Oshinsky says Janjic's idea of targeting the immune system with nanoparticles carrying pain relievers makes sense, although he cautions that the relationship between inflammation and pain is not well understood.\u003c/p>\n\u003cp>Janjic's path to this research began in 2010. She has a doctorate in medicinal chemistry, and she had recently moved to Duquesne University where she had set up a lab focused on using nanomedicine techniques to treat cancer.\u003c/p>\n\u003cp>What seemed like out of nowhere, of the blue, she started to suffer bouts of severe pain.\u003c/p>\n\u003cp>\"The one that hit me real hard was the whole body, from head to toe,\" she says. \"I've had on and off chronic pain since I was a teenager, but this was different.\"\u003c/p>\n\u003cp>In August that year, just before her students arrived back to school, she ended up in the emergency room with pain that was almost intolerable.\u003c/p>\n\u003cp>The doctors' diagnosis was discouraging. They told her she had a chronic pain syndrome. They said there wasn't much they could do about it, and they said it was for life.\u003c/p>\n\u003cp>The medicines they gave her helped with the pain somewhat, but left her feeling like she was living in a fog. She was having trouble remembering things, trouble taking notes.\u003c/p>\n\u003cp>\"Things were weird. So I decided I am going to do research on myself,\" Janjic says.\u003c/p>\n\u003cp>To control her own pain, she turned to mindfulness meditation and other non-medical interventions, including composing music and playing the piano. It's not as if the pain magically went away, she says, but she was able to carry on with her life. Some days were worse than others.\u003c/p>\n\u003cp>But she also wanted to find a medical solution.\u003c/p>\n\u003cp>She made one important treatment decision early on: She didn't want to take opioids for her pain.[contextly_sidebar id=\"QMwX3Yw6AeYbgPKNOtGQ6rPZrGu4Q9y4\"]\u003c/p>\n\u003cp>\"At the time I could have got them very easily,\" Janjic says. \"I said, 'What are you going to give me when I'm 67, or 87, if I take them now?' I knew they don't work long-term very well. So almost the refusal of opioids precipitated everything else that happened.\"\u003c/p>\n\u003cp>Looking for alternatives to opioids, she dove into the scientific literature, to learn all she could about chronic pain.\u003c/p>\n\u003cp>Chronic pain syndromes are not well understood. With acute pain, it's usually possible to identify the cause—an injury of some sort, or inflammation caused by an infection. Chronic pain may be linked to an initial mishap, but may persist long after the initial cause of the pain has disappeared. Sometimes there's no good explanation of the pain at all, a frustrating circumstance for both doctor and patients.\u003c/p>\n\u003cp>In addition to her research, Janjic started paying close attention to her own condition.\u003c/p>\n\u003cp>\"I started to understand that my body was actually inflamed,\" she says.\u003c/p>\n\u003cp>Inflammation occurs when our bodies' immune system tries to deal with some damage, maybe from an invading virus or bacteria, and sends a barrage of immune cells to the affected area. On the one hand this is a good thing, since the cells fight the infection. But on the other, it can stimulate nerve cells in a particular part of the body, causing pain.\u003c/p>\n\u003cp>Janjic also noticed something important about her pain: it varied both in intensity and in location. Sometimes it was in her knees, sometimes in her shoulders.\u003c/p>\n\u003cp>She says none of the medicines available today responded to pain's \"diversity within the body.\"\u003c/p>\n\u003cp>\"I [started] to understand the fluctuation,\" she says.\u003c/p>\n\u003cp>She realized that the fluctuation meant more immune cells were going to the part of the body where the pain was. She figured if she could get pain medicine into immune cells, that medicine would ride with those cells to where it was needed.[contextly_sidebar id=\"YRLyRHWtPrWD1BScVQCmWanq4QjZQPO0\"]\u003c/p>\n\u003cp>Before she got into pain research, Janjic was working on something called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29230567\" target=\"_blank\" rel=\"noopener\">cancer nanomedicine\u003c/a>. Cancer nanomedicines work by putting anti-cancer drugs into tiny containers called nanoparticles, and then injecting them into cancer patients, where they enter the patients' immune cells.\u003c/p>\n\u003cp>\"So what did I already know how to do? Mess with the immune system with nanomedicines,\" Janjic says. \"And that's how the idea of pain nanomedicine was born.\"\u003c/p>\n\u003cp>After many years of tinkering, she's started to get positive results. In a \u003ca href=\"https://www.jni-journal.com/article/S0165-5728(18)30012-2/fulltext\">recently published study,\u003c/a> she showed that when researchers put a nonsteroidal, anti-inflammatory drug into a nanoparticle, and then injected that into a rat, it reduced the rat's pain.\u003c/p>\n\u003cp>Janjic says her approach doesn't try to disable the immune cells.\u003c/p>\n\u003cp>\"You still want them to fight infection, you still want them to do what they're supposed to do,\" she says. \"But we almost try to stop them from going into override and causing chronic pain.\"\u003c/p>\n\u003cp>Janjic, who is also the founder and co-director of the \u003ca href=\"https://www.duq.edu/about/centers-and-institutes/chronic-pain-research-consortium\" target=\"_blank\" rel=\"noopener\">Chronic Pain Research Consortium\u003c/a> at Duquesne University, is collaborating with several labs to try pairing different pain medications with different kinds of nano-particles to see what works best. So far progress is slow. And if one of the candidates shows real promise it will be years before anything can be tested in human patients and ultimately approved by the FDA.\u003c/p>\n\u003cp>Janjic credits her own experience with pain for helping her gain a better understanding of pain and how to treat it. She thinks researchers would learn a lot from routinely talking to the people they're trying to help.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"My take home message is, 'Ask the patient first,' \" Janjic says. \"Ask the kid who's ten. Ask the grandpa with rheumatoid arthritis what that feels like. This is what I really want to see flourish. Maybe this already happening somewhere. If it is, I want to know. If you are inspiring your research this way, then I want to talk to you.\"\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=Inspired+By+Her+Own+Pain%2C+A+Researcher+Explores+Alternatives+To+Opioid+Treatments&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The explosion of deaths related to opioid misuse has underscored a pressing need for better ways of treating pain, especially chronic pain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Duquesne University pharmacology associate professor Jelena Janjic thinks she's on to one. It involves using a patient's own immune system to deliver non-opioid pain medication to places in the body where there's pain.\u003c/p>\n\u003cp>Janjic's idea, which draws from the field of cancer research, is to insert tiny amounts of over-the-counter pain medications into minute carriers called nanoparticles, and then inject these into pain patients. The medicines would then travel through the body to places where there is inflammation, and relieve the pain.\u003c/p>\n\u003cp>Janjic has a special reason for wanting to develop new medicines for chronic pain: She suffers from it herself.\u003c/p>\n\u003cp>\"As a patient, I want an answer,\" she says. \"I want to figure out this.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There's no question that the need for better, non-addictive medications is real and urgent. Researchers have come up with\u003ca href=\"https://www.painnewsnetwork.org/stories/2018/6/2/new-treatments-on-the-horizon-for-chronic-pain\"> some ideas\u003c/a>, but so far none has made it to market. Finding new treatments is difficult for any disease and it's proving especially difficult for chronic pain because the underlying causes are poorly understood.\u003c/p>\n\u003cp>Attempting to modulate inflammation as way to treat pain \"is an active area of research,\" says \u003ca href=\"https://www.ninds.nih.gov/node/8824\" target=\"_blank\" rel=\"noopener\">Michael L. Oshinsky\u003c/a>, Program Director, Pain and Migraine, at the National Institute of Neurological Disorders and Stroke.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Oshinsky says Janjic's idea of targeting the immune system with nanoparticles carrying pain relievers makes sense, although he cautions that the relationship between inflammation and pain is not well understood.\u003c/p>\n\u003cp>Janjic's path to this research began in 2010. She has a doctorate in medicinal chemistry, and she had recently moved to Duquesne University where she had set up a lab focused on using nanomedicine techniques to treat cancer.\u003c/p>\n\u003cp>What seemed like out of nowhere, of the blue, she started to suffer bouts of severe pain.\u003c/p>\n\u003cp>\"The one that hit me real hard was the whole body, from head to toe,\" she says. \"I've had on and off chronic pain since I was a teenager, but this was different.\"\u003c/p>\n\u003cp>In August that year, just before her students arrived back to school, she ended up in the emergency room with pain that was almost intolerable.\u003c/p>\n\u003cp>The doctors' diagnosis was discouraging. They told her she had a chronic pain syndrome. They said there wasn't much they could do about it, and they said it was for life.\u003c/p>\n\u003cp>The medicines they gave her helped with the pain somewhat, but left her feeling like she was living in a fog. She was having trouble remembering things, trouble taking notes.\u003c/p>\n\u003cp>\"Things were weird. So I decided I am going to do research on myself,\" Janjic says.\u003c/p>\n\u003cp>To control her own pain, she turned to mindfulness meditation and other non-medical interventions, including composing music and playing the piano. It's not as if the pain magically went away, she says, but she was able to carry on with her life. Some days were worse than others.\u003c/p>\n\u003cp>But she also wanted to find a medical solution.\u003c/p>\n\u003cp>She made one important treatment decision early on: She didn't want to take opioids for her pain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"At the time I could have got them very easily,\" Janjic says. \"I said, 'What are you going to give me when I'm 67, or 87, if I take them now?' I knew they don't work long-term very well. So almost the refusal of opioids precipitated everything else that happened.\"\u003c/p>\n\u003cp>Looking for alternatives to opioids, she dove into the scientific literature, to learn all she could about chronic pain.\u003c/p>\n\u003cp>Chronic pain syndromes are not well understood. With acute pain, it's usually possible to identify the cause—an injury of some sort, or inflammation caused by an infection. Chronic pain may be linked to an initial mishap, but may persist long after the initial cause of the pain has disappeared. Sometimes there's no good explanation of the pain at all, a frustrating circumstance for both doctor and patients.\u003c/p>\n\u003cp>In addition to her research, Janjic started paying close attention to her own condition.\u003c/p>\n\u003cp>\"I started to understand that my body was actually inflamed,\" she says.\u003c/p>\n\u003cp>Inflammation occurs when our bodies' immune system tries to deal with some damage, maybe from an invading virus or bacteria, and sends a barrage of immune cells to the affected area. On the one hand this is a good thing, since the cells fight the infection. But on the other, it can stimulate nerve cells in a particular part of the body, causing pain.\u003c/p>\n\u003cp>Janjic also noticed something important about her pain: it varied both in intensity and in location. Sometimes it was in her knees, sometimes in her shoulders.\u003c/p>\n\u003cp>She says none of the medicines available today responded to pain's \"diversity within the body.\"\u003c/p>\n\u003cp>\"I [started] to understand the fluctuation,\" she says.\u003c/p>\n\u003cp>She realized that the fluctuation meant more immune cells were going to the part of the body where the pain was. She figured if she could get pain medicine into immune cells, that medicine would ride with those cells to where it was needed.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Before she got into pain research, Janjic was working on something called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29230567\" target=\"_blank\" rel=\"noopener\">cancer nanomedicine\u003c/a>. Cancer nanomedicines work by putting anti-cancer drugs into tiny containers called nanoparticles, and then injecting them into cancer patients, where they enter the patients' immune cells.\u003c/p>\n\u003cp>\"So what did I already know how to do? Mess with the immune system with nanomedicines,\" Janjic says. \"And that's how the idea of pain nanomedicine was born.\"\u003c/p>\n\u003cp>After many years of tinkering, she's started to get positive results. In a \u003ca href=\"https://www.jni-journal.com/article/S0165-5728(18)30012-2/fulltext\">recently published study,\u003c/a> she showed that when researchers put a nonsteroidal, anti-inflammatory drug into a nanoparticle, and then injected that into a rat, it reduced the rat's pain.\u003c/p>\n\u003cp>Janjic says her approach doesn't try to disable the immune cells.\u003c/p>\n\u003cp>\"You still want them to fight infection, you still want them to do what they're supposed to do,\" she says. \"But we almost try to stop them from going into override and causing chronic pain.\"\u003c/p>\n\u003cp>Janjic, who is also the founder and co-director of the \u003ca href=\"https://www.duq.edu/about/centers-and-institutes/chronic-pain-research-consortium\" target=\"_blank\" rel=\"noopener\">Chronic Pain Research Consortium\u003c/a> at Duquesne University, is collaborating with several labs to try pairing different pain medications with different kinds of nano-particles to see what works best. So far progress is slow. And if one of the candidates shows real promise it will be years before anything can be tested in human patients and ultimately approved by the FDA.\u003c/p>\n\u003cp>Janjic credits her own experience with pain for helping her gain a better understanding of pain and how to treat it. She thinks researchers would learn a lot from routinely talking to the people they're trying to help.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"My take home message is, 'Ask the patient first,' \" Janjic says. \"Ask the kid who's ten. Ask the grandpa with rheumatoid arthritis what that feels like. This is what I really want to see flourish. Maybe this already happening somewhere. If it is, I want to know. If you are inspiring your research this way, then I want to talk to you.\"\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=Inspired+By+Her+Own+Pain%2C+A+Researcher+Explores+Alternatives+To+Opioid+Treatments&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Pediatrics Group Urges Parents to Ditch FluMist in Favor of Shots",
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"content": "\u003cp>The American Academy of Pediatrics is recommending children be vaccinated with injectable flu vaccine for the coming season, rather than the nasal spray vaccine FluMist, unless a child will only be vaccinated if he or she can forgo a needle, or if a doctor runs out of flu shots.[contextly_sidebar id=\"hDOkDX1TSKq0uExbrwfmFky6j6An7v9D\"]\u003c/p>\n\u003cp>“The AAP feels that the flu shot should be the primary vaccine choice for all children,” said Dr. Henry Bernstein, a pediatrician and an ex-officio member of the AAP’s committee on infectious diseases.\u003c/p>\n\u003cp>That advice puts the AAP’s annual flu vaccine recommendations slightly at odds with \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_w\" target=\"_blank\" rel=\"noopener\">those of the Centers for Disease Control and Prevention\u003c/a>, which state that any of the flu vaccines available for children could be used for the coming flu season.\u003c/p>\n\u003cp>Both, however, share an end goal: getting more children vaccinated.\u003c/p>\n\u003cp>Influenza can be deadly for children. In the past flu season, 180 children under the age of 18 died from the flu, making it the second most deadly flu season — after the 2009 H1N1 pandemic — since the CDC started recording pediatric flu deaths in the winter of 2005-2006.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CDC recommends everyone over the age of 6 months be vaccinated every year against the flu, unless there is a medical reason to avoid the vaccine.\u003c/p>\n\u003cp>Yet only about 60 percent of children between the ages of 6 months and 17 years got vaccinated against flu in 2016-2017, the most recent year for which data are available. Roughly eight out of every 10 children who died from flu weren’t vaccinated, said Dr. Lisa Grohskopf, a medical officer in the CDC’s influenza division.\u003c/p>\n\u003cp>The differing advice from the CDC and the AAP on AstraZeneca’s FluMist could befuddle parents and pediatricians.[contextly_sidebar id=\"ns1NFKxqZaS66Mu22mM7Fucp2b9WmmE4\"]\u003c/p>\n\u003cp>“There’s no question that ideally we would like for the CDC and the AAP to be completely harmonized” when it comes to recommendations, said Bernstein who is also a member of the Advisory Committee on Immunization Practices, which guides the CDC on vaccine decisions.\u003c/p>\n\u003cp>“Both groups are harmonized in wanting as many children to receive flu vaccine as possible each and every year,” said Bernstein. “When recommendations are not perfectly harmonized, it does pose the possibility for confusion.”\u003c/p>\n\u003cp>But any confusion might be mitigated by the fact that finding FluMist might not be easy this flu season.\u003c/p>\n\u003cp>The decision to once again recommend it — effectively giving doctors and pharmacists a go-head to use it again — was \u003ca href=\"https://www.statnews.com/2018/02/21/flu-flumist-vaccine/\">made by the ACIP in late February\u003c/a>. By that point, though, many flu vaccine orders would already have been placed for the 2018-2019 season.\u003c/p>\n\u003cp>While dozens of lots of vaccine products made by Sanofi Pasteur, GlaxoSmithKline, and Seqirus have been given the \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Post-MarketActivities/LotReleases/ucm613863.htm\" target=\"_blank\" rel=\"noopener\">green light for distribution\u003c/a> by the Food and Drug Administration, no lots of FluMist had cleared that hurdle as of Aug. 30.\u003c/p>\n\u003cp>It has been a rocky few years for FluMist, which once was deemed more effective in children than injectable flu vaccine. But just after ACIP gave FluMist a rare preferential recommendation in 2014, performance problems came into view. By the 2016-2017 flu season, the CDC’s vaccine advisers recommended it not be used in the U.S. ACIP retained that position for the following flu season as well.\u003c/p>\n\u003cp>The problem was vaccine effectiveness studies that are done every year showed FluMist had not been offering much if any protection against the influenza A virus family H1N1.\u003c/p>\n\u003cp>It wasn’t clear why the vaccine’s performance was so poor in the U.S. during the 2013-2014 and 2015-2016 seasons. To make matters more confounding, other countries that use FluMist — Canada, Finland, and Britain among them — did not see the puzzling lack of effectiveness.[contextly_sidebar id=\"plRGl9fWXC0hyQTXcSoyNMZbRMqtlHfF\"]\u003c/p>\n\u003cp>Unlike injectable flu vaccine, FluMist contains live viruses. The viruses in the vaccine, which is puffed up a nostril of the recipient, initiate the infection process, thereby activating an immune response. But the viruses in the vaccine are weakened and don’t induce illness.\u003c/p>\n\u003cp>In response to its U.S. performance problems, AstraZeneca reformulated the H1N1 portion of the vaccine. There is some evidence that suggests the updated vaccine may be more effective — although the company hasn’t been able to do studies in children to confirm that. H3N2 viruses have dominated in the last two flu seasons here.\u003c/p>\n\u003cp>“They provided some evidence that appeared promising that the new virus that’s going to go into the vaccine this season in the U.S. is a bit more fit,” said Grohskopf. “It is promising evidence that what is at least believed to be the root cause of the problem has been fixed.”\u003c/p>\n\u003cp>Bernstein said the AAP was not as convinced by the data as the CDC. He voted against recommending FluMist for the 2018-2019 season at the February ACIP meeting.\u003c/p>\n\u003cp>Another place the CDC and AAP advice diverges slightly relates to when children should be vaccinated.\u003c/p>\n\u003cp>The AAP recommendations, published Monday in the journal Pediatrics, suggest pediatricians should start urging parents to vaccinate their children as soon as flu vaccine becomes available. That can be as early as late July or August, which — depending on when flu activity picks up — is often months ahead of when children will face a flu threat. Flu season often peaks in January or February, and influenza B viruses, which are particularly hard on children, often circulate late in the winter.[contextly_sidebar id=\"99nVOxVZDXqlh05RmfHN75NAR5MEv5RW\"]\u003c/p>\n\u003cp>There are some studies that have shown protection from flu vaccine starts to wear off as the season wears on.\u003c/p>\n\u003cp>The CDC’s recommendations, published Aug. 24, suggested people should be vaccinated by the end of October, when flu activity can start to tick up.\u003c/p>\n\u003cp>Grohskopf acknowledged the variability and unpredictability of influenza makes it tough to know when to advise people to get the vaccine. “What we can say is the best time to get vaccinated is probably a couple of weeks before flu starts circulating where you are. But we can never really tell people when that is,” she admitted.\u003c/p>\n\u003cp>One thing is clear though, she said. Parents of young children should start the vaccination process earlier. That’s because children under 8 years old who haven’t had at least two flu vaccines in their life need two doses of vaccine given at least four weeks apart. The second shot should be by the end of October, the CDC guidance said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/09/03/flumist-vaccine-recommendations/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The American Academy of Pediatrics is recommending children be vaccinated with injectable flu vaccine for the coming season, rather than the nasal spray vaccine FluMist, unless a child will only be vaccinated if he or she can forgo a needle, or if a doctor runs out of flu shots.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“The AAP feels that the flu shot should be the primary vaccine choice for all children,” said Dr. Henry Bernstein, a pediatrician and an ex-officio member of the AAP’s committee on infectious diseases.\u003c/p>\n\u003cp>That advice puts the AAP’s annual flu vaccine recommendations slightly at odds with \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_w\" target=\"_blank\" rel=\"noopener\">those of the Centers for Disease Control and Prevention\u003c/a>, which state that any of the flu vaccines available for children could be used for the coming flu season.\u003c/p>\n\u003cp>Both, however, share an end goal: getting more children vaccinated.\u003c/p>\n\u003cp>Influenza can be deadly for children. In the past flu season, 180 children under the age of 18 died from the flu, making it the second most deadly flu season — after the 2009 H1N1 pandemic — since the CDC started recording pediatric flu deaths in the winter of 2005-2006.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CDC recommends everyone over the age of 6 months be vaccinated every year against the flu, unless there is a medical reason to avoid the vaccine.\u003c/p>\n\u003cp>Yet only about 60 percent of children between the ages of 6 months and 17 years got vaccinated against flu in 2016-2017, the most recent year for which data are available. Roughly eight out of every 10 children who died from flu weren’t vaccinated, said Dr. Lisa Grohskopf, a medical officer in the CDC’s influenza division.\u003c/p>\n\u003cp>The differing advice from the CDC and the AAP on AstraZeneca’s FluMist could befuddle parents and pediatricians.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“There’s no question that ideally we would like for the CDC and the AAP to be completely harmonized” when it comes to recommendations, said Bernstein who is also a member of the Advisory Committee on Immunization Practices, which guides the CDC on vaccine decisions.\u003c/p>\n\u003cp>“Both groups are harmonized in wanting as many children to receive flu vaccine as possible each and every year,” said Bernstein. “When recommendations are not perfectly harmonized, it does pose the possibility for confusion.”\u003c/p>\n\u003cp>But any confusion might be mitigated by the fact that finding FluMist might not be easy this flu season.\u003c/p>\n\u003cp>The decision to once again recommend it — effectively giving doctors and pharmacists a go-head to use it again — was \u003ca href=\"https://www.statnews.com/2018/02/21/flu-flumist-vaccine/\">made by the ACIP in late February\u003c/a>. By that point, though, many flu vaccine orders would already have been placed for the 2018-2019 season.\u003c/p>\n\u003cp>While dozens of lots of vaccine products made by Sanofi Pasteur, GlaxoSmithKline, and Seqirus have been given the \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Post-MarketActivities/LotReleases/ucm613863.htm\" target=\"_blank\" rel=\"noopener\">green light for distribution\u003c/a> by the Food and Drug Administration, no lots of FluMist had cleared that hurdle as of Aug. 30.\u003c/p>\n\u003cp>It has been a rocky few years for FluMist, which once was deemed more effective in children than injectable flu vaccine. But just after ACIP gave FluMist a rare preferential recommendation in 2014, performance problems came into view. By the 2016-2017 flu season, the CDC’s vaccine advisers recommended it not be used in the U.S. ACIP retained that position for the following flu season as well.\u003c/p>\n\u003cp>The problem was vaccine effectiveness studies that are done every year showed FluMist had not been offering much if any protection against the influenza A virus family H1N1.\u003c/p>\n\u003cp>It wasn’t clear why the vaccine’s performance was so poor in the U.S. during the 2013-2014 and 2015-2016 seasons. To make matters more confounding, other countries that use FluMist — Canada, Finland, and Britain among them — did not see the puzzling lack of effectiveness.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Unlike injectable flu vaccine, FluMist contains live viruses. The viruses in the vaccine, which is puffed up a nostril of the recipient, initiate the infection process, thereby activating an immune response. But the viruses in the vaccine are weakened and don’t induce illness.\u003c/p>\n\u003cp>In response to its U.S. performance problems, AstraZeneca reformulated the H1N1 portion of the vaccine. There is some evidence that suggests the updated vaccine may be more effective — although the company hasn’t been able to do studies in children to confirm that. H3N2 viruses have dominated in the last two flu seasons here.\u003c/p>\n\u003cp>“They provided some evidence that appeared promising that the new virus that’s going to go into the vaccine this season in the U.S. is a bit more fit,” said Grohskopf. “It is promising evidence that what is at least believed to be the root cause of the problem has been fixed.”\u003c/p>\n\u003cp>Bernstein said the AAP was not as convinced by the data as the CDC. He voted against recommending FluMist for the 2018-2019 season at the February ACIP meeting.\u003c/p>\n\u003cp>Another place the CDC and AAP advice diverges slightly relates to when children should be vaccinated.\u003c/p>\n\u003cp>The AAP recommendations, published Monday in the journal Pediatrics, suggest pediatricians should start urging parents to vaccinate their children as soon as flu vaccine becomes available. That can be as early as late July or August, which — depending on when flu activity picks up — is often months ahead of when children will face a flu threat. Flu season often peaks in January or February, and influenza B viruses, which are particularly hard on children, often circulate late in the winter.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>There are some studies that have shown protection from flu vaccine starts to wear off as the season wears on.\u003c/p>\n\u003cp>The CDC’s recommendations, published Aug. 24, suggested people should be vaccinated by the end of October, when flu activity can start to tick up.\u003c/p>\n\u003cp>Grohskopf acknowledged the variability and unpredictability of influenza makes it tough to know when to advise people to get the vaccine. “What we can say is the best time to get vaccinated is probably a couple of weeks before flu starts circulating where you are. But we can never really tell people when that is,” she admitted.\u003c/p>\n\u003cp>One thing is clear though, she said. Parents of young children should start the vaccination process earlier. That’s because children under 8 years old who haven’t had at least two flu vaccines in their life need two doses of vaccine given at least four weeks apart. The second shot should be by the end of October, the CDC guidance said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/09/03/flumist-vaccine-recommendations/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Melting cakes and melting guests. Wilting flowers and wilting brides. A hot day can spell disaster for a wedding unless there's detailed preparation beforehand.\u003c/p>\n\u003cp>The United States, on average, experiences about 74 \"mild weather days\" every year, \u003ca href=\"https://link.springer.com/article/10.1007/s10584-016-1885-9\" target=\"_blank\" rel=\"noopener\">according to a 2017 study\u003c/a> in the Journal of Climatic Change.\u003c/p>\n\u003cp>That is 74 chances to hold the perfect outdoor wedding with tolerable temperatures, low humidity and nearly no precipitation, according to Sarah Kapnick, a National Oceanic and Atmospheric Administration climate scientist and co-author of that study. She says it was inspired by frequent requests from worried friends to predict the weather on their wedding days.\u003c/p>\n\u003cp>Of course, the odds are better if the wedding is held in generally temperate San Diego (180 mild weather days per year) rather than boggy Washington, D.C. (81 mild weather days per year).\u003c/p>\n\u003cp>But overall, the globe is set to lose four mild weather days in the next two decades and a total of nine by the end of the century.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"[That means] the summers in the United States [are] getting hotter. They're also becoming more humid, particularly in the South and Southeast,\" Kapnick says.\u003c/p>\n\u003cp>Those shifts in temperature are leading to shifts in the wedding industry as bakers, photographers, florists and the couples they serve think more critically about how to beat the heat on this all-important day.\u003c/p>\n\u003cp>\u003cstrong>The Date: Fall is the New Summer\u003c/strong>\u003c/p>\n\u003cp>\"In the winter, it's actually getting warmer. And so you're having more mild weather days in the winter, and also in the shoulder seasons: spring and fall,\" Kapnick says.\u003c/p>\n\u003cp>Those shoulder seasons have become increasingly popular for weddings. \u003ca href=\"https://go.weddingwire.com/newlywed-report\" target=\"_blank\" rel=\"noopener\">According to WeddingWire's annual survey\u003c/a> of newlyweds, fewer than a third of all weddings now occur in the summer.\u003c/p>\n\u003cp>Ten years ago, wedding dates in May, June and July were most common. But in 2017, September, October and November took the top spots.\u003c/p>\n\u003cp>There's no conclusive evidence to suggest the shift is because of rising temperatures, but Kapnick says that the fall presents a lower risk of heat stress.\u003c/p>\n\u003cp>\"People are looking to get married often outside, often during pleasant weather where people can be active: They can be dancing, they can be enjoying themselves,\" she says.\u003c/p>\n\u003cp>Though, of course, thousands of weddings still take place across the country each summer.\u003c/p>\n\u003cp>\u003cstrong>The Ceremony: Shorten It\u003c/strong>\u003c/p>\n\u003cp>J.P. Reynolds has been marrying couples in Southern California for more than 20 years. He says he's often the first to bake in the hot sun at an outdoor wedding, standing patiently as the entire wedding party glides down the aisle. He also gets an extended view of the misery of guests.\u003c/p>\n\u003cp>\"People look so uncomfortable. They're fanning themselves. They're squinting. They're using the programs as shades,\" he says. \"And they're not interested in listening to someone do a reading about what is the art of marriage.\"\u003c/p>\n\u003cp>Reynolds says he's adjusting to higher temperatures.\u003c/p>\n\u003cp>He has cut down his average ceremony time by about 10 minutes and limits couples to one reading. \"But I don't want the ceremony to be wham bam. There needs to be a certain texture to the ceremony,\" he adds.\u003c/p>\n\u003cp>\u003cstrong>The Flowers: Think Tropical\u003c/strong>\u003c/p>\n\u003cp>Shawna Yamamoto, a floral designer in Orange County, Calif., urges couples to choose tropical flowers for hot, outdoor weddings, which fare best in high temperatures and usually last longer.\u003c/p>\n\u003cp>\"Roses, for example, are grown in South America. The temperatures are pretty much the same year-round there, and they're a very hardy flower,\" she says.\u003c/p>\n\u003cp>After flowers are chosen, it's a race to order and arrange them.\u003c/p>\n\u003cp>\"There's a standard rule that a flower should have a shelf life of seven days from the time they're cut. But that starts from the grower,\" explains Yamamoto.\u003c/p>\n\u003cp>Yamamoto uses a walk-in fridge and a refrigerated truck and insulates flowers in plastic wrap.\u003c/p>\n\u003cp>And she has more advice for couples: \"Rely heavily on the professional. Be open to what's in season and what's readily available. The overall look can be achieved with different flowers.\"\u003c/p>\n\u003cp>Silk flowers are also a convincing option, points out Rrivre Davies, a Los Angeles wedding designer and president of the Wedding International Professionals Association.\u003c/p>\n\u003cp>\u003cstrong>The Food: Use Twice the Ice\u003c/strong>\u003c/p>\n\u003cp>Caterers are used to handling the heat. \u003ca href=\"https://www.osha.gov/SLTC/youth/restaurant/cooking_heat.html\" target=\"_blank\" rel=\"noopener\">According to\u003c/a> the Occupational Safety and Health Administration, temperatures can reach 110 degrees in a busy kitchen.\u003c/p>\n\u003cp>But, Davies says, wedding caterers these days often need more air conditioning in their workstations — whether that's an indoor kitchen or an outdoor tent.\u003c/p>\n\u003cp>And the heat can also increase costs passed onto the engaged couple.\u003c/p>\n\u003cp>\"Caterers are telling me that they're looking at the 15-day weather forecast, and if it's going to be hot, they're buying twice the ice they used to buy,\" Davies says.\u003c/p>\n\u003cp>\u003cstrong>The Cake: Frosty or Foam\u003c/strong>\u003c/p>\n\u003cp>Heat can melt exterior decorations on a cake or undermine the structure.\u003c/p>\n\u003cp>Kimberly Bailey, owner of The Butter End Cakery in Los Angeles, had to reroute the duct work in her studio to keep the decorating room cool. She and her staff have also taken to decorating with the lights off.\u003c/p>\n\u003cp>And transporting the cake is even trickier.\u003c/p>\n\u003cp>\"We're having to coordinate timing a lot closer to when guest arrival is, and that makes it harder on our delivery schedule,\" Bailey says. \"We don't want the cake sitting out one minute longer than it has to.\"\u003c/p>\n\u003cp>She has an insulated, refrigerated van that manages \"shock\"— i.e. \"going from an air-conditioned van to a warm environment\" — by slowly warming up during transit.\u003c/p>\n\u003cp>Then, the cake may sit for up to six hours until it is cut.\u003c/p>\n\u003cp>\"We have to take extra care to work with the event planner to ensure the cake is shielded from direct sun,\" Bailey says.\u003c/p>\n\u003cp>Bakers are increasingly fielding requests from couples who ask for display-only cakes.\u003c/p>\n\u003cp>\"Some folks don't even want to take the chance. If we know it's going to be hot, they'll opt for faux tiers,\" Bailey explains. \"The base tier will be real, and the top layers will be foam drums covered in buttercream or fondant.\"\u003c/p>\n\u003cp>In those instances, the guests are served slices from a sheet cake in the kitchen. The faux cake sometimes costs more than the real thing.\u003c/p>\n\u003cp>\u003cstrong>The Venue: Keep it Shady\u003c/strong>\u003c/p>\n\u003cp>Davies says event designers should create stylish, covered spaces for outdoor ceremonies or receptions.\u003c/p>\n\u003cp>\"We created wooden pergola structures that we can put fabric on top of,\" Davies says. \"We've hung misters from those or put curtains on the side.\"\u003c/p>\n\u003cp>He also advises his clients to spend some extra money on air conditioning.\u003c/p>\n\u003cp>\u003cstrong>The Photos: Grandma Goes First\u003c/strong>\u003c/p>\n\u003cp>Photographers have traditionally followed an important courtesy: Snap the young and the elderly before the rest of the wedding party.\u003c/p>\n\u003cp>But Paul Rumohr, a wedding photographer in Los Angeles, says this courtesy has become more of a priority.\u003c/p>\n\u003cp>\"Kids have short attention spans, and in the heat, it's even crazier,\" Rumohr says.\u003c/p>\n\u003cp>And heat can also affect the quality of photographs.\u003c/p>\n\u003cp>\"The better the conditions are, the more likely you are to have great photos,\" Rumohr says.\u003c/p>\n\u003cp>People look better in overcast weather than in direct sun, according to Rumohr.\u003c/p>\n\u003cp>\"If the weather was better, I think people would be getting more for their money. We do the best that we can, given the conditions we have,\" he says.\u003c/p>\n\u003cp>\u003cstrong>The Dress: Choose Haute Over Heat\u003c/strong>\u003c/p>\n\u003cp>Magazines like \u003ca href=\"https://www.brides.com/gallery/wedding-dress-trends-fall-2018\" target=\"_blank\" rel=\"noopener\">Bride\u003c/a> and \u003ca href=\"https://www.vogue.com/article/spring-2019-bridal-fashion-week-trends\" target=\"_blank\" rel=\"noopener\">Vogue\u003c/a> set wedding dress trends for 2018: capes, full skirts, jumpsuits and long sleeves. All of these styles cover a lot of skin and likely retain body heat.\u003c/p>\n\u003cp>But the dress is one part of the wedding where staying cool doesn't really matter, according to Davies.\u003c/p>\n\u003cp>\"[Dress shops] aren't seeing a big impact in what brides are choosing,\" he says. \"When a bride has spent two or three decades thinking about what she wants to look like on her wedding day, she's not really going to be looking at the weather forecast.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Most brides, Davies says, try to duck into air conditioning when they can or have a fan handy.\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=Say+%27I+Do%27+Without+The+Sweat%3A+Wedding+Pros+Share+How+They+Beat+The+Heat&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Melting cakes and melting guests. Wilting flowers and wilting brides. A hot day can spell disaster for a wedding unless there's detailed preparation beforehand.\u003c/p>\n\u003cp>The United States, on average, experiences about 74 \"mild weather days\" every year, \u003ca href=\"https://link.springer.com/article/10.1007/s10584-016-1885-9\" target=\"_blank\" rel=\"noopener\">according to a 2017 study\u003c/a> in the Journal of Climatic Change.\u003c/p>\n\u003cp>That is 74 chances to hold the perfect outdoor wedding with tolerable temperatures, low humidity and nearly no precipitation, according to Sarah Kapnick, a National Oceanic and Atmospheric Administration climate scientist and co-author of that study. She says it was inspired by frequent requests from worried friends to predict the weather on their wedding days.\u003c/p>\n\u003cp>Of course, the odds are better if the wedding is held in generally temperate San Diego (180 mild weather days per year) rather than boggy Washington, D.C. (81 mild weather days per year).\u003c/p>\n\u003cp>But overall, the globe is set to lose four mild weather days in the next two decades and a total of nine by the end of the century.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"[That means] the summers in the United States [are] getting hotter. They're also becoming more humid, particularly in the South and Southeast,\" Kapnick says.\u003c/p>\n\u003cp>Those shifts in temperature are leading to shifts in the wedding industry as bakers, photographers, florists and the couples they serve think more critically about how to beat the heat on this all-important day.\u003c/p>\n\u003cp>\u003cstrong>The Date: Fall is the New Summer\u003c/strong>\u003c/p>\n\u003cp>\"In the winter, it's actually getting warmer. And so you're having more mild weather days in the winter, and also in the shoulder seasons: spring and fall,\" Kapnick says.\u003c/p>\n\u003cp>Those shoulder seasons have become increasingly popular for weddings. \u003ca href=\"https://go.weddingwire.com/newlywed-report\" target=\"_blank\" rel=\"noopener\">According to WeddingWire's annual survey\u003c/a> of newlyweds, fewer than a third of all weddings now occur in the summer.\u003c/p>\n\u003cp>Ten years ago, wedding dates in May, June and July were most common. But in 2017, September, October and November took the top spots.\u003c/p>\n\u003cp>There's no conclusive evidence to suggest the shift is because of rising temperatures, but Kapnick says that the fall presents a lower risk of heat stress.\u003c/p>\n\u003cp>\"People are looking to get married often outside, often during pleasant weather where people can be active: They can be dancing, they can be enjoying themselves,\" she says.\u003c/p>\n\u003cp>Though, of course, thousands of weddings still take place across the country each summer.\u003c/p>\n\u003cp>\u003cstrong>The Ceremony: Shorten It\u003c/strong>\u003c/p>\n\u003cp>J.P. Reynolds has been marrying couples in Southern California for more than 20 years. He says he's often the first to bake in the hot sun at an outdoor wedding, standing patiently as the entire wedding party glides down the aisle. He also gets an extended view of the misery of guests.\u003c/p>\n\u003cp>\"People look so uncomfortable. They're fanning themselves. They're squinting. They're using the programs as shades,\" he says. \"And they're not interested in listening to someone do a reading about what is the art of marriage.\"\u003c/p>\n\u003cp>Reynolds says he's adjusting to higher temperatures.\u003c/p>\n\u003cp>He has cut down his average ceremony time by about 10 minutes and limits couples to one reading. \"But I don't want the ceremony to be wham bam. There needs to be a certain texture to the ceremony,\" he adds.\u003c/p>\n\u003cp>\u003cstrong>The Flowers: Think Tropical\u003c/strong>\u003c/p>\n\u003cp>Shawna Yamamoto, a floral designer in Orange County, Calif., urges couples to choose tropical flowers for hot, outdoor weddings, which fare best in high temperatures and usually last longer.\u003c/p>\n\u003cp>\"Roses, for example, are grown in South America. The temperatures are pretty much the same year-round there, and they're a very hardy flower,\" she says.\u003c/p>\n\u003cp>After flowers are chosen, it's a race to order and arrange them.\u003c/p>\n\u003cp>\"There's a standard rule that a flower should have a shelf life of seven days from the time they're cut. But that starts from the grower,\" explains Yamamoto.\u003c/p>\n\u003cp>Yamamoto uses a walk-in fridge and a refrigerated truck and insulates flowers in plastic wrap.\u003c/p>\n\u003cp>And she has more advice for couples: \"Rely heavily on the professional. Be open to what's in season and what's readily available. The overall look can be achieved with different flowers.\"\u003c/p>\n\u003cp>Silk flowers are also a convincing option, points out Rrivre Davies, a Los Angeles wedding designer and president of the Wedding International Professionals Association.\u003c/p>\n\u003cp>\u003cstrong>The Food: Use Twice the Ice\u003c/strong>\u003c/p>\n\u003cp>Caterers are used to handling the heat. \u003ca href=\"https://www.osha.gov/SLTC/youth/restaurant/cooking_heat.html\" target=\"_blank\" rel=\"noopener\">According to\u003c/a> the Occupational Safety and Health Administration, temperatures can reach 110 degrees in a busy kitchen.\u003c/p>\n\u003cp>But, Davies says, wedding caterers these days often need more air conditioning in their workstations — whether that's an indoor kitchen or an outdoor tent.\u003c/p>\n\u003cp>And the heat can also increase costs passed onto the engaged couple.\u003c/p>\n\u003cp>\"Caterers are telling me that they're looking at the 15-day weather forecast, and if it's going to be hot, they're buying twice the ice they used to buy,\" Davies says.\u003c/p>\n\u003cp>\u003cstrong>The Cake: Frosty or Foam\u003c/strong>\u003c/p>\n\u003cp>Heat can melt exterior decorations on a cake or undermine the structure.\u003c/p>\n\u003cp>Kimberly Bailey, owner of The Butter End Cakery in Los Angeles, had to reroute the duct work in her studio to keep the decorating room cool. She and her staff have also taken to decorating with the lights off.\u003c/p>\n\u003cp>And transporting the cake is even trickier.\u003c/p>\n\u003cp>\"We're having to coordinate timing a lot closer to when guest arrival is, and that makes it harder on our delivery schedule,\" Bailey says. \"We don't want the cake sitting out one minute longer than it has to.\"\u003c/p>\n\u003cp>She has an insulated, refrigerated van that manages \"shock\"— i.e. \"going from an air-conditioned van to a warm environment\" — by slowly warming up during transit.\u003c/p>\n\u003cp>Then, the cake may sit for up to six hours until it is cut.\u003c/p>\n\u003cp>\"We have to take extra care to work with the event planner to ensure the cake is shielded from direct sun,\" Bailey says.\u003c/p>\n\u003cp>Bakers are increasingly fielding requests from couples who ask for display-only cakes.\u003c/p>\n\u003cp>\"Some folks don't even want to take the chance. If we know it's going to be hot, they'll opt for faux tiers,\" Bailey explains. \"The base tier will be real, and the top layers will be foam drums covered in buttercream or fondant.\"\u003c/p>\n\u003cp>In those instances, the guests are served slices from a sheet cake in the kitchen. The faux cake sometimes costs more than the real thing.\u003c/p>\n\u003cp>\u003cstrong>The Venue: Keep it Shady\u003c/strong>\u003c/p>\n\u003cp>Davies says event designers should create stylish, covered spaces for outdoor ceremonies or receptions.\u003c/p>\n\u003cp>\"We created wooden pergola structures that we can put fabric on top of,\" Davies says. \"We've hung misters from those or put curtains on the side.\"\u003c/p>\n\u003cp>He also advises his clients to spend some extra money on air conditioning.\u003c/p>\n\u003cp>\u003cstrong>The Photos: Grandma Goes First\u003c/strong>\u003c/p>\n\u003cp>Photographers have traditionally followed an important courtesy: Snap the young and the elderly before the rest of the wedding party.\u003c/p>\n\u003cp>But Paul Rumohr, a wedding photographer in Los Angeles, says this courtesy has become more of a priority.\u003c/p>\n\u003cp>\"Kids have short attention spans, and in the heat, it's even crazier,\" Rumohr says.\u003c/p>\n\u003cp>And heat can also affect the quality of photographs.\u003c/p>\n\u003cp>\"The better the conditions are, the more likely you are to have great photos,\" Rumohr says.\u003c/p>\n\u003cp>People look better in overcast weather than in direct sun, according to Rumohr.\u003c/p>\n\u003cp>\"If the weather was better, I think people would be getting more for their money. We do the best that we can, given the conditions we have,\" he says.\u003c/p>\n\u003cp>\u003cstrong>The Dress: Choose Haute Over Heat\u003c/strong>\u003c/p>\n\u003cp>Magazines like \u003ca href=\"https://www.brides.com/gallery/wedding-dress-trends-fall-2018\" target=\"_blank\" rel=\"noopener\">Bride\u003c/a> and \u003ca href=\"https://www.vogue.com/article/spring-2019-bridal-fashion-week-trends\" target=\"_blank\" rel=\"noopener\">Vogue\u003c/a> set wedding dress trends for 2018: capes, full skirts, jumpsuits and long sleeves. All of these styles cover a lot of skin and likely retain body heat.\u003c/p>\n\u003cp>But the dress is one part of the wedding where staying cool doesn't really matter, according to Davies.\u003c/p>\n\u003cp>\"[Dress shops] aren't seeing a big impact in what brides are choosing,\" he says. \"When a bride has spent two or three decades thinking about what she wants to look like on her wedding day, she's not really going to be looking at the weather forecast.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "New Gun Ranking Shows the Impact of Gun Deaths Worldwide",
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"content": "\u003cp>In 2016, more than 250,000 people worldwide died as a result of firearms, and half of all of those deaths came from six nations, including the U.S.[contextly_sidebar id=\"Sq405EaoxZZES4Xjef22Cavnquq3czrJ\"]\u003c/p>\n\u003cp>The new numbers, from the University of Washington’s Institute for Health Metrics and Evaluation’s latest study of Global Burden of Diseases, Injuries and Risk Factors, offer several new ways to measure the impact of gun deaths worldwide.\u003c/p>\n\u003cp>Half of all gun-related deaths in 2016 occurred in six nations — Brazil, the United States, Mexico, Venezuela, Colombia and Guatemala. Together, the study published in the journal JAMA noted, these countries hold less than 10 percent of the world’s population.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-444187\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/gundeaths2016IHME.png\" alt=\"\" width=\"656\" height=\"369\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME.png 656w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-160x90.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-240x135.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-375x211.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-520x293.png 520w\" sizes=\"(max-width: 656px) 100vw, 656px\">\u003c/p>\n\u003cp>Overall, 64 percent of deaths were determined to be homicides, while an additional 27 percent were suicides and 9 percent were accidental shootings.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But country to country, looking at the ways people die due to gunfire produces a deeply varied picture, said Christopher Murray, the institute’s director.\u003c/p>\n\u003cp>When it comes to the number of gun-related homicides, the U.S. ranks 30th worldwide. But suicides linked to guns occurred in the U.S. at a rate of 6.4 per 100,000 deaths — a total of 23,800 people — the second highest rate worldwide.\u003c/p>\n\u003cp>These numbers come days after a \u003ca href=\"https://www.pbs.org/newshour/politics/police-said-jacksonville-shooter-clearly-targeted-other-gamers-heres-what-we-know\" target=\"_blank\" rel=\"noopener\">gunman in Jacksonville, Florida,\u003c/a> fatally shot two people and injured 11 more before he killed himself Sunday during a video game tournament in a shopping mall.\u003c/p>\n\u003cp>While mass shootings like these capture the most media attention, they are responsible for a small sliver of overall gun deaths in the United States, gun violence experts Frederick P. Rivara, David M. Studdert and Garen J. Wintemute wrote in an editorial published in JAMA alongside the new report.[contextly_sidebar id=\"SZDflZXxowNtlSQKEIza6tXHHr8FLgte\"]\u003c/p>\n\u003cp>“In the United States and elsewhere, acts of terrorism committed with firearms and other lethal means have changed the way people live, work, travel, and play,” they wrote. “In the United States, armed guards patrol some schools, and some politicians have advocated allowing teachers to carry guns. Although mass shootings and terrorist attacks are the most visible form of gun violence, they account for only a small fraction of the public health burden of firearm-related morbidity and mortality.”\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-444188\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024.png\" alt=\"\" width=\"849\" height=\"1024\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024.png 849w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-160x193.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-800x965.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-768x926.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-240x289.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-375x452.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-520x627.png 520w\" sizes=\"(max-width: 849px) 100vw, 849px\">\u003c/p>\n\u003cp>For this latest report, researchers pulled data about 195 nations and territories, using nearly 2,900 different sources — a median of nine different datasets per nation. The study looks at data from 1990 to 2016, and was largely based on death certificate reports, Murray said.\u003c/p>\n\u003cp>In the United States, 37,200 people died as a result of overall gun use in 2016, the second highest number worldwide. But when it comes to gun deaths per capita, the U.S. ranks 20th, at a rate of 10.6 per 100,000 deaths — putting it on par with the Dominican Republic. Many places with high gun death rates had fewer deaths than the U.S. because of smaller populations. For instance, El Salvador produced the highest combined gun death rate of 39.2 per 100,000 deaths, but recorded 2,500 deaths overall. When it comes to gun-related suicides, Greenland has a higher rate than the U.S. — 22 per 100,000 deaths — but 11 deaths overall.[contextly_sidebar id=\"pS1JGptwnHklq6Q8wfMEcuPaC8OU1zOO\"]\u003c/p>\n\u003cp>Since 1990, the number of gun deaths has declined, the report said. But nearly every year since then, firearm deaths outside conflict zones outnumbered deaths that occurred as a result of war.\u003c/p>\n\u003cp>“We spend a lot of time thinking about conflict, and probably, we should be spending as much or more time thinking about how to reduce firearm-related homicide and suicide,” Murray said.\u003c/p>\n\u003cp>These latest numbers “provide the best data” on global gun deaths, said David Hemenway, who developed and directs the National Violent Death Reporting System at Harvard University. Overall, the report underscores that guns “are a major public health problem, not just in the U.S. but throughout the world.”\u003c/p>\n\u003cp>“Without good data, you just don’t have the knowledge you need to make wise decisions,” said Hemenway, who was not involved in the study. More good data like this is crucial if policymakers want to bring death numbers down, he added.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter wp-image-444189\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024.png\" alt=\"\" width=\"481\" height=\"580\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024.png 849w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-160x193.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-800x965.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-768x926.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-240x289.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-375x452.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-520x627.png 520w\" sizes=\"(max-width: 481px) 100vw, 481px\">\u003c/p>\n\u003cp>In 1996, Congress passed the\u003ca href=\"https://www.pbs.org/newshour/nation/what-we-dont-know-about-gun-violence\" target=\"_blank\" rel=\"noopener\"> Dickey Amendment\u003c/a>, which had a chilling effect on Centers for Disease Control and Prevention-led research into gun violence. Soon, the CDC withdrew questions from federal surveys about household gun ownership. Hemenway said losing these questions robbed two decades worth of researchers of the ability to gauge how easily Americans could access guns.\u003c/p>\n\u003cp>This year, Congress approved funding to allow the CDC to collect data on violent deaths from all 50 states, a huge improvement over the fraction of states that had previously made data available, Hemenway said. This would give researchers and policymakers a clearer picture about how many Americans die nationwide as a result of guns.\u003c/p>\n\u003cp>Legally procured guns play a role in most deaths by suicide in the U.S., Murray said, which means this kind of information will be even more critical as \u003ca href=\"https://www.pbs.org/newshour/health/suicide-rate-rising-fastest-among-women-cdc-says\" target=\"_blank\" rel=\"noopener\">nation’s suicide rate\u003c/a> continues to rise.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you are having thoughts of suicide, go to SpeakingOfSuicide.com/resources or call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 2016, more than 250,000 people worldwide died as a result of firearms, and half of all of those deaths came from six nations, including the U.S.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The new numbers, from the University of Washington’s Institute for Health Metrics and Evaluation’s latest study of Global Burden of Diseases, Injuries and Risk Factors, offer several new ways to measure the impact of gun deaths worldwide.\u003c/p>\n\u003cp>Half of all gun-related deaths in 2016 occurred in six nations — Brazil, the United States, Mexico, Venezuela, Colombia and Guatemala. Together, the study published in the journal JAMA noted, these countries hold less than 10 percent of the world’s population.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-444187\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/gundeaths2016IHME.png\" alt=\"\" width=\"656\" height=\"369\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME.png 656w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-160x90.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-240x135.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-375x211.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/gundeaths2016IHME-520x293.png 520w\" sizes=\"(max-width: 656px) 100vw, 656px\">\u003c/p>\n\u003cp>Overall, 64 percent of deaths were determined to be homicides, while an additional 27 percent were suicides and 9 percent were accidental shootings.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But country to country, looking at the ways people die due to gunfire produces a deeply varied picture, said Christopher Murray, the institute’s director.\u003c/p>\n\u003cp>When it comes to the number of gun-related homicides, the U.S. ranks 30th worldwide. But suicides linked to guns occurred in the U.S. at a rate of 6.4 per 100,000 deaths — a total of 23,800 people — the second highest rate worldwide.\u003c/p>\n\u003cp>These numbers come days after a \u003ca href=\"https://www.pbs.org/newshour/politics/police-said-jacksonville-shooter-clearly-targeted-other-gamers-heres-what-we-know\" target=\"_blank\" rel=\"noopener\">gunman in Jacksonville, Florida,\u003c/a> fatally shot two people and injured 11 more before he killed himself Sunday during a video game tournament in a shopping mall.\u003c/p>\n\u003cp>While mass shootings like these capture the most media attention, they are responsible for a small sliver of overall gun deaths in the United States, gun violence experts Frederick P. Rivara, David M. Studdert and Garen J. Wintemute wrote in an editorial published in JAMA alongside the new report.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“In the United States and elsewhere, acts of terrorism committed with firearms and other lethal means have changed the way people live, work, travel, and play,” they wrote. “In the United States, armed guards patrol some schools, and some politicians have advocated allowing teachers to carry guns. Although mass shootings and terrorist attacks are the most visible form of gun violence, they account for only a small fraction of the public health burden of firearm-related morbidity and mortality.”\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-444188\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024.png\" alt=\"\" width=\"849\" height=\"1024\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024.png 849w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-160x193.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-800x965.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-768x926.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-240x289.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-375x452.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-death-rate-revised-849x1024-520x627.png 520w\" sizes=\"(max-width: 849px) 100vw, 849px\">\u003c/p>\n\u003cp>For this latest report, researchers pulled data about 195 nations and territories, using nearly 2,900 different sources — a median of nine different datasets per nation. The study looks at data from 1990 to 2016, and was largely based on death certificate reports, Murray said.\u003c/p>\n\u003cp>In the United States, 37,200 people died as a result of overall gun use in 2016, the second highest number worldwide. But when it comes to gun deaths per capita, the U.S. ranks 20th, at a rate of 10.6 per 100,000 deaths — putting it on par with the Dominican Republic. Many places with high gun death rates had fewer deaths than the U.S. because of smaller populations. For instance, El Salvador produced the highest combined gun death rate of 39.2 per 100,000 deaths, but recorded 2,500 deaths overall. When it comes to gun-related suicides, Greenland has a higher rate than the U.S. — 22 per 100,000 deaths — but 11 deaths overall.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Since 1990, the number of gun deaths has declined, the report said. But nearly every year since then, firearm deaths outside conflict zones outnumbered deaths that occurred as a result of war.\u003c/p>\n\u003cp>“We spend a lot of time thinking about conflict, and probably, we should be spending as much or more time thinking about how to reduce firearm-related homicide and suicide,” Murray said.\u003c/p>\n\u003cp>These latest numbers “provide the best data” on global gun deaths, said David Hemenway, who developed and directs the National Violent Death Reporting System at Harvard University. Overall, the report underscores that guns “are a major public health problem, not just in the U.S. but throughout the world.”\u003c/p>\n\u003cp>“Without good data, you just don’t have the knowledge you need to make wise decisions,” said Hemenway, who was not involved in the study. More good data like this is crucial if policymakers want to bring death numbers down, he added.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter wp-image-444189\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024.png\" alt=\"\" width=\"481\" height=\"580\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024.png 849w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-160x193.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-800x965.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-768x926.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-240x289.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-375x452.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/top-20-total-deaths-revised-849x1024-520x627.png 520w\" sizes=\"(max-width: 481px) 100vw, 481px\">\u003c/p>\n\u003cp>In 1996, Congress passed the\u003ca href=\"https://www.pbs.org/newshour/nation/what-we-dont-know-about-gun-violence\" target=\"_blank\" rel=\"noopener\"> Dickey Amendment\u003c/a>, which had a chilling effect on Centers for Disease Control and Prevention-led research into gun violence. Soon, the CDC withdrew questions from federal surveys about household gun ownership. Hemenway said losing these questions robbed two decades worth of researchers of the ability to gauge how easily Americans could access guns.\u003c/p>\n\u003cp>This year, Congress approved funding to allow the CDC to collect data on violent deaths from all 50 states, a huge improvement over the fraction of states that had previously made data available, Hemenway said. This would give researchers and policymakers a clearer picture about how many Americans die nationwide as a result of guns.\u003c/p>\n\u003cp>Legally procured guns play a role in most deaths by suicide in the U.S., Murray said, which means this kind of information will be even more critical as \u003ca href=\"https://www.pbs.org/newshour/health/suicide-rate-rising-fastest-among-women-cdc-says\" target=\"_blank\" rel=\"noopener\">nation’s suicide rate\u003c/a> continues to rise.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you are having thoughts of suicide, go to SpeakingOfSuicide.com/resources or call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why Californians Are Living Longer With Most Types of Cancer",
"title": "Why Californians Are Living Longer With Most Types of Cancer",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>As he grew older, Dale Kunitomi paid closer attention to his health — and to his doctor’s advice. When he noticed rectal bleeding in 2010, he went to see his physician, who ordered a colonoscopy.[contextly_sidebar id=\"vc7B3eLIIv6aV3Hq5qcJq85a0z0PMqRC\"]\u003c/p>\n\u003cp>The diagnosis: colon cancer.\u003c/p>\n\u003cp>Kunitomi, now 74, underwent surgery, radiation and chemotherapy — and now he has been cancer-free for seven years. “The things that are said about early detection and living a healthy lifestyle are important,” said Kunitomi, a resident of Ventura County, Calif. “You are foolish if you don’t pay attention.”\u003c/p>\n\u003cp>Californians are living longer with most types of cancer, due to earlier detection and more effective treatments, according to\u003ca href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/13098\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a> from the University of California-Davis. But racial, ethnic and socioeconomic disparities persist, the report found.\u003c/p>\n\u003cp>The study, published this month, shows that 65 percent of people diagnosed with cancer between 2006 and 2010 survived five years or more from the time their disease was discovered, up from 58 percent for those diagnosed between 1990 and 1994. The researchers drew from data on 1.4 million California adults diagnosed with 27 different kinds of cancer. They found improved survival rates for patients with all but five types of cancer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Non-Latino whites had the highest five-year survival rate for all cancers combined, followed by Latinos — though Pacific Islanders and Asians, like Kunitomi, had the highest rates for 13 of the cancers studied, including breast, colon, liver and lung. African-Americans had the worst overall prognosis.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444171\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png\" alt=\"\" width=\"640\" height=\"469\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-160x117.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-800x586.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-768x563.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-960x703.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-240x176.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-375x275.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-520x381.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>The California numbers echo a national trend of significant improvement in cancer survival, one also tempered by racial and ethnic disparities. A recent analysis in the journal Cancer, which relied on death rather than survival rates, found a \u003ca href=\"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21460\" target=\"_blank\" rel=\"noopener\">26 percent decline in cancer mortality\u003c/a> in the United States between 1991 and 2015 — translating to nearly 2.4 million cancer deaths avoided. The study showed mortality rates declined for all the major cancers, including breast, colorectal and prostate.\u003c/p>\n\u003cp>Dr. Otis Brawley, one of the authors of that report and chief medical and scientific officer of the American Cancer Society, attributed the improvement to better screening, detection and treatment — and a decline in smoking. He said cancer deaths likely would drop even further if there were more equal access to prevention, diagnosis and treatment.[contextly_sidebar id=\"fmc02MyXuNyOxUDOEz7MyAsTaZY5UAeN\"]\u003c/p>\n\u003cp>Perhaps unsurprisingly, the UC-Davis data show that poor Californians don’t live as long with cancer as those of greater means. About three-quarters of the patients at the highest socioeconomic level, with all cancers combined, survived five years or more. Just over half the patients at the lowest levels lived that long. Age was also a major factor: The younger patients were at the time of the diagnosis, the better their chance of survival.\u003c/p>\n\u003cp>Separate research from UC-Davis, published in 2015, showed the impact of health insurance status: Uninsured patients and those on Medi-Cal — California’s version of the federal Medicaid program for low-income people — had worse cancer care and outcomes than people with private insurance.\u003c/p>\n\u003cp>The research published this month showed the most critical factor in survival was finding the cancer early, which the report said underscores the importance of screening. One hundred percent of breast cancer patients survived at least five years if their disease was detected at stage 1. Only 28 percent of patients lived that long if their cancer was found when it was at stage 4, the most advanced stage. Most types of cancer show similarly stark disparities.\u003c/p>\n\u003cp>Stages, which depend in part on the size of the tumor and whether the cancer has spread, are a gauge of how serious the disease is.\u003c/p>\n\u003cp>“The earlier things are picked up, the more likely it is that treatment is successful,” said Dr. Kenneth Kizer, senior author of the study and director of the UC-Davis Institute for Population Health Improvement.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444172\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Cancer screening and treatment for African-Americans lag behind other racial and ethnic groups, said Dr. Nancy Lee, who is on the board of Black Women’s Health Imperative, a national organization that seeks to improve the health of black women. Long-standing and sometimes unrecognized bias in the health care system disadvantages black patients in a way that can compromise their medical outcomes, said Lee, who previously led the cancer division of the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>White women in California are more likely to get breast cancer, the most common cancer among women, but black women are more likely to die from it, the UC-Davis report found.[contextly_sidebar id=\"VH6Y1JhelA7uLcj4KfqvO237ZI6LRYmK\"]\u003c/p>\n\u003cp>Bobby Smith’s wife, an African-American, died 13 years ago after her breast cancer moved into her lymph nodes and eventually metastasized to her brain. Smith said he doesn’t believe doctors gave her all the information she needed to make the best decisions about her treatment. “Health care professionals treat and serve people of color differently,” said Smith, who lives in Los Angeles.\u003c/p>\n\u003cp>The UC-Davis report used data from the \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\" rel=\"noopener\">California Cancer Registry,\u003c/a> a repository of data on cancer patients dating to 1988 that contains information on patient demographics, diagnosis, initial treatment and outcomes.\u003c/p>\n\u003cp>The rates reported in the study measure “relative” survival, which represents survival in the absence of other causes of death. The study showed patients with prostate, breast, melanoma and uterine cancers had among the highest survival rates: More than 80 percent of them lived at least five years after their diagnosis.\u003c/p>\n\u003cp>Survival did not improve for patients with some cancers, including bladder, cervical and testicular. And fewer than 20 percent of patients with cancers of the lung, liver, pancreas and esophagus lived past five years.\u003c/p>\n\u003cp>For breast cancer patients, five-year survival improved from 85 percent among those diagnosed between 1990 and 1994 to 90 percent among those diagnosed between 2006 and 2010.\u003c/p>\n\u003cp>The patterns were similar for lung cancer, the second most commonly diagnosed cancer in California and the leading cause of cancer deaths nationwide. The disease tends to be diagnosed late, and patients with stage 4 cancer had just a 4 percent survival rate after five years.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444173\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Kizer of UC-Davis said new treatments offer great promise for cancer patients, but how much money they have and who their insurers are may well determine whether or not they reap the benefits.\u003c/p>\n\u003cp>Cancer is hard enough for people with means and education, said Susan Lasker Hertz, 61, a Colorado nurse who was diagnosed with stage 2 breast cancer in 2009 and then developed leukemia three years later. Hertz, who is now in remission from both cancers, said her knowledge and experience helped her navigate the health care system and get treated quickly after her diagnosis. But it wasn’t easy.\u003c/p>\n\u003cp>“I am an educated, white, highly knowledgeable health care professional,” she said, “and it is still overwhelming.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>KHN's coverage in California is supported in part by \u003ca href=\"http://www.blueshieldcafoundation.org/\" target=\"_blank\" rel=\"noopener\">Blue Shield of California Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As he grew older, Dale Kunitomi paid closer attention to his health — and to his doctor’s advice. When he noticed rectal bleeding in 2010, he went to see his physician, who ordered a colonoscopy.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The diagnosis: colon cancer.\u003c/p>\n\u003cp>Kunitomi, now 74, underwent surgery, radiation and chemotherapy — and now he has been cancer-free for seven years. “The things that are said about early detection and living a healthy lifestyle are important,” said Kunitomi, a resident of Ventura County, Calif. “You are foolish if you don’t pay attention.”\u003c/p>\n\u003cp>Californians are living longer with most types of cancer, due to earlier detection and more effective treatments, according to\u003ca href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/13098\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a> from the University of California-Davis. But racial, ethnic and socioeconomic disparities persist, the report found.\u003c/p>\n\u003cp>The study, published this month, shows that 65 percent of people diagnosed with cancer between 2006 and 2010 survived five years or more from the time their disease was discovered, up from 58 percent for those diagnosed between 1990 and 1994. The researchers drew from data on 1.4 million California adults diagnosed with 27 different kinds of cancer. They found improved survival rates for patients with all but five types of cancer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Non-Latino whites had the highest five-year survival rate for all cancers combined, followed by Latinos — though Pacific Islanders and Asians, like Kunitomi, had the highest rates for 13 of the cancers studied, including breast, colon, liver and lung. African-Americans had the worst overall prognosis.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444171\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png\" alt=\"\" width=\"640\" height=\"469\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-160x117.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-800x586.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-768x563.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-960x703.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-240x176.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-375x275.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-520x381.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>The California numbers echo a national trend of significant improvement in cancer survival, one also tempered by racial and ethnic disparities. A recent analysis in the journal Cancer, which relied on death rather than survival rates, found a \u003ca href=\"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21460\" target=\"_blank\" rel=\"noopener\">26 percent decline in cancer mortality\u003c/a> in the United States between 1991 and 2015 — translating to nearly 2.4 million cancer deaths avoided. The study showed mortality rates declined for all the major cancers, including breast, colorectal and prostate.\u003c/p>\n\u003cp>Dr. Otis Brawley, one of the authors of that report and chief medical and scientific officer of the American Cancer Society, attributed the improvement to better screening, detection and treatment — and a decline in smoking. He said cancer deaths likely would drop even further if there were more equal access to prevention, diagnosis and treatment.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Perhaps unsurprisingly, the UC-Davis data show that poor Californians don’t live as long with cancer as those of greater means. About three-quarters of the patients at the highest socioeconomic level, with all cancers combined, survived five years or more. Just over half the patients at the lowest levels lived that long. Age was also a major factor: The younger patients were at the time of the diagnosis, the better their chance of survival.\u003c/p>\n\u003cp>Separate research from UC-Davis, published in 2015, showed the impact of health insurance status: Uninsured patients and those on Medi-Cal — California’s version of the federal Medicaid program for low-income people — had worse cancer care and outcomes than people with private insurance.\u003c/p>\n\u003cp>The research published this month showed the most critical factor in survival was finding the cancer early, which the report said underscores the importance of screening. One hundred percent of breast cancer patients survived at least five years if their disease was detected at stage 1. Only 28 percent of patients lived that long if their cancer was found when it was at stage 4, the most advanced stage. Most types of cancer show similarly stark disparities.\u003c/p>\n\u003cp>Stages, which depend in part on the size of the tumor and whether the cancer has spread, are a gauge of how serious the disease is.\u003c/p>\n\u003cp>“The earlier things are picked up, the more likely it is that treatment is successful,” said Dr. Kenneth Kizer, senior author of the study and director of the UC-Davis Institute for Population Health Improvement.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444172\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Cancer screening and treatment for African-Americans lag behind other racial and ethnic groups, said Dr. Nancy Lee, who is on the board of Black Women’s Health Imperative, a national organization that seeks to improve the health of black women. Long-standing and sometimes unrecognized bias in the health care system disadvantages black patients in a way that can compromise their medical outcomes, said Lee, who previously led the cancer division of the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>White women in California are more likely to get breast cancer, the most common cancer among women, but black women are more likely to die from it, the UC-Davis report found.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Bobby Smith’s wife, an African-American, died 13 years ago after her breast cancer moved into her lymph nodes and eventually metastasized to her brain. Smith said he doesn’t believe doctors gave her all the information she needed to make the best decisions about her treatment. “Health care professionals treat and serve people of color differently,” said Smith, who lives in Los Angeles.\u003c/p>\n\u003cp>The UC-Davis report used data from the \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\" rel=\"noopener\">California Cancer Registry,\u003c/a> a repository of data on cancer patients dating to 1988 that contains information on patient demographics, diagnosis, initial treatment and outcomes.\u003c/p>\n\u003cp>The rates reported in the study measure “relative” survival, which represents survival in the absence of other causes of death. The study showed patients with prostate, breast, melanoma and uterine cancers had among the highest survival rates: More than 80 percent of them lived at least five years after their diagnosis.\u003c/p>\n\u003cp>Survival did not improve for patients with some cancers, including bladder, cervical and testicular. And fewer than 20 percent of patients with cancers of the lung, liver, pancreas and esophagus lived past five years.\u003c/p>\n\u003cp>For breast cancer patients, five-year survival improved from 85 percent among those diagnosed between 1990 and 1994 to 90 percent among those diagnosed between 2006 and 2010.\u003c/p>\n\u003cp>The patterns were similar for lung cancer, the second most commonly diagnosed cancer in California and the leading cause of cancer deaths nationwide. The disease tends to be diagnosed late, and patients with stage 4 cancer had just a 4 percent survival rate after five years.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444173\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Kizer of UC-Davis said new treatments offer great promise for cancer patients, but how much money they have and who their insurers are may well determine whether or not they reap the benefits.\u003c/p>\n\u003cp>Cancer is hard enough for people with means and education, said Susan Lasker Hertz, 61, a Colorado nurse who was diagnosed with stage 2 breast cancer in 2009 and then developed leukemia three years later. Hertz, who is now in remission from both cancers, said her knowledge and experience helped her navigate the health care system and get treated quickly after her diagnosis. But it wasn’t easy.\u003c/p>\n\u003cp>“I am an educated, white, highly knowledgeable health care professional,” she said, “and it is still overwhelming.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN's coverage in California is supported in part by \u003ca href=\"http://www.blueshieldcafoundation.org/\" target=\"_blank\" rel=\"noopener\">Blue Shield of California Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?",
"title": "Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?",
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"content": "\u003cp>A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.\u003c/p>\n\u003cp>Public Citizen says that the study, involving treatment for \u003ca href=\"https://www.cdc.gov/sepsis/\" target=\"_blank\" rel=\"noopener\">sepsis,\u003c/a> puts patients at risk and will at best produce confusing results.\u003c/p>\n\u003cp>The \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03434028?term=NCT03434028&rank=1\" target=\"_blank\" rel=\"noopener\">CLOVERS study\u003c/a> seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients' blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.\u003c/p>\n\u003cp>Doctors use a combination of IV fluids and blood-pressure medicines called vasopressors, such as epinephrine and norepinephrine, to manage this life-threatening complication. But there is no consensus about the best strategy. Some doctors prefer to give lots of fluids and use drugs sparingly; others take the opposite approach.\u003c/p>\n\u003cp>\"So, trying to find the sweet spot — or the 'Goldilocks place' — is important,\" says \u003ca href=\"http://www.surgery.emory.edu/about-us/faculty_directory/faculty_profile_craig_coopersmith.html\" target=\"_blank\" rel=\"noopener\">Dr. Craig Coopersmith\u003c/a>, director of the surgical transplant intensive care unit at Emory University Hospital and an expert on sepsis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CLOVERS trial is an attempt to find that sweet spot. Patients who volunteer for the study are put into one of two groups: One gets plentiful fluids; the other gets limited fluids and more medication. Unlike most research, this study lacks a control group — people who receive the typically given amounts of IV fluids and drugs — as a comparison.\u003c/p>\n\u003cp>\"The problem is, both of those experimental ways for treating sepsis may do worse,\" says \u003ca href=\"https://www.citizen.org/about/michael-carome-md\" target=\"_blank\" rel=\"noopener\">Dr. Michael Carome,\u003c/a> head of the Public Citizen Health Research Group, which has lodged a complaint with federal health officials.\u003c/p>\n\u003cp>\"There may be higher mortality rates for both groups compared to usual care,\" Carome says, and without a comparison group there's no way to tell.\u003c/p>\n\u003cp>And if people on one of these experimental treatments do better than those on the other, that doesn't mean it would be better than usual care, he says. This study can't answer that question.\u003c/p>\n\u003cp>Carome is also alarmed that, in certain unusual circumstances, the protocol calls for holding off on treating dangerously low blood pressure for several hours.\u003c/p>\n\u003cp>\"No one caring for a sepsis patient would normally do that as part of usual care,\" he says.\u003c/p>\n\u003cp>The study, designed at Harvard and funded by the National Institutes of Health, went through multiple reviews by people who concluded that it didn't pose an undue risk to patients.\u003c/p>\n\u003cp>\"But the fact that it got through these layers of review with these serious design flaws signals that our system for protecting human subjects is broken,\" Carome says.\u003c/p>\n\u003cp>Coopersmith, who is not involved with the CLOVERS study, reviewed Public Citizen's complaint at NPR's request. He doesn't share Carome's sense of alarm.\u003c/p>\n\u003cp>Coopersmith agrees that including a comparison group that received the standard of care would be a better study design.\u003c/p>\n\u003cp>But, \"there's no clear standard of care for the first 24 hours,\" he says. Standard protocols for sepsis treatment dictate what doctors should do during the first six hours of treatment only, whereas the CLOVERS study is guiding treatment over a longer time period.\u003c/p>\n\u003cp>He says he agrees with Carome that the study won't clearly show that one of these experimental treatments is better than a more middle-of-the road approach to fluids and blood pressure medication; so sepsis doctors won't get clear guidance from the results. But the findings might help nudge doctors in one direction or another, he says, if it helps resolve the question of what's better — limited fluids or a lot?\u003c/p>\n\u003cp>As for the concerns about how to deal with a patient with very low blood pressure, Coopersmith says, \"in a very narrow patient population for a narrow period of time, there is a theoretical chance that someone could have what I would consider to be too low a blood pressure.\"\u003c/p>\n\u003cp>If he were a doctor involved in this trial and encountered that, he says, he would deviate from the protocol and treat that patient with standard care. He expects his colleagues would do that as well.\u003c/p>\n\u003cp>The study isn't designed the way he would have done it, Coopersmith says, but, he \"would be comfortable enrolling patients in this trial.\"\u003c/p>\n\u003cp>\u003ca href=\"http://cvbr.hms.harvard.edu/researchers/shapiro.html\" target=\"_blank\" rel=\"noopener\">Dr. Nathan Shapiro\u003c/a>, a professor of Emergency Medicine at Harvard's Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it. He declined a request for an interview, but sent a written response to NPR.\u003c/p>\n\u003cp>\"The study protocol was designed by expert clinicians in emergency and critical care medicine representing nearly 50 hospitals in the United States and follows a well-accepted design,\" he writes.\u003c/p>\n\u003cp>A spokesperson for the federal \u003ca href=\"https://www.hhs.gov/ohrp/\" target=\"_blank\" rel=\"noopener\">Office for Human Research Protections\u003c/a> says the office has not yet seen the Public Citizen complaint, but will review the allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Harris can be reached at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\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=Critics+Trying+To+Stop+A+Big+Study+Of+Sepsis+Say+The+Research+Puts+Patients+At+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The consumer advocacy group Public Citizen also says the multicenter study of life-threatening sepsis will at best produce confusing results. A Harvard doctor and designer of the research disagrees.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.\u003c/p>\n\u003cp>Public Citizen says that the study, involving treatment for \u003ca href=\"https://www.cdc.gov/sepsis/\" target=\"_blank\" rel=\"noopener\">sepsis,\u003c/a> puts patients at risk and will at best produce confusing results.\u003c/p>\n\u003cp>The \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03434028?term=NCT03434028&rank=1\" target=\"_blank\" rel=\"noopener\">CLOVERS study\u003c/a> seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients' blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.\u003c/p>\n\u003cp>Doctors use a combination of IV fluids and blood-pressure medicines called vasopressors, such as epinephrine and norepinephrine, to manage this life-threatening complication. But there is no consensus about the best strategy. Some doctors prefer to give lots of fluids and use drugs sparingly; others take the opposite approach.\u003c/p>\n\u003cp>\"So, trying to find the sweet spot — or the 'Goldilocks place' — is important,\" says \u003ca href=\"http://www.surgery.emory.edu/about-us/faculty_directory/faculty_profile_craig_coopersmith.html\" target=\"_blank\" rel=\"noopener\">Dr. Craig Coopersmith\u003c/a>, director of the surgical transplant intensive care unit at Emory University Hospital and an expert on sepsis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CLOVERS trial is an attempt to find that sweet spot. Patients who volunteer for the study are put into one of two groups: One gets plentiful fluids; the other gets limited fluids and more medication. Unlike most research, this study lacks a control group — people who receive the typically given amounts of IV fluids and drugs — as a comparison.\u003c/p>\n\u003cp>\"The problem is, both of those experimental ways for treating sepsis may do worse,\" says \u003ca href=\"https://www.citizen.org/about/michael-carome-md\" target=\"_blank\" rel=\"noopener\">Dr. Michael Carome,\u003c/a> head of the Public Citizen Health Research Group, which has lodged a complaint with federal health officials.\u003c/p>\n\u003cp>\"There may be higher mortality rates for both groups compared to usual care,\" Carome says, and without a comparison group there's no way to tell.\u003c/p>\n\u003cp>And if people on one of these experimental treatments do better than those on the other, that doesn't mean it would be better than usual care, he says. This study can't answer that question.\u003c/p>\n\u003cp>Carome is also alarmed that, in certain unusual circumstances, the protocol calls for holding off on treating dangerously low blood pressure for several hours.\u003c/p>\n\u003cp>\"No one caring for a sepsis patient would normally do that as part of usual care,\" he says.\u003c/p>\n\u003cp>The study, designed at Harvard and funded by the National Institutes of Health, went through multiple reviews by people who concluded that it didn't pose an undue risk to patients.\u003c/p>\n\u003cp>\"But the fact that it got through these layers of review with these serious design flaws signals that our system for protecting human subjects is broken,\" Carome says.\u003c/p>\n\u003cp>Coopersmith, who is not involved with the CLOVERS study, reviewed Public Citizen's complaint at NPR's request. He doesn't share Carome's sense of alarm.\u003c/p>\n\u003cp>Coopersmith agrees that including a comparison group that received the standard of care would be a better study design.\u003c/p>\n\u003cp>But, \"there's no clear standard of care for the first 24 hours,\" he says. Standard protocols for sepsis treatment dictate what doctors should do during the first six hours of treatment only, whereas the CLOVERS study is guiding treatment over a longer time period.\u003c/p>\n\u003cp>He says he agrees with Carome that the study won't clearly show that one of these experimental treatments is better than a more middle-of-the road approach to fluids and blood pressure medication; so sepsis doctors won't get clear guidance from the results. But the findings might help nudge doctors in one direction or another, he says, if it helps resolve the question of what's better — limited fluids or a lot?\u003c/p>\n\u003cp>As for the concerns about how to deal with a patient with very low blood pressure, Coopersmith says, \"in a very narrow patient population for a narrow period of time, there is a theoretical chance that someone could have what I would consider to be too low a blood pressure.\"\u003c/p>\n\u003cp>If he were a doctor involved in this trial and encountered that, he says, he would deviate from the protocol and treat that patient with standard care. He expects his colleagues would do that as well.\u003c/p>\n\u003cp>The study isn't designed the way he would have done it, Coopersmith says, but, he \"would be comfortable enrolling patients in this trial.\"\u003c/p>\n\u003cp>\u003ca href=\"http://cvbr.hms.harvard.edu/researchers/shapiro.html\" target=\"_blank\" rel=\"noopener\">Dr. Nathan Shapiro\u003c/a>, a professor of Emergency Medicine at Harvard's Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it. He declined a request for an interview, but sent a written response to NPR.\u003c/p>\n\u003cp>\"The study protocol was designed by expert clinicians in emergency and critical care medicine representing nearly 50 hospitals in the United States and follows a well-accepted design,\" he writes.\u003c/p>\n\u003cp>A spokesperson for the federal \u003ca href=\"https://www.hhs.gov/ohrp/\" target=\"_blank\" rel=\"noopener\">Office for Human Research Protections\u003c/a> says the office has not yet seen the Public Citizen complaint, but will review the allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Harris can be reached at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\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=Critics+Trying+To+Stop+A+Big+Study+Of+Sepsis+Say+The+Research+Puts+Patients+At+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Science is Finding Some Truth in ‘Microdosing’ Claims Touted by ’Shroomers and Reddit Users",
"title": "Science is Finding Some Truth in ‘Microdosing’ Claims Touted by ’Shroomers and Reddit Users",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Dennis van der Meijden isn’t aiming to see the face of God, feel one with the cosmos, grasp the hidden reality of time and space, or embark on a \u003ca href=\"https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeutic-Journeys/dp/1594774021\" target=\"_blank\" rel=\"noopener\">sacred journey\u003c/a>. What the Dutch graphic designer, producer, and rapper (under the professional name Terilekst) wants — and gets — from his twice-weekly “microdoses” of psilocybin is more modest.[contextly_sidebar id=\"2u046KLqIpjlWqt95jSvMRrGksdXK55L\"]\u003c/p>\n\u003cp>“It sharpens all the senses, as if the frequencies of all of your atoms and energy field are raised a little bit and are being slightly more conscious,” said van der Meijden, 39, who told STAT he first microdosed psilocybin — the active ingredient in “magic mushrooms” — three years ago. It makes him energetic enough to skip coffee, “as if I’m kicked in some sort of orbit for that day.” If he becomes distracted, “I’m very much aware of that, as if seeing myself from a bird’s eye view, so I can correct myself very fast.” But van der Meijden says he’s careful not to exceed about 0.4 grams, because 0.5 made him “a bit too joyful and a bit too philosophical,” which wasn’t always appropriate.\u003c/p>\n\u003cp>Microdosing involves taking roughly one-tenth the “trip” dose of a psychedelic drug, an amount too little to trigger hallucinations but enough, its proponents say, to sharpen the mind. Psilocybin microdosers (including hundreds on Reddit) report that the mushrooms can increase creativity, calm anxiety, decrease the need for caffeine, and reduce depression. There is enough evidence that trip doses might have the latter effect that, on Wednesday, London-based Compass Pathways received Food and Drug Administration \u003ca href=\"https://markets.businessinsider.com/news/stocks/compass-pathways-receives-fda-approval-for-psilocybin-therapy-clinical-trial-for-treatment-resistant-depression-1027477289\" target=\"_blank\" rel=\"noopener\">approval\u003c/a> for a Phase 2B clinical trial of psilocybin (in larger-than-microdoses) for treatment-resistant depression. But research into microdosing is minimal.\u003c/p>\n\u003cp>In the nearly 10 years since psychologist and psychedelics researcher James Fadiman introduced the notion of microdosing and devised a widely followed \u003ca href=\"https://sites.google.com/view/microdosingpsychedelics/home\" target=\"_blank\" rel=\"noopener\">protocol\u003c/a> for it, and three years after microdosing psychedelics became the latest Silicon Valley “\u003ca href=\"https://www.forbes.com/sites/robertglatter/2015/11/27/lsd-microdosing-the-new-job-enhancer-in-silicon-valley-and-beyond/#8ece3fe188a8\" target=\"_blank\" rel=\"noopener\">productivity hack\u003c/a>,” all the evidence about its effects has been anecdotal. Psilocybin is illegal almost everywhere, so it’s been nearly impossible to study scientifically. That is changing, however, as the Netherlands and other countries effectively decriminalize it and scientists in places where it remains illegal obtain government permission to study it.[contextly_sidebar id=\"uhfAqZqMFWRdicHoQZb7cSTv52omgvqK\"]\u003c/p>\n\u003cp>The scientific interest is driven, in part, by numerous reports over the years that psilocybin might have antidepressant or anti-anxiety effects that might guide the development of better psychiatric drugs. But it also reflects an itch to see whether there is any basis for the anecdotal accounts. Now, in the first \u003ca href=\"https://www.biorxiv.org/content/early/2018/08/11/384412\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of its kind, scientists in the Netherlands found that psilocybin microdoses have no noticeable effect on the problem-solving, rational-thinking, and abstract-reasoning ability called fluid intelligence. But they do seem to improve two forms of thinking that underlie creativity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Performance was significantly higher” on tests of convergent and divergent thinking, said psychologist Bernhard Hommel of Leiden University in the Netherlands, who led the study. Convergent thinking is the ability to focus on abstract concepts to identify a single solution to a well-defined problem. Divergent thinking requires meandering mental forays and mental flexibility. Psychologists consider both to be ingredients of creativity.\u003c/p>\n\u003cp>Whatever the dose, psilocybin (O-phosphoryl-4-hydroxy-N, N-dimethyltryptamine) binds to receptors for the neurotransmitter serotonin. The cortex is packed with these 5-HT2A receptors, especially in areas that control reflection, imagination, and introspection, but “whether there is a minimum dose [of psilocybin that’s required to activate them] is an empirical question that we try to tackle,” Hommel said.\u003c/p>\n\u003cp>To do so, he and his colleagues zeroed in on the effects that many users report: creativity, problem-solving, and the “cognitive flexibility” deemed crucial to both. Leiden’s Luisa Prochazkova took the lead in inviting members of the Psychedelic Society of the Netherlands to participate in the study; she got 38 takers.\u003c/p>\n\u003cp>Before their microdose, the volunteers took three standard psychological tests, two related to creative problem-solving and one an assessment of fluid intelligence. The scientists ran chemical analyses of the mushroom samples to determine how much psilocybin they contained. Since a trip dose is about 3 grams of dried ’shrooms, a microdose is around 0.33 grams. Participants averaged 0.37 grams of the dried preparation, which can be taken with food or packed into gelcaps for easy swallowing.\u003c/p>\n\u003cp>About 90 minutes after the microdose, the participants took the three tests again.\u003c/p>\n\u003cp>In the Picture Concept Task, they saw three rows of three pictures, and had to choose three — one from each row — that were related. That requires converging on the correct solution, like noticing that a bathtub, a sink, and a hose all have something to do with water. The brain must focus, weigh alternatives, and reject wrong ones.\u003c/p>\n\u003cp>In the Alternate Uses Task, the microdosers had five minutes to think of ways to use a pen (tracheotomy? finger splint?) or towel. That measures divergent thinking, to move thoughts away from writing, for example, in the case of the pen.\u003c/p>\n\u003cp>The microdosers also took a “progressive matrices” test: In blocks of two-by-two or three-by-three patterns, with the bottom right one missing, they had to choose which of six possibilities belonged in the blank square — a task that requires fluid intelligence.\u003c/p>\n\u003cp>The scientists found no post-microdose difference on the fluid intelligence test. But after microdosing, performance on the picture concept test was significantly higher (an average score of 7.6) than before (6.6). That suggested an improvement in the convergent thinking element of creativity.\u003c/p>\n\u003cp>The microdosers also came up with significantly more uses for pens and towels, 16.7 vs. 14.7. That suggests a microdose of psilocybin “allowed participants to create more out-of-the-box alternative solutions for a problem,” the scientists wrote. Taken together, the three findings suggest a specific effect of psilocybin microdoses on creativity but not on fluid intelligence.\u003c/p>\n\u003cp>For van der Meijden, a microdose of psilocybin makes his musical brainstorm sessions yield “more concepts, ideas, and solutions,” he said, partly because it lets him “better understand and visualize other people’s concepts.” In his design and illustration work, it produces a “more natural flow of line drawing” and lets him “see more possibilities in how things can be or look.” In his music, it lets him “analyze all the different instruments better” and know, for instance, whether to turn up or down the reverberation effect.\u003c/p>\n\u003cp>The Dutch study, which was published on a preprint site and has not undergone peer review at a journal, has several caveats. For one thing, having seen a test before might make people better at it. More problematic, the study didn’t have a control group of people who took something other than psilocybin. That leaves open the possibility that it wasn’t the compound that improved some forms of thinking, but the expectation that it would do so. Maybe people who microdose believe in its benefits enough to make those expectations reality.\u003c/p>\n\u003cp>On the other hand, the results fit with another new \u003ca href=\"https://www.biorxiv.org/content/early/2018/07/25/376491\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of psilocybin. In this one, scientists led by computational neuroscientist Joana Cabral of the University of Oxford used fMRI scans to study the brain activity of nine people who volunteered to be injected with 2 milligram (trip-inducing) doses. The chemical changed the functional connectivity of various brain regions, so that activity in one became synced with that in another. In particular, the rational, logical, well-behaved frontoparietal regions became “strongly destabilized,” the scientists reported, melding with activity in emotional and other regions to produce “unconstrained consciousness,” “mind wandering,” and a sense that everything is connected to everything else. Seeing connections that elude other people is almost the definition of creativity.\u003c/p>\n\u003cp>The findings in the microdosing study also fit with many anecdotal reports. One college student who is a member of the Portland, Ore., microdosing community said that although he doesn’t microdose psilocybin with the express purpose of boosting creativity or focus, he has found that “things seem to have quieted down, in terms of racing thoughts.” He can still be distracted, said Alex, 38, who asked not to be further identified because the drug is illegal in the U.S. But “if I want to go about doing something, then I have an easier time with it because I’m not being bogged down by my thoughts,” he added.\u003c/p>\n\u003cp>Jakobien van der Weijden takes one psilocybin microdose every three days, with bimonthly breaks, “to work more focused, more efficiently and be more creative” at his marketing job in the Netherlands, he said. “On the downside, I would often feel that the inspiration was still there at night and I would keep working on projects until late. So it was somewhat more difficult to maintain a healthy biorhythm.”\u003c/p>\n\u003cp>As legal strictures loosen, there will likely be more rigorous studies of microdosing psilocybin. “Scientific studies could legitimize the claimed benefits,” said Will Burns, CEO of Wenham, Mass.-based \u003ca href=\"http://www.ideasicle.com/\" target=\"_blank\" rel=\"noopener\">Ideasicle\u003c/a>, which develops branding and marketing ideas. He does not microdose, Burns said, but has \u003ca href=\"https://www.forbes.com/sites/willburns/2015/11/29/lsd-microdosing-deserves-more-serious-research/#6824b00d656d\" target=\"_blank\" rel=\"noopener\">called for\u003c/a> research into its purported effects, including improving productivity and creativity. “Right now, we’re swimming in a world of anecdotes and almost no one has taken this seriously,” he said. “We need scientific studies.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/08/23/science-testing-claimed-benefits-of-psilocybin-microdosing/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dennis van der Meijden isn’t aiming to see the face of God, feel one with the cosmos, grasp the hidden reality of time and space, or embark on a \u003ca href=\"https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeutic-Journeys/dp/1594774021\" target=\"_blank\" rel=\"noopener\">sacred journey\u003c/a>. What the Dutch graphic designer, producer, and rapper (under the professional name Terilekst) wants — and gets — from his twice-weekly “microdoses” of psilocybin is more modest.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“It sharpens all the senses, as if the frequencies of all of your atoms and energy field are raised a little bit and are being slightly more conscious,” said van der Meijden, 39, who told STAT he first microdosed psilocybin — the active ingredient in “magic mushrooms” — three years ago. It makes him energetic enough to skip coffee, “as if I’m kicked in some sort of orbit for that day.” If he becomes distracted, “I’m very much aware of that, as if seeing myself from a bird’s eye view, so I can correct myself very fast.” But van der Meijden says he’s careful not to exceed about 0.4 grams, because 0.5 made him “a bit too joyful and a bit too philosophical,” which wasn’t always appropriate.\u003c/p>\n\u003cp>Microdosing involves taking roughly one-tenth the “trip” dose of a psychedelic drug, an amount too little to trigger hallucinations but enough, its proponents say, to sharpen the mind. Psilocybin microdosers (including hundreds on Reddit) report that the mushrooms can increase creativity, calm anxiety, decrease the need for caffeine, and reduce depression. There is enough evidence that trip doses might have the latter effect that, on Wednesday, London-based Compass Pathways received Food and Drug Administration \u003ca href=\"https://markets.businessinsider.com/news/stocks/compass-pathways-receives-fda-approval-for-psilocybin-therapy-clinical-trial-for-treatment-resistant-depression-1027477289\" target=\"_blank\" rel=\"noopener\">approval\u003c/a> for a Phase 2B clinical trial of psilocybin (in larger-than-microdoses) for treatment-resistant depression. But research into microdosing is minimal.\u003c/p>\n\u003cp>In the nearly 10 years since psychologist and psychedelics researcher James Fadiman introduced the notion of microdosing and devised a widely followed \u003ca href=\"https://sites.google.com/view/microdosingpsychedelics/home\" target=\"_blank\" rel=\"noopener\">protocol\u003c/a> for it, and three years after microdosing psychedelics became the latest Silicon Valley “\u003ca href=\"https://www.forbes.com/sites/robertglatter/2015/11/27/lsd-microdosing-the-new-job-enhancer-in-silicon-valley-and-beyond/#8ece3fe188a8\" target=\"_blank\" rel=\"noopener\">productivity hack\u003c/a>,” all the evidence about its effects has been anecdotal. Psilocybin is illegal almost everywhere, so it’s been nearly impossible to study scientifically. That is changing, however, as the Netherlands and other countries effectively decriminalize it and scientists in places where it remains illegal obtain government permission to study it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The scientific interest is driven, in part, by numerous reports over the years that psilocybin might have antidepressant or anti-anxiety effects that might guide the development of better psychiatric drugs. But it also reflects an itch to see whether there is any basis for the anecdotal accounts. Now, in the first \u003ca href=\"https://www.biorxiv.org/content/early/2018/08/11/384412\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of its kind, scientists in the Netherlands found that psilocybin microdoses have no noticeable effect on the problem-solving, rational-thinking, and abstract-reasoning ability called fluid intelligence. But they do seem to improve two forms of thinking that underlie creativity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Performance was significantly higher” on tests of convergent and divergent thinking, said psychologist Bernhard Hommel of Leiden University in the Netherlands, who led the study. Convergent thinking is the ability to focus on abstract concepts to identify a single solution to a well-defined problem. Divergent thinking requires meandering mental forays and mental flexibility. Psychologists consider both to be ingredients of creativity.\u003c/p>\n\u003cp>Whatever the dose, psilocybin (O-phosphoryl-4-hydroxy-N, N-dimethyltryptamine) binds to receptors for the neurotransmitter serotonin. The cortex is packed with these 5-HT2A receptors, especially in areas that control reflection, imagination, and introspection, but “whether there is a minimum dose [of psilocybin that’s required to activate them] is an empirical question that we try to tackle,” Hommel said.\u003c/p>\n\u003cp>To do so, he and his colleagues zeroed in on the effects that many users report: creativity, problem-solving, and the “cognitive flexibility” deemed crucial to both. Leiden’s Luisa Prochazkova took the lead in inviting members of the Psychedelic Society of the Netherlands to participate in the study; she got 38 takers.\u003c/p>\n\u003cp>Before their microdose, the volunteers took three standard psychological tests, two related to creative problem-solving and one an assessment of fluid intelligence. The scientists ran chemical analyses of the mushroom samples to determine how much psilocybin they contained. Since a trip dose is about 3 grams of dried ’shrooms, a microdose is around 0.33 grams. Participants averaged 0.37 grams of the dried preparation, which can be taken with food or packed into gelcaps for easy swallowing.\u003c/p>\n\u003cp>About 90 minutes after the microdose, the participants took the three tests again.\u003c/p>\n\u003cp>In the Picture Concept Task, they saw three rows of three pictures, and had to choose three — one from each row — that were related. That requires converging on the correct solution, like noticing that a bathtub, a sink, and a hose all have something to do with water. The brain must focus, weigh alternatives, and reject wrong ones.\u003c/p>\n\u003cp>In the Alternate Uses Task, the microdosers had five minutes to think of ways to use a pen (tracheotomy? finger splint?) or towel. That measures divergent thinking, to move thoughts away from writing, for example, in the case of the pen.\u003c/p>\n\u003cp>The microdosers also took a “progressive matrices” test: In blocks of two-by-two or three-by-three patterns, with the bottom right one missing, they had to choose which of six possibilities belonged in the blank square — a task that requires fluid intelligence.\u003c/p>\n\u003cp>The scientists found no post-microdose difference on the fluid intelligence test. But after microdosing, performance on the picture concept test was significantly higher (an average score of 7.6) than before (6.6). That suggested an improvement in the convergent thinking element of creativity.\u003c/p>\n\u003cp>The microdosers also came up with significantly more uses for pens and towels, 16.7 vs. 14.7. That suggests a microdose of psilocybin “allowed participants to create more out-of-the-box alternative solutions for a problem,” the scientists wrote. Taken together, the three findings suggest a specific effect of psilocybin microdoses on creativity but not on fluid intelligence.\u003c/p>\n\u003cp>For van der Meijden, a microdose of psilocybin makes his musical brainstorm sessions yield “more concepts, ideas, and solutions,” he said, partly because it lets him “better understand and visualize other people’s concepts.” In his design and illustration work, it produces a “more natural flow of line drawing” and lets him “see more possibilities in how things can be or look.” In his music, it lets him “analyze all the different instruments better” and know, for instance, whether to turn up or down the reverberation effect.\u003c/p>\n\u003cp>The Dutch study, which was published on a preprint site and has not undergone peer review at a journal, has several caveats. For one thing, having seen a test before might make people better at it. More problematic, the study didn’t have a control group of people who took something other than psilocybin. That leaves open the possibility that it wasn’t the compound that improved some forms of thinking, but the expectation that it would do so. Maybe people who microdose believe in its benefits enough to make those expectations reality.\u003c/p>\n\u003cp>On the other hand, the results fit with another new \u003ca href=\"https://www.biorxiv.org/content/early/2018/07/25/376491\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of psilocybin. In this one, scientists led by computational neuroscientist Joana Cabral of the University of Oxford used fMRI scans to study the brain activity of nine people who volunteered to be injected with 2 milligram (trip-inducing) doses. The chemical changed the functional connectivity of various brain regions, so that activity in one became synced with that in another. In particular, the rational, logical, well-behaved frontoparietal regions became “strongly destabilized,” the scientists reported, melding with activity in emotional and other regions to produce “unconstrained consciousness,” “mind wandering,” and a sense that everything is connected to everything else. Seeing connections that elude other people is almost the definition of creativity.\u003c/p>\n\u003cp>The findings in the microdosing study also fit with many anecdotal reports. One college student who is a member of the Portland, Ore., microdosing community said that although he doesn’t microdose psilocybin with the express purpose of boosting creativity or focus, he has found that “things seem to have quieted down, in terms of racing thoughts.” He can still be distracted, said Alex, 38, who asked not to be further identified because the drug is illegal in the U.S. But “if I want to go about doing something, then I have an easier time with it because I’m not being bogged down by my thoughts,” he added.\u003c/p>\n\u003cp>Jakobien van der Weijden takes one psilocybin microdose every three days, with bimonthly breaks, “to work more focused, more efficiently and be more creative” at his marketing job in the Netherlands, he said. “On the downside, I would often feel that the inspiration was still there at night and I would keep working on projects until late. So it was somewhat more difficult to maintain a healthy biorhythm.”\u003c/p>\n\u003cp>As legal strictures loosen, there will likely be more rigorous studies of microdosing psilocybin. “Scientific studies could legitimize the claimed benefits,” said Will Burns, CEO of Wenham, Mass.-based \u003ca href=\"http://www.ideasicle.com/\" target=\"_blank\" rel=\"noopener\">Ideasicle\u003c/a>, which develops branding and marketing ideas. He does not microdose, Burns said, but has \u003ca href=\"https://www.forbes.com/sites/willburns/2015/11/29/lsd-microdosing-deserves-more-serious-research/#6824b00d656d\" target=\"_blank\" rel=\"noopener\">called for\u003c/a> research into its purported effects, including improving productivity and creativity. “Right now, we’re swimming in a world of anecdotes and almost no one has taken this seriously,” he said. “We need scientific studies.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
"airtime": "SUN 9pm-10pm",
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"meta": {
"site": "radio",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
"title": "Freakonomics Radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"title": "Here & Now",
"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
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"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
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