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"content": "\u003cdiv class=\"post-body\">\u003cp>The \u003ca href=\"https://www.latimes.com/science/sciencenow/la-sci-sn-vaccine-medical-exemptions-20181029-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">law requires\u003c/a> every child taught in school classrooms or enrolled in a child care facility — with the exemption of students who receive medical exemptions from doctors — to be fully immunized against 10 communicable diseases: diphtheria, hepatitis B, haemophilus influenzae Type B, measles, mumps, pertussis (whooping cough), poliomyelitis, rubella, tetanus and varicella (chickenpox).\u003c/p>\n\u003cp>Researchers also compared California’s vaccination rates with those of other states that still have personal belief exemptions, factoring in demographic variations.\u003c/p>\n\u003cp>Vaccination rates went up across California, particularly in counties like Sonoma and Santa Cruz, where rates have lingered below the statewide average. the report found. Non-medical exemptions decreased statewide by 2.4%, while medical exemptions increased 0.4%.\u003c/p>\n\u003cp>“When we look at those high-risk counties, we see the largest increases in vaccine coverage. 10-plus percent jumps in those areas,” said UCSF public health researcher Dr. Nathan Lo.\u003c/p>\n\u003cp>These changes brought the vaccination rate to 95% in almost all California counties, enough to provide “herd” immunity, or rates high enough that a contagious disease is less likely to spread.\u003c/p>\n\u003cp>It also means that a significant number of parents who previously received non-medical exemptions ended up complying with the law.\u003c/p>\n\u003cp>“So that nudge is enough to push the majority of these children to get properly vaccinated,” Lo said, adding that other states and countries would be wise to follow California’s lead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>For decades, major tobacco companies have fought against raising the age limit to buy their products from 18 to 21. But recently, some cigarette and e-cigarette giants have started lobbying for the minimum age to rise.\u003c/p>\n\u003cp>“Raising the purchase age to 21 reduces underage access,” a radio ad from e-cigarette giant Juul \u003ca href=\"https://newsroom.juul.com/t21/\" target=\"_blank\" rel=\"noopener noreferrer\">declared\u003c/a>. “That’s why Juul Labs supports making 21+ the law nationwide.”\u003c/p>\n\u003cp>Last week, President Trump signed a congressional spending bill that includes a new federal regulation raising the age of purchase.\u003c/p>\n\u003cp>But health advocates are not wholeheartedly celebrating the change. They worry it may help the companies stave off further sweeping regulations of their industry and wonder how stringently it will be enforced.\u003c/p>\n\u003cp>Rob Crane, a physician at Ohio State University, has been campaigning to raise the minimum age for more than two decades through \u003ca href=\"https://tobacco21.org/\" target=\"_blank\" rel=\"noopener noreferrer\">his group Tobacco 21\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When it started pushing for firmer laws, “we were killed at every turn,” he remembers. “The industry hated this idea and they used their very potent political lobbying power to stifle it in every state.”\u003c/p>\n\u003cp>Archival tobacco industry documents show why the companies objected, says \u003ca href=\"https://tobacco.ucsf.edu/people/stanton-glantz-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Stan Glantz\u003c/a>, the director of University of California San Francisco’s Center for Tobacco Control Research and Education.\u003c/p>\n\u003cp>“It’s because it made it harder to market to kids,” he says. “[It’s] very hard to design a marketing campaign where the nominal target [is] … people who are 21, and still pick up 12-year-olds.”\u003c/p>\n\u003cp>Since the beginning of the Tobacco 21 movement, the industry landscape has changed considerably. Now millions of teens are hooked on e-cigarettes, a source of considerable public concern.\u003c/p>\n\u003cp>Health advocates are currently pushing for more sweeping regulations than the age limit raise, such as banning flavors for e-cigarettes — something the industry has fought. University of Virginia historian \u003ca href=\"https://history.virginia.edu/people/profile/sem9dw\" target=\"_blank\" rel=\"noopener noreferrer\">Sarah Milov\u003c/a>, who wrote a book about tobacco, says the big companies have likely been willing to accept the stricter age limits “in order to take the public’s eyes off of other proposals for addressing youth vaping.”\u003c/p>\n\u003cp>Glantz says he thinks the new federal age restrictions give the industry “something they can argue: ‘Well, we’ve done enough. You don’t need to get rid of flavors,’ which in terms of reducing youth tobacco use is probably the single most important thing to do right now.”\u003c/p>\n\u003cp>Matthew Myers, the president of Campaign for Tobacco-Free Kids, echoed that idea. He said \u003ca href=\"https://www.tobaccofreekids.org/press-releases/2019_12_11_congress_health_bill\" target=\"_blank\" rel=\"noopener noreferrer\">in a statement\u003c/a> that the new law “will not bring about meaningful change, but will lead to the tobacco companies falsely claiming that the youth e-cigarette problem has been solved even as it continues to grow worse every day.”\u003c/p>\n\u003cp>In an op-ed earlier this year in \u003ca href=\"https://thehill.com/opinion/healthcare/431651-raise-the-legal-age-for-all-tobacco-products-to-21\" target=\"_blank\" rel=\"noopener noreferrer\">The Hill\u003c/a>, Altria CEO Howard Willard said the Food and Drug Administration made clear that the company might find itself in trouble with federal regulators unless it did more to address teen vaping.\u003c/p>\n\u003cp>“Put simply, we cannot continue to expand … [e-cigarettes] for adults unless we help curb youth access to all tobacco products, including e-vapor,” Willard said. Altria owns Philip Morris USA, which makes Marlboro cigarettes.\u003c/p>\n\u003cp>The federal age limit raise comes after a rapid succession of new laws at the state and local levels. At least 19 states and the District of Columbia have passed some form of the 21 age limit, many in the past year and with the support of big companies.\u003c/p>\n\u003cp>But Glantz says he sees a familiar strategy from the industry as these laws have passed. In this and previous fights, he says tobacco companies will preemptively lobby for bills that are weak or don’t spell out effective enforcement mechanisms.\u003c/p>\n\u003cp>[aside tag=\"vaping\" label=\"Related coverage\"]\u003c/p>\n\u003cp>“They’ve tried to co-opt the issue and started pushing bad legislation,” he said.\u003c/p>\n\u003cp>The two most prominent companies supporting the age restriction are Juul and Altria. When NPR reached out, they didn’t respond to these criticisms.\u003c/p>\n\u003cp>The federal legislation was put forward in the Senate by Democrat Tim Kaine and Republican Mitch McConnell, the majority leader who has long been seen as a friend to the tobacco industry. As \u003ca href=\"https://www.npr.org/2019/06/17/730496066/tobaccos-special-friend-what-internal-documents-say-about-mitch-mcconnell\" target=\"_blank\" rel=\"noopener noreferrer\">NPR’s Embedded podcast\u003c/a> found, “vaping and tobacco companies are currently employing McConnell’s \u003ca href=\"https://www.wfs-dc.com/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/Q1/301038362.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy adviser\u003c/a>, his former \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/RR/301024486.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy director\u003c/a> and his \u003ca href=\"https://www.akingump.com/en/lawyers-advisors/hunter-bates.html\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2018/Q4/301009679.xml\" target=\"_blank\" rel=\"noopener noreferrer\">chief of staff\u003c/a> to lobby on their behalf.”\u003c/p>\n\u003cp>In a statement \u003ca href=\"https://www.mcconnell.senate.gov/public/index.cfm/pressreleases?ID=17523CAF-6BA1-4894-9BD0-45A67B1A2D96\" target=\"_blank\" rel=\"noopener noreferrer\">after the federal law passed\u003c/a>, McConnell called the recent spate of vaping-related illnesses an “urgent crisis” and stressed that the new measure will help “keep these dangerous products away from our children.”\u003c/p>\n\u003cp>The FDA has jurisdiction over enforcing the federal law. Crane, the longtime advocate for raising the age limit, has questions about how aggressive it will be.\u003c/p>\n\u003cp>He says he’s watched how the FDA regulated the previous age limit of 18, and says he would want to see more compliance checks and fewer violations allowed for tobacco retailers. He says the law will do little to keep tobacco products away from kids and young adults if it’s not enforced, and he believes local health authorities would be more effective.\u003c/p>\n\u003cp>“We know that waiting for the FDA is kind of like waiting for Godot. They don’t do anything. They bark but never bite,” Crane says.\u003c/p>\n\u003cp>FDA Commissioner Stephen Hahn praised the new age limit and \u003ca href=\"https://twitter.com/SteveFDA/status/1208232123833958401?s=20\">said in a tweet \u003c/a>that “more details will be forthcoming as we update our regulations to carry out this provision of law.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Crane says his group is going to continue pushing for even tougher laws at the state and local levels.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener noreferrer\">https://www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Tobacco+Industry+Giants+Backed+Raising+The+Minimum+Age+Of+Purchase&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For decades, major tobacco companies have fought against raising the age limit to buy their products from 18 to 21. But recently, some cigarette and e-cigarette giants have started lobbying for the minimum age to rise.\u003c/p>\n\u003cp>“Raising the purchase age to 21 reduces underage access,” a radio ad from e-cigarette giant Juul \u003ca href=\"https://newsroom.juul.com/t21/\" target=\"_blank\" rel=\"noopener noreferrer\">declared\u003c/a>. “That’s why Juul Labs supports making 21+ the law nationwide.”\u003c/p>\n\u003cp>Last week, President Trump signed a congressional spending bill that includes a new federal regulation raising the age of purchase.\u003c/p>\n\u003cp>But health advocates are not wholeheartedly celebrating the change. They worry it may help the companies stave off further sweeping regulations of their industry and wonder how stringently it will be enforced.\u003c/p>\n\u003cp>Rob Crane, a physician at Ohio State University, has been campaigning to raise the minimum age for more than two decades through \u003ca href=\"https://tobacco21.org/\" target=\"_blank\" rel=\"noopener noreferrer\">his group Tobacco 21\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When it started pushing for firmer laws, “we were killed at every turn,” he remembers. “The industry hated this idea and they used their very potent political lobbying power to stifle it in every state.”\u003c/p>\n\u003cp>Archival tobacco industry documents show why the companies objected, says \u003ca href=\"https://tobacco.ucsf.edu/people/stanton-glantz-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Stan Glantz\u003c/a>, the director of University of California San Francisco’s Center for Tobacco Control Research and Education.\u003c/p>\n\u003cp>“It’s because it made it harder to market to kids,” he says. “[It’s] very hard to design a marketing campaign where the nominal target [is] … people who are 21, and still pick up 12-year-olds.”\u003c/p>\n\u003cp>Since the beginning of the Tobacco 21 movement, the industry landscape has changed considerably. Now millions of teens are hooked on e-cigarettes, a source of considerable public concern.\u003c/p>\n\u003cp>Health advocates are currently pushing for more sweeping regulations than the age limit raise, such as banning flavors for e-cigarettes — something the industry has fought. University of Virginia historian \u003ca href=\"https://history.virginia.edu/people/profile/sem9dw\" target=\"_blank\" rel=\"noopener noreferrer\">Sarah Milov\u003c/a>, who wrote a book about tobacco, says the big companies have likely been willing to accept the stricter age limits “in order to take the public’s eyes off of other proposals for addressing youth vaping.”\u003c/p>\n\u003cp>Glantz says he thinks the new federal age restrictions give the industry “something they can argue: ‘Well, we’ve done enough. You don’t need to get rid of flavors,’ which in terms of reducing youth tobacco use is probably the single most important thing to do right now.”\u003c/p>\n\u003cp>Matthew Myers, the president of Campaign for Tobacco-Free Kids, echoed that idea. He said \u003ca href=\"https://www.tobaccofreekids.org/press-releases/2019_12_11_congress_health_bill\" target=\"_blank\" rel=\"noopener noreferrer\">in a statement\u003c/a> that the new law “will not bring about meaningful change, but will lead to the tobacco companies falsely claiming that the youth e-cigarette problem has been solved even as it continues to grow worse every day.”\u003c/p>\n\u003cp>In an op-ed earlier this year in \u003ca href=\"https://thehill.com/opinion/healthcare/431651-raise-the-legal-age-for-all-tobacco-products-to-21\" target=\"_blank\" rel=\"noopener noreferrer\">The Hill\u003c/a>, Altria CEO Howard Willard said the Food and Drug Administration made clear that the company might find itself in trouble with federal regulators unless it did more to address teen vaping.\u003c/p>\n\u003cp>“Put simply, we cannot continue to expand … [e-cigarettes] for adults unless we help curb youth access to all tobacco products, including e-vapor,” Willard said. Altria owns Philip Morris USA, which makes Marlboro cigarettes.\u003c/p>\n\u003cp>The federal age limit raise comes after a rapid succession of new laws at the state and local levels. At least 19 states and the District of Columbia have passed some form of the 21 age limit, many in the past year and with the support of big companies.\u003c/p>\n\u003cp>But Glantz says he sees a familiar strategy from the industry as these laws have passed. In this and previous fights, he says tobacco companies will preemptively lobby for bills that are weak or don’t spell out effective enforcement mechanisms.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“They’ve tried to co-opt the issue and started pushing bad legislation,” he said.\u003c/p>\n\u003cp>The two most prominent companies supporting the age restriction are Juul and Altria. When NPR reached out, they didn’t respond to these criticisms.\u003c/p>\n\u003cp>The federal legislation was put forward in the Senate by Democrat Tim Kaine and Republican Mitch McConnell, the majority leader who has long been seen as a friend to the tobacco industry. As \u003ca href=\"https://www.npr.org/2019/06/17/730496066/tobaccos-special-friend-what-internal-documents-say-about-mitch-mcconnell\" target=\"_blank\" rel=\"noopener noreferrer\">NPR’s Embedded podcast\u003c/a> found, “vaping and tobacco companies are currently employing McConnell’s \u003ca href=\"https://www.wfs-dc.com/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/Q1/301038362.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy adviser\u003c/a>, his former \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2019/RR/301024486.xml\" target=\"_blank\" rel=\"noopener noreferrer\">policy director\u003c/a> and his \u003ca href=\"https://www.akingump.com/en/lawyers-advisors/hunter-bates.html\">former\u003c/a> \u003ca href=\"http://disclosures.house.gov/ld/ldxmlrelease/2018/Q4/301009679.xml\" target=\"_blank\" rel=\"noopener noreferrer\">chief of staff\u003c/a> to lobby on their behalf.”\u003c/p>\n\u003cp>In a statement \u003ca href=\"https://www.mcconnell.senate.gov/public/index.cfm/pressreleases?ID=17523CAF-6BA1-4894-9BD0-45A67B1A2D96\" target=\"_blank\" rel=\"noopener noreferrer\">after the federal law passed\u003c/a>, McConnell called the recent spate of vaping-related illnesses an “urgent crisis” and stressed that the new measure will help “keep these dangerous products away from our children.”\u003c/p>\n\u003cp>The FDA has jurisdiction over enforcing the federal law. Crane, the longtime advocate for raising the age limit, has questions about how aggressive it will be.\u003c/p>\n\u003cp>He says he’s watched how the FDA regulated the previous age limit of 18, and says he would want to see more compliance checks and fewer violations allowed for tobacco retailers. He says the law will do little to keep tobacco products away from kids and young adults if it’s not enforced, and he believes local health authorities would be more effective.\u003c/p>\n\u003cp>“We know that waiting for the FDA is kind of like waiting for Godot. They don’t do anything. They bark but never bite,” Crane says.\u003c/p>\n\u003cp>FDA Commissioner Stephen Hahn praised the new age limit and \u003ca href=\"https://twitter.com/SteveFDA/status/1208232123833958401?s=20\">said in a tweet \u003c/a>that “more details will be forthcoming as we update our regulations to carry out this provision of law.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Crane says his group is going to continue pushing for even tougher laws at the state and local levels.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener noreferrer\">https://www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Tobacco+Industry+Giants+Backed+Raising+The+Minimum+Age+Of+Purchase&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>For many Americans, hallucinogens still evoke the psychedelic ’60s, bringing to mind the sex-and-drugs lifestyle of the hippie counterculture.\u003c/p>\n\u003cp>But that stereotype lags behind reality, by several decades. Today, psychedelic experimentation is more likely to refer to dozens of clinical trials taking place at universities and research facilities. The psychedelics under study range from psilocybin, the active ingredient in psychedelic mushrooms, to MDMA (also known as Ecstasy or Molly), to LSD, among others. Researchers are studying them for their therapeutic potential in treating hard-to-treat conditions such as PTSD, addiction, depression and anxiety.\u003c/p>\n\u003cp>[aside tag='smoking' label='More Coverage.']\u003c/p>\n\u003cp>The promise of freedom from cigarettes was what compelled Carine Chen-McLaughlin, 65, to enroll in an experimental study of psilocybin therapy for smokers. She was desperate to break free from her decades-long physical addiction to nicotine. Quitting smoking had felt impossible for so long.\u003c/p>\n\u003cp>“It’s basically saying good-bye to a very old friend, and worrying about: Am I going to be OK without this good friend?” the Baltimore resident says.\u003c/p>\n\u003cp>Like many of the 49 million \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6845a2.htm?s_cid=mm6845a2_w\" target=\"_blank\" rel=\"noopener noreferrer\">tobacco users\u003c/a> in the U.S., Chen-McLaughlin wanted to quit and had tried various methods: nicotine gum, the nicotine patch and even stopping cold turkey. But nothing worked for more than a couple days.\u003c/p>\n\u003cp>The clinical trial she joined took place in her hometown of Baltimore, at Johns Hopkins School of Medicine. While she was a bit anxious about the experiment, Chen-McLaughlin says she was nevertheless hopeful about trying something totally different.\u003c/p>\n\u003cp>“I think I was more excited that… maybe, \u003cem>maybe \u003c/em>this is it!” she says with a laugh.\u003c/p>\n\u003ch3>A research revival\u003c/h3>\n\u003cp>Therapeutic research on psilocybin, LSD and other psychedelic drugs isn’t new. Beginning in the 1950s, researchers investigated them as potential treatments for alcohol addiction, cancer-related anxiety, depression and other common psychological ills.\u003c/p>\n\u003cp>But then came the “psychedelic ’60s,” a time when American counterculture embraced these then-legal drugs. The resulting widespread use — and abuse — of psychedelics ultimately triggered a backlash that led the federal government to criminalize these substances. By the early 1970s, many ongoing studies into the potential medical benefits of psychedelics had halted.\u003c/p>\n\u003cp>“Unfortunately, all of that legitimate research was really sacrificed because of the association between psychedelics and the counterculture,” says \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/0800020/matthew-johnson\" target=\"_blank\" rel=\"noopener noreferrer\">Matthew Johnson\u003c/a>, an associate professor of psychiatry at Johns Hopkins School of Medicine and the lead investigator in the psilocybin study for smoking cessation.\u003c/p>\n\u003cp>Today, however, a new wave of psychedelic research has taken hold, with dozens of clinical studies happening at U.S. academic institutions. In fact, some of the experimental therapies involving psilocbyin\u003ca href=\"https://www.medscape.com/viewarticle/921789\" target=\"_blank\" rel=\"noopener noreferrer\"> have recently received \u003c/a>“breakthrough therapy” designations \u003ca href=\"https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/breakthrough-therapy\" target=\"_blank\" rel=\"noopener noreferrer\">from the FDA\u003c/a>, which can help speed their progress towards eventual market approval.\u003c/p>\n\u003cp>Although the studies are legal, the federal government does not provide any financial support for psychedelic research, so the researchers must rely on private organizations for funding. The Johns Hopkins study, for instance, is supported by the non-profit \u003ca href=\"https://heffter.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Heffter Research Institute\u003c/a> in New Mexico.\u003c/p>\n\u003cp>“We’re ever hopeful and we’re continuing to put in [funding] applications,” Johnson says. “But so far, the National Institutes of Health has not funded any therapeutic research with psilocybin.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Charles Grob']‘Slowly but surely, our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer.’[/pullquote]\u003c/p>\n\u003cp>Dr. Charles Grob, a psychiatrist at UCLA’s David Geffen School of Medicine, has studied the therapeutic potential of psychedelics since the 1980s. His \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20819978\" target=\"_blank\" rel=\"noopener noreferrer\">four-year-long pilot study\u003c/a> of psilocybin-assisted therapy on patients with anxiety and advanced-stage cancer was among the first studies to launch this modern-day era of psychedelic research. It was published in the Archives of General Psychiatry in 2011.\u003c/p>\n\u003cp>Grob attributes the resurgence of research interest in psychedelics to several factors: a dire need for new mental health treatments, a more sophisticated understanding of the underlying hallucinogenic compounds and a growing body of research literature showing promising results from around the world.\u003c/p>\n\u003cp>All those trends are helping to destigmatize the use of psychedelics for psychological healing, Grob says.\u003c/p>\n\u003cp>“Slowly but surely, our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer,” he says.\u003c/p>\n\u003ch3>Therapeutic advantages — and risks\u003c/h3>\n\u003cp>Studies show psychedelics aren’t physically addictive. And research has shown them to be safe when administered properly to healthy patients. But Johnson cautions that psychedelics can be abused.\u003c/p>\n\u003cp>“We are not encouraging people to [take psilocybin] on their own,” Johnson says. “There are definitely risks, we know what those are … and we have a way to address them in these research studies.”\u003c/p>\n\u003cp>In particular, a \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0028390818302296\" target=\"_blank\" rel=\"noopener noreferrer\">study by Johnson and his team\u003c/a>, published in 2018, shows psilocybin can cause harm to those with a predisposition to psychosis. So potential study participants undergo “a couple of very long days” of screening before they can be admitted into the clinical trial, he says.\u003c/p>\n\u003cp>For those deemed healthy and able to undergo this therapy, there are no long-term or ongoing prescriptions, as is the case with other therapies for quitting smoking, like Chantix.\u003c/p>\n\u003cp>In Johnson’s current study, the patient ingests only one dose of psilocybin during a special session that takes place about halfway through a series of 10 cognitive behavioral therapy sessions.\u003c/p>\n\u003ch3>Promising results for quitting cigarettes\u003c/h3>\n\u003cp>So far, about 40 out of 80 participants have completed the 13-week protocol for the Johns Hopkins study. It begins with four hours of preparatory counseling before the patient takes the lab-produced psilocybin in pill form.\u003c/p>\n\u003cp>The psilocybin session lasts about six hours and is supervised by two therapeutic “guides” who provide comfort and assurance as needed. As the hallucinogen kicks in, patients are counseled to close their eyes, go inward and experience whatever shows up.\u003c/p>\n\u003cp>So far, half of the 40 participants who’ve completed the current Johns Hopkins smoking cessation program have quit smoking, as confirmed by urine and breath samples, Johnson says.\u003c/p>\n\u003cp>That compares to a 10% to 35% success rate for conventional therapies such as nicotine-replacement medications or cognitive behavioral therapy alone, says Johnson.\u003c/p>\n\u003cp>Johnson says the evidence collected so far suggests a couple more doses of psilocybin might prove even more successful.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286320/\">his pilot study\u003c/a> published in 2014, 15 participants received a similar amount of counseling as those in Chen-McLaughlin’s group. But instead of one dose of psilocybin, they got three. Six months later, 80% were smoke-free, Johnson says.\u003c/p>\n\u003cp>Still, Johnson cautions against too much enthusiasm just yet, because the studies at this point are small.\u003c/p>\n\u003cp>He says if his current study maintains a favorable success rate, the U.S. Food and Drug Administration would then require him to replicate that success in larger, Phase 3 clinical trials before the agency could consider approving psilocybin-assisted therapy as a treatment for addicted smokers.\u003c/p>\n\u003cp>“The caveat to all this is that we have so much more to learn and to explore, to really understand what’s going on,” he says.\u003c/p>\n\u003ch3>A shift in perspective\u003c/h3>\n\u003cp>How psilocybin might help with addiction is not yet clear.\u003c/p>\n\u003cp>“Our best guess at this point is that while the drug is active, the brain is operating in a dramatically, qualitatively different fashion,” Johnson says.\u003c/p>\n\u003cp>Most notably, areas of the brain that normally don’t communicate begin to do so, while well-worn neural pathways go quiet. What’s more, because psychedelics don’t numb the mind in the way alcohol and some other drugs do, patients report leaving the session with their newfound insights intact.\u003c/p>\n\u003cp>“People often report a remarkable clarity,” Johnson says.”They know what’s going on [during the experience and] they can observe their life and themselves from a much different vantage point – a much broader vantage point.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Matthew Johnson']‘Our best guess at this point is that while the drug is active, the brain is operating in a dramatically, qualitatively different fashion.’[/pullquote]\u003c/p>\n\u003cp>This perspective shift is part of the “mystical experience” that recreational psilocybin users report, and that spiritual users, such as shamans, have described for centuries. One theory of how these drugs may help is that experiencing feelings of unity, sacredness and transcendence can help change thought patterns that fuel addiction.\u003c/p>\n\u003cp>That doesn’t mean the experience is necessarily easy, or even enjoyable. Chen-McLaughlin reported that as she lay for hours on the couch,the psilocybin unleashed a host of fears, which took the form of swirling dark clouds that she believed were trying to suffocate her.\u003c/p>\n\u003cp>“And that was really super, super scary,” she says. “And I cried, I think at least four out of five, six hours.”\u003c/p>\n\u003cp>Yet, she says, through the entire experience, she had a vision of her recently-deceased mother, who seemed to stand by as a sort of spiritual sentry, helping her to face those dark, cloud-like fears. At that very point, as she became determined to confront them, Chen-McLaughlin says, the dark clouds dissipated — and so did her desire to smoke.\u003c/p>\n\u003cp>“I haven’t smoked since March 23, 2018,” she says, adding that she has no clear idea why it worked.\u003c/p>\n\u003cp>Since her psilocybin experience, Chen-McLaughlin has not only quit smoking, she reports feeling physically repulsed by cigarettes. One day when she was feeling stressed, she asked her cigarette-smoking husband for a puff of his. But when she reached for it, she says, she couldn’t even make herself touch it.\u003c/p>\n\u003cp>“You could pay me $5,000 and I couldn’t do it,” she says. “I know it sounds really weird, but that’s what happened: Something in my brain sort of got switched.”\u003c/p>\n\u003cp>Still, she attributes her success in quitting smoking not just to psilocybin, but to a combination of the drug and all the hours of cognitive behavioral therapy she received along with it.\u003c/p>\n\u003cp>“If I just walked in and took a psilocybin pill,” she says, ” I don’t think it would have worked.”\u003c/p>\n\u003cp>\u003cem>Stephanie O’Neill is a health and science writer in California.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR’s reporting partnership with \u003c/em>\u003ca href=\"https://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Way+To+Quit%3F+Psychedelic+Therapy+Offers+Promise+For+Smoking+Cessation&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>[ad fullwidth]\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "A New Way To Quit? Psychedelic Therapy Offers Promise For Smoking Cessation | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For many Americans, hallucinogens still evoke the psychedelic ’60s, bringing to mind the sex-and-drugs lifestyle of the hippie counterculture.\u003c/p>\n\u003cp>But that stereotype lags behind reality, by several decades. Today, psychedelic experimentation is more likely to refer to dozens of clinical trials taking place at universities and research facilities. The psychedelics under study range from psilocybin, the active ingredient in psychedelic mushrooms, to MDMA (also known as Ecstasy or Molly), to LSD, among others. Researchers are studying them for their therapeutic potential in treating hard-to-treat conditions such as PTSD, addiction, depression and anxiety.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The promise of freedom from cigarettes was what compelled Carine Chen-McLaughlin, 65, to enroll in an experimental study of psilocybin therapy for smokers. She was desperate to break free from her decades-long physical addiction to nicotine. Quitting smoking had felt impossible for so long.\u003c/p>\n\u003cp>“It’s basically saying good-bye to a very old friend, and worrying about: Am I going to be OK without this good friend?” the Baltimore resident says.\u003c/p>\n\u003cp>Like many of the 49 million \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6845a2.htm?s_cid=mm6845a2_w\" target=\"_blank\" rel=\"noopener noreferrer\">tobacco users\u003c/a> in the U.S., Chen-McLaughlin wanted to quit and had tried various methods: nicotine gum, the nicotine patch and even stopping cold turkey. But nothing worked for more than a couple days.\u003c/p>\n\u003cp>The clinical trial she joined took place in her hometown of Baltimore, at Johns Hopkins School of Medicine. While she was a bit anxious about the experiment, Chen-McLaughlin says she was nevertheless hopeful about trying something totally different.\u003c/p>\n\u003cp>“I think I was more excited that… maybe, \u003cem>maybe \u003c/em>this is it!” she says with a laugh.\u003c/p>\n\u003ch3>A research revival\u003c/h3>\n\u003cp>Therapeutic research on psilocybin, LSD and other psychedelic drugs isn’t new. Beginning in the 1950s, researchers investigated them as potential treatments for alcohol addiction, cancer-related anxiety, depression and other common psychological ills.\u003c/p>\n\u003cp>But then came the “psychedelic ’60s,” a time when American counterculture embraced these then-legal drugs. The resulting widespread use — and abuse — of psychedelics ultimately triggered a backlash that led the federal government to criminalize these substances. By the early 1970s, many ongoing studies into the potential medical benefits of psychedelics had halted.\u003c/p>\n\u003cp>“Unfortunately, all of that legitimate research was really sacrificed because of the association between psychedelics and the counterculture,” says \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/0800020/matthew-johnson\" target=\"_blank\" rel=\"noopener noreferrer\">Matthew Johnson\u003c/a>, an associate professor of psychiatry at Johns Hopkins School of Medicine and the lead investigator in the psilocybin study for smoking cessation.\u003c/p>\n\u003cp>Today, however, a new wave of psychedelic research has taken hold, with dozens of clinical studies happening at U.S. academic institutions. In fact, some of the experimental therapies involving psilocbyin\u003ca href=\"https://www.medscape.com/viewarticle/921789\" target=\"_blank\" rel=\"noopener noreferrer\"> have recently received \u003c/a>“breakthrough therapy” designations \u003ca href=\"https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/breakthrough-therapy\" target=\"_blank\" rel=\"noopener noreferrer\">from the FDA\u003c/a>, which can help speed their progress towards eventual market approval.\u003c/p>\n\u003cp>Although the studies are legal, the federal government does not provide any financial support for psychedelic research, so the researchers must rely on private organizations for funding. The Johns Hopkins study, for instance, is supported by the non-profit \u003ca href=\"https://heffter.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Heffter Research Institute\u003c/a> in New Mexico.\u003c/p>\n\u003cp>“We’re ever hopeful and we’re continuing to put in [funding] applications,” Johnson says. “But so far, the National Institutes of Health has not funded any therapeutic research with psilocybin.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Charles Grob, a psychiatrist at UCLA’s David Geffen School of Medicine, has studied the therapeutic potential of psychedelics since the 1980s. His \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20819978\" target=\"_blank\" rel=\"noopener noreferrer\">four-year-long pilot study\u003c/a> of psilocybin-assisted therapy on patients with anxiety and advanced-stage cancer was among the first studies to launch this modern-day era of psychedelic research. It was published in the Archives of General Psychiatry in 2011.\u003c/p>\n\u003cp>Grob attributes the resurgence of research interest in psychedelics to several factors: a dire need for new mental health treatments, a more sophisticated understanding of the underlying hallucinogenic compounds and a growing body of research literature showing promising results from around the world.\u003c/p>\n\u003cp>All those trends are helping to destigmatize the use of psychedelics for psychological healing, Grob says.\u003c/p>\n\u003cp>“Slowly but surely, our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer,” he says.\u003c/p>\n\u003ch3>Therapeutic advantages — and risks\u003c/h3>\n\u003cp>Studies show psychedelics aren’t physically addictive. And research has shown them to be safe when administered properly to healthy patients. But Johnson cautions that psychedelics can be abused.\u003c/p>\n\u003cp>“We are not encouraging people to [take psilocybin] on their own,” Johnson says. “There are definitely risks, we know what those are … and we have a way to address them in these research studies.”\u003c/p>\n\u003cp>In particular, a \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0028390818302296\" target=\"_blank\" rel=\"noopener noreferrer\">study by Johnson and his team\u003c/a>, published in 2018, shows psilocybin can cause harm to those with a predisposition to psychosis. So potential study participants undergo “a couple of very long days” of screening before they can be admitted into the clinical trial, he says.\u003c/p>\n\u003cp>For those deemed healthy and able to undergo this therapy, there are no long-term or ongoing prescriptions, as is the case with other therapies for quitting smoking, like Chantix.\u003c/p>\n\u003cp>In Johnson’s current study, the patient ingests only one dose of psilocybin during a special session that takes place about halfway through a series of 10 cognitive behavioral therapy sessions.\u003c/p>\n\u003ch3>Promising results for quitting cigarettes\u003c/h3>\n\u003cp>So far, about 40 out of 80 participants have completed the 13-week protocol for the Johns Hopkins study. It begins with four hours of preparatory counseling before the patient takes the lab-produced psilocybin in pill form.\u003c/p>\n\u003cp>The psilocybin session lasts about six hours and is supervised by two therapeutic “guides” who provide comfort and assurance as needed. As the hallucinogen kicks in, patients are counseled to close their eyes, go inward and experience whatever shows up.\u003c/p>\n\u003cp>So far, half of the 40 participants who’ve completed the current Johns Hopkins smoking cessation program have quit smoking, as confirmed by urine and breath samples, Johnson says.\u003c/p>\n\u003cp>That compares to a 10% to 35% success rate for conventional therapies such as nicotine-replacement medications or cognitive behavioral therapy alone, says Johnson.\u003c/p>\n\u003cp>Johnson says the evidence collected so far suggests a couple more doses of psilocybin might prove even more successful.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286320/\">his pilot study\u003c/a> published in 2014, 15 participants received a similar amount of counseling as those in Chen-McLaughlin’s group. But instead of one dose of psilocybin, they got three. Six months later, 80% were smoke-free, Johnson says.\u003c/p>\n\u003cp>Still, Johnson cautions against too much enthusiasm just yet, because the studies at this point are small.\u003c/p>\n\u003cp>He says if his current study maintains a favorable success rate, the U.S. Food and Drug Administration would then require him to replicate that success in larger, Phase 3 clinical trials before the agency could consider approving psilocybin-assisted therapy as a treatment for addicted smokers.\u003c/p>\n\u003cp>“The caveat to all this is that we have so much more to learn and to explore, to really understand what’s going on,” he says.\u003c/p>\n\u003ch3>A shift in perspective\u003c/h3>\n\u003cp>How psilocybin might help with addiction is not yet clear.\u003c/p>\n\u003cp>“Our best guess at this point is that while the drug is active, the brain is operating in a dramatically, qualitatively different fashion,” Johnson says.\u003c/p>\n\u003cp>Most notably, areas of the brain that normally don’t communicate begin to do so, while well-worn neural pathways go quiet. What’s more, because psychedelics don’t numb the mind in the way alcohol and some other drugs do, patients report leaving the session with their newfound insights intact.\u003c/p>\n\u003cp>“People often report a remarkable clarity,” Johnson says.”They know what’s going on [during the experience and] they can observe their life and themselves from a much different vantage point – a much broader vantage point.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This perspective shift is part of the “mystical experience” that recreational psilocybin users report, and that spiritual users, such as shamans, have described for centuries. One theory of how these drugs may help is that experiencing feelings of unity, sacredness and transcendence can help change thought patterns that fuel addiction.\u003c/p>\n\u003cp>That doesn’t mean the experience is necessarily easy, or even enjoyable. Chen-McLaughlin reported that as she lay for hours on the couch,the psilocybin unleashed a host of fears, which took the form of swirling dark clouds that she believed were trying to suffocate her.\u003c/p>\n\u003cp>“And that was really super, super scary,” she says. “And I cried, I think at least four out of five, six hours.”\u003c/p>\n\u003cp>Yet, she says, through the entire experience, she had a vision of her recently-deceased mother, who seemed to stand by as a sort of spiritual sentry, helping her to face those dark, cloud-like fears. At that very point, as she became determined to confront them, Chen-McLaughlin says, the dark clouds dissipated — and so did her desire to smoke.\u003c/p>\n\u003cp>“I haven’t smoked since March 23, 2018,” she says, adding that she has no clear idea why it worked.\u003c/p>\n\u003cp>Since her psilocybin experience, Chen-McLaughlin has not only quit smoking, she reports feeling physically repulsed by cigarettes. One day when she was feeling stressed, she asked her cigarette-smoking husband for a puff of his. But when she reached for it, she says, she couldn’t even make herself touch it.\u003c/p>\n\u003cp>“You could pay me $5,000 and I couldn’t do it,” she says. “I know it sounds really weird, but that’s what happened: Something in my brain sort of got switched.”\u003c/p>\n\u003cp>Still, she attributes her success in quitting smoking not just to psilocybin, but to a combination of the drug and all the hours of cognitive behavioral therapy she received along with it.\u003c/p>\n\u003cp>“If I just walked in and took a psilocybin pill,” she says, ” I don’t think it would have worked.”\u003c/p>\n\u003cp>\u003cem>Stephanie O’Neill is a health and science writer in California.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR’s reporting partnership with \u003c/em>\u003ca href=\"https://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Way+To+Quit%3F+Psychedelic+Therapy+Offers+Promise+For+Smoking+Cessation&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003c/p>\u003c/div>",
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"content": "\u003cp>The Department of Labor’s workplace safety agency is getting ready to take new action to reduce workers’ exposure to dangerous \u003ca href=\"https://www.cdc.gov/niosh/topics/silica/default.html\" target=\"_blank\" rel=\"noopener noreferrer\">silica\u003c/a> dust that can irreparably damage the lungs.\u003c/p>\n\u003cp>But the agency’s new program doesn’t give special attention to the kitchen and bathroom countertop industry, which has recently seen \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/02/766028237/workers-are-falling-ill-even-dying-after-making-kitchen-countertops\" target=\"_blank\" rel=\"noopener noreferrer\">cases\u003c/a> of severe lung damage that have alarmed public health officials.\u003c/p>\n\u003cp>Physicians have found aggressive forms of the disease silicosis in young, previously healthy \u003ca href=\"https://www.npr.org/series/785708157/silicosis-in-u-s-countertop-workers\" target=\"_blank\" rel=\"noopener noreferrer\">workers\u003c/a> who cut and polished countertops made out of natural stone and \u003ca href=\"https://www.npr.org/sections/health-shots/2019/12/02/782958005/there-s-no-good-dust-what-happens-after-quartz-countertops-leave-the-factory\" target=\"_blank\" rel=\"noopener noreferrer\">engineered quartz\u003c/a>, a composite material that typically has a silica content of more than 90%. Some workers have died, and others will need lung transplants.\u003c/p>\n\u003cp>Finding silicosis in the countertop industry was something new for the United States, where over 2 million American workers are exposed to silica dust in other jobs like construction, \u003ca href=\"https://www.cdc.gov/features/preventing-silicosis/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">according\u003c/a> to the Centers for Disease Control and Prevention. The silica dust comes from cutting, grinding, mixing or demolishing materials like stone, concrete and brick.\u003c/p>\n\u003cp>In Australia, \u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30478-7/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">studies\u003c/a> of countertop workers have found that more than 10% have silicosis. It’s unknown how many of the estimated 100,000 countertop workers in the U. S. are affected.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lawmakers \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/07/767916317/lawmakers-seek-protections-for-workers-against-lung-damage-tied-to-making-counte\" target=\"_blank\" rel=\"noopener noreferrer\">wrote\u003c/a> to the Occupational Safety and Health Administration in October, calling for the agency to issue a new \u003ca href=\"https://www.osha.gov/enforcement/directives/nep\" target=\"_blank\" rel=\"noopener noreferrer\">National Emphasis Program\u003c/a> to focus agency resources on the engineered stone countertop fabrication industry and make it easier for inspectors to target those workplaces.\u003c/p>\n\u003cp>The American Public Health Association also wrote to OSHA in October, saying “there is an urgent need for OSHA enforcement and outreach on respirable silica in this industry. … Targeted inspections in the industry will help determine the magnitude of the problem.” As of Dec. 20, OSHA had not responded to the association.\u003c/p>\n\u003cp>On Dec. 19, however, the Department of Labor did \u003ca href=\"https://www.npr.org/documents/2019/dec/12-19-2019%20Scott%20RE-Silica%20NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">inform lawmakers \u003c/a>that it \u003ca href=\"https://www.npr.org/documents/2019/dec/12-19-2019%20Adams%20RE-Silica%20NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">intends to implement\u003c/a> a new \u003ca href=\"https://www.npr.org/documents/2019/dec/Silica_NEP.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">National Emphasis Program\u003c/a> for silica, which will replace a similar program that was \u003ca href=\"https://www.osha.gov/enforcement/directives/cpl-03-00-007-0\">canceled\u003c/a> in October of 2017.\u003c/p>\n\u003cp>[aside tag='health' label='More Coverage.']\u003c/p>\n\u003cp>A required 10-day notice was given to House and Senate appropriations committees on Dec. 17, which means the program could go into effect very soon. It will require that 2% of all OSHA inspections every year occur in workplaces at elevated risk of silica exposures.\u003c/p>\n\u003cp>But countertop fabricators are just one targeted industry in a long list that includes everything from iron foundries to concrete pipe manufacturing to machine shops.\u003c/p>\n\u003cp>“OSHA anticipates that the majority of the inspections will occur in construction,” according to a description of the program provided to lawmakers, because most exposures to silica dust occur on construction sites.\u003c/p>\n\u003cp>One congressional aide said it wasn’t clear how many additional inspections would actually occur at countertop fabrication shops, and called this a woefully inadequate response to what some public health experts fear is a potential crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The spending bill that passed this past week did provide OSHA with an increase of $24 million above its 2019 enacted funding level, however, which means more money will be available for inspections and enforcement.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Safety+Program+Takes+On+Silica+Dust+Amid+A+Possible+Crisis&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Maria Isabel Bueso and her family have waited months to learn whether they could stay in the country. Bueso has lived in the Bay Area for 16 years under a special immigration status in order to get treatment for a rare genetic disease. \u003ca href=\"https://www.kqed.org/news/11771386/advocating-for-my-own-life-bay-area-woman-getting-lifesaving-care-faces-deportation\">In August\u003c/a>, she received a letter from U.S. Citizenship and Immigration Services demanding that she leave the country. But Bueso became a leading advocate on behalf of hundreds of immigrants who received similar letters, and her story highlighted the harm of President Trump’s sweeping immigration policies.\u003c/p>\n\u003cp>And on Dec. 6, Bueso \u003ca href=\"https://www.kqed.org/news/11790433/concord-woman-with-rare-disease-granted-reprieve-from-deportation\">got word\u003c/a> that she can stay in the U.S. for at least two more years.\u003c/p>\n\u003cp>Guest: \u003ca href=\"https://twitter.com/FaridaJhabvala\">Farida Jhabvala Romero\u003c/a>, KQED immigration reporter\u003c/p>\n\u003cdiv class=\"c-message_actions__container c-message__actions\" role=\"group\" aria-label=\"Message actions\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "‘Brain Waste': Highly Skilled Immigrants Struggle to Fill Workforce Gaps",
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"content": "\u003cp>Burmese doctors dish sushi at a restaurant, a Jordanian computer engineer drives for Uber, and a Nepali non-profit program officer stocks shelves at a Walmart.\u003c/p>\n\u003cp>Nearly two million college-educated immigrants labor in jobs for which they are overqualified, or cannot find work at all.\u003c/p>\n\u003cp>The so-called “brain waste” phenomenon is costing California and other states billions of dollars per year in lost individual earnings and tax revenues, according to estimates by the Migration Policy Institute. The problem is worsening as, among immigrants continuing to arrive in the United States, there’s a greater proportion of college-educated individuals, experts warn.\u003c/p>\n\u003cp>[audio src=\"https://od1.kqed.org/anon.kqed/radio/tcr/2020/01/JhabvalaRomeroRefugeeWorkforce.mp3\" /]\u003c/p>\n\u003cp>New immigrants face barriers to obtaining high-skilled jobs that may take years to overcome, \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">including\u003c/a> the lack of U.S. professional work experience and technical English fluency. The process for getting foreign credentials recognized in this country can be long, complicated and expensive, especially in highly regulated fields like health care.\u003c/p>\n\u003cp>Wilmer Garcia Ricardo, a physician in Cuba and Venezuela for seven years, was admitted to the U.S. in 2012 through a now-defunct government humanitarian parole program for Cuban medical professionals. But once he resettled in Louisville, Ky., Garcia Ricardo was left on his own to figure out how to work again as a doctor in America.\u003c/p>\n\u003cp>“It has been years of study and sacrifice,” said Garcia Ricardo, now 38 years old.\u003c/p>\n\u003cfigure id=\"attachment_11790706\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790706\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">International Rescue Committee staffer Saeideh Mahdavisefat leads a job interview workshop with recently arrived refugees at the resettlement agency’s offices in San Jose on Oct. 16, 2019. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He took classes to improve his English. He bought books online and looked into blogs and forums about other immigrant physicians going through the rigorous U.S. medical licensing process. Meanwhile, he got a job as a patient care aide at a nursing home to pay his bills.\u003c/p>\n\u003cp>“That was like, being a doctor in January 2012, and then, three months after, going to the bottom of the health care system in America,” said Garcia Ricardo. “It was frustrating.”\u003c/p>\n\u003cp>Professional demotion is typical among the recent immigrants, including refugees, asylees and other humanitarian migrants who get help adjusting to life in America through the International Rescue Committee, said Kevin Davis, career development coordinator at the resettlement agency’s offices in San Jose.\u003c/p>\n\u003cp>IRC’s program focuses on helping humanitarian migrants rebuild or start careers in the U.S. through training, coaching and scholarships.\u003c/p>\n\u003cp>While many of these immigrants come with limited English or professional work experience, Davis estimates about half of the 200 clients in his program per year are highly skilled or college educated.\u003c/p>\n\u003cp>Regardless of their talents and expertise, nearly all of them get what Davis calls “survival jobs” in retail, hospitality, security and other industries during their first months in the U.S.\u003c/p>\n\u003cp>“The survival job is like a stepping stone,” he said. “And once they can pay their immediate bills, then we will work with them to sort of say, ‘All right, well, what comes next?’”\u003c/p>\n\u003cfigure id=\"attachment_11790707\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790707\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A billboard at the International Rescue Committee San Jose office displays advice for newly arrived immigrants to handle job interviews. The resettlement agency provides training, coaching and scholarships for humanitarian migrants to start or rebuild careers in the U.S. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Brain Waste’\u003c/h3>\n\u003cp>In California, about 450,000 immigrants with at least a bachelor’s degree are underemployed, meaning they have low-skilled jobs , or they can’t find work at all, according to an \u003ca href=\"https://www.migrationpolicy.org/research/untapped-talent-costs-brain-waste-among-highly-skilled-immigrants-united-states\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> by the Migration Policy Institute. About 25 percent of highly skilled immigrants are overqualified for their jobs in the state compared to 19 percent for the U.S. born workers.\u003c/p>\n\u003cp>The cost to California, the state with the largest immigrant population, is significant: about $9.4 billion in lost annual earnings that result in nearly $700 million foregone state and local taxes, said Jeanne Batalova, a senior policy analyst at the institute and co-author of the report.\u003c/p>\n\u003cp>Compared to the U.S., countries like Canada and Australia have invested more resources to help immigrants understand and navigate licensing and other requirements to make their way into professional occupations, she said.\u003c/p>\n\u003cp>“The United States has a fairly laissez faire approach to helping immigrants integrate into the labor market. And really the approach is sink or swim,” said Batalova. “Unfortunately, at the national level, there hasn’t really been a strategy developed to deal with what we call ‘brain waste.’”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The issue has become more pronounced as the U.S. economy increasingly depends on highly skilled workers. Moreover, in recent years, a larger proportion of immigrants — about \u003ca href=\"https://www.migrationpolicy.org/news/mpi-reveals-striking-finding-nearly-half-immigrant-adults-arriving-us-2011-have-college-degree\" target=\"_blank\" rel=\"noopener noreferrer\">48 percent\u003c/a> — arrive in the U.S. with at least a bachelor’s degree, said Batalova.\u003c/p>\n\u003cp>“That can become an important talent pool, if their skills are put to good use,” she said.\u003c/p>\n\u003cp>On the other hand, employers often don’t know how to interpret and determine the value of an applicant’s credentials from foreign universities, said Jina Krause-Vilmar, CEO at Upwardly Global, a non-profit founded in San Francisco that helps place high-skilled immigrants and refugees in professional careers in the U.S.\u003c/p>\n\u003cp>“How do you value somebody from the University of Baghdad versus somebody from UCLA?” said Krause-Vilmar, whose organization frequently works with employers. “Part of it is building that awareness amongst employers so that they can effectively understand what this untapped talent pool offers.”\u003c/p>\n\u003cfigure id=\"attachment_11790712\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790712\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Wilmer Garcia Ricardo is now a medical resident in the San Joaquin General Hospitals’ family medicine department. He said obtaining work experience in the U.S. through the UCLA International Medical Graduate program was key to obtaining his residency position. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>One Doctor’s Story\u003c/h3>\n\u003cp>Garcia Ricardo, who trained as a family medicine practitioner in Cuba, knew of the need for more physicians in the U.S. In the next decade, California will face a shortfall of 4,100 primary care clinicians, which is \u003ca href=\"https://calmatters.org/projects/california-doctor-shortage-free-med-school-loan-repayment-recruiting-solutions/\" target=\"_blank\" rel=\"noopener noreferrer\">already affecting\u003c/a> rural and low-income urban areas, \u003ca href=\"https://futurehealthworkforce.org/2019/02/04/ca-looming-workforce-crisis/\" target=\"_blank\" rel=\"noopener noreferrer\">according to\u003c/a> the California Future Health Workforce Commission.\u003c/p>\n\u003cp>[aside postID=\"news_11722933\" label=\"\"]The Cuban immigrant said he spent six years and more than $10,000 to eventually pass the U.S. medical licensing exams and apply for residency programs, which he needs to be licensed as a doctor in any state. He drove Uber and Lyft on the side to make ends meet, he said.\u003c/p>\n\u003cp>“I applied to 166 programs, and I received one interview invitation,” said Garcia Ricardo. “And at the end of a process, all that money was lost. I was not granted a position.”\u003c/p>\n\u003cp>He figures a big reason was that, unlike domestic medical graduates, he didn’t have any “hands-on medical experience” in this country.\u003c/p>\n\u003cp>“All my experience as a doctor was from Cuba and Venezuela, and all my work experience in the U.S. was as a patient assistant,” said Garcia Ricardo, with a shrug.\u003c/p>\n\u003cp>But he didn’t give up.\u003c/p>\n\u003cp>It was a unique program in California, the UCLA International Medical Graduate Program, that finally gave him the qualifications and training to better compete for coveted residency spots in family medicine.\u003c/p>\n\u003cp>Applying to residency programs is an extremely competitive process, and those positions are very limited, especially in rural and low-income communities, said Dr. Michelle Bholat, an associate professor at the UCLA Department of Family Medicine and co-director of the IMG program.\u003c/p>\n\u003cp>“If I had a magic wand, I would say ‘Let us get some additional residency positions available in our most underserved areas in California,’” said Bholat.\u003c/p>\n\u003cp>Thanks to a \u003ca href=\"https://sd30.senate.ca.gov/news/press-releases/2012-07-16-holly-mitchell-bill-will-add-new-doctors-underserved-communities\" target=\"_blank\" rel=\"noopener noreferrer\">state law\u003c/a> approved in 2012, Spanish-speaking physicians in the IMG program can work under supervision with patients at a Los Angeles family clinic and hospital, so they learn the U.S. health care system and gain valuable work experience.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Michelle Bholat, co-director of the IMG program\"]‘What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term.’[/pullquote]Although there are hundreds of applicants to the program each year, only about 15 physicians are admitted, said Bholat.\u003c/p>\n\u003cp>In exchange for the training, the doctors commit to working at least two years in underserved medical communities once they are licensed. Since 2006, 140 doctors have graduated from the IMG program.\u003c/p>\n\u003cp>Bholat has high hopes for one of this year’s graduates, Garcia Ricardo. Now, he is a medical resident at San Joaquin General Hospital, south of Stockton. Most patients at the county hospital qualify for Medi-Cal, and about 40 percent speak Spanish, according to doctors.\u003c/p>\n\u003cp>“He’s going to be a role model for that Latino community to know that ‘You know what? I have a doctor that understands me. I have a doctor who’s going to be there for my family,”’ said Bholat.\u003c/p>\n\u003cp>Garcia Ricardo compared the years he struggled in America to regain his profession to feeling like a fish out of water, gasping for air and flopping around.\u003c/p>\n\u003cp>“And then you put the fish back in the water? That’s the same feeling I had when I had a white coat back on,” said Garcia Ricardo, and smiled.\u003c/p>\n\u003cp>Dr. Elyas Parsa, who oversees San Joaquin General Hospital’s family residency program, said it’s “invaluable” to have a physician like Garcia Ricardo who culturally understands patients and speaks their language. Immigrant physicians are also passionate about working with underserved communities, said Parsa.\u003c/p>\n\u003cp>“What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term,” said Parsa, himself a political refugee from Iran.\u003c/p>\n\u003ch3>Rules Vary State by State\u003c/h3>\n\u003cp>While the federal government oversees immigration, state governments regulate the practice of occupations. Those requirements often vary across state lines and can be cumbersome to navigate.\u003c/p>\n\u003cp>[aside postID=\"news_11682562,news_11299596,news_13815450\" label=\"Related coverage\"]Some states like Utah and South Dakota have modified certain licensing requirements to make it easier for internationally trained professionals to re-enter fields such as occupational therapy or dentistry, according to a \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">report\u003c/a> by the National Conference of State Legislatures.\u003c/p>\n\u003cp>In recent years, U.S. Department of Labor has provided \u003ca href=\"https://www.dol.gov/newsroom/releases/eta/eta20180625\" target=\"_blank\" rel=\"noopener noreferrer\">grants\u003c/a> for states to study how to streamline occupational licensing rules, in part to make it easier for people to be recertified after they move to another state.\u003c/p>\n\u003cp>The federal government could also provide additional financial support to organizations that help internationally educated professionals integrate into the U.S. workforce, said Batalova of the Migration Policy Institute.\u003c/p>\n\u003cp>Refugees, asylees and other immigrants can access limited federal and local financial support while they look for work. But there’s a lot of pressure to earn income as soon as possible, especially in high-cost regions like the Bay Area. Davis at the IRC said his program often coaches immigrants to take gradual steps into careers in healthcare and other industries desperate for workers.\u003c/p>\n\u003cp>Eden Asfaha, 38, followed that trajectory.\u003c/p>\n\u003cfigure id=\"attachment_11790710\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790710\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eden Asfaha, an asylee from Eritrea, works the cashier at a Holiday Inn restaurant in San Jose, Calif. on Nov. 14, 2019. Asfaha is finishing training to be licensed as a phlebotomy technician. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Starting a New Path\u003c/h3>\n\u003cp>Asfaha was a secretary for a European Union diplomatic office in her native Eritrea, and worked in community development for European-based non-profits.\u003c/p>\n\u003cp>After winning asylum in the U.S. in 2014, she attended an IRC job fair to land her first American job as a cashier and hostess at a San Jose restaurant. That allowed her to enroll in classes at De Anza Community College in Cupertino to become a phlebotomy technician.\u003c/p>\n\u003cp>“I decided to switch to something that’s practical that I can find a job in the laboratory,” said Asfaha, an evangelical Christian who fled Eritrea to escape religious persecution.\u003c/p>\n\u003cp>She eventually plans to go back to school to train as a medical lab technician, she said.\u003c/p>\n\u003cp>“When I came here, I knew I would be starting from scratch. I knew it was going to be a hard road ahead,” said Asfaha. “I just have to take the steps I need to get in there.”\u003c/p>\n\u003cp>\u003cem>The California Dream series is a statewide media collaboration of CalMatters, KPBS, KPCC, KQED and Capital Public Radio, with support from the Corporation for Public Broadcasting, the James Irvine Foundation and the College Futures Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11768052\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg\" alt=\"\" width=\"800\" height=\"219\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219-160x44.jpg 160w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Burmese doctors dish sushi at a restaurant, a Jordanian computer engineer drives for Uber, and a Nepali non-profit program officer stocks shelves at a Walmart.\u003c/p>\n\u003cp>Nearly two million college-educated immigrants labor in jobs for which they are overqualified, or cannot find work at all.\u003c/p>\n\u003cp>The so-called “brain waste” phenomenon is costing California and other states billions of dollars per year in lost individual earnings and tax revenues, according to estimates by the Migration Policy Institute. The problem is worsening as, among immigrants continuing to arrive in the United States, there’s a greater proportion of college-educated individuals, experts warn.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>New immigrants face barriers to obtaining high-skilled jobs that may take years to overcome, \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">including\u003c/a> the lack of U.S. professional work experience and technical English fluency. The process for getting foreign credentials recognized in this country can be long, complicated and expensive, especially in highly regulated fields like health care.\u003c/p>\n\u003cp>Wilmer Garcia Ricardo, a physician in Cuba and Venezuela for seven years, was admitted to the U.S. in 2012 through a now-defunct government humanitarian parole program for Cuban medical professionals. But once he resettled in Louisville, Ky., Garcia Ricardo was left on his own to figure out how to work again as a doctor in America.\u003c/p>\n\u003cp>“It has been years of study and sacrifice,” said Garcia Ricardo, now 38 years old.\u003c/p>\n\u003cfigure id=\"attachment_11790706\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790706\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40416_Photo-2-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">International Rescue Committee staffer Saeideh Mahdavisefat leads a job interview workshop with recently arrived refugees at the resettlement agency’s offices in San Jose on Oct. 16, 2019. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He took classes to improve his English. He bought books online and looked into blogs and forums about other immigrant physicians going through the rigorous U.S. medical licensing process. Meanwhile, he got a job as a patient care aide at a nursing home to pay his bills.\u003c/p>\n\u003cp>“That was like, being a doctor in January 2012, and then, three months after, going to the bottom of the health care system in America,” said Garcia Ricardo. “It was frustrating.”\u003c/p>\n\u003cp>Professional demotion is typical among the recent immigrants, including refugees, asylees and other humanitarian migrants who get help adjusting to life in America through the International Rescue Committee, said Kevin Davis, career development coordinator at the resettlement agency’s offices in San Jose.\u003c/p>\n\u003cp>IRC’s program focuses on helping humanitarian migrants rebuild or start careers in the U.S. through training, coaching and scholarships.\u003c/p>\n\u003cp>While many of these immigrants come with limited English or professional work experience, Davis estimates about half of the 200 clients in his program per year are highly skilled or college educated.\u003c/p>\n\u003cp>Regardless of their talents and expertise, nearly all of them get what Davis calls “survival jobs” in retail, hospitality, security and other industries during their first months in the U.S.\u003c/p>\n\u003cp>“The survival job is like a stepping stone,” he said. “And once they can pay their immediate bills, then we will work with them to sort of say, ‘All right, well, what comes next?’”\u003c/p>\n\u003cfigure id=\"attachment_11790707\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790707\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40415_Photo-5-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A billboard at the International Rescue Committee San Jose office displays advice for newly arrived immigrants to handle job interviews. The resettlement agency provides training, coaching and scholarships for humanitarian migrants to start or rebuild careers in the U.S. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Brain Waste’\u003c/h3>\n\u003cp>In California, about 450,000 immigrants with at least a bachelor’s degree are underemployed, meaning they have low-skilled jobs , or they can’t find work at all, according to an \u003ca href=\"https://www.migrationpolicy.org/research/untapped-talent-costs-brain-waste-among-highly-skilled-immigrants-united-states\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> by the Migration Policy Institute. About 25 percent of highly skilled immigrants are overqualified for their jobs in the state compared to 19 percent for the U.S. born workers.\u003c/p>\n\u003cp>The cost to California, the state with the largest immigrant population, is significant: about $9.4 billion in lost annual earnings that result in nearly $700 million foregone state and local taxes, said Jeanne Batalova, a senior policy analyst at the institute and co-author of the report.\u003c/p>\n\u003cp>Compared to the U.S., countries like Canada and Australia have invested more resources to help immigrants understand and navigate licensing and other requirements to make their way into professional occupations, she said.\u003c/p>\n\u003cp>“The United States has a fairly laissez faire approach to helping immigrants integrate into the labor market. And really the approach is sink or swim,” said Batalova. “Unfortunately, at the national level, there hasn’t really been a strategy developed to deal with what we call ‘brain waste.’”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The issue has become more pronounced as the U.S. economy increasingly depends on highly skilled workers. Moreover, in recent years, a larger proportion of immigrants — about \u003ca href=\"https://www.migrationpolicy.org/news/mpi-reveals-striking-finding-nearly-half-immigrant-adults-arriving-us-2011-have-college-degree\" target=\"_blank\" rel=\"noopener noreferrer\">48 percent\u003c/a> — arrive in the U.S. with at least a bachelor’s degree, said Batalova.\u003c/p>\n\u003cp>“That can become an important talent pool, if their skills are put to good use,” she said.\u003c/p>\n\u003cp>On the other hand, employers often don’t know how to interpret and determine the value of an applicant’s credentials from foreign universities, said Jina Krause-Vilmar, CEO at Upwardly Global, a non-profit founded in San Francisco that helps place high-skilled immigrants and refugees in professional careers in the U.S.\u003c/p>\n\u003cp>“How do you value somebody from the University of Baghdad versus somebody from UCLA?” said Krause-Vilmar, whose organization frequently works with employers. “Part of it is building that awareness amongst employers so that they can effectively understand what this untapped talent pool offers.”\u003c/p>\n\u003cfigure id=\"attachment_11790712\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790712\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40413_Photo-3-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Wilmer Garcia Ricardo is now a medical resident in the San Joaquin General Hospitals’ family medicine department. He said obtaining work experience in the U.S. through the UCLA International Medical Graduate program was key to obtaining his residency position. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>One Doctor’s Story\u003c/h3>\n\u003cp>Garcia Ricardo, who trained as a family medicine practitioner in Cuba, knew of the need for more physicians in the U.S. In the next decade, California will face a shortfall of 4,100 primary care clinicians, which is \u003ca href=\"https://calmatters.org/projects/california-doctor-shortage-free-med-school-loan-repayment-recruiting-solutions/\" target=\"_blank\" rel=\"noopener noreferrer\">already affecting\u003c/a> rural and low-income urban areas, \u003ca href=\"https://futurehealthworkforce.org/2019/02/04/ca-looming-workforce-crisis/\" target=\"_blank\" rel=\"noopener noreferrer\">according to\u003c/a> the California Future Health Workforce Commission.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The Cuban immigrant said he spent six years and more than $10,000 to eventually pass the U.S. medical licensing exams and apply for residency programs, which he needs to be licensed as a doctor in any state. He drove Uber and Lyft on the side to make ends meet, he said.\u003c/p>\n\u003cp>“I applied to 166 programs, and I received one interview invitation,” said Garcia Ricardo. “And at the end of a process, all that money was lost. I was not granted a position.”\u003c/p>\n\u003cp>He figures a big reason was that, unlike domestic medical graduates, he didn’t have any “hands-on medical experience” in this country.\u003c/p>\n\u003cp>“All my experience as a doctor was from Cuba and Venezuela, and all my work experience in the U.S. was as a patient assistant,” said Garcia Ricardo, with a shrug.\u003c/p>\n\u003cp>But he didn’t give up.\u003c/p>\n\u003cp>It was a unique program in California, the UCLA International Medical Graduate Program, that finally gave him the qualifications and training to better compete for coveted residency spots in family medicine.\u003c/p>\n\u003cp>Applying to residency programs is an extremely competitive process, and those positions are very limited, especially in rural and low-income communities, said Dr. Michelle Bholat, an associate professor at the UCLA Department of Family Medicine and co-director of the IMG program.\u003c/p>\n\u003cp>“If I had a magic wand, I would say ‘Let us get some additional residency positions available in our most underserved areas in California,’” said Bholat.\u003c/p>\n\u003cp>Thanks to a \u003ca href=\"https://sd30.senate.ca.gov/news/press-releases/2012-07-16-holly-mitchell-bill-will-add-new-doctors-underserved-communities\" target=\"_blank\" rel=\"noopener noreferrer\">state law\u003c/a> approved in 2012, Spanish-speaking physicians in the IMG program can work under supervision with patients at a Los Angeles family clinic and hospital, so they learn the U.S. health care system and gain valuable work experience.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Although there are hundreds of applicants to the program each year, only about 15 physicians are admitted, said Bholat.\u003c/p>\n\u003cp>In exchange for the training, the doctors commit to working at least two years in underserved medical communities once they are licensed. Since 2006, 140 doctors have graduated from the IMG program.\u003c/p>\n\u003cp>Bholat has high hopes for one of this year’s graduates, Garcia Ricardo. Now, he is a medical resident at San Joaquin General Hospital, south of Stockton. Most patients at the county hospital qualify for Medi-Cal, and about 40 percent speak Spanish, according to doctors.\u003c/p>\n\u003cp>“He’s going to be a role model for that Latino community to know that ‘You know what? I have a doctor that understands me. I have a doctor who’s going to be there for my family,”’ said Bholat.\u003c/p>\n\u003cp>Garcia Ricardo compared the years he struggled in America to regain his profession to feeling like a fish out of water, gasping for air and flopping around.\u003c/p>\n\u003cp>“And then you put the fish back in the water? That’s the same feeling I had when I had a white coat back on,” said Garcia Ricardo, and smiled.\u003c/p>\n\u003cp>Dr. Elyas Parsa, who oversees San Joaquin General Hospital’s family residency program, said it’s “invaluable” to have a physician like Garcia Ricardo who culturally understands patients and speaks their language. Immigrant physicians are also passionate about working with underserved communities, said Parsa.\u003c/p>\n\u003cp>“What we have seen, at least in our program, is that the residents that are from those backgrounds tend to want to stay in that community and serve those patients long term,” said Parsa, himself a political refugee from Iran.\u003c/p>\n\u003ch3>Rules Vary State by State\u003c/h3>\n\u003cp>While the federal government oversees immigration, state governments regulate the practice of occupations. Those requirements often vary across state lines and can be cumbersome to navigate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Some states like Utah and South Dakota have modified certain licensing requirements to make it easier for internationally trained professionals to re-enter fields such as occupational therapy or dentistry, according to a \u003ca href=\"http://www.ncsl.org/research/labor-and-employment/barriers-to-work-immigrants-with-work-authorization.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">report\u003c/a> by the National Conference of State Legislatures.\u003c/p>\n\u003cp>In recent years, U.S. Department of Labor has provided \u003ca href=\"https://www.dol.gov/newsroom/releases/eta/eta20180625\" target=\"_blank\" rel=\"noopener noreferrer\">grants\u003c/a> for states to study how to streamline occupational licensing rules, in part to make it easier for people to be recertified after they move to another state.\u003c/p>\n\u003cp>The federal government could also provide additional financial support to organizations that help internationally educated professionals integrate into the U.S. workforce, said Batalova of the Migration Policy Institute.\u003c/p>\n\u003cp>Refugees, asylees and other immigrants can access limited federal and local financial support while they look for work. But there’s a lot of pressure to earn income as soon as possible, especially in high-cost regions like the Bay Area. Davis at the IRC said his program often coaches immigrants to take gradual steps into careers in healthcare and other industries desperate for workers.\u003c/p>\n\u003cp>Eden Asfaha, 38, followed that trajectory.\u003c/p>\n\u003cfigure id=\"attachment_11790710\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11790710\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/12/RS40414_Photo-4-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eden Asfaha, an asylee from Eritrea, works the cashier at a Holiday Inn restaurant in San Jose, Calif. on Nov. 14, 2019. Asfaha is finishing training to be licensed as a phlebotomy technician. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Starting a New Path\u003c/h3>\n\u003cp>Asfaha was a secretary for a European Union diplomatic office in her native Eritrea, and worked in community development for European-based non-profits.\u003c/p>\n\u003cp>After winning asylum in the U.S. in 2014, she attended an IRC job fair to land her first American job as a cashier and hostess at a San Jose restaurant. That allowed her to enroll in classes at De Anza Community College in Cupertino to become a phlebotomy technician.\u003c/p>\n\u003cp>“I decided to switch to something that’s practical that I can find a job in the laboratory,” said Asfaha, an evangelical Christian who fled Eritrea to escape religious persecution.\u003c/p>\n\u003cp>She eventually plans to go back to school to train as a medical lab technician, she said.\u003c/p>\n\u003cp>“When I came here, I knew I would be starting from scratch. I knew it was going to be a hard road ahead,” said Asfaha. “I just have to take the steps I need to get in there.”\u003c/p>\n\u003cp>\u003cem>The California Dream series is a statewide media collaboration of CalMatters, KPBS, KPCC, KQED and Capital Public Radio, with support from the Corporation for Public Broadcasting, the James Irvine Foundation and the College Futures Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11768052\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg\" alt=\"\" width=\"800\" height=\"219\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/CADreamBanner-1-800x219-160x44.jpg 160w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "lgbtq-groups-call-on-facebook-to-remove-misleading-ads-about-hiv-prevention-drugs",
"title": "LGBTQ Groups Call on Facebook to Remove Misleading Ads About HIV Prevention Drugs",
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"headTitle": "LGBTQ Groups Call on Facebook to Remove Misleading Ads About HIV Prevention Drugs | KQED",
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"content": "\u003cp>Nearly 60 LGBTQ and public health groups have signed an open letter accusing Facebook of running misleading ads about medication aimed to prevent the transmission of HIV. The ads, paid for by personal injury attorneys, claim so-called pre-exposure prophylaxis (PrEP) medications like Truvada can have serious side effects.\u003c/p>\n\u003cp>\u003ca href=\"https://www.washingtonpost.com/technology/2019/12/09/facebook-ads-are-pushing-misinformation-about-hiv-prevention-drugs-lgbt-activists-say-harming-public-health/\" target=\"_blank\" rel=\"noopener noreferrer\">The Washington Post\u003c/a> found one Facebook page called “\u003ca href=\"https://www.facebook.com/acaseforwomen/\" target=\"_blank\" rel=\"noopener noreferrer\">A Case For Women\u003c/a>,” which ran ads last fall that said, “Truvada and other HIV prevention medications have been linked to serious bone and kidney problems.”\u003c/p>\n\u003cp>Foster City-based Gilead Sciences makes two HIV prevention medications, the older Truvada and the newer Descovy. Studies indicate Descovy may cause fewer side effects than Truvada, which has been shown to negatively affect kidney and bone health, because of differences in the drugs’ active ingredients. But if an ad doesn’t specify which drug it’s referring to, or if it only mentions Truvada, it can sound like all PrEP treatments are potentially detrimental.\u003c/p>\n\u003cp>In an \u003ca href=\"https://www.glaad.org/blog/open-letter-facebook\" target=\"_blank\" rel=\"noopener noreferrer\">open letter\u003c/a>, 58 groups — including the Desmond Tutu HIV Foundation in South Africa and the San Francisco AIDS Foundation — argue Facebook is ignoring their concerns that these ads put “people’s lives in imminent danger” because they scare people away from medications that prevent HIV transmission.\u003c/p>\n\u003cblockquote>\u003cp>This issue goes beyond misinformation, as it puts real people’s lives in imminent danger. The U.S. Centers for Disease Control and Prevention reports that when taken daily, PrEP is highly effective for preventing HIV from sex or injection drug use. The CDC states: “Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.” The World Health Organization recommends that “people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention.”\u003c/p>\u003c/blockquote>\n\u003cp>“There are many, many people out there who aren’t on it that should be,” said social psychology professor \u003ca href=\"https://www.philliphammack.com\" target=\"_blank\" rel=\"noopener noreferrer\">Phillip Hammack\u003c/a>, who directs the Sexual and Gender Diversity Laboratory at UC Santa Cruz.\u003c/p>\n\u003cp>[aside postID=\"news_11764275,news_11787003,news_11783864\" label=\"More on Facebook\"]“We have a moral obligation to ensure that the messaging about public health is not misleading. Pre-exposure prophylaxis (PrEP) has been an extremely effective way of addressing the spread of HIV among many populations, including gay and bisexual men,” Hammack added.\u003c/p>\n\u003cp>Ironically, the open letter was published on \u003ca href=\"https://www.glaad.org\" target=\"_blank\" rel=\"noopener noreferrer\">GLAAD’s website\u003c/a>, which \u003ca href=\"https://www.facebook.com/help/202924156415780\" target=\"_blank\" rel=\"noopener noreferrer\">advises Facebook\u003c/a> on LGBT issues.\u003c/p>\n\u003cp>In a statement, Facebook countered, “We value our work with LGBTQ groups and constantly seek their input. While these ads do not violate our ad policies nor have they been rated false by third-party fact-checkers, we’re always examining ways to improve and help these key groups better understand how we apply our policies.”\u003c/p>\n\u003cp>While he doesn’t use Facebook, long-term HIV+ patient \u003ca href=\"http://www.sjsu.edu/hsr/about/faculty/lecturers/kevinroe/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Kevin Roe\u003c/a>, a lecturer at San Jose State’s Department of Public Health and Recreation, said he “fully supports anti PreP (Truvada) ads.” After about ten years on Truvada, Roe developed “moderate kidney disease and a large kidney stone that had to be cut out and was 95% Truvada isolates.”\u003c/p>\n\u003cp>This isn’t the first time Facebook’s assessment of controversial advertisements put the social media giant in the crosshairs of public opinion.\u003c/p>\n\u003cp>Facebook CEO Mark Zuckerberg has experienced a great deal of blowback following his attempts to frame the conversation as one about free speech, including at this event hosted by Georgetown University:\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=nP–X4GhuP4]There’s no legislation that requires social media platforms ban misleading or controversial content. But Facebook can choose to carve out a particular exemption — and it has, in the case of \u003ca href=\"https://about.fb.com/news/2019/03/combatting-vaccine-misinformation/\" target=\"_blank\" rel=\"noopener noreferrer\">anti-vaccine content\u003c/a> as recently as last March.\u003c/p>\n\u003cp>Just last week, Facebook \u003ca href=\"https://about.fb.com/news/2019/12/taking-action-against-ad-fraud/\" target=\"_blank\" rel=\"noopener noreferrer\">announced a lawsuit\u003c/a> against advertisers that encouraged people to install malware that “enabled the defendants to compromise people’s Facebook accounts and run deceptive ads promoting items such as counterfeit goods and diet pills.”\u003c/p>\n\u003cp>The vast majority of Facebook’s revenues are \u003ca href=\"https://investor.fb.com/investor-news/press-release-details/2019/Facebook-Reports-Third-Quarter-2019-Results/default.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">driven by advertising\u003c/a>.\u003c/p>\n\u003cp>“Any kind of deterrent to this medication is not in the interest of public health,” said UCSC’s Hammack. “That’s the delicate balance, weighing the financial interests of a few and the larger, collective good for us all.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nearly 60 LGBTQ and public health groups have signed an open letter accusing Facebook of running misleading ads about medication aimed to prevent the transmission of HIV. The ads, paid for by personal injury attorneys, claim so-called pre-exposure prophylaxis (PrEP) medications like Truvada can have serious side effects.\u003c/p>\n\u003cp>\u003ca href=\"https://www.washingtonpost.com/technology/2019/12/09/facebook-ads-are-pushing-misinformation-about-hiv-prevention-drugs-lgbt-activists-say-harming-public-health/\" target=\"_blank\" rel=\"noopener noreferrer\">The Washington Post\u003c/a> found one Facebook page called “\u003ca href=\"https://www.facebook.com/acaseforwomen/\" target=\"_blank\" rel=\"noopener noreferrer\">A Case For Women\u003c/a>,” which ran ads last fall that said, “Truvada and other HIV prevention medications have been linked to serious bone and kidney problems.”\u003c/p>\n\u003cp>Foster City-based Gilead Sciences makes two HIV prevention medications, the older Truvada and the newer Descovy. Studies indicate Descovy may cause fewer side effects than Truvada, which has been shown to negatively affect kidney and bone health, because of differences in the drugs’ active ingredients. But if an ad doesn’t specify which drug it’s referring to, or if it only mentions Truvada, it can sound like all PrEP treatments are potentially detrimental.\u003c/p>\n\u003cp>In an \u003ca href=\"https://www.glaad.org/blog/open-letter-facebook\" target=\"_blank\" rel=\"noopener noreferrer\">open letter\u003c/a>, 58 groups — including the Desmond Tutu HIV Foundation in South Africa and the San Francisco AIDS Foundation — argue Facebook is ignoring their concerns that these ads put “people’s lives in imminent danger” because they scare people away from medications that prevent HIV transmission.\u003c/p>\n\u003cblockquote>\u003cp>This issue goes beyond misinformation, as it puts real people’s lives in imminent danger. The U.S. Centers for Disease Control and Prevention reports that when taken daily, PrEP is highly effective for preventing HIV from sex or injection drug use. The CDC states: “Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.” The World Health Organization recommends that “people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention.”\u003c/p>\u003c/blockquote>\n\u003cp>“There are many, many people out there who aren’t on it that should be,” said social psychology professor \u003ca href=\"https://www.philliphammack.com\" target=\"_blank\" rel=\"noopener noreferrer\">Phillip Hammack\u003c/a>, who directs the Sexual and Gender Diversity Laboratory at UC Santa Cruz.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We have a moral obligation to ensure that the messaging about public health is not misleading. Pre-exposure prophylaxis (PrEP) has been an extremely effective way of addressing the spread of HIV among many populations, including gay and bisexual men,” Hammack added.\u003c/p>\n\u003cp>Ironically, the open letter was published on \u003ca href=\"https://www.glaad.org\" target=\"_blank\" rel=\"noopener noreferrer\">GLAAD’s website\u003c/a>, which \u003ca href=\"https://www.facebook.com/help/202924156415780\" target=\"_blank\" rel=\"noopener noreferrer\">advises Facebook\u003c/a> on LGBT issues.\u003c/p>\n\u003cp>In a statement, Facebook countered, “We value our work with LGBTQ groups and constantly seek their input. While these ads do not violate our ad policies nor have they been rated false by third-party fact-checkers, we’re always examining ways to improve and help these key groups better understand how we apply our policies.”\u003c/p>\n\u003cp>While he doesn’t use Facebook, long-term HIV+ patient \u003ca href=\"http://www.sjsu.edu/hsr/about/faculty/lecturers/kevinroe/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Kevin Roe\u003c/a>, a lecturer at San Jose State’s Department of Public Health and Recreation, said he “fully supports anti PreP (Truvada) ads.” After about ten years on Truvada, Roe developed “moderate kidney disease and a large kidney stone that had to be cut out and was 95% Truvada isolates.”\u003c/p>\n\u003cp>This isn’t the first time Facebook’s assessment of controversial advertisements put the social media giant in the crosshairs of public opinion.\u003c/p>\n\u003cp>Facebook CEO Mark Zuckerberg has experienced a great deal of blowback following his attempts to frame the conversation as one about free speech, including at this event hosted by Georgetown University:\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/nP'\n title='//www.youtube.com/embed/nP'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>There’s no legislation that requires social media platforms ban misleading or controversial content. But Facebook can choose to carve out a particular exemption — and it has, in the case of \u003ca href=\"https://about.fb.com/news/2019/03/combatting-vaccine-misinformation/\" target=\"_blank\" rel=\"noopener noreferrer\">anti-vaccine content\u003c/a> as recently as last March.\u003c/p>\n\u003cp>Just last week, Facebook \u003ca href=\"https://about.fb.com/news/2019/12/taking-action-against-ad-fraud/\" target=\"_blank\" rel=\"noopener noreferrer\">announced a lawsuit\u003c/a> against advertisers that encouraged people to install malware that “enabled the defendants to compromise people’s Facebook accounts and run deceptive ads promoting items such as counterfeit goods and diet pills.”\u003c/p>\n\u003cp>The vast majority of Facebook’s revenues are \u003ca href=\"https://investor.fb.com/investor-news/press-release-details/2019/Facebook-Reports-Third-Quarter-2019-Results/default.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">driven by advertising\u003c/a>.\u003c/p>\n\u003cp>“Any kind of deterrent to this medication is not in the interest of public health,” said UCSC’s Hammack. “That’s the delicate balance, weighing the financial interests of a few and the larger, collective good for us all.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When BJ Miller was a sophomore at Princeton University, he climbed atop a commuter train that had been parked for the night. What began as a lark took a tragic turn when 11,000 volts of electricity suddenly surged through his body.\u003c/p>\n\u003cp>“There was a big explosion, a big flash of light, and I was thrown … quite some distance,” Miller says. “My body was literally smoking.”\u003c/p>\n\u003cp>Miller survived that 1990 accident but lost both legs below the knee and half of one arm. Coming close to death and dealing with pain and disability inspired him to go into medicine and the field of \u003ca href=\"https://www.npr.org/tags/499181710/disability-rights\">disability rights\u003c/a>.\u003c/p>\n\u003cp>As a \u003ca href=\"https://www.npr.org/tags/134950354/palliative-care/archive?date=12-31-2013\">palliative care\u003c/a> physician at UCSF’s Cancer Center, \u003ca href=\"https://www.sfchronicle.com/news/article/BJ-Miller-pain-doctor-at-the-Zen-Hospice-Project-2369267.php\">Miller draws on his own experiences\u003c/a> to help people with their physical, emotional and spiritual pain at the end of their lives. His new book, with co-author Shoshana Berger, is \u003cem>A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death.\u003c/em>\u003c/p>\n\u003cp>Miller says it’s hard for him to regret the accident that changed his life.\u003c/p>\n\u003cp>“So much has flowed from it,” he says. “If I’m honest, there’s a little bit of pride. … [What] I’m a little proud of is the decision to work with this experience over time, to dig into it, to mine it, to find a creative energy in it.”\u003c/p>\n\u003chr>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>\u003cstrong>Interview highlights\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>On how growing up with his mother, who had polio, influenced him\u003c/strong>\u003c/p>\n\u003cp>To grow up around disability from a young age, to have that carved into your worldview was, you can imagine, hugely helpful for me as a 19-year-old kid with ostensibly everything going for him. … To know in your bones that you’re on borrowed time with being “able-bodied” — I knew that. I didn’t have to learn that, and that was a huge advantage. …\u003c/p>\n\u003cp>In my early childhood, she used crutches and a brace and was extremely physically capable. And then, over time, from the early ’80s on, it’s just been a very slow decline to the point now where she really requires an electric wheelchair, has a little bit of ability to stand, but not for very long, etc. …\u003c/p>\n\u003cp>People think you’re Jesus because you’ve gone through something special. They treat you like you’ve got special knowledge, or they treat you a little bit like Frankenstein. Of course, those two responses are related. Neither of them is accurate. But that’s the kind of vibe you can get — a lot of us who have disabilities know very well. And I had seen that. I knew how to read that, thanks to my mother.\u003c/p>\n\u003cp>\u003cstrong>On deciding to pursue palliative medicine \u003c/strong>\u003c/p>\n\u003cp>I started doing a little work [in] arts advocacy and disability rights. But basically … thanks to the disability rights movement, I realized that disability is not something to be ashamed of. It’s not something to overcome, to put behind you — it’s something to work with. It doesn’t go away. I can’t overcome this; it’s my daily experience. So instead the compulsion was to work with it — in a professional way that I could make a living. And medicine lit up, theoretically, as a way where I could use these experiences and pay them forward in some way or draw from them — not overcome them and put them behind me.\u003c/p>\n\u003cp>[aside label=\"Related Coverage\" postID=news_11784435,futureofyou_443966,stateofhealth_364223]\u003c/p>\n\u003cp>\u003cstrong>On palliative care and the treatment of suffering \u003c/strong>\u003c/p>\n\u003cp>That’s why I think hospice and palliative medicine is so interesting. You don’t just treat pain. You treat suffering. Suffering is a multiheaded beast. … Basically palliative care is the treatment of suffering, versus the rest of medicine as the treatment of disease. …\u003c/p>\n\u003cp>So what is suffering? Well, suffering, there’s a lot of different ways to define it. \u003ca href=\"https://www.bmj.com/content/suppl/2005/07/18/331.7509.DC1\">Cicely Saunders\u003c/a>, the grandmother of hospice work, she called it “total pain.” That [it has] a physical component, a psychological and emotional component, a spiritual component. It’s a multiheaded entity. One might say it affects how you see yourself. It affects your identity. I’ve come to understand suffering as a wedge — a gap that opens up in you. The gap between the world you have and the world you want. So, it gets at your desire, it gets at your longing, it gets at what you’re lacking.\u003c/p>\n\u003cp>\u003cstrong>On finding the balance between life and death, and joy and sorrow\u003c/strong>\u003c/p>\n\u003cp>Coming out of the back side of the experience of my own injuries, my own brush with death, etc., I came out of there eventually holding life much more loosely. So it didn’t teach me to cling to life with my fingernails, that that was the way through. It taught me some adult trick of simultaneously holding on to opposing emotions. …\u003c/p>\n\u003cp>Grief does this. But anyone who’s dealt with pain — chronic pain — when the clouds part even for a moment and you have the absence of pain, it’s a stunning feeling. I remember feeling that I really wanted to stay close to that interface between joy and sorrow, between pain and pleasure, between life and death. It felt like such a rich, rich place that I had been forced into. I had to hang out there for a while, but I became a little enamored of it, because from there I could just as easily get to sorrow as I could get to joy. And that to me has felt like a kind of a dexterity or an agility, something very good. … So death is close by, pain is close by — so is the rest of life. So is the good stuff. That zone, it helps me imagine what my patients are going through, being close to death.\u003c/p>\n\u003cp>\u003cstrong>On how he helps his patients with both their fear of dying and their fear of being dead \u003c/strong>\u003c/p>\n\u003cp>Fear helps point to the things that you care about, the things you love, the things you’re afraid to lose. Fear is a big important subject and really requires and demands looking at. The sooner we do, the better, because oftentimes it’s not so darn scary. … It’s helpful when patients will confess some fear to me. … People say, “Actually I’m afraid of the pain I imagine is going to happen during the dying process.” So the fear of dying, the fear of the dying process. That’s an important distinction, because any hospice and palliative medicine team can do a lot to quell the pain and the sorrow that happens during the dying process. We have medications. We have ways of being with each other. We have ways of positioning your body. There’s all sorts of things to do, so suffering is not necessarily part of the dying process. And there’s a lot of reassurance. … We understand that process pretty well, and there’s a lot we can do. So that’s an important distinction. That’s pretty concrete. That’s knowable.\u003c/p>\n\u003cp>Now, some of my patients will say, “That’s one thing. But I’m actually afraid of being dead. I’m afraid of being in the ground. I’m afraid of what comes next or whatever else.” Then my response, of course, is, “Well, gosh, I don’t know what that’s like either. But let’s think about it. Let’s talk about it.” And when we push on that one, I think most of us can get to a place where we realize that we’re not just our bodies — and our bodies, once they’re dead, aren’t likely to be feeling anything.\u003c/p>\n\u003cp>But when you push on that one, you can open up [about] what is known as [the] modern acronym of FOMO — fear of missing out. That’s very often at the heart of people’s fear of being dead — like all that they’re going to miss. And this idea that the world is going to continue on without them, all the things they’re not going to get to see, etc. But if you go there, then what has that done? That has pointed us very squarely to all the things we love and care about. And then that becomes a nice compass for our way forward, how we’re going to live until we die. The fear there, the things we are afraid to miss, are the things we really should uptick in terms of our attention now.\u003c/p>\n\u003cp>\u003cem>Sam Briger and Joel Wolfram produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=After+A+Freak+Accident%2C+A+Doctor+Finds+Insight+Into+%27Living+Life+And+Facing+Death%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When BJ Miller was a sophomore at Princeton University, he climbed atop a commuter train that had been parked for the night. What began as a lark took a tragic turn when 11,000 volts of electricity suddenly surged through his body.\u003c/p>\n\u003cp>“There was a big explosion, a big flash of light, and I was thrown … quite some distance,” Miller says. “My body was literally smoking.”\u003c/p>\n\u003cp>Miller survived that 1990 accident but lost both legs below the knee and half of one arm. Coming close to death and dealing with pain and disability inspired him to go into medicine and the field of \u003ca href=\"https://www.npr.org/tags/499181710/disability-rights\">disability rights\u003c/a>.\u003c/p>\n\u003cp>As a \u003ca href=\"https://www.npr.org/tags/134950354/palliative-care/archive?date=12-31-2013\">palliative care\u003c/a> physician at UCSF’s Cancer Center, \u003ca href=\"https://www.sfchronicle.com/news/article/BJ-Miller-pain-doctor-at-the-Zen-Hospice-Project-2369267.php\">Miller draws on his own experiences\u003c/a> to help people with their physical, emotional and spiritual pain at the end of their lives. His new book, with co-author Shoshana Berger, is \u003cem>A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death.\u003c/em>\u003c/p>\n\u003cp>Miller says it’s hard for him to regret the accident that changed his life.\u003c/p>\n\u003cp>“So much has flowed from it,” he says. “If I’m honest, there’s a little bit of pride. … [What] I’m a little proud of is the decision to work with this experience over time, to dig into it, to mine it, to find a creative energy in it.”\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>Interview highlights\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>On how growing up with his mother, who had polio, influenced him\u003c/strong>\u003c/p>\n\u003cp>To grow up around disability from a young age, to have that carved into your worldview was, you can imagine, hugely helpful for me as a 19-year-old kid with ostensibly everything going for him. … To know in your bones that you’re on borrowed time with being “able-bodied” — I knew that. I didn’t have to learn that, and that was a huge advantage. …\u003c/p>\n\u003cp>In my early childhood, she used crutches and a brace and was extremely physically capable. And then, over time, from the early ’80s on, it’s just been a very slow decline to the point now where she really requires an electric wheelchair, has a little bit of ability to stand, but not for very long, etc. …\u003c/p>\n\u003cp>People think you’re Jesus because you’ve gone through something special. They treat you like you’ve got special knowledge, or they treat you a little bit like Frankenstein. Of course, those two responses are related. Neither of them is accurate. But that’s the kind of vibe you can get — a lot of us who have disabilities know very well. And I had seen that. I knew how to read that, thanks to my mother.\u003c/p>\n\u003cp>\u003cstrong>On deciding to pursue palliative medicine \u003c/strong>\u003c/p>\n\u003cp>I started doing a little work [in] arts advocacy and disability rights. But basically … thanks to the disability rights movement, I realized that disability is not something to be ashamed of. It’s not something to overcome, to put behind you — it’s something to work with. It doesn’t go away. I can’t overcome this; it’s my daily experience. So instead the compulsion was to work with it — in a professional way that I could make a living. And medicine lit up, theoretically, as a way where I could use these experiences and pay them forward in some way or draw from them — not overcome them and put them behind me.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>On palliative care and the treatment of suffering \u003c/strong>\u003c/p>\n\u003cp>That’s why I think hospice and palliative medicine is so interesting. You don’t just treat pain. You treat suffering. Suffering is a multiheaded beast. … Basically palliative care is the treatment of suffering, versus the rest of medicine as the treatment of disease. …\u003c/p>\n\u003cp>So what is suffering? Well, suffering, there’s a lot of different ways to define it. \u003ca href=\"https://www.bmj.com/content/suppl/2005/07/18/331.7509.DC1\">Cicely Saunders\u003c/a>, the grandmother of hospice work, she called it “total pain.” That [it has] a physical component, a psychological and emotional component, a spiritual component. It’s a multiheaded entity. One might say it affects how you see yourself. It affects your identity. I’ve come to understand suffering as a wedge — a gap that opens up in you. The gap between the world you have and the world you want. So, it gets at your desire, it gets at your longing, it gets at what you’re lacking.\u003c/p>\n\u003cp>\u003cstrong>On finding the balance between life and death, and joy and sorrow\u003c/strong>\u003c/p>\n\u003cp>Coming out of the back side of the experience of my own injuries, my own brush with death, etc., I came out of there eventually holding life much more loosely. So it didn’t teach me to cling to life with my fingernails, that that was the way through. It taught me some adult trick of simultaneously holding on to opposing emotions. …\u003c/p>\n\u003cp>Grief does this. But anyone who’s dealt with pain — chronic pain — when the clouds part even for a moment and you have the absence of pain, it’s a stunning feeling. I remember feeling that I really wanted to stay close to that interface between joy and sorrow, between pain and pleasure, between life and death. It felt like such a rich, rich place that I had been forced into. I had to hang out there for a while, but I became a little enamored of it, because from there I could just as easily get to sorrow as I could get to joy. And that to me has felt like a kind of a dexterity or an agility, something very good. … So death is close by, pain is close by — so is the rest of life. So is the good stuff. That zone, it helps me imagine what my patients are going through, being close to death.\u003c/p>\n\u003cp>\u003cstrong>On how he helps his patients with both their fear of dying and their fear of being dead \u003c/strong>\u003c/p>\n\u003cp>Fear helps point to the things that you care about, the things you love, the things you’re afraid to lose. Fear is a big important subject and really requires and demands looking at. The sooner we do, the better, because oftentimes it’s not so darn scary. … It’s helpful when patients will confess some fear to me. … People say, “Actually I’m afraid of the pain I imagine is going to happen during the dying process.” So the fear of dying, the fear of the dying process. That’s an important distinction, because any hospice and palliative medicine team can do a lot to quell the pain and the sorrow that happens during the dying process. We have medications. We have ways of being with each other. We have ways of positioning your body. There’s all sorts of things to do, so suffering is not necessarily part of the dying process. And there’s a lot of reassurance. … We understand that process pretty well, and there’s a lot we can do. So that’s an important distinction. That’s pretty concrete. That’s knowable.\u003c/p>\n\u003cp>Now, some of my patients will say, “That’s one thing. But I’m actually afraid of being dead. I’m afraid of being in the ground. I’m afraid of what comes next or whatever else.” Then my response, of course, is, “Well, gosh, I don’t know what that’s like either. But let’s think about it. Let’s talk about it.” And when we push on that one, I think most of us can get to a place where we realize that we’re not just our bodies — and our bodies, once they’re dead, aren’t likely to be feeling anything.\u003c/p>\n\u003cp>But when you push on that one, you can open up [about] what is known as [the] modern acronym of FOMO — fear of missing out. That’s very often at the heart of people’s fear of being dead — like all that they’re going to miss. And this idea that the world is going to continue on without them, all the things they’re not going to get to see, etc. But if you go there, then what has that done? That has pointed us very squarely to all the things we love and care about. And then that becomes a nice compass for our way forward, how we’re going to live until we die. The fear there, the things we are afraid to miss, are the things we really should uptick in terms of our attention now.\u003c/p>\n\u003cp>\u003cem>Sam Briger and Joel Wolfram produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=After+A+Freak+Accident%2C+A+Doctor+Finds+Insight+Into+%27Living+Life+And+Facing+Death%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>This story was originally published on July 31, 2019.\u003c/em>\u003c/p>\n\u003cp>[dropcap]G[/dropcap]rowing up, Robin Burton didn’t really know much about her mother, Cloudia Leslie Wells. “I was never told that my mom was mentally ill. My grandparents raised me, her mom and dad, and my mom would come home for a couple months and she’d be gone for a couple of years, and this was normal to me growing up,” she said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Robin Burton, founder of the Facebook group Missing & Homeless']‘The only thing that I want to say to my mom whenever I find her is, “I love you.” That means more to me than anything else in the world, is just for her to hear those three words: “I love you.”‘[/pullquote]\u003c/p>\n\u003cp>Burton was an adult by the time she learned her mom had been diagnosed with paranoid schizophrenia. That finally answered questions unanswered when her mom was breezing in and out of her life. Like many kids who don’t understand what they’re looking at when they’re looking at severe mental illness, little Robin came up with a story.\u003c/p>\n\u003cp>“I thought that she was living the life of the rich and famous, and didn’t have time for me. That was so far from the truth,” she said.\u003c/p>\n\u003cp>That was a sadness she learned to live with early in life. But when Burton was in her 20s, she lost her mom in a new and different way. First, her grandparents died. Then, when her mom swung through town, sometime around Christmas in 1994, and learned about their deaths, she left and didn’t come back. Ever.\u003c/p>\n\u003cp>“I was 23 whenever she went missing, and I’m 48 years old now,” Burton said.\u003c/p>\n\u003cp>Schizophrenia can be a debilitating disease. There’s no known cure, though medications can help. “We don’t know what it is. We don’t know what causes it. I don’t even know what the meaning of a cure would be,” said \u003ca href=\"https://medicine.yale.edu/psychiatry/people/robert_rosenheck.profile\" target=\"_blank\" rel=\"noopener noreferrer\">Robert Rosenheck\u003c/a>, professor of psychiatry and of health policy at the Yale School of Medicine.\u003c/p>\n\u003cfigure id=\"attachment_11764368\" class=\"wp-caption aligncenter\" style=\"max-width: 720px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11764368\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538.jpg\" alt=\"A rare family photo of young Robin Burton with her mother, Cloudia Leslie Wells.\" width=\"720\" height=\"540\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538.jpg 720w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538-536x402.jpg 536w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\">\u003cfigcaption class=\"wp-caption-text\">A rare family photo of young Robin Burton with her mother, Cloudia Leslie Wells. \u003ccite>(Courtesy of Robin Burton)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scientists do know schizophrenia affects people of every race, culture and economic class. Common symptoms include delusions, social withdrawal and an inability to cope with strong emotions. “Schizophrenia interferes with all areas of mental life. It makes it hard to think clearly. It makes people fearful, angry sometimes, and sometimes numb,” Rosenheck added.\u003c/p>\n\u003cp>That’s why you see so many homeless people with schizophrenia. It’s hard for other people to connect with them and stay connected.\u003c/p>\n\u003cp>As the years wore on, Burton hired a private investigator to find Cloudia, though a lot of people told her to let it go. A lot of people tell her that now. But Burton won’t give up on the hope that Cloudia is still alive, and that there might be some benefit to seeing her again.\u003c/p>\n\u003cp>“I’m not here to judge my mom, and I’m not here to ask her any questions on why she didn’t come home, or where she’s been, because she has her own reasons. The only thing that I want to say to my mom whenever I find her is, ‘I love you.’ That means more to me than anything else in the world, is just for her to hear those three words: ‘I love you.’ ”\u003c/p>\n\u003cp>The question is, how to find her?\u003c/p>\n\u003ch2>The First Trip to California\u003c/h2>\n\u003cp>Burton lives in Collinsville, Illinois. “I work at Geico. I’m an insurance agent. I also bartend on the weekends,” at a popular local watering hole called Ardie and Tiny’s.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Robin Burton, founder of the Facebook group Missing & Homeless']‘You know, the question that I get asked a lot, and most families do that are looking for their missing loved ones that are living homeless, is maybe they don’t want to be found.’[/pullquote]One evening, almost five years ago, Burton was working at that bar, “and it was a slow night, and I had a phone call from my private investigator, and he had told me that he doesn’t know how he missed it. But my mom’s Social Security number was used at a homeless shelter in 2013.”\u003c/p>\n\u003cp>It was a homeless shelter in Santa Monica, California, roughly 2,000 miles from Collinsville.\u003c/p>\n\u003cp>Burton explained, “I didn’t think a whole lot of it because I’ve been on wild goose chases before. I told a customer, just for small talk, about the phone call conversation. Unbeknownst to me, that customer went home and started Googling the Web. Two days later, he called me on the phone and he said, ‘Robin, I need your email address. There’s something I want you to look at.’ ”\u003c/p>\n\u003cp>It was a 2014 article from the Los Angeles Times, talking about the annual point-in-time count of the local homeless population. There was one photograph up top, of a homeless woman on the street. “I knew immediately that it was her. Because your eyes don’t change.”\u003c/p>\n\u003cp>Burton called up the L.A. Times, and the reporter put Burton in touch with the photographer, who said the photo was taken one year before the article was written.\u003c/p>\n\u003cp>“January 2013 in Santa Monica, California, the exact same place and area my mom’s Social Security number was used. In the same year. And that was all the confirmation I needed, ’cause I already knew it was her,” Burton said.\u003c/p>\n\u003cp>That tip was 2 years old, but she decided to chase it down anyway. She set up a Go Fund Me page to get help paying for a rental car to get to California, and for a motel room to stay in when she got there.\u003c/p>\n\u003cp>A local \u003ca href=\"https://fox2now.com/2015/02/17/collinsville-woman-heads-to-la-to-find-her-mother-after-spotting-her-in-la-times-picture/\" target=\"_blank\" rel=\"noopener noreferrer\">Fox News\u003c/a> outlet broadcast a set-up story the night before Burton left for L.A. By then, Burton had talked with a police officer at the LAPD, who told her Cloudia had been sighted on L.A.’s skid row. Burton told Fox, “I’m not scared of skid row. That’s not my biggest fear. My biggest fear is my mom not wanting to come back with me. Alls I know is I have to find her. I gotta let her know I love her.”\u003c/p>\n\u003ch2>Lessons Learned on Skid Row\u003c/h2>\n\u003cfigure id=\"attachment_11764385\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11764385 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A woman passes a wheelchair-bound homeless man on Spring Street on May 1, 2017, in Los Angeles. The 2017 Greater Los Angeles Homeless Count indicated a dramatic jump of 20 percent in the city of Los Angeles, while Los Angeles County has spiked 23 percent. \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There has been a skid row in Los Angeles since the late 19th century. There have been attempts to clear out the poverty and crime from this square mile in the heart of downtown since the 1950s.\u003c/p>\n\u003cp>But it’s never looked as bad as it does in modern times: a tent city of roughly 4,000 people has sprung up on these sun-baked concrete sidewalks, crawling with rats and bedbugs, reeking with the smell of human urine and feces.\u003c/p>\n\u003cp>Robin arrived in 2015 carrying a box of candy bars wrapped with her mom’s picture, but she made a critical mistake. She brought along another TV camera crew.\u003c/p>\n\u003cp>People on the streets were not happy to see that, or her. “The very first day out there was very scary and emotional for me. I broke down crying. I had to leave. I had to leave and I had to go back to my motel and take a deep breath and re-evaluate.”\u003c/p>\n\u003cp>Back in the motel room, Burton decided she needed to try again, in a different way. “Without the cameras, everything was so different. and it was actually the homeless that was helping me look for my mom. It was them that was telling me, ‘You know I wish I had somebody looking for me.’ ”\u003c/p>\n\u003cp>You could imagine Cloudia visiting a place like the \u003ca href=\"https://www.downtownwomenscenter.org\" target=\"_blank\" rel=\"noopener noreferrer\">Downtown Women’s Center\u003c/a>. Homeless and near-homeless women from all over Southern California come here looking for help for a range of problems.\u003c/p>\n\u003cp>“We serve about 4,000 women a year and it’s very fairly infrequent that we see them reunify. It’s really probably only about five a year,” said chief program officer Erika Hartman, who betrays in her voice a certain exhaustion at the very idea of what sounds like a much desired fairy-tale ending.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Robin Burton, founder of the Facebook group Missing & Homeless']‘I was very, very angry at God. How could you send me a picture after 20 years? How could I go out there and not find her? And it wasn’t until I came home and I realized I’m not alone. There are other families just like me.’[/pullquote]“Usually, at the point that they have come to skid row, they have really run out of other connections that they can turn to. Sometimes, it’s because they’ve really exhausted their relationships with people who are trying support them. Or who have set boundaries due to substance use. Lots of women report experiencing shame about homelessness,” Hartman said.\u003c/p>\n\u003cp>Even with help, three weeks passed with no sign of Cloudia. Some people told Burton they believed Cloudia must be dead. Whatever the case, Burton needed to go back home and get back to work.\u003c/p>\n\u003cp>That spring, Burton started a Facebook group called \u003ca href=\"https://www.facebook.com/MissingHomelessOrg/\" target=\"_blank\" rel=\"noopener noreferrer\">Missing & Homeless\u003c/a>. The concept is simple: post a person’s story, with enough details and photos, in the hopes somebody in the group will recognize that missing person and help put them in touch with the family looking for them.\u003c/p>\n\u003cp>“They’re not a piece of garbage, you know. They’re somebody’s mother. They’re somebody son. They’re somebody’s sister.”\u003c/p>\n\u003cfigure id=\"attachment_11764316\" class=\"wp-caption aligncenter\" style=\"max-width: 742px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11764316\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/1485734303999.jpeg\" alt=\"One of numerous posters Robin Burton has drawn up over the years in the search for her mother, believed to be homeless somewhere in California.\" width=\"742\" height=\"960\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/1485734303999.jpeg 742w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/1485734303999-160x207.jpeg 160w\" sizes=\"auto, (max-width: 742px) 100vw, 742px\">\u003cfigcaption class=\"wp-caption-text\">One of numerous posters Robin Burton has drawn up over the years in the search for her mother, believed to be homeless somewhere in California. \u003ccite>(Courtesy of Robin Burton)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>An Education in Finding People\u003c/h2>\n\u003cp>Robin said she functions like a reporter when a family contacts her for help. She presses them for more information. Where, exactly, did the person go missing? Are there any distinguishing characteristics, like eye color or tattoos? Do they suffer from mental illness or addiction?\u003c/p>\n\u003cp>The details make it easier to find somebody, but they also emotionally engage the Facebook group members. As opposed to say, some generic post about a Jane Doe.\u003c/p>\n\u003cp>“I had no idea when I started ‘Missing & Homeless’ what it was going to become, and how many followers and supporters that we were gonna have. Then we started finding people. Four years later, we have probably found 70 or 80 people,” Burton said.\u003c/p>\n\u003cp>It turns out a lot of the group’s 63,000 members are homeless themselves, typically logging into Facebook at public libraries — in part because they don’t have any barriers precluding them from getting involved.\u003c/p>\n\u003cp>[aside tag='homelessness' label='More on Homelessness']\u003c/p>\n\u003cp>Burton has had a number of frustrating conversations with health care providers and social service workers who won’t say boo about someone who friends and family are searching for.\u003c/p>\n\u003cp>“You can walk into a homeless shelter or a soup kitchen and they will not tell you if they’re there. My mom could be in the same building as me and I would never even know it. It’s heartbreaking, whenever you have a family member that is missing and living homeless, the lack of help that you get because of it,” Burton said.\u003c/p>\n\u003cp>There’s a very big reason why most social workers and health care providers would not tell Robin if her mom was in a particular building. It’s against federal law, specifically, the \u003ca href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Health Insurance Portability and Accountability Act of 1996\u003c/a>. HIPAA, as most people call it, has a provision that protects the privacy of individuals’ medical records, including the fact of a person’s presence in a facility.\u003c/p>\n\u003cp>Hartman of the Downtown Women’s Center explained staff are happy to take a message and pass it on. But it’s the homeless person’s choice whether to connect. Always. In part, because they can’t presume the best about people who say they’re searching for a loved one.\u003c/p>\n\u003cp>“We have women who have been trafficked or abused or exploited by family members,” Hartman said. “Many of them don’t list an emergency contact. We have women who pass and we don’t know how to find a next of kin.”\u003c/p>\n\u003cp>In other words, many of these women have good reasons they don’t want to be found. Burton gets that. She’s also seen enough to know some people are just too far gone into the abyss of mental illness, or addiction, or both.\u003c/p>\n\u003cp>“I had a lady that was looking for her son that was schizophrenic, and he was found after, after five or six years, and she didn’t recognize him at first. You know, because the streets weather you. You change drastically. He didn’t recognize her either, and he said, ‘You’re not my mom.’ He’s missing again,” Burton said.\u003c/p>\n\u003cp>So far, we’ve been presuming that the right homeless person has been correctly identified. Sometimes, people eager to help say they’ve seen someone they actually haven’t.\u003c/p>\n\u003cp>It happened to Burton, just weeks after she returned home from skid row that first time. A volunteer from the Downtown Women’s Center called Burton to say Cloudia was there.\u003c/p>\n\u003cp>Burton bought a plane ticket. She was sitting on that plane ahead of takeoff, when she got another call saying the volunteer was mistaken. The timing was such that Burton flew to L.A. and back: an expensive, useless and emotionally painful trip.\u003c/p>\n\u003cp>Now, that wouldn’t stop Burton from recommending families make every effort to file missing person reports, and take all the other recommended steps. Because the wins, when they happen, are so satisfying.\u003c/p>\n\u003cfigure id=\"attachment_11764346\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11764346\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut.jpg\" alt=\"A former workmate of Corey Abernathy's asked his parents for permission to post this on the Facebook group "Missing & Homeless." That's how a housemate of Abernathy's in San Francisco spotted it, and told him, and he called his parents after a radio silence of two years.\" width=\"1920\" height=\"1246\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-160x104.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-800x519.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-1020x662.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-1200x779.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A former workmate of Corey Abernathy asked his parents for permission to post this on the Facebook group “Missing & Homeless.” That’s how a housemate of Abernathy’s in San Francisco spotted it, and told him, and he called his parents after a radio silence of two years. \u003ccite>(Courtesy of Corey Abernathy)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>A Win in San Francisco\u003c/h2>\n\u003cp>Corey Abernathy, and his parents, Cathy and Robert Abernathy, agreed to meet me on a bright, breezy day at one of his favorite haunts in San Francisco: Crissy Field. When he was homeless, Corey used to camp in the Presidio, not far from where tourists whiz by on their rented bicycles and children eat ice cream while wearing fleece jackets.\u003c/p>\n\u003cp>“I just thought too much about life. I felt a lot of pressure,” Corey said. He’s 5-foot-9. About 160 pounds. Hair and beard close-cropped. His blue eyes twinkle in the sun. He looks like he’s gotten a lot of sun in recent years, but nothing that seems out of the ordinary for an athletic white man in his early 30s.\u003c/p>\n\u003cp>Corey was 28 when he decided to throw on a backpack one day and leave his parents’ home in Willits in Mendocino County. With no warning, or explanation — though there were signs when the family looks back on it — that he wasn’t happy. That he was drifting.\u003c/p>\n\u003cp>“I just remember that there was like a weird amount of anxiety on me,” Abernathy said. “I always tried to make sense of everything. I put too much pressure on myself that wasn’t really there. Yeah, the way I dealt with it was just drinking a lot.”\u003c/p>\n\u003cp>He’d struggled with anxiety since childhood. He didn’t seem to have a strong idea for a career the way his older brother had. He dropped out of Sacramento State almost as soon as he got there. He lost a job in retail, then switched to a local casino. But there, he was surrounded by alcohol, and the consequences were predictable.\u003c/p>\n\u003cp>Corey started reading about people who dropped out of society for a different kind of life. “So it wasn’t like one single moment. It was something I was thinking about for probably like a year,” he explained.\u003c/p>\n\u003cp>Then Corey got a DUI, something he was really ashamed about. He thought to himself, if he had no money, he wouldn’t be able to buy alcohol. And if he had nothing to worry about, he wouldn’t want to buy alcohol.\u003c/p>\n\u003cp>He explained, “My car got towed and I just said, ‘I’m done.’ At the time, it was a good feeling. I don’t have to deal with problems I can’t figure out anymore.”\u003c/p>\n\u003cp>But remember, he was living with his parents at the time. And when he walked out that front door, he left no note. No explanation. His mom, Cathy, is a registered nurse. His dad, Robert, is a retired custom cabinetmaker.\u003c/p>\n\u003cp>His father recalled the day, “Got home and the house was empty. To me, it looked like he’d just walked out the door to go out for a walk. Everything was still in his room. Nothing disturbed. He just disappeared.”\u003c/p>\n\u003cp>They called the police and filed a missing person’s report. Only to discover the police in Mendocino County have a loose attitude about adults who disappear, given the local marijuana growing industry’s reliance on seasonal workers. In this business, pruning is called “trimming,” and many of the trimmers come and go.\u003c/p>\n\u003cp>“In Mendocino County, Sonoma County if a adult is missing, they’re out trimming,” Cathy said. “It was October and it was trimming season. They took the report, but they weren’t doing anything with it.”\u003c/p>\n\u003cp>So Robert and Cathy had to start looking on their own. Corey’s friends helped. A former workmate tacking up a poster in Ukiah met a homeless person who directed them to Fort Bragg, where Robert and Cathy found Corey in a park, about six weeks after he disappeared. But Corey wouldn’t come back.\u003c/p>\n\u003cp>“I wasn’t ready to see them,” he said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Corey Abernathy, building a new life for himself in San Francisco after more than three years homeless']‘I gave everything up, you know. It was like, I don’t know if I’m ever going to have a room again. I don’t know if I’m ever going to have a relationship again. I distinctively classified myself aside from society.’[/pullquote]\u003c/p>\n\u003cp>Robert described his thinking in that moment, “As much as I wanted to grab him and throw him in the car, I knew he’d be gone again. So that was the hardest decision I’ve ever had to make was to let him go.”\u003c/p>\n\u003cp>So they did, and Corey kept hitchhiking, to Point Arena, Gualala and finally San Francisco — where he proceeded to bounce from sleeping rough in the Presidio to side streets and shelters, sporadically sending his parents Facebook messages from public libraries. Until he stopped doing that. The last one was in February 2016.\u003c/p>\n\u003cp>“I felt regret and guilt. I knew I was going to have to figure out a way to speak to them, and yeah, apologize,” Corey said.\u003c/p>\n\u003cp>Every now and then, his parents would get a lead and take off to follow it, only to find it mistaken. Often, from somebody overcome with wishful thinking. A lot of guys on the street look like Corey. “OK, he’s here. He’s in Yuba City. He’s in Sacramento. Manteca. Denver. I mean, you name it, he was there,” Robert said.\u003c/p>\n\u003cp>Weeks turned into months, and then years. Corey’s last messages came from San Francisco. So Robert and Cathy drove south repeatedly to scour the city’s Tenderloin on foot. “He could be on the next block over headed in the opposite direction, and we’d never know it. You know, there were days when we walked 25 miles,” Robert said.\u003c/p>\n\u003cp>The night before Corey left his parents’ home in Willits, Cathy started having this recurring dream — nightmare, really.\u003c/p>\n\u003cp>In it, she keeps getting woken up by her nephew, Bobby, who committed suicide in 2010. It’s like he was a contact from the underworld, trying to tell her something about her son.\u003c/p>\n\u003cp>“He’d wake me up that, ‘We gotta get going.’ I was on the hard ground. I was cold. I wasn’t safe. I had to get moving. You know, we had to get moving,” she recalled.\u003c/p>\n\u003cp>Then, at some point, the nightmares abruptly stopped. Cathy had two theories about what happened to Corey. “Maybe, you know, he’s getting his life together. Or he wasn’t on this earth anymore. You know, it was one of the two.”\u003c/p>\n\u003cp>As it happened, this was right around the time Corey was ready for rehab. He got involved with \u003ca href=\"https://www.aa.org\" target=\"_blank\" rel=\"noopener noreferrer\">Alcoholics Anonymous\u003c/a>. He got into a sober living facility.\u003c/p>\n\u003cp>But he didn’t reconnect with his parents. And two years passed. That’s when, early this year, one of Corey’s old workmates posted on “Missing & Homeless.” And someone Corey lives with recognized him. And told Corey. And Corey called home.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Robert Abernathy, whose son went missing for more than three years']‘You see the homeless. You hear about people missing family. And that’s supposed to happen to other people. It’s not supposed to happen to you. With Corey missing, I am much, much, much more aware of how it’s happening everywhere. Man, this is an epidemic.’[/pullquote]\u003c/p>\n\u003cp>“I don’t even remember the drive down here. You know, we sat down, and he talked about why — some of the things that made him leave. And him realizing that the DUI, everybody gets one and it’s nothing to run from, but this is something he’s been thinking about, and it’s something he needed to finish. And it’s like, he’s part of our family, and as I told him, he’s going to be my son forever, no matter what. I still love him,” Robert said.\u003c/p>\n\u003cp>These days, Robert and Cathy come down from Willits periodically to visit Corey in San Francisco.\u003c/p>\n\u003cp>Corey doesn’t have a strong answer as to why he didn’t call his parents before a prompt from the acquaintance who spotted him on “Missing & Homeless.” What Corey can say is that he was ready when he got the nudge.\u003c/p>\n\u003ch2>The Kind of Story Robin Burton Lives For\u003c/h2>\n\u003cp>“A lot of homeless are afraid to contact their family because they don’t know if they’re going to be turned away,” Burton said. “Some, you know, it’s just they’ve been gone for so long they don’t even know what to say to families anymore. Those are our miracle stories. There was a reason he was supposed to be found, and there was closure.”\u003c/p>\n\u003cp>The search for Cloudia morphed into something else for Burton. She’s found a mission, a purpose in life, as a guide for others in need. The story about Burton’s search for her mom has become an invitation for people to trust her. “The same people have probably heard it a thousand times. Well, now they’re coming to me for help and we’re finding their families.”\u003c/p>\n\u003cp>That’s not to say there haven’t been personal wins for Burton, too. She never knew who her father was. But this summer, she found him. She was told as a kid that her mom got pregnant at 17, and had her at 18. But her grandparents didn’t know who her father was.\u003c/p>\n\u003cp>Recently, Burton took a DNA test and it led to Kansas and her 71- year-old dad. He doesn’t profess to remember Cloudia, but has met with Burton once already — and she’s going to Kansas soon to spend some vacation time with him.\u003c/p>\n\u003cp>Burton’s got a new lead for Cloudia, by the way, from someone in San Francisco who thought they saw her back in June. She would be 66 years old now. White woman, round face that’s probably slouched somewhat with age, presumed shoulder-length gray hair. Might still answer to the name of Cloudia. Or Leslie. Or Diane. Or some other name we don’t know about. Yet.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published on July 31, 2019.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">G\u003c/span>\u003c/p>\u003cp>rowing up, Robin Burton didn’t really know much about her mother, Cloudia Leslie Wells. “I was never told that my mom was mentally ill. My grandparents raised me, her mom and dad, and my mom would come home for a couple months and she’d be gone for a couple of years, and this was normal to me growing up,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘The only thing that I want to say to my mom whenever I find her is, “I love you.” That means more to me than anything else in the world, is just for her to hear those three words: “I love you.”‘",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Burton was an adult by the time she learned her mom had been diagnosed with paranoid schizophrenia. That finally answered questions unanswered when her mom was breezing in and out of her life. Like many kids who don’t understand what they’re looking at when they’re looking at severe mental illness, little Robin came up with a story.\u003c/p>\n\u003cp>“I thought that she was living the life of the rich and famous, and didn’t have time for me. That was so far from the truth,” she said.\u003c/p>\n\u003cp>That was a sadness she learned to live with early in life. But when Burton was in her 20s, she lost her mom in a new and different way. First, her grandparents died. Then, when her mom swung through town, sometime around Christmas in 1994, and learned about their deaths, she left and didn’t come back. Ever.\u003c/p>\n\u003cp>“I was 23 whenever she went missing, and I’m 48 years old now,” Burton said.\u003c/p>\n\u003cp>Schizophrenia can be a debilitating disease. There’s no known cure, though medications can help. “We don’t know what it is. We don’t know what causes it. I don’t even know what the meaning of a cure would be,” said \u003ca href=\"https://medicine.yale.edu/psychiatry/people/robert_rosenheck.profile\" target=\"_blank\" rel=\"noopener noreferrer\">Robert Rosenheck\u003c/a>, professor of psychiatry and of health policy at the Yale School of Medicine.\u003c/p>\n\u003cfigure id=\"attachment_11764368\" class=\"wp-caption aligncenter\" style=\"max-width: 720px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11764368\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538.jpg\" alt=\"A rare family photo of young Robin Burton with her mother, Cloudia Leslie Wells.\" width=\"720\" height=\"540\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538.jpg 720w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/FB_IMG_1558461841538-536x402.jpg 536w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\">\u003cfigcaption class=\"wp-caption-text\">A rare family photo of young Robin Burton with her mother, Cloudia Leslie Wells. \u003ccite>(Courtesy of Robin Burton)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scientists do know schizophrenia affects people of every race, culture and economic class. Common symptoms include delusions, social withdrawal and an inability to cope with strong emotions. “Schizophrenia interferes with all areas of mental life. It makes it hard to think clearly. It makes people fearful, angry sometimes, and sometimes numb,” Rosenheck added.\u003c/p>\n\u003cp>That’s why you see so many homeless people with schizophrenia. It’s hard for other people to connect with them and stay connected.\u003c/p>\n\u003cp>As the years wore on, Burton hired a private investigator to find Cloudia, though a lot of people told her to let it go. A lot of people tell her that now. But Burton won’t give up on the hope that Cloudia is still alive, and that there might be some benefit to seeing her again.\u003c/p>\n\u003cp>“I’m not here to judge my mom, and I’m not here to ask her any questions on why she didn’t come home, or where she’s been, because she has her own reasons. The only thing that I want to say to my mom whenever I find her is, ‘I love you.’ That means more to me than anything else in the world, is just for her to hear those three words: ‘I love you.’ ”\u003c/p>\n\u003cp>The question is, how to find her?\u003c/p>\n\u003ch2>The First Trip to California\u003c/h2>\n\u003cp>Burton lives in Collinsville, Illinois. “I work at Geico. I’m an insurance agent. I also bartend on the weekends,” at a popular local watering hole called Ardie and Tiny’s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘You know, the question that I get asked a lot, and most families do that are looking for their missing loved ones that are living homeless, is maybe they don’t want to be found.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>One evening, almost five years ago, Burton was working at that bar, “and it was a slow night, and I had a phone call from my private investigator, and he had told me that he doesn’t know how he missed it. But my mom’s Social Security number was used at a homeless shelter in 2013.”\u003c/p>\n\u003cp>It was a homeless shelter in Santa Monica, California, roughly 2,000 miles from Collinsville.\u003c/p>\n\u003cp>Burton explained, “I didn’t think a whole lot of it because I’ve been on wild goose chases before. I told a customer, just for small talk, about the phone call conversation. Unbeknownst to me, that customer went home and started Googling the Web. Two days later, he called me on the phone and he said, ‘Robin, I need your email address. There’s something I want you to look at.’ ”\u003c/p>\n\u003cp>It was a 2014 article from the Los Angeles Times, talking about the annual point-in-time count of the local homeless population. There was one photograph up top, of a homeless woman on the street. “I knew immediately that it was her. Because your eyes don’t change.”\u003c/p>\n\u003cp>Burton called up the L.A. Times, and the reporter put Burton in touch with the photographer, who said the photo was taken one year before the article was written.\u003c/p>\n\u003cp>“January 2013 in Santa Monica, California, the exact same place and area my mom’s Social Security number was used. In the same year. And that was all the confirmation I needed, ’cause I already knew it was her,” Burton said.\u003c/p>\n\u003cp>That tip was 2 years old, but she decided to chase it down anyway. She set up a Go Fund Me page to get help paying for a rental car to get to California, and for a motel room to stay in when she got there.\u003c/p>\n\u003cp>A local \u003ca href=\"https://fox2now.com/2015/02/17/collinsville-woman-heads-to-la-to-find-her-mother-after-spotting-her-in-la-times-picture/\" target=\"_blank\" rel=\"noopener noreferrer\">Fox News\u003c/a> outlet broadcast a set-up story the night before Burton left for L.A. By then, Burton had talked with a police officer at the LAPD, who told her Cloudia had been sighted on L.A.’s skid row. Burton told Fox, “I’m not scared of skid row. That’s not my biggest fear. My biggest fear is my mom not wanting to come back with me. Alls I know is I have to find her. I gotta let her know I love her.”\u003c/p>\n\u003ch2>Lessons Learned on Skid Row\u003c/h2>\n\u003cfigure id=\"attachment_11764385\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11764385 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS27189_GettyImages-691243686-qut-1200x800.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A woman passes a wheelchair-bound homeless man on Spring Street on May 1, 2017, in Los Angeles. The 2017 Greater Los Angeles Homeless Count indicated a dramatic jump of 20 percent in the city of Los Angeles, while Los Angeles County has spiked 23 percent. \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There has been a skid row in Los Angeles since the late 19th century. There have been attempts to clear out the poverty and crime from this square mile in the heart of downtown since the 1950s.\u003c/p>\n\u003cp>But it’s never looked as bad as it does in modern times: a tent city of roughly 4,000 people has sprung up on these sun-baked concrete sidewalks, crawling with rats and bedbugs, reeking with the smell of human urine and feces.\u003c/p>\n\u003cp>Robin arrived in 2015 carrying a box of candy bars wrapped with her mom’s picture, but she made a critical mistake. She brought along another TV camera crew.\u003c/p>\n\u003cp>People on the streets were not happy to see that, or her. “The very first day out there was very scary and emotional for me. I broke down crying. I had to leave. I had to leave and I had to go back to my motel and take a deep breath and re-evaluate.”\u003c/p>\n\u003cp>Back in the motel room, Burton decided she needed to try again, in a different way. “Without the cameras, everything was so different. and it was actually the homeless that was helping me look for my mom. It was them that was telling me, ‘You know I wish I had somebody looking for me.’ ”\u003c/p>\n\u003cp>You could imagine Cloudia visiting a place like the \u003ca href=\"https://www.downtownwomenscenter.org\" target=\"_blank\" rel=\"noopener noreferrer\">Downtown Women’s Center\u003c/a>. Homeless and near-homeless women from all over Southern California come here looking for help for a range of problems.\u003c/p>\n\u003cp>“We serve about 4,000 women a year and it’s very fairly infrequent that we see them reunify. It’s really probably only about five a year,” said chief program officer Erika Hartman, who betrays in her voice a certain exhaustion at the very idea of what sounds like a much desired fairy-tale ending.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I was very, very angry at God. How could you send me a picture after 20 years? How could I go out there and not find her? And it wasn’t until I came home and I realized I’m not alone. There are other families just like me.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Usually, at the point that they have come to skid row, they have really run out of other connections that they can turn to. Sometimes, it’s because they’ve really exhausted their relationships with people who are trying support them. Or who have set boundaries due to substance use. Lots of women report experiencing shame about homelessness,” Hartman said.\u003c/p>\n\u003cp>Even with help, three weeks passed with no sign of Cloudia. Some people told Burton they believed Cloudia must be dead. Whatever the case, Burton needed to go back home and get back to work.\u003c/p>\n\u003cp>That spring, Burton started a Facebook group called \u003ca href=\"https://www.facebook.com/MissingHomelessOrg/\" target=\"_blank\" rel=\"noopener noreferrer\">Missing & Homeless\u003c/a>. The concept is simple: post a person’s story, with enough details and photos, in the hopes somebody in the group will recognize that missing person and help put them in touch with the family looking for them.\u003c/p>\n\u003cp>“They’re not a piece of garbage, you know. They’re somebody’s mother. They’re somebody son. They’re somebody’s sister.”\u003c/p>\n\u003cfigure id=\"attachment_11764316\" class=\"wp-caption aligncenter\" style=\"max-width: 742px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11764316\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/1485734303999.jpeg\" alt=\"One of numerous posters Robin Burton has drawn up over the years in the search for her mother, believed to be homeless somewhere in California.\" width=\"742\" height=\"960\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/1485734303999.jpeg 742w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/1485734303999-160x207.jpeg 160w\" sizes=\"auto, (max-width: 742px) 100vw, 742px\">\u003cfigcaption class=\"wp-caption-text\">One of numerous posters Robin Burton has drawn up over the years in the search for her mother, believed to be homeless somewhere in California. \u003ccite>(Courtesy of Robin Burton)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>An Education in Finding People\u003c/h2>\n\u003cp>Robin said she functions like a reporter when a family contacts her for help. She presses them for more information. Where, exactly, did the person go missing? Are there any distinguishing characteristics, like eye color or tattoos? Do they suffer from mental illness or addiction?\u003c/p>\n\u003cp>The details make it easier to find somebody, but they also emotionally engage the Facebook group members. As opposed to say, some generic post about a Jane Doe.\u003c/p>\n\u003cp>“I had no idea when I started ‘Missing & Homeless’ what it was going to become, and how many followers and supporters that we were gonna have. Then we started finding people. Four years later, we have probably found 70 or 80 people,” Burton said.\u003c/p>\n\u003cp>It turns out a lot of the group’s 63,000 members are homeless themselves, typically logging into Facebook at public libraries — in part because they don’t have any barriers precluding them from getting involved.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Burton has had a number of frustrating conversations with health care providers and social service workers who won’t say boo about someone who friends and family are searching for.\u003c/p>\n\u003cp>“You can walk into a homeless shelter or a soup kitchen and they will not tell you if they’re there. My mom could be in the same building as me and I would never even know it. It’s heartbreaking, whenever you have a family member that is missing and living homeless, the lack of help that you get because of it,” Burton said.\u003c/p>\n\u003cp>There’s a very big reason why most social workers and health care providers would not tell Robin if her mom was in a particular building. It’s against federal law, specifically, the \u003ca href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Health Insurance Portability and Accountability Act of 1996\u003c/a>. HIPAA, as most people call it, has a provision that protects the privacy of individuals’ medical records, including the fact of a person’s presence in a facility.\u003c/p>\n\u003cp>Hartman of the Downtown Women’s Center explained staff are happy to take a message and pass it on. But it’s the homeless person’s choice whether to connect. Always. In part, because they can’t presume the best about people who say they’re searching for a loved one.\u003c/p>\n\u003cp>“We have women who have been trafficked or abused or exploited by family members,” Hartman said. “Many of them don’t list an emergency contact. We have women who pass and we don’t know how to find a next of kin.”\u003c/p>\n\u003cp>In other words, many of these women have good reasons they don’t want to be found. Burton gets that. She’s also seen enough to know some people are just too far gone into the abyss of mental illness, or addiction, or both.\u003c/p>\n\u003cp>“I had a lady that was looking for her son that was schizophrenic, and he was found after, after five or six years, and she didn’t recognize him at first. You know, because the streets weather you. You change drastically. He didn’t recognize her either, and he said, ‘You’re not my mom.’ He’s missing again,” Burton said.\u003c/p>\n\u003cp>So far, we’ve been presuming that the right homeless person has been correctly identified. Sometimes, people eager to help say they’ve seen someone they actually haven’t.\u003c/p>\n\u003cp>It happened to Burton, just weeks after she returned home from skid row that first time. A volunteer from the Downtown Women’s Center called Burton to say Cloudia was there.\u003c/p>\n\u003cp>Burton bought a plane ticket. She was sitting on that plane ahead of takeoff, when she got another call saying the volunteer was mistaken. The timing was such that Burton flew to L.A. and back: an expensive, useless and emotionally painful trip.\u003c/p>\n\u003cp>Now, that wouldn’t stop Burton from recommending families make every effort to file missing person reports, and take all the other recommended steps. Because the wins, when they happen, are so satisfying.\u003c/p>\n\u003cfigure id=\"attachment_11764346\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11764346\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut.jpg\" alt=\"A former workmate of Corey Abernathy's asked his parents for permission to post this on the Facebook group "Missing & Homeless." That's how a housemate of Abernathy's in San Francisco spotted it, and told him, and he called his parents after a radio silence of two years.\" width=\"1920\" height=\"1246\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-160x104.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-800x519.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-1020x662.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38248_Corey-qut-1200x779.jpg 1200w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A former workmate of Corey Abernathy asked his parents for permission to post this on the Facebook group “Missing & Homeless.” That’s how a housemate of Abernathy’s in San Francisco spotted it, and told him, and he called his parents after a radio silence of two years. \u003ccite>(Courtesy of Corey Abernathy)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>A Win in San Francisco\u003c/h2>\n\u003cp>Corey Abernathy, and his parents, Cathy and Robert Abernathy, agreed to meet me on a bright, breezy day at one of his favorite haunts in San Francisco: Crissy Field. When he was homeless, Corey used to camp in the Presidio, not far from where tourists whiz by on their rented bicycles and children eat ice cream while wearing fleece jackets.\u003c/p>\n\u003cp>“I just thought too much about life. I felt a lot of pressure,” Corey said. He’s 5-foot-9. About 160 pounds. Hair and beard close-cropped. His blue eyes twinkle in the sun. He looks like he’s gotten a lot of sun in recent years, but nothing that seems out of the ordinary for an athletic white man in his early 30s.\u003c/p>\n\u003cp>Corey was 28 when he decided to throw on a backpack one day and leave his parents’ home in Willits in Mendocino County. With no warning, or explanation — though there were signs when the family looks back on it — that he wasn’t happy. That he was drifting.\u003c/p>\n\u003cp>“I just remember that there was like a weird amount of anxiety on me,” Abernathy said. “I always tried to make sense of everything. I put too much pressure on myself that wasn’t really there. Yeah, the way I dealt with it was just drinking a lot.”\u003c/p>\n\u003cp>He’d struggled with anxiety since childhood. He didn’t seem to have a strong idea for a career the way his older brother had. He dropped out of Sacramento State almost as soon as he got there. He lost a job in retail, then switched to a local casino. But there, he was surrounded by alcohol, and the consequences were predictable.\u003c/p>\n\u003cp>Corey started reading about people who dropped out of society for a different kind of life. “So it wasn’t like one single moment. It was something I was thinking about for probably like a year,” he explained.\u003c/p>\n\u003cp>Then Corey got a DUI, something he was really ashamed about. He thought to himself, if he had no money, he wouldn’t be able to buy alcohol. And if he had nothing to worry about, he wouldn’t want to buy alcohol.\u003c/p>\n\u003cp>He explained, “My car got towed and I just said, ‘I’m done.’ At the time, it was a good feeling. I don’t have to deal with problems I can’t figure out anymore.”\u003c/p>\n\u003cp>But remember, he was living with his parents at the time. And when he walked out that front door, he left no note. No explanation. His mom, Cathy, is a registered nurse. His dad, Robert, is a retired custom cabinetmaker.\u003c/p>\n\u003cp>His father recalled the day, “Got home and the house was empty. To me, it looked like he’d just walked out the door to go out for a walk. Everything was still in his room. Nothing disturbed. He just disappeared.”\u003c/p>\n\u003cp>They called the police and filed a missing person’s report. Only to discover the police in Mendocino County have a loose attitude about adults who disappear, given the local marijuana growing industry’s reliance on seasonal workers. In this business, pruning is called “trimming,” and many of the trimmers come and go.\u003c/p>\n\u003cp>“In Mendocino County, Sonoma County if a adult is missing, they’re out trimming,” Cathy said. “It was October and it was trimming season. They took the report, but they weren’t doing anything with it.”\u003c/p>\n\u003cp>So Robert and Cathy had to start looking on their own. Corey’s friends helped. A former workmate tacking up a poster in Ukiah met a homeless person who directed them to Fort Bragg, where Robert and Cathy found Corey in a park, about six weeks after he disappeared. But Corey wouldn’t come back.\u003c/p>\n\u003cp>“I wasn’t ready to see them,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I gave everything up, you know. It was like, I don’t know if I’m ever going to have a room again. I don’t know if I’m ever going to have a relationship again. I distinctively classified myself aside from society.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Robert described his thinking in that moment, “As much as I wanted to grab him and throw him in the car, I knew he’d be gone again. So that was the hardest decision I’ve ever had to make was to let him go.”\u003c/p>\n\u003cp>So they did, and Corey kept hitchhiking, to Point Arena, Gualala and finally San Francisco — where he proceeded to bounce from sleeping rough in the Presidio to side streets and shelters, sporadically sending his parents Facebook messages from public libraries. Until he stopped doing that. The last one was in February 2016.\u003c/p>\n\u003cp>“I felt regret and guilt. I knew I was going to have to figure out a way to speak to them, and yeah, apologize,” Corey said.\u003c/p>\n\u003cp>Every now and then, his parents would get a lead and take off to follow it, only to find it mistaken. Often, from somebody overcome with wishful thinking. A lot of guys on the street look like Corey. “OK, he’s here. He’s in Yuba City. He’s in Sacramento. Manteca. Denver. I mean, you name it, he was there,” Robert said.\u003c/p>\n\u003cp>Weeks turned into months, and then years. Corey’s last messages came from San Francisco. So Robert and Cathy drove south repeatedly to scour the city’s Tenderloin on foot. “He could be on the next block over headed in the opposite direction, and we’d never know it. You know, there were days when we walked 25 miles,” Robert said.\u003c/p>\n\u003cp>The night before Corey left his parents’ home in Willits, Cathy started having this recurring dream — nightmare, really.\u003c/p>\n\u003cp>In it, she keeps getting woken up by her nephew, Bobby, who committed suicide in 2010. It’s like he was a contact from the underworld, trying to tell her something about her son.\u003c/p>\n\u003cp>“He’d wake me up that, ‘We gotta get going.’ I was on the hard ground. I was cold. I wasn’t safe. I had to get moving. You know, we had to get moving,” she recalled.\u003c/p>\n\u003cp>Then, at some point, the nightmares abruptly stopped. Cathy had two theories about what happened to Corey. “Maybe, you know, he’s getting his life together. Or he wasn’t on this earth anymore. You know, it was one of the two.”\u003c/p>\n\u003cp>As it happened, this was right around the time Corey was ready for rehab. He got involved with \u003ca href=\"https://www.aa.org\" target=\"_blank\" rel=\"noopener noreferrer\">Alcoholics Anonymous\u003c/a>. He got into a sober living facility.\u003c/p>\n\u003cp>But he didn’t reconnect with his parents. And two years passed. That’s when, early this year, one of Corey’s old workmates posted on “Missing & Homeless.” And someone Corey lives with recognized him. And told Corey. And Corey called home.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘You see the homeless. You hear about people missing family. And that’s supposed to happen to other people. It’s not supposed to happen to you. With Corey missing, I am much, much, much more aware of how it’s happening everywhere. Man, this is an epidemic.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I don’t even remember the drive down here. You know, we sat down, and he talked about why — some of the things that made him leave. And him realizing that the DUI, everybody gets one and it’s nothing to run from, but this is something he’s been thinking about, and it’s something he needed to finish. And it’s like, he’s part of our family, and as I told him, he’s going to be my son forever, no matter what. I still love him,” Robert said.\u003c/p>\n\u003cp>These days, Robert and Cathy come down from Willits periodically to visit Corey in San Francisco.\u003c/p>\n\u003cp>Corey doesn’t have a strong answer as to why he didn’t call his parents before a prompt from the acquaintance who spotted him on “Missing & Homeless.” What Corey can say is that he was ready when he got the nudge.\u003c/p>\n\u003ch2>The Kind of Story Robin Burton Lives For\u003c/h2>\n\u003cp>“A lot of homeless are afraid to contact their family because they don’t know if they’re going to be turned away,” Burton said. “Some, you know, it’s just they’ve been gone for so long they don’t even know what to say to families anymore. Those are our miracle stories. There was a reason he was supposed to be found, and there was closure.”\u003c/p>\n\u003cp>The search for Cloudia morphed into something else for Burton. She’s found a mission, a purpose in life, as a guide for others in need. The story about Burton’s search for her mom has become an invitation for people to trust her. “The same people have probably heard it a thousand times. Well, now they’re coming to me for help and we’re finding their families.”\u003c/p>\n\u003cp>That’s not to say there haven’t been personal wins for Burton, too. She never knew who her father was. But this summer, she found him. She was told as a kid that her mom got pregnant at 17, and had her at 18. But her grandparents didn’t know who her father was.\u003c/p>\n\u003cp>Recently, Burton took a DNA test and it led to Kansas and her 71- year-old dad. He doesn’t profess to remember Cloudia, but has met with Burton once already — and she’s going to Kansas soon to spend some vacation time with him.\u003c/p>\n\u003cp>Burton’s got a new lead for Cloudia, by the way, from someone in San Francisco who thought they saw her back in June. She would be 66 years old now. White woman, round face that’s probably slouched somewhat with age, presumed shoulder-length gray hair. Might still answer to the name of Cloudia. Or Leslie. Or Diane. Or some other name we don’t know about. Yet.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Primary care doctors are a hot commodity across California.\u003c/p>\n\u003cp>Students are being lured by full-ride scholarships to medical schools. New grads are specifically recruited for training residencies. And full-fledged doctors are being offered loan repayment programs to serve low-income residents or work in underserved areas.\u003c/p>\n\u003cp>These efforts are intended to ease or stave off the physician shortage expected to peak within the next decade in California. By 2030, the state will be short some 4,000 physicians, according to a study from the HealthForce Center at UC San Francisco.\u003c/p>\n\u003cp>The shortage is already acute in rural and inner city areas, especially in the Inland Empire of Southern California where the number of physicians needs to double just to reach the recommended amount to serve the fast-growing population.\u003c/p>\n\u003cp>“The Inland Empire region has one of the lowest ratios of physicians, including primary care physicians, and that creates a number of challenges,” said Dr. Geoffrey Leung, ambulatory medical director for the Riverside University Health System. “ When we have delays in care, that can result in sort of chronic illnesses or acute illnesses that become worse.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>With high student loans, medical school grads have been turning to better-paying specialties instead of primary care, such as family practice, pediatrics or obstetrics, leaving some areas in dire need.\u003c/p>\n\u003cp>“In California in particular, what’s unique is that the total number of physicians isn’t as big of a problem as where they are located,” said Mark Henderson, professor of internal medicine and associate dean of admissions at the UC Davis School of Medicine. “It’s really a maldistribution problem.”\u003c/p>\n\u003cp>Health insurers, medical professionals and community leaders are working on solutions. This summer, the state offered 250-plus doctors loan repayment plans in exchange for ensuring 30% of their caseloads were Medi-Cal patients.\u003c/p>\n\u003cp>Meanwhile, insurer LA Care is spending millions on recruiting new doctors and, in South Los Angeles, the Martin Luther King Jr. Community Hospital is working to create a new residency program. In the Inland Empire, leaders are working to create a “middle school to medical school” pipeline.\u003c/p>\n\u003cp>Because doctors tend to practice near where they trained, where they are from or where they have a family connection, resources are being poured into the expansion or creation of training programs that are situated where the need is.\u003c/p>\n\u003cfigure id=\"attachment_11789007\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11789007\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-3-800x594.jpg\" alt=\"\" width=\"800\" height=\"594\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa completed his residency with Riverside County’s University Health System and stayed on as a full-fledged physician and faculty member of the residency. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Most Impacted Region In The State: The Inland Empire\u003c/h3>\n\u003cp>Inland Empire officials have been working on this for quite some time. A statewide report from The Future Health Workforce Commission released this year found the number of physicians is 35 per 100,000 people, compared to the recommended 70 doctors, making it the most impacted region in the state.\u003c/p>\n\u003cp>Because of that need the state approved a new University of California medical school that opened in 2013 at UC Riverside specifically to train doctors to serve the local area. It offers scholarships to students who promise to return after residency to practice in the area and reaches out to kids interested in health careers.\u003c/p>\n\u003cp>The county and medical school have partnered to expand long-standing residency programs by inviting more students to train in the area. And both institutions recruit with an eye toward geographic nativity, meaning if an applicant is from or has a connection to the area they get priority.\u003c/p>\n\u003cp>For cancer survivor Cesilia Jimenez these efforts by the county are paying off.\u003c/p>\n\u003cp>Recently Jimenez received the results of her latest scans at the Moreno Valley Community Health Center from Dr. Moazzum Bajwa.\u003c/p>\n\u003cp>She had been putting it off.\u003c/p>\n\u003cp>“I’ve been so nervous to hear those results, I knew I wanted to hear them from you,” she told Bajwa after he assured her that everything on the scans looked good.\u003c/p>\n\u003cp>It was Bajwa, who was a resident at the time, who diagnosed a cancerous tumor in her neck and got her treatment for it after she had sought answers for years as to why she was losing her ability to walk.\u003c/p>\n\u003cfigure id=\"attachment_11789006\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11789006\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-2-800x567.jpg\" alt=\"\" width=\"800\" height=\"567\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa and patient Cesilia Jimenez hug after her recent appointment. Jimenez said he’s a godsend and that without him she might still be trying to figure out what was wrong. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, he is an attending physician and teaching residents through Riverside University Health System and the UCR medical school. Bajwa is considered a success story in Riverside County’s efforts to grow, recruit and retain primary care doctors in the region.\u003c/p>\n\u003cp>So far the county is seeing success, Leung said. About four out of 10 residents stay in the Inland Empire after their training and eight to nine stay in Southern California. While those numbers are not that different from other programs across the state, opening the medical school and expanding training slots have kept doctors in the area.\u003cbr>\nDr. Takesha Cooper is on the admissions committee at the medical school, where priority is given to applicants who have a permanent or active mailing address in the area or went to college or attended high school in the Inland Empire.\u003c/p>\n\u003cp>“We do a holistic review and don’t just look at test scores,” she said. “We call it mission fits.”\u003c/p>\n\u003cp>Cooper defines it as applicants with connections to the area and who believe in the school’s mission to help the medically underserved region and train a diverse workforce of physicians. “We have to focus and attract and try to keep people who are growing up in this area, who have ties and are more likely to stay,” she said.\u003c/p>\n\u003cp>So far, the medical school is seeing early success. Of its 128 graduates, about 31% are training as residents in the Inland Empire.\u003c/p>\n\u003ch3>“I Needed To Serve This Population”\u003c/h3>\n\u003cp>Cooper is the kind of local student the school hopes to capture.\u003c/p>\n\u003cp>She grew up in Moreno Valley long before the medical school opened. She went away for college, completed medical school at the University of Southern California and moved to the Bay Area for her residency and a fellowship in child and adolescent psychiatry.\u003c/p>\n\u003cp>And, as statistics bear out, she set up her practice in Palo Alto, near Stanford where she finished her training.\u003cbr>\n“I did that for five years but I started to feel like I’m not really needed here,” she said. “My heart told me I needed to serve this population.”\u003c/p>\n\u003cp>So she came back to Riverside to practice and then she joined the faculty at UCR and has since helped start a residency in general adult psychiatry and a fellowship in child psychiatry as a way to train and keep much-needed mental health professionals in the area.\u003c/p>\n\u003cp>“If our residents had to go to UCLA or UC San Diego or Irvine, chances are they would have stayed in that area and practiced,” she said. “It’s what I did.”\u003c/p>\n\u003cp>It’s the same strategy the county uses in recruiting medical school graduates like Bajwa to its residency programs, said Dr. Adolfo Aguilera, associate director of the University Health System residency program, who also stayed on after he trained in Riverside more than two decades ago.\u003c/p>\n\u003cp>“When somebody has a connection to the area, you know, they are invested in what they’re going to be doing,” he said. “If they’re here to stay, they’re going to want to make sure that they are providing the best care that they can, that they are essentially trying to build the program so that we’re able to outreach to our community and serve their needs”\u003c/p>\n\u003cp>Bajwa is from the East Coast but the program’s goals matched his when he interviewed and Riverside was his first choice. He also had another reason for coming and staying: His wife is from Riverside and she’s also a physician.\u003c/p>\n\u003cp>“The connection with my wife is what brought me out here first,” he said. “But it was the community and identity of building something bigger than myself that I fell in love with.”\u003c/p>\n\u003cp>That’s what Leung, Aguilera and others in Riverside hope will happen with many of the students and residents they recruit. And they are not alone.\u003c/p>\n\u003cfigure id=\"attachment_11789008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11789008\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-4-800x566.jpg\" alt=\"\" width=\"800\" height=\"566\">\u003cfigcaption class=\"wp-caption-text\">Dr. Adolfo Aguilera is associate director of the Riverside County University Health System and University of California School of Medicine residency program and physician in charge at the Moreno Valley Community Health Center. s \u003ccite>(Elizabeth Aguilera/CalMatter)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Recruiting Physicians Where They Are Needed\u003c/h3>\n\u003cp>This kind of thinking is happening across the state in areas lacking physicians.\u003c/p>\n\u003cp>In Northern California, UC Davis has partnered with the Oregon Health and Science University in Portland and created a program called COMPADRE, or California Oregon Medical Partnership to Address Disparities in Rural Education. It focuses on the area between Davis and Portland to recruit kids to medical school and to provide a program that allows them to train where they are from.\u003c/p>\n\u003cp>“We’ll modify their curriculum to allow them to remain in their home community for a large part of their training to keep them connected to a community health center in the region,” Henderson said. “If we get physicians who actually grew up or have a connection to these communities they will be less burned out and will have meaningful relationships to the community and the hospital.”\u003c/p>\n\u003cp>In urban South Los Angeles, the MLK Jr. Community Hospital set up its own medical group in 2016 that recruits and hires physicians to practice in the neighborhood and is slated to start a residency training program in 2022, said Elaine Batchlor, CEO of the hospital.\u003c/p>\n\u003cp>“The strategy is to recruit doctors who have an interest in working in underserved communities, to offer them a state of the art practice environment with high quality colleagues,” she said. “We offer market compensation and the possibility of having loans forgiven because they are working in a medically underserved area.”\u003c/p>\n\u003cp>Bringing residency slots to communities is a strategy that costs money. These slots are usually paid for by the Medicare program but the federal government has not created new residency positions in years. So the program at MLK and other new training sites are being funded by the host institutions or insurers like LA Care Health Plan.\u003c/p>\n\u003cp>LA Care serves 2 million Medi-Cal patients in Southern California. Last year the insurer committed 5% of its reserves, about $31 million a year for five years, to a program called Elevating the Safety Net, said John Baackes, CEO of the organization. It includes scholarships for medical school students, funding for residency slots, grants to clinics and private practices to recruit primary care doctors into Los Angeles County and loan repayment up to $180,000 for those newly recruited physicians who stay three years.\u003c/p>\n\u003cp>“We’re hoping that when their three years is up they will have fallen in love with L.A. and their practice and they’ll stay on with us,” Baackes said. “We’re aimed at the safety net populations, those people who are on Medi-Cal or uninsured, and we think this is the right thing to do is invest in the future of this population.”\u003c/p>\n\u003cp>In Riverside, the residency program that produced Dr. Bajwa is also partly supported by the county. Riverside County funds 52 positions beyond what the federal government provides.\u003c/p>\n\u003cp>“We are over our cap, which means every resident that we add on top of that limit are entirely funded through the county,” said Leung, of Riverside University Health System. “Any improvement that we make in the Inland Empire area whether it is in workforce, education or in terms of policy or the way we think about developing neighborhoods, all of those things help make the Inland Empire the sort of area that people want to move to and that help us with recruiting doctors, resident physicians and medical school students.”\u003c/p>\n\u003cp>For patients, having access to a doctor over the long term that they know and trust pays off.\u003c/p>\n\u003cp>Before Dr. Bajwa, Cesilia Jimenez never knew who she was going to see at the clinic.\u003c/p>\n\u003cp>“It feels good to just come and he knows what we are going to talk about and not me explaining to the doctor what I’ve been through,” she said.\u003c/p>\n\u003cp>When she left their appointment Bajwa gave her a hug before she walked out on her own.\u003c/p>\n\u003cp>“Many programs talk about serving the underserved but here the focus that the faculty have on actually taking care of the community and doing outreach in the community is just unparalleled I think,” Bajwa said. “That was something I wanted to be a part of.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The doctor shortage is already acute in rural and inner city areas, especially in the Inland Empire, where the number of physicians needs to double just to serve the fast-growing population.",
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"title": "Med School Free Rides and Loan Repayments — California Tries to Boost Its Dwindling Doctor Supply | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Primary care doctors are a hot commodity across California.\u003c/p>\n\u003cp>Students are being lured by full-ride scholarships to medical schools. New grads are specifically recruited for training residencies. And full-fledged doctors are being offered loan repayment programs to serve low-income residents or work in underserved areas.\u003c/p>\n\u003cp>These efforts are intended to ease or stave off the physician shortage expected to peak within the next decade in California. By 2030, the state will be short some 4,000 physicians, according to a study from the HealthForce Center at UC San Francisco.\u003c/p>\n\u003cp>The shortage is already acute in rural and inner city areas, especially in the Inland Empire of Southern California where the number of physicians needs to double just to reach the recommended amount to serve the fast-growing population.\u003c/p>\n\u003cp>“The Inland Empire region has one of the lowest ratios of physicians, including primary care physicians, and that creates a number of challenges,” said Dr. Geoffrey Leung, ambulatory medical director for the Riverside University Health System. “ When we have delays in care, that can result in sort of chronic illnesses or acute illnesses that become worse.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>With high student loans, medical school grads have been turning to better-paying specialties instead of primary care, such as family practice, pediatrics or obstetrics, leaving some areas in dire need.\u003c/p>\n\u003cp>“In California in particular, what’s unique is that the total number of physicians isn’t as big of a problem as where they are located,” said Mark Henderson, professor of internal medicine and associate dean of admissions at the UC Davis School of Medicine. “It’s really a maldistribution problem.”\u003c/p>\n\u003cp>Health insurers, medical professionals and community leaders are working on solutions. This summer, the state offered 250-plus doctors loan repayment plans in exchange for ensuring 30% of their caseloads were Medi-Cal patients.\u003c/p>\n\u003cp>Meanwhile, insurer LA Care is spending millions on recruiting new doctors and, in South Los Angeles, the Martin Luther King Jr. Community Hospital is working to create a new residency program. In the Inland Empire, leaders are working to create a “middle school to medical school” pipeline.\u003c/p>\n\u003cp>Because doctors tend to practice near where they trained, where they are from or where they have a family connection, resources are being poured into the expansion or creation of training programs that are situated where the need is.\u003c/p>\n\u003cfigure id=\"attachment_11789007\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11789007\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-3-800x594.jpg\" alt=\"\" width=\"800\" height=\"594\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa completed his residency with Riverside County’s University Health System and stayed on as a full-fledged physician and faculty member of the residency. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Most Impacted Region In The State: The Inland Empire\u003c/h3>\n\u003cp>Inland Empire officials have been working on this for quite some time. A statewide report from The Future Health Workforce Commission released this year found the number of physicians is 35 per 100,000 people, compared to the recommended 70 doctors, making it the most impacted region in the state.\u003c/p>\n\u003cp>Because of that need the state approved a new University of California medical school that opened in 2013 at UC Riverside specifically to train doctors to serve the local area. It offers scholarships to students who promise to return after residency to practice in the area and reaches out to kids interested in health careers.\u003c/p>\n\u003cp>The county and medical school have partnered to expand long-standing residency programs by inviting more students to train in the area. And both institutions recruit with an eye toward geographic nativity, meaning if an applicant is from or has a connection to the area they get priority.\u003c/p>\n\u003cp>For cancer survivor Cesilia Jimenez these efforts by the county are paying off.\u003c/p>\n\u003cp>Recently Jimenez received the results of her latest scans at the Moreno Valley Community Health Center from Dr. Moazzum Bajwa.\u003c/p>\n\u003cp>She had been putting it off.\u003c/p>\n\u003cp>“I’ve been so nervous to hear those results, I knew I wanted to hear them from you,” she told Bajwa after he assured her that everything on the scans looked good.\u003c/p>\n\u003cp>It was Bajwa, who was a resident at the time, who diagnosed a cancerous tumor in her neck and got her treatment for it after she had sought answers for years as to why she was losing her ability to walk.\u003c/p>\n\u003cfigure id=\"attachment_11789006\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11789006\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-2-800x567.jpg\" alt=\"\" width=\"800\" height=\"567\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa and patient Cesilia Jimenez hug after her recent appointment. Jimenez said he’s a godsend and that without him she might still be trying to figure out what was wrong. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, he is an attending physician and teaching residents through Riverside University Health System and the UCR medical school. Bajwa is considered a success story in Riverside County’s efforts to grow, recruit and retain primary care doctors in the region.\u003c/p>\n\u003cp>So far the county is seeing success, Leung said. About four out of 10 residents stay in the Inland Empire after their training and eight to nine stay in Southern California. While those numbers are not that different from other programs across the state, opening the medical school and expanding training slots have kept doctors in the area.\u003cbr>\nDr. Takesha Cooper is on the admissions committee at the medical school, where priority is given to applicants who have a permanent or active mailing address in the area or went to college or attended high school in the Inland Empire.\u003c/p>\n\u003cp>“We do a holistic review and don’t just look at test scores,” she said. “We call it mission fits.”\u003c/p>\n\u003cp>Cooper defines it as applicants with connections to the area and who believe in the school’s mission to help the medically underserved region and train a diverse workforce of physicians. “We have to focus and attract and try to keep people who are growing up in this area, who have ties and are more likely to stay,” she said.\u003c/p>\n\u003cp>So far, the medical school is seeing early success. Of its 128 graduates, about 31% are training as residents in the Inland Empire.\u003c/p>\n\u003ch3>“I Needed To Serve This Population”\u003c/h3>\n\u003cp>Cooper is the kind of local student the school hopes to capture.\u003c/p>\n\u003cp>She grew up in Moreno Valley long before the medical school opened. She went away for college, completed medical school at the University of Southern California and moved to the Bay Area for her residency and a fellowship in child and adolescent psychiatry.\u003c/p>\n\u003cp>And, as statistics bear out, she set up her practice in Palo Alto, near Stanford where she finished her training.\u003cbr>\n“I did that for five years but I started to feel like I’m not really needed here,” she said. “My heart told me I needed to serve this population.”\u003c/p>\n\u003cp>So she came back to Riverside to practice and then she joined the faculty at UCR and has since helped start a residency in general adult psychiatry and a fellowship in child psychiatry as a way to train and keep much-needed mental health professionals in the area.\u003c/p>\n\u003cp>“If our residents had to go to UCLA or UC San Diego or Irvine, chances are they would have stayed in that area and practiced,” she said. “It’s what I did.”\u003c/p>\n\u003cp>It’s the same strategy the county uses in recruiting medical school graduates like Bajwa to its residency programs, said Dr. Adolfo Aguilera, associate director of the University Health System residency program, who also stayed on after he trained in Riverside more than two decades ago.\u003c/p>\n\u003cp>“When somebody has a connection to the area, you know, they are invested in what they’re going to be doing,” he said. “If they’re here to stay, they’re going to want to make sure that they are providing the best care that they can, that they are essentially trying to build the program so that we’re able to outreach to our community and serve their needs”\u003c/p>\n\u003cp>Bajwa is from the East Coast but the program’s goals matched his when he interviewed and Riverside was his first choice. He also had another reason for coming and staying: His wife is from Riverside and she’s also a physician.\u003c/p>\n\u003cp>“The connection with my wife is what brought me out here first,” he said. “But it was the community and identity of building something bigger than myself that I fell in love with.”\u003c/p>\n\u003cp>That’s what Leung, Aguilera and others in Riverside hope will happen with many of the students and residents they recruit. And they are not alone.\u003c/p>\n\u003cfigure id=\"attachment_11789008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11789008\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-4-800x566.jpg\" alt=\"\" width=\"800\" height=\"566\">\u003cfigcaption class=\"wp-caption-text\">Dr. Adolfo Aguilera is associate director of the Riverside County University Health System and University of California School of Medicine residency program and physician in charge at the Moreno Valley Community Health Center. s \u003ccite>(Elizabeth Aguilera/CalMatter)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Recruiting Physicians Where They Are Needed\u003c/h3>\n\u003cp>This kind of thinking is happening across the state in areas lacking physicians.\u003c/p>\n\u003cp>In Northern California, UC Davis has partnered with the Oregon Health and Science University in Portland and created a program called COMPADRE, or California Oregon Medical Partnership to Address Disparities in Rural Education. It focuses on the area between Davis and Portland to recruit kids to medical school and to provide a program that allows them to train where they are from.\u003c/p>\n\u003cp>“We’ll modify their curriculum to allow them to remain in their home community for a large part of their training to keep them connected to a community health center in the region,” Henderson said. “If we get physicians who actually grew up or have a connection to these communities they will be less burned out and will have meaningful relationships to the community and the hospital.”\u003c/p>\n\u003cp>In urban South Los Angeles, the MLK Jr. Community Hospital set up its own medical group in 2016 that recruits and hires physicians to practice in the neighborhood and is slated to start a residency training program in 2022, said Elaine Batchlor, CEO of the hospital.\u003c/p>\n\u003cp>“The strategy is to recruit doctors who have an interest in working in underserved communities, to offer them a state of the art practice environment with high quality colleagues,” she said. “We offer market compensation and the possibility of having loans forgiven because they are working in a medically underserved area.”\u003c/p>\n\u003cp>Bringing residency slots to communities is a strategy that costs money. These slots are usually paid for by the Medicare program but the federal government has not created new residency positions in years. So the program at MLK and other new training sites are being funded by the host institutions or insurers like LA Care Health Plan.\u003c/p>\n\u003cp>LA Care serves 2 million Medi-Cal patients in Southern California. Last year the insurer committed 5% of its reserves, about $31 million a year for five years, to a program called Elevating the Safety Net, said John Baackes, CEO of the organization. It includes scholarships for medical school students, funding for residency slots, grants to clinics and private practices to recruit primary care doctors into Los Angeles County and loan repayment up to $180,000 for those newly recruited physicians who stay three years.\u003c/p>\n\u003cp>“We’re hoping that when their three years is up they will have fallen in love with L.A. and their practice and they’ll stay on with us,” Baackes said. “We’re aimed at the safety net populations, those people who are on Medi-Cal or uninsured, and we think this is the right thing to do is invest in the future of this population.”\u003c/p>\n\u003cp>In Riverside, the residency program that produced Dr. Bajwa is also partly supported by the county. Riverside County funds 52 positions beyond what the federal government provides.\u003c/p>\n\u003cp>“We are over our cap, which means every resident that we add on top of that limit are entirely funded through the county,” said Leung, of Riverside University Health System. “Any improvement that we make in the Inland Empire area whether it is in workforce, education or in terms of policy or the way we think about developing neighborhoods, all of those things help make the Inland Empire the sort of area that people want to move to and that help us with recruiting doctors, resident physicians and medical school students.”\u003c/p>\n\u003cp>For patients, having access to a doctor over the long term that they know and trust pays off.\u003c/p>\n\u003cp>Before Dr. Bajwa, Cesilia Jimenez never knew who she was going to see at the clinic.\u003c/p>\n\u003cp>“It feels good to just come and he knows what we are going to talk about and not me explaining to the doctor what I’ve been through,” she said.\u003c/p>\n\u003cp>When she left their appointment Bajwa gave her a hug before she walked out on her own.\u003c/p>\n\u003cp>“Many programs talk about serving the underserved but here the focus that the faculty have on actually taking care of the community and doing outreach in the community is just unparalleled I think,” Bajwa said. “That was something I wanted to be a part of.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>President Trump has made price transparency a centerpiece of his health care agenda. Friday he announced two regulatory changes in a bid to provide more easy-to-read price information to patients.\u003c/p>\n\u003cp>The first effort targets hospitals, \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/cy-2020-hospital-outpatient-prospective-payment-system-opps-policy-changes-hospital-price\" target=\"_blank\" rel=\"noopener noreferrer\">finalizing a rule\u003c/a> that requires them to display their secret, negotiated rates to patients starting in January 2021. The second is \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-proposed-rule-cms-9915-p\" target=\"_blank\" rel=\"noopener noreferrer\">a proposal\u003c/a> to make insurance companies show patients their expected out-of-pocket costs through an online tool. That proposed rule is subject to 60 days of public comment, and it’s unclear when it would go into effect.\u003c/p>\n\u003cp>“Our goal is to give patients the knowledge they need about the real price of health care services,” said Trump. “They’ll be able to check them, compare them, go to different locations, so they can shop for the highest-quality care at the lowest cost.”\u003c/p>\n\u003cp>Administration officials heralded both rules as historic and transformative to the health care system.\u003c/p>\n\u003cp>“Under the status quo, health care prices are about as clear as mud to patients,” said Center for Medicare & Medicaid Services Administrator Seema Verma in a written statement. “Today’s rules usher in a new era that upends the status quo to empower patients and put them first.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As NPR has reported, \u003ca href=\"https://www.npr.org/sections/health-shots/2019/06/24/735578519/trumps-plan-to-lower-your-hospital-costs-heres-what-you-need-to-know\" target=\"_blank\" rel=\"noopener noreferrer\">hospitals are currently\u003c/a> required to post their “list prices” online, but that information has been very hard to use and doesn’t tell consumers much about what they are likely to pay. The new rule makes hospitals show what they really pay for services — not the list prices — and requires them to make that information easy to read and easy to access.\u003c/p>\n\u003cp>“I don’t know if the hospitals are going to like me too much anymore with this,” Trump said in a White House news conference Friday afternoon. “That’s OK.” He later added, “We’re stopping American patients from just getting — pure and simple, two words, very simple words — ripped off. Because they’ve been ripped off for years. For a lot of years.”\u003c/p>\n\u003cp>[aside postID=\"news_11752360\" label= \"Related Coverage\"]\u003c/p>\n\u003cp>The second rule Trump announced Friday (which is a proposed rule, still subject to public comments before being finalized) affects insurance companies. It would essentially make insurers give patients their “explanation of benefits” upfront. It would require insurers to explain how much a service would cost, how much your plan would pay and how much you would owe — before the service is performed. The idea is that patients could use that information to shop around ahead of time for a better deal — assuming a better deal can be found, and the service isn’t a medical emergency.\u003c/p>\n\u003cp>Certainly these rules would give patients more information than they currently have. The other promise of these rules — that they will bring down health care costs — is more of an open question.\u003c/p>\n\u003cp>\u003ca href=\"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&s=higher&dct=PS&D=CMS-2019-0109\" target=\"_blank\" rel=\"noopener noreferrer\">In public comments\u003c/a> for the hospital rule, hospitals argued that having to make their negotiated rates public would backfire — if a hospital is charging less than another one nearby, it could theoretically raise its price to more closely match its competitor’s.\u003c/p>\n\u003cp>Secretary of Health and Human Services Alex Azar dismissed that argument on a call with reporters Friday morning.\u003c/p>\n\u003cp>“This is a canard,” he said. “Point me to one sector of the American economy where the disclosure of having price information in a competitive marketplace actually leads to higher prices as opposed to lower prices.”\u003c/p>\n\u003cp>Larry Levitt, executive vice president of the Kaiser Family Foundation, \u003ca href=\"https://twitter.com/larry_levitt/status/1195354683197530112\" target=\"_blank\" rel=\"noopener noreferrer\">pointed out on Twitter\u003c/a> that the penalty for hospitals that defy Trump’s transparency rule was “quite weak.”\u003c/p>\n\u003cp>https://twitter.com/larry_levitt/status/1195354683197530112\u003c/p>\n\u003cp>“A maximum fine of $300 per day,” he wrote. “The technical term for that is ‘chump change.’ I wonder how many hospitals will just pay the fine.”\u003c/p>\n\u003cp>There’s also an open question about whether these rules will survive legal challenges. Another Trump administration proposal to show \u003ca href=\"https://www.npr.org/2019/07/09/739770699/judge-blocks-trump-rule-requiring-pharma-companies-to-say-price-of-drugs-in-tv-a\" target=\"_blank\" rel=\"noopener noreferrer\">drug list prices in television ads\u003c/a> was blocked in the courts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We may face litigation, but we feel we’re on a very sound legal footing for what we’re asking,” Azar told reporters.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trump+Wants+Insurers+and+Hospitals+To+Show+Real+Prices+To+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>President Trump has made price transparency a centerpiece of his health care agenda. Friday he announced two regulatory changes in a bid to provide more easy-to-read price information to patients.\u003c/p>\n\u003cp>The first effort targets hospitals, \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/cy-2020-hospital-outpatient-prospective-payment-system-opps-policy-changes-hospital-price\" target=\"_blank\" rel=\"noopener noreferrer\">finalizing a rule\u003c/a> that requires them to display their secret, negotiated rates to patients starting in January 2021. The second is \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-proposed-rule-cms-9915-p\" target=\"_blank\" rel=\"noopener noreferrer\">a proposal\u003c/a> to make insurance companies show patients their expected out-of-pocket costs through an online tool. That proposed rule is subject to 60 days of public comment, and it’s unclear when it would go into effect.\u003c/p>\n\u003cp>“Our goal is to give patients the knowledge they need about the real price of health care services,” said Trump. “They’ll be able to check them, compare them, go to different locations, so they can shop for the highest-quality care at the lowest cost.”\u003c/p>\n\u003cp>Administration officials heralded both rules as historic and transformative to the health care system.\u003c/p>\n\u003cp>“Under the status quo, health care prices are about as clear as mud to patients,” said Center for Medicare & Medicaid Services Administrator Seema Verma in a written statement. “Today’s rules usher in a new era that upends the status quo to empower patients and put them first.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The second rule Trump announced Friday (which is a proposed rule, still subject to public comments before being finalized) affects insurance companies. It would essentially make insurers give patients their “explanation of benefits” upfront. It would require insurers to explain how much a service would cost, how much your plan would pay and how much you would owe — before the service is performed. The idea is that patients could use that information to shop around ahead of time for a better deal — assuming a better deal can be found, and the service isn’t a medical emergency.\u003c/p>\n\u003cp>Certainly these rules would give patients more information than they currently have. The other promise of these rules — that they will bring down health care costs — is more of an open question.\u003c/p>\n\u003cp>\u003ca href=\"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&s=higher&dct=PS&D=CMS-2019-0109\" target=\"_blank\" rel=\"noopener noreferrer\">In public comments\u003c/a> for the hospital rule, hospitals argued that having to make their negotiated rates public would backfire — if a hospital is charging less than another one nearby, it could theoretically raise its price to more closely match its competitor’s.\u003c/p>\n\u003cp>Secretary of Health and Human Services Alex Azar dismissed that argument on a call with reporters Friday morning.\u003c/p>\n\u003cp>“This is a canard,” he said. “Point me to one sector of the American economy where the disclosure of having price information in a competitive marketplace actually leads to higher prices as opposed to lower prices.”\u003c/p>\n\u003cp>Larry Levitt, executive vice president of the Kaiser Family Foundation, \u003ca href=\"https://twitter.com/larry_levitt/status/1195354683197530112\" target=\"_blank\" rel=\"noopener noreferrer\">pointed out on Twitter\u003c/a> that the penalty for hospitals that defy Trump’s transparency rule was “quite weak.”\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>“A maximum fine of $300 per day,” he wrote. “The technical term for that is ‘chump change.’ I wonder how many hospitals will just pay the fine.”\u003c/p>\n\u003cp>There’s also an open question about whether these rules will survive legal challenges. Another Trump administration proposal to show \u003ca href=\"https://www.npr.org/2019/07/09/739770699/judge-blocks-trump-rule-requiring-pharma-companies-to-say-price-of-drugs-in-tv-a\" target=\"_blank\" rel=\"noopener noreferrer\">drug list prices in television ads\u003c/a> was blocked in the courts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We may face litigation, but we feel we’re on a very sound legal footing for what we’re asking,” Azar told reporters.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trump+Wants+Insurers+and+Hospitals+To+Show+Real+Prices+To+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"slug": "marin-woman-dies-of-vaping-related-illness-in-first-recorded-bay-area-fatality-linked-to-e-cigarettes",
"title": "Marin Woman Dies of Vaping-Related Illness in First Recorded Bay Area Fatality Linked to E-Cigarettes",
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"headTitle": "Marin Woman Dies of Vaping-Related Illness in First Recorded Bay Area Fatality Linked to E-Cigarettes | KQED",
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"content": "\u003cp>A previously healthy Marin County woman in her 40s who started vaping six months ago has died, county officials announced Wednesday.\u003c/p>\n\u003cp>“With sadness, we report that there has been a death in our community suspected to be caused by severe lung injury associated with vaping,” said Dr. Matt Willis, a public health officer with Marin Health and Human Services, in a news release.\u003c/p>\n\u003cp>Marin County Chief Deputy Coroner Robert Fielding identified the victim as Amanda Arconti, a 45-year-old Marin County resident who also had an apartment in Vacaville, \u003ca href=\"https://www.ktvu.com/news/health-dept-woman-dies-after-complications-related-to-e-cigarettes-could-be-fourth-possible-vaping-fatality-in-california\" target=\"_blank\" rel=\"noopener noreferrer\">KTVU reported\u003c/a>. She died on Nov. 7 at Novato Community Hospital.\u003c/p>\n\u003cp>Her death appears to be linked to either vaping or previous tobacco use, Fielding said, but noted that a coming autopsy would determine the final cause of death.\u003c/p>\n\u003cp>Arconti was admitted to the hospital last Thursday, describing symptoms that had persisted for about four days, including coughing, shortness of breath, chest pain and fever, Willis said. Her condition then rapidly progressed to respiratory distress, he added, at which point she was transferred to the hospital’s intensive care unit and placed on a breathing machine before dying the following day.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is one of the characteristics of this kind of lung injury: It can be really rapidly progressive in people who are otherwise healthy,” he said.\u003c/p>\n\u003cp>Her death marks the fourth vaping-related fatality in California since July, and the 40th recorded nationally \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">by the U.S. Centers for Disease Control and Prevention\u003c/a>. The agency has also documented over 2,000 suspected cases nationwide of lung damage associated with e-cigarettes in the growing epidemic.[aside label=\"related content\" tag=\"e-cigarettes\"]\u003c/p>\n\u003cp>Marin Health and Human Services issued a warning in September recommending that residents cease e-cigarette use and vaping until the cause of the outbreak is discovered. Most cities in Marin County also recently moved to ban the sale of flavored tobacco beginning in January 2020.\u003c/p>\n\u003cp>Willis said his agency is working with the CDC and the California Department of Public Health to obtain test samples of the vaping liquid the woman used and hopes to determine what specifically contributed to her death.\u003c/p>\n\u003cp>“We’re refining what those compounds might be and are going to be using the public health lab to actually test samples themselves that we have collected,” Willis said. His team is relying on the victim’s family members to collect and provide additional evidence, and hopes to have test results within a few weeks, he said.\u003c/p>\n\u003cp>Although the specific products or compounds that cause lung injury after use of e-cigarettes are still unknown, the CDC \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">announced last week\u003c/a> that vitamin E acetate may be a contributor in some cases.\u003c/p>\n\u003cp>Oil-based vitamin E is sometimes added to vaping liquids, especially those containing the psychoactive cannabis compound THC, but numerous confirmed cases of lung injury have not been tied to THC, county officials said.\u003c/p>\n\u003cp>There are several thousand formulations of vaping liquids, many of which have not been tested for safety, according to the county.\u003c/p>\n\u003cp>Symptoms of e-cigarette and vaping-associated lung injury, (EVALI) can include shortness of breath, coughing or chest pain, often accompanied by nausea, fever, vomiting or diarrhea. Anyone experiencing these symptoms after using e-cigarettes should seek prompt medical attention, health officials said.\u003c/p>\n\u003cp>“The message is simple: It’s not safe to vape,” Willis said. “Until we have a better understanding of the cause of this outbreak, it’s best to avoid these products entirely.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article includes reporting from Bay City News’ James Lanaras.\u003c/em>\u003c/p>\n\n",
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"title": "Marin Woman Dies of Vaping-Related Illness in First Recorded Bay Area Fatality Linked to E-Cigarettes | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A previously healthy Marin County woman in her 40s who started vaping six months ago has died, county officials announced Wednesday.\u003c/p>\n\u003cp>“With sadness, we report that there has been a death in our community suspected to be caused by severe lung injury associated with vaping,” said Dr. Matt Willis, a public health officer with Marin Health and Human Services, in a news release.\u003c/p>\n\u003cp>Marin County Chief Deputy Coroner Robert Fielding identified the victim as Amanda Arconti, a 45-year-old Marin County resident who also had an apartment in Vacaville, \u003ca href=\"https://www.ktvu.com/news/health-dept-woman-dies-after-complications-related-to-e-cigarettes-could-be-fourth-possible-vaping-fatality-in-california\" target=\"_blank\" rel=\"noopener noreferrer\">KTVU reported\u003c/a>. She died on Nov. 7 at Novato Community Hospital.\u003c/p>\n\u003cp>Her death appears to be linked to either vaping or previous tobacco use, Fielding said, but noted that a coming autopsy would determine the final cause of death.\u003c/p>\n\u003cp>Arconti was admitted to the hospital last Thursday, describing symptoms that had persisted for about four days, including coughing, shortness of breath, chest pain and fever, Willis said. Her condition then rapidly progressed to respiratory distress, he added, at which point she was transferred to the hospital’s intensive care unit and placed on a breathing machine before dying the following day.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is one of the characteristics of this kind of lung injury: It can be really rapidly progressive in people who are otherwise healthy,” he said.\u003c/p>\n\u003cp>Her death marks the fourth vaping-related fatality in California since July, and the 40th recorded nationally \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">by the U.S. Centers for Disease Control and Prevention\u003c/a>. The agency has also documented over 2,000 suspected cases nationwide of lung damage associated with e-cigarettes in the growing epidemic.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Marin Health and Human Services issued a warning in September recommending that residents cease e-cigarette use and vaping until the cause of the outbreak is discovered. Most cities in Marin County also recently moved to ban the sale of flavored tobacco beginning in January 2020.\u003c/p>\n\u003cp>Willis said his agency is working with the CDC and the California Department of Public Health to obtain test samples of the vaping liquid the woman used and hopes to determine what specifically contributed to her death.\u003c/p>\n\u003cp>“We’re refining what those compounds might be and are going to be using the public health lab to actually test samples themselves that we have collected,” Willis said. His team is relying on the victim’s family members to collect and provide additional evidence, and hopes to have test results within a few weeks, he said.\u003c/p>\n\u003cp>Although the specific products or compounds that cause lung injury after use of e-cigarettes are still unknown, the CDC \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">announced last week\u003c/a> that vitamin E acetate may be a contributor in some cases.\u003c/p>\n\u003cp>Oil-based vitamin E is sometimes added to vaping liquids, especially those containing the psychoactive cannabis compound THC, but numerous confirmed cases of lung injury have not been tied to THC, county officials said.\u003c/p>\n\u003cp>There are several thousand formulations of vaping liquids, many of which have not been tested for safety, according to the county.\u003c/p>\n\u003cp>Symptoms of e-cigarette and vaping-associated lung injury, (EVALI) can include shortness of breath, coughing or chest pain, often accompanied by nausea, fever, vomiting or diarrhea. Anyone experiencing these symptoms after using e-cigarettes should seek prompt medical attention, health officials said.\u003c/p>\n\u003cp>“The message is simple: It’s not safe to vape,” Willis said. “Until we have a better understanding of the cause of this outbreak, it’s best to avoid these products entirely.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article includes reporting from Bay City News’ James Lanaras.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"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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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"radiolab": {
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"reveal": {
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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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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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