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Roughly two-thirds of women who have been abused said they remained fearful and concerned for their safety after the abuse, the CDC reported, and half of these women said they developed symptoms of post-traumatic stress disorder, which can cause further physical health consequences.\u003c/p>\n\u003cp>Under the latest guidelines, physicians would ask women of reproductive age during appointments if they have experienced violence at the hands of someone they know. Women who indicate they have would then be referred for further services, such as \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/1524838016637080\" target=\"_blank\" rel=\"noopener\">counseling\u003c/a> or \u003ca href=\"https://www.liebertpub.com/doi/10.1089/jwh.2015.5547\" target=\"_blank\" rel=\"noopener\">home visits\u003c/a>.\u003c/p>\n\u003cp>These recommendations bolster a set of guidelines initially released in 2013. Guidelines are reviewed every five years to adapt standing practices to new evidence.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the #MeToo era, advocates suggest that, anecdotally, they have seen more victims empowered to speak out about what has happened to them. In the last year, the Domestic Violence Hotline reported a 30-percent rise in calls, the \u003ca href=\"https://www.nytimes.com/2018/10/16/us/domestic-violence-hotline-me-too.html\" target=\"_blank\" rel=\"noopener\">New York Times reported\u003c/a>.\u003c/p>\n\u003cp>But unlike the many #MeToo experiences revealed on social media, survivors of domestic violence often are not ready to go public in part because of stigma and the idea that domestic violence occurs in a relationship between two consenting adults rather than a situation bound by fear, abuse and threats. Lisa James, director of health at Futures Without Violence, credits the movement with inviting people to be “more comfortable with disclosure.”[contextly_sidebar id=\"KW16iKwutQKVUIspOtLQoZNCrloWfZng\"]\u003c/p>\n\u003cp>“That’s all the more reason why we want to have health care providers there, ready and trained on how to open up that conversation,” James said. Making it a routine part of a health checkup may help relieve the onus on victims to protect themselves by speaking out.\u003c/p>\n\u003cp>Here’s a closer look at these recommendations and how they can help women at risk.\u003c/p>\n\u003cp>\u003cstrong>What’s new about the guidelines?\u003c/strong>\u003c/p>\n\u003cp>Females of reproductive age — between 15 and 44 years old — are at \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22754606\" target=\"_blank\" rel=\"noopener\">potential risk for abuse\u003c/a>, according to the guidelines. But other factors, including abuse during childhood, joblessness and difficulty paying bills, marital problems and substance use, raise the chances that a woman may endure violence from someone she knows.\u003c/p>\n\u003cp>The recommendations suggest clinicians ask all female patients in this age group screening \u003ca href=\"https://www.cdc.gov/violenceprevention/pdf/ipv/ipvandsvscreening.pdf\" target=\"_blank\" rel=\"noopener\">questions\u003c/a>, like: Have you ever been emotionally or physically abused by your partner or someone important to you? And, within the last year, have you ever been hit, slapped, kicked or otherwise physically hurt by someone?\u003c/p>\n\u003cp>If a woman indicates that she has been the victim of such violence, the clinician should to refer the patient for more intensive, ongoing support services, according to the new guidelines.\u003c/p>\n\u003cp>Handing a stack of brochures to a patient and suggesting she call a hotline phone number is not enough, said John Epling, a family physician in Roanoke, Virginia, who served on the task force that developed these recommendations.\u003c/p>\n\u003cp>“Anybody experiencing intimate partner violence would need lots of support figuring their options,” he said.\u003c/p>\n\u003cp>\u003cstrong>Why weren’t men or seniors or other groups included in these screening recommendations?\u003c/strong>\u003c/p>\n\u003cp>These recommendations address intimate partner violence among adolescent and middle-aged women because the task force develops recommendations based on available research, Epling said. They acknowledge there is not enough evidence that assesses good screening practices to craft guidelines for men, seniors and vulnerable adult populations, even though it is a very common problem.[contextly_sidebar id=\"LpwI1Vg9g6FZYhBogzNZWmIPx9ZOdahX\"]\u003c/p>\n\u003cp>With more research in hand, he suggested the task force can revisit these issues in the years to come.\u003c/p>\n\u003cp>\u003cstrong>Will the guidelines help prevent violence?\u003c/strong>\u003c/p>\n\u003cp>The health care system can go further, James said, especially with the understanding that victims of intimate partner violence aren’t always ready to disclose the abuse they face. She suggested a universal education approach where every patient, including men who might be committing or targeted by intimate partner violence, is told about the impact on one’s health.\u003c/p>\n\u003cp>It will take time and more data and evidence to determine if these strategies lead to improved access to services for people who endure violence. Rather than waiting until physical and sexual abuse happen, James said these approaches could bolster efforts to prevent harm in the first place.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>If you are experiencing domestic violence, call the National Domestic Violence Hotline at 1−800−799−7233 or TTY 1−800−787−3224.\u003c/em>\u003c/strong>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Throughout their lifetimes, one out of four women and one out of 10 men will experience some form of intimate partner violence, including rape, physical abuse and stalking, according to the Centers for Disease Control and Prevention’s \u003ca href=\"https://www.cdc.gov/violenceprevention/pdf/NISVS-StateReportFactsheet.pdf\" target=\"_blank\" rel=\"noopener\">National Intimate Partner and Sexual Violence survey\u003c/a> from 2010, the latest year with available data.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>How doctors and nurses should screen patients for such intimate partner violence is the subject of updated recommendations issued Tuesday by the U.S. Preventative Services Task Force and \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2708121\">published\u003c/a> in the Journal of the American Medical Association.\u003c/p>\n\u003cp>The best estimates likely under-represent the true scope and scale of intimate partner violence because victims often are afraid to disclose what has happened to them. Roughly two-thirds of women who have been abused said they remained fearful and concerned for their safety after the abuse, the CDC reported, and half of these women said they developed symptoms of post-traumatic stress disorder, which can cause further physical health consequences.\u003c/p>\n\u003cp>Under the latest guidelines, physicians would ask women of reproductive age during appointments if they have experienced violence at the hands of someone they know. Women who indicate they have would then be referred for further services, such as \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/1524838016637080\" target=\"_blank\" rel=\"noopener\">counseling\u003c/a> or \u003ca href=\"https://www.liebertpub.com/doi/10.1089/jwh.2015.5547\" target=\"_blank\" rel=\"noopener\">home visits\u003c/a>.\u003c/p>\n\u003cp>These recommendations bolster a set of guidelines initially released in 2013. Guidelines are reviewed every five years to adapt standing practices to new evidence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the #MeToo era, advocates suggest that, anecdotally, they have seen more victims empowered to speak out about what has happened to them. In the last year, the Domestic Violence Hotline reported a 30-percent rise in calls, the \u003ca href=\"https://www.nytimes.com/2018/10/16/us/domestic-violence-hotline-me-too.html\" target=\"_blank\" rel=\"noopener\">New York Times reported\u003c/a>.\u003c/p>\n\u003cp>But unlike the many #MeToo experiences revealed on social media, survivors of domestic violence often are not ready to go public in part because of stigma and the idea that domestic violence occurs in a relationship between two consenting adults rather than a situation bound by fear, abuse and threats. Lisa James, director of health at Futures Without Violence, credits the movement with inviting people to be “more comfortable with disclosure.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“That’s all the more reason why we want to have health care providers there, ready and trained on how to open up that conversation,” James said. Making it a routine part of a health checkup may help relieve the onus on victims to protect themselves by speaking out.\u003c/p>\n\u003cp>Here’s a closer look at these recommendations and how they can help women at risk.\u003c/p>\n\u003cp>\u003cstrong>What’s new about the guidelines?\u003c/strong>\u003c/p>\n\u003cp>Females of reproductive age — between 15 and 44 years old — are at \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22754606\" target=\"_blank\" rel=\"noopener\">potential risk for abuse\u003c/a>, according to the guidelines. But other factors, including abuse during childhood, joblessness and difficulty paying bills, marital problems and substance use, raise the chances that a woman may endure violence from someone she knows.\u003c/p>\n\u003cp>The recommendations suggest clinicians ask all female patients in this age group screening \u003ca href=\"https://www.cdc.gov/violenceprevention/pdf/ipv/ipvandsvscreening.pdf\" target=\"_blank\" rel=\"noopener\">questions\u003c/a>, like: Have you ever been emotionally or physically abused by your partner or someone important to you? And, within the last year, have you ever been hit, slapped, kicked or otherwise physically hurt by someone?\u003c/p>\n\u003cp>If a woman indicates that she has been the victim of such violence, the clinician should to refer the patient for more intensive, ongoing support services, according to the new guidelines.\u003c/p>\n\u003cp>Handing a stack of brochures to a patient and suggesting she call a hotline phone number is not enough, said John Epling, a family physician in Roanoke, Virginia, who served on the task force that developed these recommendations.\u003c/p>\n\u003cp>“Anybody experiencing intimate partner violence would need lots of support figuring their options,” he said.\u003c/p>\n\u003cp>\u003cstrong>Why weren’t men or seniors or other groups included in these screening recommendations?\u003c/strong>\u003c/p>\n\u003cp>These recommendations address intimate partner violence among adolescent and middle-aged women because the task force develops recommendations based on available research, Epling said. They acknowledge there is not enough evidence that assesses good screening practices to craft guidelines for men, seniors and vulnerable adult populations, even though it is a very common problem.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>With more research in hand, he suggested the task force can revisit these issues in the years to come.\u003c/p>\n\u003cp>\u003cstrong>Will the guidelines help prevent violence?\u003c/strong>\u003c/p>\n\u003cp>The health care system can go further, James said, especially with the understanding that victims of intimate partner violence aren’t always ready to disclose the abuse they face. She suggested a universal education approach where every patient, including men who might be committing or targeted by intimate partner violence, is told about the impact on one’s health.\u003c/p>\n\u003cp>It will take time and more data and evidence to determine if these strategies lead to improved access to services for people who endure violence. Rather than waiting until physical and sexual abuse happen, James said these approaches could bolster efforts to prevent harm in the first place.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>If you are experiencing domestic violence, call the National Domestic Violence Hotline at 1−800−799−7233 or TTY 1−800−787−3224.\u003c/em>\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Jewelry with the toxic metal cadmium is showing up on the shelves of national retailers including Ross, Nordstrom Rack and Papaya, according to newly released test results.[contextly_sidebar id=”ALDsOv55bDFULA2So32zIuna6vUPT8ZY”]\u003c/p>\n\u003cp>Analysis done for the nonprofit Center for Environmental Health revealed some jewelry sold with women’s dresses and shirts was nearly pure cadmium, which can cause cancer and reproductive harm after prolonged exposure.\u003c/p>\n\u003cp>Consumer advocates were hopeful cadmium had disappeared from the U.S. jewelry market following changes prompted by a 2010 Associated Press investigation that found Chinese manufacturers were using the metal to make kids’ jewelry. States including California outlawed cadmium in children’s jewelry, and testing by the center found the chemical had virtually disappeared from jewelry by 2012.\u003c/p>\n\u003cp>No laws address cadmium in adult jewelry, however, and last year the center decided to check those products. Lab testing found 31 adult jewelry items purchased from retail stores were at least 40 percent cadmium, and most were more than 90 percent, according to results shared exclusively with the AP.\u003c/p>\n\u003cp>California’s law allows no more than 0.03 percent cadmium in children’s jewelry. The precise health risk from the tested jewelry is unclear because researchers did not assess whether small amounts shed when the jewelry is handled and worn.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Over time, cadmium accumulates in the body and can damage the kidneys and bones. Most exposure happens by ingesting small amounts or by breathing it, most commonly through tobacco, which can contain cadmium. Researchers also have documented some absorption through skin contact, though the phenomenon is not well-studied.\u003c/p>\n\u003cp>Michael Harbut, a practicing doctor who as a university professor has researched cadmium’s cancer-causing properties, noted that contact can trigger skin rashes including psoriasis.[contextly_sidebar id=”9G8nAOWjWB7rKBq3G09Isa3CXvUagJIr”]\u003c/p>\n\u003cp>“Cadmium is bad,” said Harbut, who teaches at Michigan State University’s College of Human Medicine. “Given a choice between wearing something with cadmium in it, or wearing something without cadmium in it, I would take the product without cadmium.”\u003c/p>\n\u003cp>The Oakland-based nonprofit bought all the test samples in the San Francisco Bay Area this year or last. The extent to which contaminated jewelry is in stores elsewhere isn’t clear, though a national retailer would not typically limit a product to just one region.\u003c/p>\n\u003cp>The center said the problem should not be underestimated because of the limited market sampling.\u003c/p>\n\u003cp>“If you’re the person that buys and is wearing that jewelry, you don’t really care whether it’s a common problem or a rare problem,” said Caroline Cox, senior scientist at the center. “You have a problem.”\u003c/p>\n\u003cp>Brent Cleaveland, executive director of the Fashion Jewelry and Accessories Trade Association, said he does not believe the test results suggest a larger problem. Most major retailers have a stringent system for testing and analyzing what they sell, he said.\u003c/p>\n\u003cp>Most of the tainted items were sold at Ross, which operates more than 1,400 stores in 38 states. One pendant from a necklace chain was 100 percent cadmium, according to the testing.\u003c/p>\n\u003cp>In a written statement, Ross said it is committed to protecting its customers and has “addressed this issue with our supplier.” The retailer would not say whether it pulled suspect jewelry from stores.\u003c/p>\n\u003cp>The brands found with high cadmium levels in Ross stores include Tacera and Vibe Sportswear.[contextly_sidebar id=”2hYrwgIWmBjwxEyj6CkS5HFRDE3kS5EJ”]\u003c/p>\n\u003cp>Xinwei Xie, chief executive officer at Trend Textile Inc., which owns Tacera, declined to comment when reached by phone. The Skate Group Inc., which owns Vibe Sportswear, did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Papaya said it considers cadmium in its products a serious problem. It operates more than 100 retail locations nationwide.\u003c/p>\n\u003cp>Steven Kim, an attorney representing Papaya, said the company has recalled the products where contamination was found and stopped buying from the manufacturer in China.\u003c/p>\n\u003cp>“Our manufacturers are required to represent and warrant that their products are in legal compliance,” Kim said. “Papaya is very strict and stops doing business with any manufacturer which fails to comply.”\u003c/p>\n\u003cp>Nordstrom spokeswoman Emily Sterken said the company is “reaching out to these vendors to make them aware of the situation and get more information on these items.”\u003c/p>\n\u003cp>The Center for Environmental Health has long used California law to force companies to reduce levels of harmful materials in consumer products, including cadmium and lead in jewelry.\u003c/p>\n\u003cp>Under the state’s Proposition 65, businesses must inform consumers about significant exposures to chemicals that cause cancer or other reproductive harm. The nonprofit has settled Proposition 65 claims against 36 companies, including Gap Inc. and Target Corp., which agreed to not sell jewelry with more than 0.03 percent cadmium.\u003c/p>\n\u003cp>That limit for children’s jewelry took effect after the AP reported in 2010 that some Chinese jewelry manufacturers were substituting cadmium for lead, the use of which Congress clamped down on following a string of imported-product safety scandals.\u003c/p>\n\u003cp>The jewelry industry helped write voluntary U.S. standards following the AP investigation, but the U.S. Consumer Product Safety Commission did not mandate any cadmium limits.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Associated Press writer Justin Pritchard contributed to this report.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jewelry with the toxic metal cadmium is showing up on the shelves of national retailers including Ross, Nordstrom Rack and Papaya, according to newly released test results.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Analysis done for the nonprofit Center for Environmental Health revealed some jewelry sold with women’s dresses and shirts was nearly pure cadmium, which can cause cancer and reproductive harm after prolonged exposure.\u003c/p>\n\u003cp>Consumer advocates were hopeful cadmium had disappeared from the U.S. jewelry market following changes prompted by a 2010 Associated Press investigation that found Chinese manufacturers were using the metal to make kids’ jewelry. States including California outlawed cadmium in children’s jewelry, and testing by the center found the chemical had virtually disappeared from jewelry by 2012.\u003c/p>\n\u003cp>No laws address cadmium in adult jewelry, however, and last year the center decided to check those products. Lab testing found 31 adult jewelry items purchased from retail stores were at least 40 percent cadmium, and most were more than 90 percent, according to results shared exclusively with the AP.\u003c/p>\n\u003cp>California’s law allows no more than 0.03 percent cadmium in children’s jewelry. The precise health risk from the tested jewelry is unclear because researchers did not assess whether small amounts shed when the jewelry is handled and worn.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Over time, cadmium accumulates in the body and can damage the kidneys and bones. Most exposure happens by ingesting small amounts or by breathing it, most commonly through tobacco, which can contain cadmium. Researchers also have documented some absorption through skin contact, though the phenomenon is not well-studied.\u003c/p>\n\u003cp>Michael Harbut, a practicing doctor who as a university professor has researched cadmium’s cancer-causing properties, noted that contact can trigger skin rashes including psoriasis.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Cadmium is bad,” said Harbut, who teaches at Michigan State University’s College of Human Medicine. “Given a choice between wearing something with cadmium in it, or wearing something without cadmium in it, I would take the product without cadmium.”\u003c/p>\n\u003cp>The Oakland-based nonprofit bought all the test samples in the San Francisco Bay Area this year or last. The extent to which contaminated jewelry is in stores elsewhere isn’t clear, though a national retailer would not typically limit a product to just one region.\u003c/p>\n\u003cp>The center said the problem should not be underestimated because of the limited market sampling.\u003c/p>\n\u003cp>“If you’re the person that buys and is wearing that jewelry, you don’t really care whether it’s a common problem or a rare problem,” said Caroline Cox, senior scientist at the center. “You have a problem.”\u003c/p>\n\u003cp>Brent Cleaveland, executive director of the Fashion Jewelry and Accessories Trade Association, said he does not believe the test results suggest a larger problem. Most major retailers have a stringent system for testing and analyzing what they sell, he said.\u003c/p>\n\u003cp>Most of the tainted items were sold at Ross, which operates more than 1,400 stores in 38 states. One pendant from a necklace chain was 100 percent cadmium, according to the testing.\u003c/p>\n\u003cp>In a written statement, Ross said it is committed to protecting its customers and has “addressed this issue with our supplier.” The retailer would not say whether it pulled suspect jewelry from stores.\u003c/p>\n\u003cp>The brands found with high cadmium levels in Ross stores include Tacera and Vibe Sportswear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Xinwei Xie, chief executive officer at Trend Textile Inc., which owns Tacera, declined to comment when reached by phone. The Skate Group Inc., which owns Vibe Sportswear, did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Papaya said it considers cadmium in its products a serious problem. It operates more than 100 retail locations nationwide.\u003c/p>\n\u003cp>Steven Kim, an attorney representing Papaya, said the company has recalled the products where contamination was found and stopped buying from the manufacturer in China.\u003c/p>\n\u003cp>“Our manufacturers are required to represent and warrant that their products are in legal compliance,” Kim said. “Papaya is very strict and stops doing business with any manufacturer which fails to comply.”\u003c/p>\n\u003cp>Nordstrom spokeswoman Emily Sterken said the company is “reaching out to these vendors to make them aware of the situation and get more information on these items.”\u003c/p>\n\u003cp>The Center for Environmental Health has long used California law to force companies to reduce levels of harmful materials in consumer products, including cadmium and lead in jewelry.\u003c/p>\n\u003cp>Under the state’s Proposition 65, businesses must inform consumers about significant exposures to chemicals that cause cancer or other reproductive harm. The nonprofit has settled Proposition 65 claims against 36 companies, including Gap Inc. and Target Corp., which agreed to not sell jewelry with more than 0.03 percent cadmium.\u003c/p>\n\u003cp>That limit for children’s jewelry took effect after the AP reported in 2010 that some Chinese jewelry manufacturers were substituting cadmium for lead, the use of which Congress clamped down on following a string of imported-product safety scandals.\u003c/p>\n\u003cp>The jewelry industry helped write voluntary U.S. standards following the AP investigation, but the U.S. Consumer Product Safety Commission did not mandate any cadmium limits.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Associated Press writer Justin Pritchard contributed to this report.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.[contextly_sidebar id=”lms9rSPdk5pG72xqgRdVMiGv0hv7IpdH”]\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.[contextly_sidebar id=”KPqEb6LD9ky4mDsIDJAEnoEvgzkEna45″]\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.[contextly_sidebar id=”ZbtYikLAiggPmeNWkxr4kKECzkkjZf4Z”]\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it’s rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>“It’s a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.”\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>“It’s really hundreds of people who have essentially contributed to this work,” he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>“If the field of genetics is able to compile large collections consisting of millions of people,” he wonders, “why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it’s rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>“It’s a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.”\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>“It’s really hundreds of people who have essentially contributed to this work,” he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>“If the field of genetics is able to compile large collections consisting of millions of people,” he wonders, “why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "For Cervical Cancer Screening, Women Over 30 Can Now Choose HPV Test Only",
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"content": "\u003cp>Federal health advisers say women can now consider three options when it's time for their cervical cancer screening tests. The influential group, the U.S. Preventive Services Task Force, has expanded its recommendations for this potentially lifesaving exam.\u003c/p>\n\u003cp>The new recommendations \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10897\" target=\"_blank\" rel=\"noopener\">are published\u003c/a> in the latest issue of \u003cem>JAMA.\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022605/\" target=\"_blank\" rel=\"noopener\">Pap smears\u003c/a> have saved many lives since they became available decades ago. Inspecting samples of cervical tissue for precancerous changes is effective at catching possible cancer and is still the go-to test for women ages 21 to 29, according to the USPSTF guidelines.\u003c/p>\n\u003cp>But there's another option. \"Most cervical cancer is caused by what's called the human papillomavirus, or HPV,\" says \u003ca href=\"https://profiles.stanford.edu/douglas-owens\" target=\"_blank\" rel=\"noopener\">Dr. Douglas Owens\u003c/a>, a professor of medicine at Stanford University and vice chair of the USPSTF. \"And we now have tests for HPV and that's an important step forward.\"\u003c/p>\n\u003cp>These tests are available alone or in combination with the Pap test. And the USPSTF now says \u003ca href=\"https://www.npr.org/sections/health-shots/2018/07/03/625696664/for-women-over-30-there-may-be-a-better-choice-than-the-pap-smear\" target=\"_blank\" rel=\"noopener\">the evidence\u003c/a> is strong enough that HPV tests can be used by themselves, for women over 30. That third choice expands on the task force's previous recommendation, which was for the Pap test or the combination test.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And while Pap tests should be repeated every three years, women can wait five years between HPV tests.\u003c/p>\n\u003cp>\"Five years is a good balance between the benefits and harms,\" Owens says. \"It's still highly effective at detecting cancer, and screening more frequently than that may increase some of the potential harms, so we think that's a good interval.\"\u003c/p>\n\u003cp>Potential harms of too frequent screening include unnecessary follow-ups such as biopsies. In a draft recommendation released last year, the task force had considered suggesting just two options, either the Pap smear or the HPV test, but its final recommendation included the hybrid test too.\u003c/p>\n\u003cp>\"The HPV test alone is not available everywhere,\" Owens explains. \"And so we want to be sure that women no matter where they're receiving care have options for cervical cancer screening.\"\u003c/p>\n\u003cp>He says the combination test is widely available, as is the Pap test, \"so all of those are good options and a woman can discuss with her physician what's available at the place where she's receiving care.\"\u003c/p>\n\u003cp>Women may not notice the difference between tests because tissue samples are all collected the same way. But \u003ca href=\"http://pressroom.cancer.org/debbiesaslow\" target=\"_blank\" rel=\"noopener\">Debbie Saslow\u003c/a>, senior director for HPV-related and women's cancers at the American Cancer Society, says if women have a choice, she would recommend the HPV test for women over 30.\u003c/p>\n\u003cp>\"I truly believe that including the HPV test, either along with the Pap or instead of the Pap, is superior than the Pap alone,\" she says. There's some evidence the HPV test is better than the Pap test at detecting a less common form of cervical cancer, adenocarcinoma, she says. \"So wouldn't you rather find the two most common cancers instead of just the one most common type?\"\u003c/p>\n\u003cp>The task force emphasizes that all three tests are highly effective. The overarching recommendation is simply that women should get screened, and to do so regularly until the age of 65. If screening has been adequate up to that point, the task force says women do not need further cervical cancer screening.\u003c/p>\n\u003cp>Health officials also recommend the HPV vaccine, which is given to girls and young women, up to age 26. (Boys and young men are encouraged to get the HPV vaccine as well.) But Owens says a vaccine alone doesn't replace cervical cancer screening.\u003c/p>\n\u003cp>\"Our recommendation applies to everyone whether you've been vaccinated or not,\" he says. \"It's very important that women do not forgo screening because they've been vaccinated.\"\u003c/p>\n\u003cp>An effective vaccine could ultimately render cervical cancer screening unnecessary, but that change will require careful study and could be years away.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can reach Richard Harris at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">rharris@npr.org\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=For+Cervical+Cancer+Screening%2C+Women+Over+30+Can+Now+Choose+The+HPV+Test+Only&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Federal health advisers say women can now consider three options when it's time for their cervical cancer screening tests. The influential group, the U.S. Preventive Services Task Force, has expanded its recommendations for this potentially lifesaving exam.\u003c/p>\n\u003cp>The new recommendations \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10897\" target=\"_blank\" rel=\"noopener\">are published\u003c/a> in the latest issue of \u003cem>JAMA.\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022605/\" target=\"_blank\" rel=\"noopener\">Pap smears\u003c/a> have saved many lives since they became available decades ago. Inspecting samples of cervical tissue for precancerous changes is effective at catching possible cancer and is still the go-to test for women ages 21 to 29, according to the USPSTF guidelines.\u003c/p>\n\u003cp>But there's another option. \"Most cervical cancer is caused by what's called the human papillomavirus, or HPV,\" says \u003ca href=\"https://profiles.stanford.edu/douglas-owens\" target=\"_blank\" rel=\"noopener\">Dr. Douglas Owens\u003c/a>, a professor of medicine at Stanford University and vice chair of the USPSTF. \"And we now have tests for HPV and that's an important step forward.\"\u003c/p>\n\u003cp>These tests are available alone or in combination with the Pap test. And the USPSTF now says \u003ca href=\"https://www.npr.org/sections/health-shots/2018/07/03/625696664/for-women-over-30-there-may-be-a-better-choice-than-the-pap-smear\" target=\"_blank\" rel=\"noopener\">the evidence\u003c/a> is strong enough that HPV tests can be used by themselves, for women over 30. That third choice expands on the task force's previous recommendation, which was for the Pap test or the combination test.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And while Pap tests should be repeated every three years, women can wait five years between HPV tests.\u003c/p>\n\u003cp>\"Five years is a good balance between the benefits and harms,\" Owens says. \"It's still highly effective at detecting cancer, and screening more frequently than that may increase some of the potential harms, so we think that's a good interval.\"\u003c/p>\n\u003cp>Potential harms of too frequent screening include unnecessary follow-ups such as biopsies. In a draft recommendation released last year, the task force had considered suggesting just two options, either the Pap smear or the HPV test, but its final recommendation included the hybrid test too.\u003c/p>\n\u003cp>\"The HPV test alone is not available everywhere,\" Owens explains. \"And so we want to be sure that women no matter where they're receiving care have options for cervical cancer screening.\"\u003c/p>\n\u003cp>He says the combination test is widely available, as is the Pap test, \"so all of those are good options and a woman can discuss with her physician what's available at the place where she's receiving care.\"\u003c/p>\n\u003cp>Women may not notice the difference between tests because tissue samples are all collected the same way. But \u003ca href=\"http://pressroom.cancer.org/debbiesaslow\" target=\"_blank\" rel=\"noopener\">Debbie Saslow\u003c/a>, senior director for HPV-related and women's cancers at the American Cancer Society, says if women have a choice, she would recommend the HPV test for women over 30.\u003c/p>\n\u003cp>\"I truly believe that including the HPV test, either along with the Pap or instead of the Pap, is superior than the Pap alone,\" she says. There's some evidence the HPV test is better than the Pap test at detecting a less common form of cervical cancer, adenocarcinoma, she says. \"So wouldn't you rather find the two most common cancers instead of just the one most common type?\"\u003c/p>\n\u003cp>The task force emphasizes that all three tests are highly effective. The overarching recommendation is simply that women should get screened, and to do so regularly until the age of 65. If screening has been adequate up to that point, the task force says women do not need further cervical cancer screening.\u003c/p>\n\u003cp>Health officials also recommend the HPV vaccine, which is given to girls and young women, up to age 26. (Boys and young men are encouraged to get the HPV vaccine as well.) But Owens says a vaccine alone doesn't replace cervical cancer screening.\u003c/p>\n\u003cp>\"Our recommendation applies to everyone whether you've been vaccinated or not,\" he says. \"It's very important that women do not forgo screening because they've been vaccinated.\"\u003c/p>\n\u003cp>An effective vaccine could ultimately render cervical cancer screening unnecessary, but that change will require careful study and could be years away.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can reach Richard Harris at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">rharris@npr.org\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=For+Cervical+Cancer+Screening%2C+Women+Over+30+Can+Now+Choose+The+HPV+Test+Only&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Promoting the HPV Vaccine Doesn’t Lead to More Teen Sex, Study Shows",
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"content": "\u003cp>Teens are no more sexually promiscuous in states that have passed legislation promoting the HPV vaccine than those living in states that have not, according to a newly published study.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study, released in the journal Pediatrics, compared the District of Columbia and 23 U.S. states that passed legislation to promote the vaccine for human papillomavirus (HPV) with states with no such policies. Researchers then analyzed the results of a \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf\" target=\"_blank\" rel=\"noopener\">multi-year survey\u003c/a> conducted by the Centers for Disease Control and Prevention to determine whether teens living in states with pro-HPV vaccine policies had more sex. They didn’t, the study concluded.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation,” the study said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In states that promoted vaccines, these policies ranged from in-school awareness programs to incentivizing insurance companies to cover the vaccine’s cost, said Erin Cook, the study’s primary author who led this research as part of her doctoral dissertation in epidemiology at the Harvard T.H. Chan School of Public Health.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“The big takeaway is that passage of legislation regarding HPV didn’t seem to be associated with any changes in adolescent sexual behaviors in the sample of states we were able to look at,” Cook said.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study did not examine how well these policies were implemented but simply used the mere presence or absence of such legislation as an indicator of a state’s political will to act on HPV vaccine, cancer prevention and public health, she cautioned.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">According to the CDC, some 79 million Americans have HPV; it’s the most common sexually transmitted infection in the U.S., this latest study says. Another 14 million people are infected with HPV each year, the CDC says, many of them in their teens and early 20s. Cervical cancer cases \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31206-5/fulltext\" target=\"_blank\" rel=\"noopener\">almost always link\u003c/a> back to the human papillomavirus, according to the Lancet.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. approved use of the three-dose HPV vaccine for girls in 2006 and for boys in 2011. By 2014, just a third of U.S. girls — 37 percent — and 13 percent of American boys had completed the vaccination course. By 2016, nearly half of U.S. girls were vaccinated.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Still, half of U.S. states have not implemented policies to promote the vaccine, which scientific research shows can effectively \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html\" target=\"_blank\" rel=\"noopener\">prevent cancers caused by HPV infection\u003c/a>, according to the CDC.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">These findings are not new, despite persistent attitudes that the HPV vaccine could encourage sexual promiscuity. In 2015, JAMA published a Harvard Medical School study that showed \u003ca style=\"color: #000000\" href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2109856\" target=\"_blank\" rel=\"noopener\">no link between the vaccine\u003c/a>and a change in teen sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In 2007, Gary Freed, a pediatrician and professor at the University of Michigan, chaired the National Vaccine Advisory Council, and told \u003ca style=\"color: #000000\" href=\"http://www.pbs.org/now/shows/308/hpv-vaccine.html\" target=\"_blank\" rel=\"noopener\">Now on PBS\u003c/a>: “If we have the ability to prevent any cancer deaths, much less a significant number of cancer deaths that affect a segment of our population that historically have not been necessarily as well served as they could have been, then I think it’s incumbent upon society to make sure that we’re able to prevent these cancers.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Freed said this latest study reinforces the idea that teens are not deciding whether to have sex based on the threat of receiving an HPV infection. This is partly because so few people have heard of HPV, and because “adolescents think in the here and now, not 40 years from now.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“We as a society need to decide how much we want to prevent cervical cancer for the children of today,” Freed said. “That’s really what this is all about. We can make pap smears a thing of the past.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. is not alone in its sluggish implementation of a vaccine that can prevent illness and death as a result of cervical cancer. In 2016, \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30099-7/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">a study published in the Lancet\u003c/a> reported that out of 64 nations and 12 territories, only 47 million women finished the three-dose HPV vaccine course. Most of those women lived in high-income or upper middle income countries, the study said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Access to HPV vaccination in low-income and lower-middle-income countries is almost non-existent, despite these countries carrying most of the burden of cervical cancer cases worldwide,” the report said.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Teens are no more sexually promiscuous in states that have passed legislation promoting the HPV vaccine than those living in states that have not, according to a newly published study.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study, released in the journal Pediatrics, compared the District of Columbia and 23 U.S. states that passed legislation to promote the vaccine for human papillomavirus (HPV) with states with no such policies. Researchers then analyzed the results of a \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf\" target=\"_blank\" rel=\"noopener\">multi-year survey\u003c/a> conducted by the Centers for Disease Control and Prevention to determine whether teens living in states with pro-HPV vaccine policies had more sex. They didn’t, the study concluded.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation,” the study said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In states that promoted vaccines, these policies ranged from in-school awareness programs to incentivizing insurance companies to cover the vaccine’s cost, said Erin Cook, the study’s primary author who led this research as part of her doctoral dissertation in epidemiology at the Harvard T.H. Chan School of Public Health.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“The big takeaway is that passage of legislation regarding HPV didn’t seem to be associated with any changes in adolescent sexual behaviors in the sample of states we were able to look at,” Cook said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study did not examine how well these policies were implemented but simply used the mere presence or absence of such legislation as an indicator of a state’s political will to act on HPV vaccine, cancer prevention and public health, she cautioned.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">According to the CDC, some 79 million Americans have HPV; it’s the most common sexually transmitted infection in the U.S., this latest study says. Another 14 million people are infected with HPV each year, the CDC says, many of them in their teens and early 20s. Cervical cancer cases \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31206-5/fulltext\" target=\"_blank\" rel=\"noopener\">almost always link\u003c/a> back to the human papillomavirus, according to the Lancet.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. approved use of the three-dose HPV vaccine for girls in 2006 and for boys in 2011. By 2014, just a third of U.S. girls — 37 percent — and 13 percent of American boys had completed the vaccination course. By 2016, nearly half of U.S. girls were vaccinated.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Still, half of U.S. states have not implemented policies to promote the vaccine, which scientific research shows can effectively \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html\" target=\"_blank\" rel=\"noopener\">prevent cancers caused by HPV infection\u003c/a>, according to the CDC.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">These findings are not new, despite persistent attitudes that the HPV vaccine could encourage sexual promiscuity. In 2015, JAMA published a Harvard Medical School study that showed \u003ca style=\"color: #000000\" href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2109856\" target=\"_blank\" rel=\"noopener\">no link between the vaccine\u003c/a>and a change in teen sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In 2007, Gary Freed, a pediatrician and professor at the University of Michigan, chaired the National Vaccine Advisory Council, and told \u003ca style=\"color: #000000\" href=\"http://www.pbs.org/now/shows/308/hpv-vaccine.html\" target=\"_blank\" rel=\"noopener\">Now on PBS\u003c/a>: “If we have the ability to prevent any cancer deaths, much less a significant number of cancer deaths that affect a segment of our population that historically have not been necessarily as well served as they could have been, then I think it’s incumbent upon society to make sure that we’re able to prevent these cancers.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Freed said this latest study reinforces the idea that teens are not deciding whether to have sex based on the threat of receiving an HPV infection. This is partly because so few people have heard of HPV, and because “adolescents think in the here and now, not 40 years from now.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“We as a society need to decide how much we want to prevent cervical cancer for the children of today,” Freed said. “That’s really what this is all about. We can make pap smears a thing of the past.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. is not alone in its sluggish implementation of a vaccine that can prevent illness and death as a result of cervical cancer. In 2016, \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30099-7/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">a study published in the Lancet\u003c/a> reported that out of 64 nations and 12 territories, only 47 million women finished the three-dose HPV vaccine course. Most of those women lived in high-income or upper middle income countries, the study said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Access to HPV vaccination in low-income and lower-middle-income countries is almost non-existent, despite these countries carrying most of the burden of cervical cancer cases worldwide,” the report said.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Women Survive Heart Attack More Often When Doctor is Female, Study Finds",
"title": "Women Survive Heart Attack More Often When Doctor is Female, Study Finds",
"headTitle": "Women’s Health | KQED Future of You | KQED Science",
"content": "\u003cp>Much like shoes or skinny jeans, heart attacks can fit women a little differently than men. Their symptoms don’t always look the same, and for a meshwork of reasons, physicians all too often fail to diagnose heart attacks in women with enough time to intervene.\u003c/p>\n\u003cp>The consequence: Women are more likely to die from heart attacks than men are. But, according to a new study, not if they’re treated by female doctors.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1800097115\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, published Monday in Proceedings of the National Academy of Sciences, found that female patients are two to three times more likely to survive a heart attack when the doctor overseeing their care is also a woman. But the difference diminished when male doctors worked in emergency rooms with a higher percentage of female physicians.\u003c/p>\n\u003cp>In fact, both men and women suffering heart attacks fared better when treated by female doctors or when treated by men working alongside more female clinicians, the authors reported.\u003c/p>\n\u003cp>These findings raise an unavoidable question: Are women better doctors? And, does rubbing elbows with women physicians help men become better clinicians? The answers are more convoluted than the questions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Previous research has found better outcomes among hospitalized Medicare patients treated by women, but the underlying reasons remain murky at best.\u003c/p>\n\u003cp>“It’s important to not get caught up in the idea that women are better doctors,” said Dr. Klea Bertakis, a physician and researcher at the University of California, Davis, who studies gender dynamics in health care. “It’s not a men-against-women kind of thing, it’s what are the best practice styles and how can we teach them.”\u003c/p>\n\u003cp>Bertakis pointed to specific practice behaviors – female physicians tend to share more information with patients and to focus more on partnership and patient participation. Male physicians, on the other hand, tend to stick to “the facts,” emphasizing the patient history and physical exam, she said.\u003c/p>\n\u003cp>Dr. Sharonne Hayes, a cardiologist at the Mayo Women’s Heart Clinic, broke down one common explanation for the differences in outcomes for male and female heart attack patients — the symptoms.\u003c/p>\n\u003cp>During a heart attack, women are less likely to experience chest pain, and are more likely to present with nausea and vomiting. But Hayes pointed out that there are more similarities than differences: 30 percent of both men and women won’t experience chest pain, and men can have nausea, too. The symptom hypothesis doesn’t fully explain the different rates of diagnosis and survival.\u003c/p>\n\u003cp>Hayes suggested that part of the problem is that physicians and people in general are “still stuck with some confirmation bias about who gets a heart attack.”\u003c/p>\n\u003cp>The new study, conducted by three business school professors at the University of Minnesota, Washington University in St. Louis, and Harvard, started by looking at whether gender concordance between patients and the attending physicians in the emergency department influenced survival.\u003c/p>\n\u003cp>“There’s relatively deep streams of literature in economics, political science, and sociology that suggest when advocates differ from the people they advocate for, there are often penalties,” said lead author Brad Greenwood of Minnesota’s Carlson School of Management.\u003c/p>\n\u003cp>“Penalties” are business-speak that, when applied in an emergency room, refer to mortality. And “advocacy,” in this case, translates to physician care.\u003c/p>\n\u003cp>Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, Greenwood and his colleagues found that when the gender of the patient matched the gender of the physician, both male and female patients were more likely to survive.\u003c/p>\n\u003cp>Looking more closely at the data revealed that female patients treated by male physicians were the least likely to survive a heart attack.\u003c/p>\n\u003cp>The magnitude of the difference impressed Greenwood, but he was not surprised by its existence.\u003c/p>\n\u003cp>Greenwood and his co-authors took their research one step further, studying not only the physicians’ gender, but their environment. They found that patients were more likely to survive heart attacks when treated in emergency departments with higher percentages of female physicians.\u003c/p>\n\u003cp>Greenwood and co-author Seth Carnahan, of Washington University, were both hesitant to speculate about the reasons underlying their observations. Carnahan — who compared the patient-physician relationship to an employee-customer one — acknowledged that, as business professors, he and his colleagues lack the perspective of clinicians.\u003c/p>\n\u003cp>“We have expertise in analyzing data like this and thinking about organizational problems, but we don’t have the firsthand experience and knowledge that doctors have,” he said.\u003c/p>\n\u003cp>Hayes said their statistical analysis went beyond what most doctors could even “conceptualize,” but she and Bertakis expressed some concern over the study’s methods and conclusions. The data, now eight years old, might miss the impact of recent efforts to educate physicians and the public about gender differences in cardiovascular disease.\u003c/p>\n\u003cp>Both physicians also noted that the attending doctor used in the data analysis was likely the physician that discharged the patient — or signed their death certificate — which might not be the same doctor who treated the patient in the emergency room.\u003c/p>\n\u003cp>Bertakis took issue with the the study’s recommendation that one way to improve outcomes would be to increase the number of female physicians in the emergency department.\u003c/p>\n\u003cp>“These approaches are not likely to be feasible,” she said. Instead, she would focus on continuing to improve the curriculum in medical schools and in residency programs to teach physicians about gender differences — both at the patient and physician level — in cardiovascular care.\u003c/p>\n\u003cp>Hayes would like future research to focus on understanding why male physicians who work among more female doctors have better patient survival rates. “Where’s the education coming from? Is it in the hallways and at the watercooler?” she asked. “Or are there policy changes and practice changes?”\u003c/p>\n\u003cp>The new study is a launchpad to address these questions, she said: “Understanding differences in how we need to care for men and women — particularly with heart disease, but for many other conditions — is something we should all be teaching our medical students, and learning, and incorporating in our daily practice.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/08/06/heart-attacks-women-female-doctors/\" 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>Much like shoes or skinny jeans, heart attacks can fit women a little differently than men. Their symptoms don’t always look the same, and for a meshwork of reasons, physicians all too often fail to diagnose heart attacks in women with enough time to intervene.\u003c/p>\n\u003cp>The consequence: Women are more likely to die from heart attacks than men are. But, according to a new study, not if they’re treated by female doctors.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1800097115\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, published Monday in Proceedings of the National Academy of Sciences, found that female patients are two to three times more likely to survive a heart attack when the doctor overseeing their care is also a woman. But the difference diminished when male doctors worked in emergency rooms with a higher percentage of female physicians.\u003c/p>\n\u003cp>In fact, both men and women suffering heart attacks fared better when treated by female doctors or when treated by men working alongside more female clinicians, the authors reported.\u003c/p>\n\u003cp>These findings raise an unavoidable question: Are women better doctors? And, does rubbing elbows with women physicians help men become better clinicians? The answers are more convoluted than the questions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Previous research has found better outcomes among hospitalized Medicare patients treated by women, but the underlying reasons remain murky at best.\u003c/p>\n\u003cp>“It’s important to not get caught up in the idea that women are better doctors,” said Dr. Klea Bertakis, a physician and researcher at the University of California, Davis, who studies gender dynamics in health care. “It’s not a men-against-women kind of thing, it’s what are the best practice styles and how can we teach them.”\u003c/p>\n\u003cp>Bertakis pointed to specific practice behaviors – female physicians tend to share more information with patients and to focus more on partnership and patient participation. Male physicians, on the other hand, tend to stick to “the facts,” emphasizing the patient history and physical exam, she said.\u003c/p>\n\u003cp>Dr. Sharonne Hayes, a cardiologist at the Mayo Women’s Heart Clinic, broke down one common explanation for the differences in outcomes for male and female heart attack patients — the symptoms.\u003c/p>\n\u003cp>During a heart attack, women are less likely to experience chest pain, and are more likely to present with nausea and vomiting. But Hayes pointed out that there are more similarities than differences: 30 percent of both men and women won’t experience chest pain, and men can have nausea, too. The symptom hypothesis doesn’t fully explain the different rates of diagnosis and survival.\u003c/p>\n\u003cp>Hayes suggested that part of the problem is that physicians and people in general are “still stuck with some confirmation bias about who gets a heart attack.”\u003c/p>\n\u003cp>The new study, conducted by three business school professors at the University of Minnesota, Washington University in St. Louis, and Harvard, started by looking at whether gender concordance between patients and the attending physicians in the emergency department influenced survival.\u003c/p>\n\u003cp>“There’s relatively deep streams of literature in economics, political science, and sociology that suggest when advocates differ from the people they advocate for, there are often penalties,” said lead author Brad Greenwood of Minnesota’s Carlson School of Management.\u003c/p>\n\u003cp>“Penalties” are business-speak that, when applied in an emergency room, refer to mortality. And “advocacy,” in this case, translates to physician care.\u003c/p>\n\u003cp>Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, Greenwood and his colleagues found that when the gender of the patient matched the gender of the physician, both male and female patients were more likely to survive.\u003c/p>\n\u003cp>Looking more closely at the data revealed that female patients treated by male physicians were the least likely to survive a heart attack.\u003c/p>\n\u003cp>The magnitude of the difference impressed Greenwood, but he was not surprised by its existence.\u003c/p>\n\u003cp>Greenwood and his co-authors took their research one step further, studying not only the physicians’ gender, but their environment. They found that patients were more likely to survive heart attacks when treated in emergency departments with higher percentages of female physicians.\u003c/p>\n\u003cp>Greenwood and co-author Seth Carnahan, of Washington University, were both hesitant to speculate about the reasons underlying their observations. Carnahan — who compared the patient-physician relationship to an employee-customer one — acknowledged that, as business professors, he and his colleagues lack the perspective of clinicians.\u003c/p>\n\u003cp>“We have expertise in analyzing data like this and thinking about organizational problems, but we don’t have the firsthand experience and knowledge that doctors have,” he said.\u003c/p>\n\u003cp>Hayes said their statistical analysis went beyond what most doctors could even “conceptualize,” but she and Bertakis expressed some concern over the study’s methods and conclusions. The data, now eight years old, might miss the impact of recent efforts to educate physicians and the public about gender differences in cardiovascular disease.\u003c/p>\n\u003cp>Both physicians also noted that the attending doctor used in the data analysis was likely the physician that discharged the patient — or signed their death certificate — which might not be the same doctor who treated the patient in the emergency room.\u003c/p>\n\u003cp>Bertakis took issue with the the study’s recommendation that one way to improve outcomes would be to increase the number of female physicians in the emergency department.\u003c/p>\n\u003cp>“These approaches are not likely to be feasible,” she said. Instead, she would focus on continuing to improve the curriculum in medical schools and in residency programs to teach physicians about gender differences — both at the patient and physician level — in cardiovascular care.\u003c/p>\n\u003cp>Hayes would like future research to focus on understanding why male physicians who work among more female doctors have better patient survival rates. “Where’s the education coming from? Is it in the hallways and at the watercooler?” she asked. “Or are there policy changes and practice changes?”\u003c/p>\n\u003cp>The new study is a launchpad to address these questions, she said: “Understanding differences in how we need to care for men and women — particularly with heart disease, but for many other conditions — is something we should all be teaching our medical students, and learning, and incorporating in our daily practice.”\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/2018/08/06/heart-attacks-women-female-doctors/\" 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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"disqusTitle": "Heading May Be Riskier For Female Soccer Players Than Males",
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"content": "\u003cp>The first rule of soccer is pretty obvious: don't use your hands. But soccer's signature move, heading the ball, can cause a detectable impact on players' brains. And according to a study \u003ca href=\"https://pubs.rsna.org/doi/10.1148/radiol.2018180217\" target=\"_blank\" rel=\"noopener\">published Tuesday in Radiology\u003c/a>, female players are more sensitive to the impact than males.\u003c/p>\n\u003cp>The study authors found that female amateur soccer players who frequently head balls showed more white matter brain alterations than their male counterparts. The study included 49 women and 49 men, ages 18 to 50, and examined MRI imaging of players' brains. Each female player was compared to a male player of a similar age and with other similar characteristics including frequency of heading exposure.\u003c/p>\n\u003cp>Lead author \u003ca href=\"http://www.einstein.yu.edu/faculty/148/michael-lipton/\" target=\"_blank\" rel=\"noopener\">Michael Lipton\u003c/a>, a neuroradiologist and neuroscientist at Albert Einstein College of Medicine, says white matter in the brain can be compared to fiber optic cable, which connects a network of computer. White matter is made up thread-like axon nerve fibers that connect neurons to each other, and their protective covering, myelin.\u003c/p>\n\u003cp>Heading causes these brain tissues to become disorganized, Lipton says. His previous research found that these abnormalities accompany \u003ca href=\"https://www.einstein.yu.edu/docs/labs/michael-lipton/Soccer_heading_is_associated_with_WM.pdf\" target=\"_blank\" rel=\"noopener\">poorer cognitive function\u003c/a> associated with memory or attention issues when associated with heading.\u003c/p>\n\u003cp>\"The most important finding here is that we see that in women's brains, actually looking at brain tissue, there seems to be a greater sensitivity to repetitive, very low-level injury relative to men,\" he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An important note about this research, Lipton says, is that it isn't about concussions. Instead, it's measuring \"sub-concussive injuries,\" or repeated impacts that don't cause any immediate, acknowledged problem for the player, but could be problematic in the long-term.\u003c/p>\n\u003cp>\"It's actually more important to define what's happening in people that are not yet symptomatic, because that's where there's still an opportunity to head off long-term problems,\" he says.\u003c/p>\n\u003cp>It's already known that female soccer players are at a higher risk of concussion than males. Wellington Hsu, a professor of orthopedic surgery at Northwestern University, \u003ca href=\"http://aaos-annualmeeting-presskit.org/2017/research-news/concussions_hsu/\" target=\"_blank\" rel=\"noopener\">led a decade-long study\u003c/a> of injuries among high school athletes that found this.\u003c/p>\n\u003cp>But the current study gives additional evidence that women are more susceptible to the impact of heading, and shows more areas of women's brains are susceptible to potential injury than men's.\u003c/p>\n\u003cp>Hsu, who was not involved in the current study, says while it's not possible to draw firm conclusions from the study alone, it suggests a path forward for making the sport safer.\u003c/p>\n\u003cp>\"What I think this paper may lead to is further research in the preventative mechanisms of concussions, whether or not it's a brace or a helmet or heading technique or a different way we think about this in men and women,\" Hsu says.\u003c/p>\n\u003cp>Women \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC233178/\" target=\"_blank\" rel=\"noopener\">are more likely to report concussion-related symptoms\u003c/a> than men, but Lipton says there has been debate over whether women actually are more sensitive or just more likely to speak up.\u003c/p>\n\u003cp>This study confirms that there are changes in the tissue of women's brains after these repetitive hits from the soccer ball that are different from men in a similar situation.\u003c/p>\n\u003cp>\"This is the first time anybody has put a definitive piece of information behind what has been a contentious dispute as to whether women's brains are intrinsically more sensitive, or whether it's an artifact of reporting of symptoms,\" Lipton says.\u003c/p>\n\u003cp>It's unclear why women more biologically likely to be affected by repetitive heading. Lipton says it could have to do with sex hormones, or with the fact that women typically having less body and muscle mass than their male counterparts.\u003c/p>\n\u003cp>Thomas Kaminski, a professor of kinesiology and applied physiology at the University of Delaware, who was not involved in the study, says that the differences in these changes in the brain could have to do with neck strength. Women typically have weaker necks and smaller heads than men.\u003c/p>\n\u003cp>Does this research mean women should hang up their cleats forever? Probably not, says Lipton. There are a lot of \u003ca href=\"https://www.npr.org/sections/health-shots/2014/04/02/297910425/run-when-youre-25-for-a-sharper-brain-when-youre-45\" target=\"_blank\" rel=\"noopener\">brain health benefits to getting active\u003c/a>, and women are actually okay to head the ball up to a certain point.\u003c/p>\n\u003cp>\"We're not saying that you head the ball and then you're brain injured,\" Lipton says. \"The data consistently shows that there seems to be some level of exposure to these repeated impacts which is pretty well tolerated by most people. It's really a matter of figuring out how much is too much.\"\u003c/p>\n\u003cp>Lipton says he hopes to find out if there's a safe threshold on heading impact for women. The latest FIFA data shows \u003ca href=\"https://www.fifa.com/mm/document/fifafacts/bcoffsurv/emaga_9384_10704.pdf\" target=\"_blank\" rel=\"noopener\">265 million people play soccer\u003c/a> across the globe, and Lipton says, adverse effects when multiplied by that many people \"potentially [pose] a huge public health concern.\"\u003c/p>\n\u003cp>\"The problem isn't that [soccer is] creating all kinds of vegetative, brain damaged people,\" he says. \"But what's the potential benefit of athletics that's being given up by the effect of this kind of repeated head injury? And is there a way to strike a balance so that people can benefit maximally and not incur the adverse effects?\"\u003c/p>\n\u003cp>Kaminski says it would be interesting to take this research one step forward and explore this problem in youth. In the U.S., youth players can start heading the ball at age 11. He thinks it's worth questioning whether that age cutoff should be older. Parents are faced with the issue of wanting their kids to be active but safe at the same time, he says.\u003c/p>\n\u003cp>\"What happens if [children] head the ball ten times, or a hundred times?\" he says. \"Would you see these changes? Those are the big question marks I have.\"\u003c/p>\n\u003cp>Carla Garcia, a Brooklyn resident and participant in the study, has been playing soccer since she was five. Now 52, she says these results probably won't change the way she plays, but if she were younger, she would consider heading the ball a bit less. She joined the study as a way to give back to the sport she loves — and she even wants to donate her brain to science to help researchers understand brain injuries.\u003c/p>\n\u003cp>\"I think it probably over the long term will have an effect on the way that younger women and younger people play, and I got involved for that reason,\" she says. \"I thought that Dr. Lipton and his colleagues could find the way to make it safer for kids to play.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Sara Kiley Watson is NPR's Science desk intern.\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=Heading+May+Be+Riskier+For+Female+Soccer+Players+Than+Males&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first rule of soccer is pretty obvious: don't use your hands. But soccer's signature move, heading the ball, can cause a detectable impact on players' brains. And according to a study \u003ca href=\"https://pubs.rsna.org/doi/10.1148/radiol.2018180217\" target=\"_blank\" rel=\"noopener\">published Tuesday in Radiology\u003c/a>, female players are more sensitive to the impact than males.\u003c/p>\n\u003cp>The study authors found that female amateur soccer players who frequently head balls showed more white matter brain alterations than their male counterparts. The study included 49 women and 49 men, ages 18 to 50, and examined MRI imaging of players' brains. Each female player was compared to a male player of a similar age and with other similar characteristics including frequency of heading exposure.\u003c/p>\n\u003cp>Lead author \u003ca href=\"http://www.einstein.yu.edu/faculty/148/michael-lipton/\" target=\"_blank\" rel=\"noopener\">Michael Lipton\u003c/a>, a neuroradiologist and neuroscientist at Albert Einstein College of Medicine, says white matter in the brain can be compared to fiber optic cable, which connects a network of computer. White matter is made up thread-like axon nerve fibers that connect neurons to each other, and their protective covering, myelin.\u003c/p>\n\u003cp>Heading causes these brain tissues to become disorganized, Lipton says. His previous research found that these abnormalities accompany \u003ca href=\"https://www.einstein.yu.edu/docs/labs/michael-lipton/Soccer_heading_is_associated_with_WM.pdf\" target=\"_blank\" rel=\"noopener\">poorer cognitive function\u003c/a> associated with memory or attention issues when associated with heading.\u003c/p>\n\u003cp>\"The most important finding here is that we see that in women's brains, actually looking at brain tissue, there seems to be a greater sensitivity to repetitive, very low-level injury relative to men,\" he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An important note about this research, Lipton says, is that it isn't about concussions. Instead, it's measuring \"sub-concussive injuries,\" or repeated impacts that don't cause any immediate, acknowledged problem for the player, but could be problematic in the long-term.\u003c/p>\n\u003cp>\"It's actually more important to define what's happening in people that are not yet symptomatic, because that's where there's still an opportunity to head off long-term problems,\" he says.\u003c/p>\n\u003cp>It's already known that female soccer players are at a higher risk of concussion than males. Wellington Hsu, a professor of orthopedic surgery at Northwestern University, \u003ca href=\"http://aaos-annualmeeting-presskit.org/2017/research-news/concussions_hsu/\" target=\"_blank\" rel=\"noopener\">led a decade-long study\u003c/a> of injuries among high school athletes that found this.\u003c/p>\n\u003cp>But the current study gives additional evidence that women are more susceptible to the impact of heading, and shows more areas of women's brains are susceptible to potential injury than men's.\u003c/p>\n\u003cp>Hsu, who was not involved in the current study, says while it's not possible to draw firm conclusions from the study alone, it suggests a path forward for making the sport safer.\u003c/p>\n\u003cp>\"What I think this paper may lead to is further research in the preventative mechanisms of concussions, whether or not it's a brace or a helmet or heading technique or a different way we think about this in men and women,\" Hsu says.\u003c/p>\n\u003cp>Women \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC233178/\" target=\"_blank\" rel=\"noopener\">are more likely to report concussion-related symptoms\u003c/a> than men, but Lipton says there has been debate over whether women actually are more sensitive or just more likely to speak up.\u003c/p>\n\u003cp>This study confirms that there are changes in the tissue of women's brains after these repetitive hits from the soccer ball that are different from men in a similar situation.\u003c/p>\n\u003cp>\"This is the first time anybody has put a definitive piece of information behind what has been a contentious dispute as to whether women's brains are intrinsically more sensitive, or whether it's an artifact of reporting of symptoms,\" Lipton says.\u003c/p>\n\u003cp>It's unclear why women more biologically likely to be affected by repetitive heading. Lipton says it could have to do with sex hormones, or with the fact that women typically having less body and muscle mass than their male counterparts.\u003c/p>\n\u003cp>Thomas Kaminski, a professor of kinesiology and applied physiology at the University of Delaware, who was not involved in the study, says that the differences in these changes in the brain could have to do with neck strength. Women typically have weaker necks and smaller heads than men.\u003c/p>\n\u003cp>Does this research mean women should hang up their cleats forever? Probably not, says Lipton. There are a lot of \u003ca href=\"https://www.npr.org/sections/health-shots/2014/04/02/297910425/run-when-youre-25-for-a-sharper-brain-when-youre-45\" target=\"_blank\" rel=\"noopener\">brain health benefits to getting active\u003c/a>, and women are actually okay to head the ball up to a certain point.\u003c/p>\n\u003cp>\"We're not saying that you head the ball and then you're brain injured,\" Lipton says. \"The data consistently shows that there seems to be some level of exposure to these repeated impacts which is pretty well tolerated by most people. It's really a matter of figuring out how much is too much.\"\u003c/p>\n\u003cp>Lipton says he hopes to find out if there's a safe threshold on heading impact for women. The latest FIFA data shows \u003ca href=\"https://www.fifa.com/mm/document/fifafacts/bcoffsurv/emaga_9384_10704.pdf\" target=\"_blank\" rel=\"noopener\">265 million people play soccer\u003c/a> across the globe, and Lipton says, adverse effects when multiplied by that many people \"potentially [pose] a huge public health concern.\"\u003c/p>\n\u003cp>\"The problem isn't that [soccer is] creating all kinds of vegetative, brain damaged people,\" he says. \"But what's the potential benefit of athletics that's being given up by the effect of this kind of repeated head injury? And is there a way to strike a balance so that people can benefit maximally and not incur the adverse effects?\"\u003c/p>\n\u003cp>Kaminski says it would be interesting to take this research one step forward and explore this problem in youth. In the U.S., youth players can start heading the ball at age 11. He thinks it's worth questioning whether that age cutoff should be older. Parents are faced with the issue of wanting their kids to be active but safe at the same time, he says.\u003c/p>\n\u003cp>\"What happens if [children] head the ball ten times, or a hundred times?\" he says. \"Would you see these changes? Those are the big question marks I have.\"\u003c/p>\n\u003cp>Carla Garcia, a Brooklyn resident and participant in the study, has been playing soccer since she was five. Now 52, she says these results probably won't change the way she plays, but if she were younger, she would consider heading the ball a bit less. She joined the study as a way to give back to the sport she loves — and she even wants to donate her brain to science to help researchers understand brain injuries.\u003c/p>\n\u003cp>\"I think it probably over the long term will have an effect on the way that younger women and younger people play, and I got involved for that reason,\" she says. \"I thought that Dr. Lipton and his colleagues could find the way to make it safer for kids to play.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Sara Kiley Watson is NPR's Science desk intern.\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=Heading+May+Be+Riskier+For+Female+Soccer+Players+Than+Males&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hospitals Gear Up For New Diagnosis: Human Trafficking",
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"headTitle": "Women’s Health | KQED Future of You | KQED Science",
"content": "\u003cp>The woman arrived at the emergency department at Huntington Hospital on New York's Long Island after she was hit by her boyfriend during an argument. Her situation raised concerns among the medical staff, which had recently been trained to be on the lookout for signs of sex trafficking.\u003c/p>\n\u003cp>An undocumented immigrant from El Salvador, she worked at a local cantina frequented by immigrants. Her job was to get patrons drinks and to dance with them, but many workers in those jobs are expected to offer sex, too. Her boyfriend didn't want her to work there, and that led to the fight, one doctor recalled.\u003c/p>\n\u003cp>As part of the intake process, the emergency staff asked the 36-year-old woman a series of questions about whether she'd ever had sex for money, or whether she had to give someone else part of what she earns, among other things. The screening questions were part of a new program at Northwell Health, a 23-hospital system in the New York metro area that includes Huntington Hospital, to train staff and provide them with \u003ca href=\"https://www.northwell.edu/about/news/press-releases/training-staff-identify-help-human-trafficking-victims\" target=\"_blank\" rel=\"noopener\">tools to identify and support victims of human trafficking\u003c/a>.\u003c/p>\n\u003cp>There are few hard figures for how many people are harmed by human trafficking, the term used when individuals are forced to work or have sex for someone else's commercial benefit. Polaris, a Washington, D.C.-based nonprofit that \u003ca href=\"https://humantraffickinghotline.org/type-trafficking/human-trafficking\" target=\"_blank\" rel=\"noopener\">advocates for these people and runs help lines\u003c/a> for them, says calls and texts to its national hotlines have\u003ca href=\"http://polarisproject.org/sites/default/files/2017NHTHStats%20%281%29.pdf\" target=\"_blank\" rel=\"noopener\"> steadily ticked up in recent years\u003c/a>, increasing the number of cases 13 percent to 8,759 between 2016 and 2017.\u003c/p>\n\u003cp>But health care providers frequently fail to recognize these patients' situation. According to a \u003ca href=\"http://www.globalcenturion.org/wp-content/uploads/2014/08/The-Health-Consequences-of-Sex-Trafficking.pdf\" target=\"_blank\" rel=\"noopener\">2014 survey of about 100 survivors of sex trafficking\u003c/a>, 88 percent said that while they were being trafficked they had contact with a health care provider, typically someone in an emergency department.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"When trafficking victims come through the health care system but we don't identify them, it's a big missed opportunity,\" says Dr. Santhosh Paulus, a family physician who is the site director of the Huntington Hospital's family medicine residency program and who started the program at Northwell.\u003c/p>\n\u003cp>Northwell is one of a growing number of hospitals and health care systems that are putting such programs in place. They want to alert staff to be on the lookout for trafficking, much as they watch for signs of child abuse, domestic violence and elder abuse.\u003c/p>\n\u003cp>Since last spring, nearly 300 staff members at Huntington Hospital and a family clinic have received training in how to spot trafficking victims and how to help them.\u003c/p>\n\u003cp>Training is given not only to doctors and nurses but also to registration and reception staff, social workers and security guards. Restore NYC, an organization that assists people caught up in sex trafficking, provided the initial training to key staff, and a hospital task force trains the others. During the next few years, similar efforts will be rolled out at all of Northwell's 23 hospitals, Paulus says.\u003c/p>\n\u003cp>Identifying victims of trafficking is not unlike identifying victims of other forms of violence, says Dr. Wendy Macias-Konstantopoulos, director of the \u003ca href=\"https://www.massgeneral.org/emergencymedicineglobalhealth/initiatives/Human-Trafficking-Initiative.aspx\" target=\"_blank\" rel=\"noopener\">Human Trafficking Initiative\u003c/a> at Massachusetts General Hospital in Boston.\u003c/p>\n\u003cp>One of the big red flags is when people delay coming in for medical care, such as waiting weeks to come in to get an injured ankle or sexually transmitted infection checked out, Macias-Konstantopoulos says. Or it may be a pattern of injuries that don't make sense. Sometimes people are reluctant to explain their injury, or they come in with someone who seems overbearing.\u003c/p>\n\u003cp>\"Having a high index of suspicion is the first step,\" she says. \"If we're not asking about it, we're just not going to see it.\"\u003c/p>\n\u003cp>Starting in October, health care providers can also start \u003ca href=\"https://www.aha.org/system/files/2018-07/icd-10-code-human-trafficking_0.pdf\" target=\"_blank\" rel=\"noopener\">using new diagnosis codes\u003c/a> in their records to differentiate trafficking from other types of abuse. This will help track the number of victims and provide appropriate treatment.\u003c/p>\n\u003cp>Asking may not be enough, however. Depending on what's going on in their lives, these patients may not be willing or ready to acknowledge that they need help, says \u003ca href=\"https://www.traffickinginstitute.org/holly-austin-gibbs-joins-the-human-trafficking-institute/\" target=\"_blank\" rel=\"noopener\">Holly Gibbs\u003c/a>, human trafficking response program director for Dignity Health, a health care system with nearly 40 hospitals in California, Nevada and Arizona.\u003c/p>\n\u003cp>Gibbs knows the issue well. She was forced briefly into prostitution in Atlantic City, N.J., after meeting a man at a shopping mall as a 14-year-old and running away with him. The man persuaded Gibbs to go with him with promises of a new, glamorous life as a musician or model.\u003c/p>\n\u003cp>At the time, Gibbs says, she thought that what happened to her was her own fault, a result of choices she made. No health care or law enforcement professional connected her to social services that could have helped her understand otherwise. She was reunited with her family by law enforcement personnel, who arrested the man, who was later convicted.\u003c/p>\n\u003cp>Dignity Health has implemented a human trafficking response program in the emergency departments and labor and delivery areas of each of its hospitals. Now it's rolling out the program at clinics and physicians' offices as well.\u003c/p>\n\u003cp>A key priority is to help clinicians know how to talk to patients about any violence they may be facing and to connect the patients with outside sources of help.\u003c/p>\n\u003cp>But in the end, if these patients don't want assistance, \"you respect their wishes,\" Gibbs says. \"They may not be ready to accept help now, but you may plant seeds so they'll be able to accept it later on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>\u003cem> is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that isn't affiliated with Kaiser Permanente. You can follow Michelle Andrews on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\" target=\"_blank\" rel=\"noopener\">@mandrews110\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hospitals+Gear+Up+For+New+Diagnosis%3A+Human+Trafficking+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Many people forced into labor or the sex trade seek medical help at some point, and health care workers are being trained to identify them and to offer assistance. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The woman arrived at the emergency department at Huntington Hospital on New York's Long Island after she was hit by her boyfriend during an argument. Her situation raised concerns among the medical staff, which had recently been trained to be on the lookout for signs of sex trafficking.\u003c/p>\n\u003cp>An undocumented immigrant from El Salvador, she worked at a local cantina frequented by immigrants. Her job was to get patrons drinks and to dance with them, but many workers in those jobs are expected to offer sex, too. Her boyfriend didn't want her to work there, and that led to the fight, one doctor recalled.\u003c/p>\n\u003cp>As part of the intake process, the emergency staff asked the 36-year-old woman a series of questions about whether she'd ever had sex for money, or whether she had to give someone else part of what she earns, among other things. The screening questions were part of a new program at Northwell Health, a 23-hospital system in the New York metro area that includes Huntington Hospital, to train staff and provide them with \u003ca href=\"https://www.northwell.edu/about/news/press-releases/training-staff-identify-help-human-trafficking-victims\" target=\"_blank\" rel=\"noopener\">tools to identify and support victims of human trafficking\u003c/a>.\u003c/p>\n\u003cp>There are few hard figures for how many people are harmed by human trafficking, the term used when individuals are forced to work or have sex for someone else's commercial benefit. Polaris, a Washington, D.C.-based nonprofit that \u003ca href=\"https://humantraffickinghotline.org/type-trafficking/human-trafficking\" target=\"_blank\" rel=\"noopener\">advocates for these people and runs help lines\u003c/a> for them, says calls and texts to its national hotlines have\u003ca href=\"http://polarisproject.org/sites/default/files/2017NHTHStats%20%281%29.pdf\" target=\"_blank\" rel=\"noopener\"> steadily ticked up in recent years\u003c/a>, increasing the number of cases 13 percent to 8,759 between 2016 and 2017.\u003c/p>\n\u003cp>But health care providers frequently fail to recognize these patients' situation. According to a \u003ca href=\"http://www.globalcenturion.org/wp-content/uploads/2014/08/The-Health-Consequences-of-Sex-Trafficking.pdf\" target=\"_blank\" rel=\"noopener\">2014 survey of about 100 survivors of sex trafficking\u003c/a>, 88 percent said that while they were being trafficked they had contact with a health care provider, typically someone in an emergency department.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"When trafficking victims come through the health care system but we don't identify them, it's a big missed opportunity,\" says Dr. Santhosh Paulus, a family physician who is the site director of the Huntington Hospital's family medicine residency program and who started the program at Northwell.\u003c/p>\n\u003cp>Northwell is one of a growing number of hospitals and health care systems that are putting such programs in place. They want to alert staff to be on the lookout for trafficking, much as they watch for signs of child abuse, domestic violence and elder abuse.\u003c/p>\n\u003cp>Since last spring, nearly 300 staff members at Huntington Hospital and a family clinic have received training in how to spot trafficking victims and how to help them.\u003c/p>\n\u003cp>Training is given not only to doctors and nurses but also to registration and reception staff, social workers and security guards. Restore NYC, an organization that assists people caught up in sex trafficking, provided the initial training to key staff, and a hospital task force trains the others. During the next few years, similar efforts will be rolled out at all of Northwell's 23 hospitals, Paulus says.\u003c/p>\n\u003cp>Identifying victims of trafficking is not unlike identifying victims of other forms of violence, says Dr. Wendy Macias-Konstantopoulos, director of the \u003ca href=\"https://www.massgeneral.org/emergencymedicineglobalhealth/initiatives/Human-Trafficking-Initiative.aspx\" target=\"_blank\" rel=\"noopener\">Human Trafficking Initiative\u003c/a> at Massachusetts General Hospital in Boston.\u003c/p>\n\u003cp>One of the big red flags is when people delay coming in for medical care, such as waiting weeks to come in to get an injured ankle or sexually transmitted infection checked out, Macias-Konstantopoulos says. Or it may be a pattern of injuries that don't make sense. Sometimes people are reluctant to explain their injury, or they come in with someone who seems overbearing.\u003c/p>\n\u003cp>\"Having a high index of suspicion is the first step,\" she says. \"If we're not asking about it, we're just not going to see it.\"\u003c/p>\n\u003cp>Starting in October, health care providers can also start \u003ca href=\"https://www.aha.org/system/files/2018-07/icd-10-code-human-trafficking_0.pdf\" target=\"_blank\" rel=\"noopener\">using new diagnosis codes\u003c/a> in their records to differentiate trafficking from other types of abuse. This will help track the number of victims and provide appropriate treatment.\u003c/p>\n\u003cp>Asking may not be enough, however. Depending on what's going on in their lives, these patients may not be willing or ready to acknowledge that they need help, says \u003ca href=\"https://www.traffickinginstitute.org/holly-austin-gibbs-joins-the-human-trafficking-institute/\" target=\"_blank\" rel=\"noopener\">Holly Gibbs\u003c/a>, human trafficking response program director for Dignity Health, a health care system with nearly 40 hospitals in California, Nevada and Arizona.\u003c/p>\n\u003cp>Gibbs knows the issue well. She was forced briefly into prostitution in Atlantic City, N.J., after meeting a man at a shopping mall as a 14-year-old and running away with him. The man persuaded Gibbs to go with him with promises of a new, glamorous life as a musician or model.\u003c/p>\n\u003cp>At the time, Gibbs says, she thought that what happened to her was her own fault, a result of choices she made. No health care or law enforcement professional connected her to social services that could have helped her understand otherwise. She was reunited with her family by law enforcement personnel, who arrested the man, who was later convicted.\u003c/p>\n\u003cp>Dignity Health has implemented a human trafficking response program in the emergency departments and labor and delivery areas of each of its hospitals. Now it's rolling out the program at clinics and physicians' offices as well.\u003c/p>\n\u003cp>A key priority is to help clinicians know how to talk to patients about any violence they may be facing and to connect the patients with outside sources of help.\u003c/p>\n\u003cp>But in the end, if these patients don't want assistance, \"you respect their wishes,\" Gibbs says. \"They may not be ready to accept help now, but you may plant seeds so they'll be able to accept it later on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>\u003cem> is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that isn't affiliated with Kaiser Permanente. You can follow Michelle Andrews on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\" target=\"_blank\" rel=\"noopener\">@mandrews110\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hospitals+Gear+Up+For+New+Diagnosis%3A+Human+Trafficking+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hormone Levels Likely Influence A Woman's Risk Of Alzheimer's. But Exactly How?",
"title": "Hormone Levels Likely Influence A Woman's Risk Of Alzheimer's. But Exactly How?",
"headTitle": "Women’s Health | KQED Future of You | KQED Science",
"content": "\u003cp>There's new evidence that a woman's levels of female sex hormones, including estrogen and progesterone, can influence her risk of Alzheimer's and other forms of dementia.[contextly_sidebar id=\"rPJOdHYPkIXQXRx2JEsrHPZVgzMtEJk7\"]\u003c/p>\n\u003cp>Women are less likely to develop dementia later in life if they begin to menstruate earlier, go through menopause later, and have more than one child, researchers \u003ca href=\"https://www.alz.org/aaic/pressroom.asp\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> Monday at the \u003ca href=\"https://www.alz.org/aaic/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association International Conference\u003c/a> in Chicago.\u003c/p>\n\u003cp>And recent studies offer hints that \u003ca href=\"https://medlineplus.gov/hormonereplacementtherapy.html\" target=\"_blank\" rel=\"noopener\">hormone replacement therapy\u003c/a>, which fell out of favor more than a decade ago, might offer a way to protect a woman's brain if it is given at the right time, the researchers said.\u003c/p>\n\u003cp>The findings could help explain why women make up nearly two-thirds of people in the U.S. with Alzheimer's, says \u003ca href=\"http://nationalacademies.org/hmd/Activities/Research/NeuroForum/Member%20Profiles/Maria%20Carrillo.aspx\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, the association's chief scientific officer.\u003c/p>\n\u003cp>\"It isn't just that women are living longer,\" Carrillo says. \"There is some biological underpinning. And because of the large numbers of women that are affected, it is important to find out [what it is].\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Scientists have long suspected that sex hormones such as estrogen and progesterone play a role in Alzheimer's. And two studies on dementia and what occurs during a women's reproductive years support that idea.[contextly_sidebar id=\"Wwp2fmV71pvuOzg04oa6uZxzPex1NtQ3\"]\u003c/p>\n\u003cp>One of the studies looked at nearly 15,000 women in California. And it found an association between a woman's reproductive history and her risk of memory problems later in life.\u003c/p>\n\u003cp>The risk of dementia for women who had three or more children was 12 percent lower than the risk for women who had one child, according to \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/gilsanz-paola\" target=\"_blank\" rel=\"noopener\">Paola Gilsanz\u003c/a> of Kaiser Permanente Northern California Division of Research, and \u003ca href=\"https://profiles.ucsf.edu/rachel.whitmer\" target=\"_blank\" rel=\"noopener\">Rachel Whitmer\u003c/a> of the University of California, Davis.\u003c/p>\n\u003cp>Also, women who began to menstruate earlier and went through menopause later were less likely to develop dementia. Menopause at age 45 or younger seemed to increase the risk by 28 percent.\u003c/p>\n\u003cp>Another study of 133 elderly women in the U.K. found that the more months of pregnancy they experienced during their lives, the lower their risk of developing Alzheimer's.\u003c/p>\n\u003cp>The findings all suggest that female sex hormones — which rise at puberty and during pregnancy, then fall at menopause — are somehow affecting a woman's risk of developing Alzheimer's and other forms of dementia. The results also suggest that greater exposure to these hormones, through more pregnancies or more reproductive years, can reduce a woman's risk.\u003c/p>\n\u003cp>But it's still not clear whether the mere presence of female sex hormones is a reason that the frequency of Alzheimer's is greater in women than in men.\u003c/p>\n\u003cp>One possibility is that it's not female sex hormones on their own, but rapid changes in their levels that are a problem, says \u003ca href=\"https://crwg.uic.edu/crwg-home/crwg-staff/pauline-maki-phd/\" target=\"_blank\" rel=\"noopener\">Pauline Maki\u003c/a>, a professor of psychiatry and psychology at the University of Illinois at Chicago, who presented research at the Alzheimer's conference.[contextly_sidebar id=\"YEYwp8N3sM3v9aN2dUZdqE3yWweQzhJS\"]\u003c/p>\n\u003cp>\"Women experience these very dramatic hormonal transitions that in the long run can give rise to Alzheimer's disease,\" she says.\u003c/p>\n\u003cp>One way for women to minimize the dramatic hormonal changes that occur at menopause is to use hormone replacement therapy.\u003c/p>\n\u003cp>That approach fell out of favor more than a decade ago when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/12771112\" target=\"_blank\" rel=\"noopener\">large study\u003c/a> found that women who took estrogen plus progestin after menopause were actually more likely to get some form of dementia. They also appeared to have a higher risk of heart disease and breast cancer.\u003c/p>\n\u003cp>But Maki says more recent studies suggest that hormone therapy — especially estrogen alone — really can be helpful if women get it at the right time.\u003c/p>\n\u003cp>\"The effects of hormone therapy depend on the timing of use,\" Maki says. \"Use later in life is detrimental, whereas use early in the menopausal transition could be beneficial.\"\u003c/p>\n\u003cp>An analysis presented at the Alzheimer's conference supports that idea.\u003c/p>\n\u003cp>It found that in two recent studies, women who started taking estrogen after age 65 were more likely to have trouble with thinking and memory. But women who started taking estrogen between 50 and 54 were not.\u003c/p>\n\u003cp>And estrogen may benefit the mental function of younger women because it reduces the hot flashes associated with menopause, Maki says.[contextly_sidebar id=\"v9bruUJ5zucWs4sZPfqccXVqvwa2qouD\"]\u003c/p>\n\u003cp>\"The more hot flashes a woman has, the worse her memory performance,\" Maki says, citing her own research. \"And when we intervene to address those hot flashes, her memory performance bounces back.\"\u003c/p>\n\u003cp>Findings like that are renewing interest in the idea that someday, it may be possible to use hormones around the time of menopause to prevent Alzheimer's and other forms of dementia later on, Maki says.\u003c/p>\n\u003cp>In the meantime, there's evidence that hormonal differences between men and women may affect their brains in ways that affect doctors' ability to accurately diagnose Alzheimer's, Maki says.\u003c/p>\n\u003cp>At the Alzheimer's conference, she presented research showing that women tend to have higher verbal memory skills than men, even when they are in the early stages of Alzheimer's. As a result, women are likely to be diagnosed with the disease later than men.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's unclear whether male hormones, such as testosterone, affect a man's risk of Alzheimer's.\u003c/p>\n\u003chr>\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=Hormone+Levels+Likely+Influence+A+Woman%27s+Risk+Of+Alzheimer%27s.+But+Exactly+How%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There's new evidence that a woman's levels of female sex hormones, including estrogen and progesterone, can influence her risk of Alzheimer's and other forms of dementia.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Women are less likely to develop dementia later in life if they begin to menstruate earlier, go through menopause later, and have more than one child, researchers \u003ca href=\"https://www.alz.org/aaic/pressroom.asp\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> Monday at the \u003ca href=\"https://www.alz.org/aaic/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association International Conference\u003c/a> in Chicago.\u003c/p>\n\u003cp>And recent studies offer hints that \u003ca href=\"https://medlineplus.gov/hormonereplacementtherapy.html\" target=\"_blank\" rel=\"noopener\">hormone replacement therapy\u003c/a>, which fell out of favor more than a decade ago, might offer a way to protect a woman's brain if it is given at the right time, the researchers said.\u003c/p>\n\u003cp>The findings could help explain why women make up nearly two-thirds of people in the U.S. with Alzheimer's, says \u003ca href=\"http://nationalacademies.org/hmd/Activities/Research/NeuroForum/Member%20Profiles/Maria%20Carrillo.aspx\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, the association's chief scientific officer.\u003c/p>\n\u003cp>\"It isn't just that women are living longer,\" Carrillo says. \"There is some biological underpinning. And because of the large numbers of women that are affected, it is important to find out [what it is].\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Scientists have long suspected that sex hormones such as estrogen and progesterone play a role in Alzheimer's. And two studies on dementia and what occurs during a women's reproductive years support that idea.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>One of the studies looked at nearly 15,000 women in California. And it found an association between a woman's reproductive history and her risk of memory problems later in life.\u003c/p>\n\u003cp>The risk of dementia for women who had three or more children was 12 percent lower than the risk for women who had one child, according to \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/gilsanz-paola\" target=\"_blank\" rel=\"noopener\">Paola Gilsanz\u003c/a> of Kaiser Permanente Northern California Division of Research, and \u003ca href=\"https://profiles.ucsf.edu/rachel.whitmer\" target=\"_blank\" rel=\"noopener\">Rachel Whitmer\u003c/a> of the University of California, Davis.\u003c/p>\n\u003cp>Also, women who began to menstruate earlier and went through menopause later were less likely to develop dementia. Menopause at age 45 or younger seemed to increase the risk by 28 percent.\u003c/p>\n\u003cp>Another study of 133 elderly women in the U.K. found that the more months of pregnancy they experienced during their lives, the lower their risk of developing Alzheimer's.\u003c/p>\n\u003cp>The findings all suggest that female sex hormones — which rise at puberty and during pregnancy, then fall at menopause — are somehow affecting a woman's risk of developing Alzheimer's and other forms of dementia. The results also suggest that greater exposure to these hormones, through more pregnancies or more reproductive years, can reduce a woman's risk.\u003c/p>\n\u003cp>But it's still not clear whether the mere presence of female sex hormones is a reason that the frequency of Alzheimer's is greater in women than in men.\u003c/p>\n\u003cp>One possibility is that it's not female sex hormones on their own, but rapid changes in their levels that are a problem, says \u003ca href=\"https://crwg.uic.edu/crwg-home/crwg-staff/pauline-maki-phd/\" target=\"_blank\" rel=\"noopener\">Pauline Maki\u003c/a>, a professor of psychiatry and psychology at the University of Illinois at Chicago, who presented research at the Alzheimer's conference.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Women experience these very dramatic hormonal transitions that in the long run can give rise to Alzheimer's disease,\" she says.\u003c/p>\n\u003cp>One way for women to minimize the dramatic hormonal changes that occur at menopause is to use hormone replacement therapy.\u003c/p>\n\u003cp>That approach fell out of favor more than a decade ago when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/12771112\" target=\"_blank\" rel=\"noopener\">large study\u003c/a> found that women who took estrogen plus progestin after menopause were actually more likely to get some form of dementia. They also appeared to have a higher risk of heart disease and breast cancer.\u003c/p>\n\u003cp>But Maki says more recent studies suggest that hormone therapy — especially estrogen alone — really can be helpful if women get it at the right time.\u003c/p>\n\u003cp>\"The effects of hormone therapy depend on the timing of use,\" Maki says. \"Use later in life is detrimental, whereas use early in the menopausal transition could be beneficial.\"\u003c/p>\n\u003cp>An analysis presented at the Alzheimer's conference supports that idea.\u003c/p>\n\u003cp>It found that in two recent studies, women who started taking estrogen after age 65 were more likely to have trouble with thinking and memory. But women who started taking estrogen between 50 and 54 were not.\u003c/p>\n\u003cp>And estrogen may benefit the mental function of younger women because it reduces the hot flashes associated with menopause, Maki says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The more hot flashes a woman has, the worse her memory performance,\" Maki says, citing her own research. \"And when we intervene to address those hot flashes, her memory performance bounces back.\"\u003c/p>\n\u003cp>Findings like that are renewing interest in the idea that someday, it may be possible to use hormones around the time of menopause to prevent Alzheimer's and other forms of dementia later on, Maki says.\u003c/p>\n\u003cp>In the meantime, there's evidence that hormonal differences between men and women may affect their brains in ways that affect doctors' ability to accurately diagnose Alzheimer's, Maki says.\u003c/p>\n\u003cp>At the Alzheimer's conference, she presented research showing that women tend to have higher verbal memory skills than men, even when they are in the early stages of Alzheimer's. As a result, women are likely to be diagnosed with the disease later than men.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's unclear whether male hormones, such as testosterone, affect a man's risk of Alzheimer's.\u003c/p>\n\u003chr>\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=Hormone+Levels+Likely+Influence+A+Woman%27s+Risk+Of+Alzheimer%27s.+But+Exactly+How%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>For most women under 65, a visit to the gynecologist often includes an unpleasant necessity: a Pap smear to check for cervical cancer risk.\u003c/p>\n\u003cp>The test involves letting a doctor or nurse scrape cells from the back of the cervix, which are visually inspected for signs of abnormality.\u003c/p>\n\u003cp>There's another way to screen for cervical cancer risk, by directly testing for the human papillomavirus, or HPV, which causes 99 percent of cervical cancer. \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7464\" target=\"_blank\" rel=\"noopener\"> A study published in JAMA\u003c/a> Tuesday suggests that method might be preferable for women age 30 and over.\u003c/p>\n\u003cp>The FDA in 2014 approved the first HPV test, which tests cervical cells for the presence of HPV.\u003c/p>\n\u003cp>HPV testing also can be done on samples of vaginal and cervical secretions that clinicians or women themselves gather with a swab — a less invasive process than the Pap. That process was shown to be accurate in multiple studies but is not yet used in clinical practice in the U.S.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new study, called the HPV FOCAL trial, compared the HPV test with traditional Pap smear screening among 19,000 Canadian women over four years. It adds to a body of research suggesting that HPV testing might be more accurate.\u003c/p>\n\u003cp>\"In our world this study is going to be a pretty big deal, in a good way,\" says \u003ca href=\"https://faculty.mdanderson.org/profiles/kathleen_schmeler.html\" target=\"_blank\" rel=\"noopener\">Dr. Kathleen Schmeler\u003c/a>, a gynecologic oncologist at the University of Texas MD Anderson Cancer Center.\u003c/p>\n\u003cp>Schmeler says that in the U.S., it has been hard to justify replacing the Pap smear with the HPV test because there has not been a head-to-head comparison until now.\u003c/p>\n\u003cp>The issue is not resolved. Some are still skeptical of relying on HPV testing alone, and co-testing, or using both the HPV test and a Pap smear, is still the standard.\u003c/p>\n\u003cp>Cervical cancer screening is essential because nearly \u003ca href=\"https://gis.cdc.gov/Cancer/USCS/DataViz.html\" target=\"_blank\" rel=\"noopener\">13,000 women in the U.S. are diagnosed with cervical cancer\u003c/a> annually. More than 4,000 women die from it, even with screening and treatment.\u003c/p>\n\u003cp>Current screening guidelines from the U.S. Preventive Services Task Force recommend women ages 30 to 65 have a Pap smear every three years, or every five years if an HPV test is done at the same time.\u003c/p>\n\u003cp>But \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/cervical-cancer-screening2\" target=\"_blank\" rel=\"noopener\">draft recommendations issued last fall by USPSTF\u003c/a> recommended just one or the other — a Pap smear or an HPV test — instead of co-testing for women 30 and up. The organization has yet to issue final guidelines. This new study could prove important in deciding practice guidelines.\u003c/p>\n\u003cp>At the start of the HPV FOCAL trial, some women received HPV testing and some had a Pap smear; those in the Pap smear group who tested negative had a second Pap after two years. Both groups were tested again using both methods after four years.\u003c/p>\n\u003cp>Neither method was foolproof. The final round of co-testing found additional abnormal cells in some women who originally tested negative in both groups. Women who originally had the Pap smear were more than twice as likely to have abnormal cells. Of the women who tested negative on the HPV test only 22 women showed abnormal cells (grade 3 or worse), while from the Pap smear group, 52 women ended up with abnormal cells.\u003c/p>\n\u003cp>\"What our study shows is that by using HPV testing, we detect precancerous lesions earlier,\" says \u003ca href=\"http://www.spph.ubc.ca/person/gina-ogilvie/\" target=\"_blank\" rel=\"noopener\">lead author Dr. Gina Ogilvie\u003c/a>. \"If women have a negative HPV test, they are significantly less likely to have a precancerous lesion four years later, meaning we can extend screening time.\"\u003c/p>\n\u003cp>Ogilvie, a professor of medicine at the University of British Columbia, says this study shows that the real value of co-testing actually comes from the HPV test, not the Pap smear.\u003c/p>\n\u003cp>Studies like this one could lead to a change in guidelines, according to Dr. Chris Zahn, the vice president of practice for the American College of Obstetricians and Gynecologists.\u003c/p>\n\u003cp>\"This study adds evidence to those that evaluated use of HPV as a primary screening modality, and the findings support the use of HPV only as a primary screen,\" he wrote in an email.\u003c/p>\n\u003cp>Even if guidelines do change for women over 30, the Pap smear is still important for women ages 21-29. They can't rely on HPV testing, Schmeler says, because almost everyone in that age group will contract HPV, and in many cases it goes away on its own. If the virus persists until their 30s, that's where problems come in.\u003c/p>\n\u003cp>\"If you tested everyone for HPV in their 20s, they are almost all going to be positive, but there's going to be all of this intervention that's not needed,\" she says.\u003c/p>\n\u003cp>Moving away from co-testing may not be a good idea, says \u003ca href=\"http://www.colposcopycenter.com/MeetDrMarkSpitzer.html\" target=\"_blank\" rel=\"noopener\">Mark Spitzer\u003c/a>, an OB-GYN and past president of American Society for Colposcopy and Cervical Pathology. He wrote in an email that this new study actually shows the small but significant benefit of co-testing. He cites the small group of women who had abnormal cells discovered through a Pap smear at the end of the study period.\u003c/p>\n\u003cp>\"In the U.S., co-testing is currently the recommended gold standard, and neither doctors nor their patients should be willing to give up the added benefit you get from screening with a Pap test and HPV test together,\" he says.\u003c/p>\n\u003cp>\u003ca href=\"https://medicine.umich.edu/dept/family-medicine/diane-m-harper-md-mph-ms\">Dr. Diane Harper,\u003c/a> a professor of medicine who researches HPV at the University of Michigan, argues that the study was \"extraordinarily well done\" and moving away from co-testing could result in a decrease of false positives.\u003c/p>\n\u003cp>\"The whole reason for [co-testing] is that you get a slight improvement in sensitivity,\" Harper says. \"But your false positive rate blows up. It's up to 30 percent of people [who] are falsely positive.\"\u003c/p>\n\u003cp>Women who have a positive Pap smear generally get a colposcopy, which is an even closer \u003ca href=\"https://www.mayoclinic.org/tests-procedures/colposcopy/about/pac-20385036\" target=\"_blank\" rel=\"noopener\">examination of the cervix, vagina and vulva \u003c/a>for signs of disease.\u003c/p>\n\u003cp>A false positive could mean going through a biopsy during a colposcopy. Biopsies come with risks like bleeding, infection and pelvic pain, according to the Mayo Clinic. Harper says false positives bring unnecessary costs and fears to patients.\u003c/p>\n\u003cp>\"That's a lot of women that are unnecessarily worried,\" she says.\u003c/p>\n\u003cp>Women can get a clear result from a simple HPV test and those who receive a negative result will be able to trust those results for several years, she says.\u003c/p>\n\u003cp>\"It's really amazing — there's no other test that gives us this level of reassurance for that period of time for a cancer,\" Harper says.\u003c/p>\n\u003cp>Pap smears rely on the human eye to get results, she says, and it's far preferable to detect problems on a molecular level.\u003c/p>\n\u003cp>One caution about the study findings, says \u003ca href=\"https://www.uclahealth.org/carol-mangione\" target=\"_blank\" rel=\"noopener\">Dr. Carol Mangione\u003c/a>, a USPSTF task force member and UCLA professor of medicine, is that screening — either kind — is what saves lives. She says the method of testing comes second to being sure that all women, \u003ca href=\"https://www.npr.org/sections/health-shots/2017/10/11/556895389/could-making-cancer-screening-simpler-increase-womens-risk\" target=\"_blank\" rel=\"noopener\">especially high-prevalence groups like black and Hispanic women\u003c/a>, are able to get the testing they need.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Most cases of cervical cancer happen in women who have not been regularly screened, or who have been screened, but don't have access to appropriate treatment,\" she says. \"When we think about cervical cancer screening, we want to think about it in the framework of how do we get this test in the hands of all women?\"\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=For+Women+Over+30%2C+There+May+Be+A+Better+Choice+Than+The+Pap+Smear&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For most women under 65, a visit to the gynecologist often includes an unpleasant necessity: a Pap smear to check for cervical cancer risk.\u003c/p>\n\u003cp>The test involves letting a doctor or nurse scrape cells from the back of the cervix, which are visually inspected for signs of abnormality.\u003c/p>\n\u003cp>There's another way to screen for cervical cancer risk, by directly testing for the human papillomavirus, or HPV, which causes 99 percent of cervical cancer. \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7464\" target=\"_blank\" rel=\"noopener\"> A study published in JAMA\u003c/a> Tuesday suggests that method might be preferable for women age 30 and over.\u003c/p>\n\u003cp>The FDA in 2014 approved the first HPV test, which tests cervical cells for the presence of HPV.\u003c/p>\n\u003cp>HPV testing also can be done on samples of vaginal and cervical secretions that clinicians or women themselves gather with a swab — a less invasive process than the Pap. That process was shown to be accurate in multiple studies but is not yet used in clinical practice in the U.S.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new study, called the HPV FOCAL trial, compared the HPV test with traditional Pap smear screening among 19,000 Canadian women over four years. It adds to a body of research suggesting that HPV testing might be more accurate.\u003c/p>\n\u003cp>\"In our world this study is going to be a pretty big deal, in a good way,\" says \u003ca href=\"https://faculty.mdanderson.org/profiles/kathleen_schmeler.html\" target=\"_blank\" rel=\"noopener\">Dr. Kathleen Schmeler\u003c/a>, a gynecologic oncologist at the University of Texas MD Anderson Cancer Center.\u003c/p>\n\u003cp>Schmeler says that in the U.S., it has been hard to justify replacing the Pap smear with the HPV test because there has not been a head-to-head comparison until now.\u003c/p>\n\u003cp>The issue is not resolved. Some are still skeptical of relying on HPV testing alone, and co-testing, or using both the HPV test and a Pap smear, is still the standard.\u003c/p>\n\u003cp>Cervical cancer screening is essential because nearly \u003ca href=\"https://gis.cdc.gov/Cancer/USCS/DataViz.html\" target=\"_blank\" rel=\"noopener\">13,000 women in the U.S. are diagnosed with cervical cancer\u003c/a> annually. More than 4,000 women die from it, even with screening and treatment.\u003c/p>\n\u003cp>Current screening guidelines from the U.S. Preventive Services Task Force recommend women ages 30 to 65 have a Pap smear every three years, or every five years if an HPV test is done at the same time.\u003c/p>\n\u003cp>But \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/cervical-cancer-screening2\" target=\"_blank\" rel=\"noopener\">draft recommendations issued last fall by USPSTF\u003c/a> recommended just one or the other — a Pap smear or an HPV test — instead of co-testing for women 30 and up. The organization has yet to issue final guidelines. This new study could prove important in deciding practice guidelines.\u003c/p>\n\u003cp>At the start of the HPV FOCAL trial, some women received HPV testing and some had a Pap smear; those in the Pap smear group who tested negative had a second Pap after two years. Both groups were tested again using both methods after four years.\u003c/p>\n\u003cp>Neither method was foolproof. The final round of co-testing found additional abnormal cells in some women who originally tested negative in both groups. Women who originally had the Pap smear were more than twice as likely to have abnormal cells. Of the women who tested negative on the HPV test only 22 women showed abnormal cells (grade 3 or worse), while from the Pap smear group, 52 women ended up with abnormal cells.\u003c/p>\n\u003cp>\"What our study shows is that by using HPV testing, we detect precancerous lesions earlier,\" says \u003ca href=\"http://www.spph.ubc.ca/person/gina-ogilvie/\" target=\"_blank\" rel=\"noopener\">lead author Dr. Gina Ogilvie\u003c/a>. \"If women have a negative HPV test, they are significantly less likely to have a precancerous lesion four years later, meaning we can extend screening time.\"\u003c/p>\n\u003cp>Ogilvie, a professor of medicine at the University of British Columbia, says this study shows that the real value of co-testing actually comes from the HPV test, not the Pap smear.\u003c/p>\n\u003cp>Studies like this one could lead to a change in guidelines, according to Dr. Chris Zahn, the vice president of practice for the American College of Obstetricians and Gynecologists.\u003c/p>\n\u003cp>\"This study adds evidence to those that evaluated use of HPV as a primary screening modality, and the findings support the use of HPV only as a primary screen,\" he wrote in an email.\u003c/p>\n\u003cp>Even if guidelines do change for women over 30, the Pap smear is still important for women ages 21-29. They can't rely on HPV testing, Schmeler says, because almost everyone in that age group will contract HPV, and in many cases it goes away on its own. If the virus persists until their 30s, that's where problems come in.\u003c/p>\n\u003cp>\"If you tested everyone for HPV in their 20s, they are almost all going to be positive, but there's going to be all of this intervention that's not needed,\" she says.\u003c/p>\n\u003cp>Moving away from co-testing may not be a good idea, says \u003ca href=\"http://www.colposcopycenter.com/MeetDrMarkSpitzer.html\" target=\"_blank\" rel=\"noopener\">Mark Spitzer\u003c/a>, an OB-GYN and past president of American Society for Colposcopy and Cervical Pathology. He wrote in an email that this new study actually shows the small but significant benefit of co-testing. He cites the small group of women who had abnormal cells discovered through a Pap smear at the end of the study period.\u003c/p>\n\u003cp>\"In the U.S., co-testing is currently the recommended gold standard, and neither doctors nor their patients should be willing to give up the added benefit you get from screening with a Pap test and HPV test together,\" he says.\u003c/p>\n\u003cp>\u003ca href=\"https://medicine.umich.edu/dept/family-medicine/diane-m-harper-md-mph-ms\">Dr. Diane Harper,\u003c/a> a professor of medicine who researches HPV at the University of Michigan, argues that the study was \"extraordinarily well done\" and moving away from co-testing could result in a decrease of false positives.\u003c/p>\n\u003cp>\"The whole reason for [co-testing] is that you get a slight improvement in sensitivity,\" Harper says. \"But your false positive rate blows up. It's up to 30 percent of people [who] are falsely positive.\"\u003c/p>\n\u003cp>Women who have a positive Pap smear generally get a colposcopy, which is an even closer \u003ca href=\"https://www.mayoclinic.org/tests-procedures/colposcopy/about/pac-20385036\" target=\"_blank\" rel=\"noopener\">examination of the cervix, vagina and vulva \u003c/a>for signs of disease.\u003c/p>\n\u003cp>A false positive could mean going through a biopsy during a colposcopy. Biopsies come with risks like bleeding, infection and pelvic pain, according to the Mayo Clinic. Harper says false positives bring unnecessary costs and fears to patients.\u003c/p>\n\u003cp>\"That's a lot of women that are unnecessarily worried,\" she says.\u003c/p>\n\u003cp>Women can get a clear result from a simple HPV test and those who receive a negative result will be able to trust those results for several years, she says.\u003c/p>\n\u003cp>\"It's really amazing — there's no other test that gives us this level of reassurance for that period of time for a cancer,\" Harper says.\u003c/p>\n\u003cp>Pap smears rely on the human eye to get results, she says, and it's far preferable to detect problems on a molecular level.\u003c/p>\n\u003cp>One caution about the study findings, says \u003ca href=\"https://www.uclahealth.org/carol-mangione\" target=\"_blank\" rel=\"noopener\">Dr. Carol Mangione\u003c/a>, a USPSTF task force member and UCLA professor of medicine, is that screening — either kind — is what saves lives. She says the method of testing comes second to being sure that all women, \u003ca href=\"https://www.npr.org/sections/health-shots/2017/10/11/556895389/could-making-cancer-screening-simpler-increase-womens-risk\" target=\"_blank\" rel=\"noopener\">especially high-prevalence groups like black and Hispanic women\u003c/a>, are able to get the testing they need.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Most cases of cervical cancer happen in women who have not been regularly screened, or who have been screened, but don't have access to appropriate treatment,\" she says. \"When we think about cervical cancer screening, we want to think about it in the framework of how do we get this test in the hands of all women?\"\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=For+Women+Over+30%2C+There+May+Be+A+Better+Choice+Than+The+Pap+Smear&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Legislature May Create New Harassment Unit",
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"content": "\u003cp>The California Legislature may create a new investigative unit to focus solely on harassment and discrimination complaints and hire an outside panel of experts to recommend discipline for perpetrators.[contextly_sidebar id=\"gygDT1q9e2GXTpIUvnzOlJzHxf7Un2mj\"]\u003c/p>\n\u003cp>Those are key pieces of a sweeping policy overhaul proposed Friday by two lawmakers tasked with revamping the Capitol’s sexual misconduct policies after several lawmakers and high-level staffers were accused of groping and other inappropriate conduct. The policy could be edited before an approval vote June 25, but Assembly and Senate leaders offered their support.\u003c/p>\n\u003cp>Critical details are still lacking, such as how much the new unit would cost, how many employees it would include and how members of the independent review panel would be selected. But Assemblywoman Laura Friedman and Sen. Holly Mitchell, who drove the new proposal, called it a major step toward improving the Capitol culture to better protect employees from harassment and discrimination.\u003c/p>\n\u003cp>“This is a sea change,” Friedman said, a Glendale Democrat. “I think (it’s) very, very different from what other government entities have done.”\u003c/p>\n\u003cp>In the wake of the #MeToo movement, statehouses across the country are grappling with how best to handle inappropriate workplace culture and conduct by lawmakers who can only be removed by voters.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The newly proposed “Workplace Conduct Unit” would operate within the Legislative Counsel’s office. Friedman said it would operate independently, but a policy outline shared with reports said the Legislative Counsel would oversee the unit.[contextly_sidebar id=\"NvLxTNw55pZieA3bpNA5g1Yv3c3lysMm\"]\u003c/p>\n\u003cp>The Legislature would also appoint five outside experts to a panel tasked with reviewing the facts discovered by investigators, determining whether the accusations have merit and recommending how the Legislature should respond. Discipline options could range from requiring an employee or lawmaker to undergo more bias training to termination.\u003c/p>\n\u003cp>But the Assembly and Senate would still have the ultimate say on how to discipline employees.\u003c/p>\n\u003cp>Critics of the Legislature’s existing policy have said it’s unfair because it is not truly independent. Friedman and Mitchell said it hasn’t been determined whether now-active investigations would be re-routed through the new process if it is adopted. The Assembly just resumed an investigation into a groping allegation against Democratic Assemblywoman Cristina Garcia after determining last month it couldn’t be substantiated.\u003c/p>\n\u003cp>The proposed policy also aims to spur a shift in how people in the Capitol community speak and act toward each other. It encourages people to report minor incidents such as insensitive comments all the way through more aggressive acts of misconduct.[contextly_sidebar id=\"o7tnf7HZ8VgExXfhk7wX49GBtlwjq3re\"]\u003c/p>\n\u003cp>Not every complaint would go through the full investigative process, but the policy is designed to clamp down on any type of behavior that contributes to a toxic culture. It would revamp the Legislature’s training process to be more hands on and include sessions on implicit bias.\u003c/p>\n\u003cp>“You can have the best policy on paper but until the culture of your organization really embodies that culture you want to have, those policies can only go so far,” Friedman said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new investigative unit and panel system would handle any type of harassment or discrimination complaints, including those based on race or sexual orientation. Other complaints would go through the normal human resources process.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The California Legislature may create a new investigative unit to focus solely on harassment and discrimination complaints and hire an outside panel of experts to recommend discipline for perpetrators.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Those are key pieces of a sweeping policy overhaul proposed Friday by two lawmakers tasked with revamping the Capitol’s sexual misconduct policies after several lawmakers and high-level staffers were accused of groping and other inappropriate conduct. The policy could be edited before an approval vote June 25, but Assembly and Senate leaders offered their support.\u003c/p>\n\u003cp>Critical details are still lacking, such as how much the new unit would cost, how many employees it would include and how members of the independent review panel would be selected. But Assemblywoman Laura Friedman and Sen. Holly Mitchell, who drove the new proposal, called it a major step toward improving the Capitol culture to better protect employees from harassment and discrimination.\u003c/p>\n\u003cp>“This is a sea change,” Friedman said, a Glendale Democrat. “I think (it’s) very, very different from what other government entities have done.”\u003c/p>\n\u003cp>In the wake of the #MeToo movement, statehouses across the country are grappling with how best to handle inappropriate workplace culture and conduct by lawmakers who can only be removed by voters.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The newly proposed “Workplace Conduct Unit” would operate within the Legislative Counsel’s office. Friedman said it would operate independently, but a policy outline shared with reports said the Legislative Counsel would oversee the unit.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Legislature would also appoint five outside experts to a panel tasked with reviewing the facts discovered by investigators, determining whether the accusations have merit and recommending how the Legislature should respond. Discipline options could range from requiring an employee or lawmaker to undergo more bias training to termination.\u003c/p>\n\u003cp>But the Assembly and Senate would still have the ultimate say on how to discipline employees.\u003c/p>\n\u003cp>Critics of the Legislature’s existing policy have said it’s unfair because it is not truly independent. Friedman and Mitchell said it hasn’t been determined whether now-active investigations would be re-routed through the new process if it is adopted. The Assembly just resumed an investigation into a groping allegation against Democratic Assemblywoman Cristina Garcia after determining last month it couldn’t be substantiated.\u003c/p>\n\u003cp>The proposed policy also aims to spur a shift in how people in the Capitol community speak and act toward each other. It encourages people to report minor incidents such as insensitive comments all the way through more aggressive acts of misconduct.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Not every complaint would go through the full investigative process, but the policy is designed to clamp down on any type of behavior that contributes to a toxic culture. It would revamp the Legislature’s training process to be more hands on and include sessions on implicit bias.\u003c/p>\n\u003cp>“You can have the best policy on paper but until the culture of your organization really embodies that culture you want to have, those policies can only go so far,” Friedman said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new investigative unit and panel system would handle any type of harassment or discrimination complaints, including those based on race or sexual orientation. Other complaints would go through the normal human resources process.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "U.S. Suicide Rates Are Rising Faster Among Women Than Men",
"title": "U.S. Suicide Rates Are Rising Faster Among Women Than Men",
"headTitle": "Women’s Health | KQED Future of You | KQED Science",
"content": "\u003cp>The number of people dying by suicide in the United States has risen by about 30 percent in the past two decades. And while the majority of suicide-related deaths today are among boys and men, a study published Thursday by the \u003ca href=\"https://www.cdc.gov/nchs/index.htm\" target=\"_blank\" rel=\"noopener\">National Center for Health Statistics\u003c/a> finds that the number of girls and women taking their own lives is rising.\u003c/p>\n\u003cp>\"Typically there's between three and four times as many suicides among males as among females,\" says \u003ca href=\"https://www.cdc.gov/nchs/injury/ice/steering_committee.htm\" target=\"_blank\" rel=\"noopener\">Dr. Holly Hedegaard\u003c/a>, a medical epidemiologist at the NCHS and the main author of the new \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db309.htm\">study\u003c/a>. In 2016, about 21 boys or men out of 100,000 took their own lives. On the other hand, just six girls or women out of 100,000 died by suicide that year.\u003c/p>\n\u003cp>But when Hedegaard and her colleagues compared the rise in the rates of death by suicide from 2000 to 2016, the increase was significantly larger for females — increasing by 21 percent for boys and men, compared with 50 percent for girls and women.\u003c/p>\n\u003cp>There's \"sort of a narrowing of the [gender] gap in rates,\" Hedegaard notes.\u003c/p>\n\u003cp>The biggest change was seen among women in late middle age. \"For females between the ages of 45 and 64, the suicide rate increased by 60 percent,\" she says. \"That's a pretty large increase in a relatively short period of time.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That the increase for women was more than double the increase for men \"did indeed surprise me,\" says \u003ca href=\"http://www.emory.edu/grady/emory-at-grady/doctors/kaslow.html\" target=\"_blank\" rel=\"noopener\">Nadine Kaslow\u003c/a>, a psychologist at Emory University and the \u003ca href=\"http://www.news.emory.edu/stories/2012/11/psych_kaslow_apa_president/campus.html\">past president\u003c/a> of the \u003ca href=\"http://www.apa.org/\">American Psychological Association\u003c/a>, who was not involved in the study. She says she finds the overall trends for both men and women \"disturbing.\"\u003c/p>\n\u003cp>Scientists don't yet know the reasons behind the steeper rise in the number of girls and women taking their own lives, says Kaslow. \"We're really just beginning to see these differences, and so people are just now beginning to look at this.\"[contextly_sidebar id=\"k6MDe9evjHueopXOQ84nJ1lOI9jYSpJm\"]\u003c/p>\n\u003cp>Though there are different factors at play in each case, excessive stress is a known risk factor for suicide overall, she says.\u003c/p>\n\u003cp>\"People often die by suicide when they just feel totally overwhelmed,\" Kaslow says.\u003c/p>\n\u003cp>According to the American Psychological Association, women say their \u003ca href=\"http://www.apa.org/news/press/releases/stress/2010/gender-stress.aspx\" target=\"_blank\" rel=\"noopener\">stress levels have risen\u003c/a> in recent years. And middle-aged women belonging to the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2013/01/30/170694962/middle-aged-breadwinners-become-part-of-the-sandwich-generation\" target=\"_blank\" rel=\"noopener\">sandwich generation\u003c/a> are especially feeling the pressure of their many responsibilities at home and at work.\u003c/p>\n\u003cp>\"So they may be taking care of children, of parents, have work demands and then more responsibilities,\" Kaslow says.\u003c/p>\n\u003cp>There's also been \u003ca href=\"https://www.census.gov/newsroom/press-releases/2016/cb16-192.html\" target=\"_blank\" rel=\"noopener\">a rise\u003c/a> in the last few decades in the number of single-parent households headed by women. That means more women trying to do everything alone, she says.\u003c/p>\n\u003cp>\"And so there's, sort of, stress everywhere,\" she says. \"They may not have time to take care of themselves, to be kind to themselves, to get the social support they need.\"\u003c/p>\n\u003cp>The new report also shows that more adolescent girls are choosing to end their lives, notes Kaslow. So the problem is not specific to middle-aged women, but across all age groups.\u003c/p>\n\u003cp>\"Suicide is a public health concern,\" says \u003ca href=\"https://afsp.org/about-afsp/jill-harkavy-friedman-ph-d/\" target=\"_blank\" rel=\"noopener\">Jill Harkavy-Friedman\u003c/a>, the vice president of research at the American Foundation for Suicide Prevention. The statistics published Thursday underscore the need for a national prevention effort, she adds.\u003c/p>\n\u003cp>The report also looked at the means of suicide, as recorded in death certificates, and found that firearms remain an important method, particularly for boys and men.\u003c/p>\n\u003cp>\"For males, pretty much from age 15 and older, the majority of the suicides [involved] firearms,\" says Hedegaard.\u003c/p>\n\u003cp>\"We know that limiting access to lethal-means of any kind can reduce suicide,\" Harkavy-Friedman says, \"especially if you limit access during a crisis moment.\"\u003c/p>\n\u003cp>To help prevent suicide, society needs to offer better access to mental health care, she says. And each one of us can do our bit, too, by watching out for the warnings signs among friends and family.\u003c/p>\n\u003cp>Be aware, she says, if you notice something's changing in a loved one, friend or colleague. For example, if their mood is changing, she says, \"maybe they're more irritable, or withdrawn. Maybe they're talking about being a burden.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At times like these, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23466401\" target=\"_blank\" rel=\"noopener\">it is important\u003c/a> to let people know they're not alone. \"It sounds simple,\" she says. \"But it does make a difference.\"\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=U.S.+Suicide+Rates+Are+Rising+Faster+Among+Women+Than+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "You can help prevent suicide, researchers say, by knowing the signs and reaching out. More boys and men in the U.S. take their own lives than women and girls, but that difference has narrowed.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The number of people dying by suicide in the United States has risen by about 30 percent in the past two decades. And while the majority of suicide-related deaths today are among boys and men, a study published Thursday by the \u003ca href=\"https://www.cdc.gov/nchs/index.htm\" target=\"_blank\" rel=\"noopener\">National Center for Health Statistics\u003c/a> finds that the number of girls and women taking their own lives is rising.\u003c/p>\n\u003cp>\"Typically there's between three and four times as many suicides among males as among females,\" says \u003ca href=\"https://www.cdc.gov/nchs/injury/ice/steering_committee.htm\" target=\"_blank\" rel=\"noopener\">Dr. Holly Hedegaard\u003c/a>, a medical epidemiologist at the NCHS and the main author of the new \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db309.htm\">study\u003c/a>. In 2016, about 21 boys or men out of 100,000 took their own lives. On the other hand, just six girls or women out of 100,000 died by suicide that year.\u003c/p>\n\u003cp>But when Hedegaard and her colleagues compared the rise in the rates of death by suicide from 2000 to 2016, the increase was significantly larger for females — increasing by 21 percent for boys and men, compared with 50 percent for girls and women.\u003c/p>\n\u003cp>There's \"sort of a narrowing of the [gender] gap in rates,\" Hedegaard notes.\u003c/p>\n\u003cp>The biggest change was seen among women in late middle age. \"For females between the ages of 45 and 64, the suicide rate increased by 60 percent,\" she says. \"That's a pretty large increase in a relatively short period of time.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That the increase for women was more than double the increase for men \"did indeed surprise me,\" says \u003ca href=\"http://www.emory.edu/grady/emory-at-grady/doctors/kaslow.html\" target=\"_blank\" rel=\"noopener\">Nadine Kaslow\u003c/a>, a psychologist at Emory University and the \u003ca href=\"http://www.news.emory.edu/stories/2012/11/psych_kaslow_apa_president/campus.html\">past president\u003c/a> of the \u003ca href=\"http://www.apa.org/\">American Psychological Association\u003c/a>, who was not involved in the study. She says she finds the overall trends for both men and women \"disturbing.\"\u003c/p>\n\u003cp>Scientists don't yet know the reasons behind the steeper rise in the number of girls and women taking their own lives, says Kaslow. \"We're really just beginning to see these differences, and so people are just now beginning to look at this.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Though there are different factors at play in each case, excessive stress is a known risk factor for suicide overall, she says.\u003c/p>\n\u003cp>\"People often die by suicide when they just feel totally overwhelmed,\" Kaslow says.\u003c/p>\n\u003cp>According to the American Psychological Association, women say their \u003ca href=\"http://www.apa.org/news/press/releases/stress/2010/gender-stress.aspx\" target=\"_blank\" rel=\"noopener\">stress levels have risen\u003c/a> in recent years. And middle-aged women belonging to the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2013/01/30/170694962/middle-aged-breadwinners-become-part-of-the-sandwich-generation\" target=\"_blank\" rel=\"noopener\">sandwich generation\u003c/a> are especially feeling the pressure of their many responsibilities at home and at work.\u003c/p>\n\u003cp>\"So they may be taking care of children, of parents, have work demands and then more responsibilities,\" Kaslow says.\u003c/p>\n\u003cp>There's also been \u003ca href=\"https://www.census.gov/newsroom/press-releases/2016/cb16-192.html\" target=\"_blank\" rel=\"noopener\">a rise\u003c/a> in the last few decades in the number of single-parent households headed by women. That means more women trying to do everything alone, she says.\u003c/p>\n\u003cp>\"And so there's, sort of, stress everywhere,\" she says. \"They may not have time to take care of themselves, to be kind to themselves, to get the social support they need.\"\u003c/p>\n\u003cp>The new report also shows that more adolescent girls are choosing to end their lives, notes Kaslow. So the problem is not specific to middle-aged women, but across all age groups.\u003c/p>\n\u003cp>\"Suicide is a public health concern,\" says \u003ca href=\"https://afsp.org/about-afsp/jill-harkavy-friedman-ph-d/\" target=\"_blank\" rel=\"noopener\">Jill Harkavy-Friedman\u003c/a>, the vice president of research at the American Foundation for Suicide Prevention. The statistics published Thursday underscore the need for a national prevention effort, she adds.\u003c/p>\n\u003cp>The report also looked at the means of suicide, as recorded in death certificates, and found that firearms remain an important method, particularly for boys and men.\u003c/p>\n\u003cp>\"For males, pretty much from age 15 and older, the majority of the suicides [involved] firearms,\" says Hedegaard.\u003c/p>\n\u003cp>\"We know that limiting access to lethal-means of any kind can reduce suicide,\" Harkavy-Friedman says, \"especially if you limit access during a crisis moment.\"\u003c/p>\n\u003cp>To help prevent suicide, society needs to offer better access to mental health care, she says. And each one of us can do our bit, too, by watching out for the warnings signs among friends and family.\u003c/p>\n\u003cp>Be aware, she says, if you notice something's changing in a loved one, friend or colleague. For example, if their mood is changing, she says, \"maybe they're more irritable, or withdrawn. Maybe they're talking about being a burden.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At times like these, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23466401\" target=\"_blank\" rel=\"noopener\">it is important\u003c/a> to let people know they're not alone. \"It sounds simple,\" she says. \"But it does make a difference.\"\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=U.S.+Suicide+Rates+Are+Rising+Faster+Among+Women+Than+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "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",
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"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.",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"science-friday": {
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