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"content": "\u003cfigure id=\"attachment_3471\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/pertussis.jpg\" rel=\"attachment wp-att-3471\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/pertussis.jpg\" alt=\"Electron microscope image of the bacterium (Bordetella pertussis) responsible for pertussis (whooping cough).\" width=\"640\" height=\"360\" class=\"size-full wp-image-3471\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Electron microscope image of the bacterium (Bordetella pertussis) responsible for pertussis (whooping cough).\u003cbr>Image: \u003ca href=\"http://www.flickr.com/photos/sanofi-pasteur/5280262078/\" target=\"_blank\" rel=\"noopener\">Sanofi Pasteur via Flickr\u003c/a>, CC BY-NC-ND 2.0\u003c/figcaption>\u003c/figure>\n\u003cp>In 1976, public health officials celebrated when whooping cough cases dropped to 1,010—the fewest ever reported. Before widespread vaccination against whooping cough, the disease infected up to 270,000 people a year, killing as many as 10,000, mostly infants. Just five years earlier, widespread vaccination against smallpox had worked so well that health officials retired the vaccine, raising hopes that whooping cough might follow a similar path. But whooping cough, or pertussis—named after the pathogenic bacterium \u003cem>Bordetella pertussis\u003c/em>—has proven a far more formidable opponent. \u003c/p>\n\u003cp>In recent years, despite relatively high vaccination rates, the pathogen has come roaring back to infect people in numbers not seen since the pre-vaccine days. Several states \u003ca href=\"http://www.cdc.gov/pertussis/outbreaks/trends.html\">suffered outbreaks\u003c/a> last year, with more than 41,000 cases reported across the country. \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/PertussisReport2011-11-10.pdf\">California’s epidemic hit in 2010\u003c/a>, when more than 9,000 people fell ill—the highest number in more than 60 years—and 10 infants died. Pertussis has also rebounded in Europe. England and Wales saw a \u003ca href=\"http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2013PressReleases/130201Casesofwhoopingcoughdeclineafterrecordnumbers/\">record number of cases in 2012\u003c/a>, with more than 9,700 cases and 14 infant deaths. \u003c/p>\n\u003cp>Pertussis attacks the respiratory track to cause spasmodic coughing, vomiting and severe breathing problems as thick mucus clogs the lungs. Most deaths occur in babies because the buildup of mucus quickly overwhelms their still-developing blood vessels, depriving their lungs of oxygen. “It’s like they’re being strangled to death by this particular bacteria,” \u003ca href=\"http://www.youtube.com/watch?v=CkE7w_DiWUY\">pediatrician Paul Offit says\u003c/a> of watching a stricken child. \u003c/p>\n\u003cp>Although vaccination protects infants, babies younger than two months old—too young to receive the first of five recommended vaccinations—face the greatest risk of death. Nine of the 10 children who died during the California epidemic were less than two months old. \u003c/p>\n\u003cp>Several factors may account for recent pertussis outbreaks, including waning effectiveness of the vaccine, the \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22293463\">evolution of more aggressive pathogens\u003c/a>, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/10905967?dopt=Abstract\">mismatch between the vaccine\u003c/a> and the bacterium and \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1209051\">increased awareness \u003c/a>among health professionals. Following the California epidemic, researchers at Kaiser Permanente’s Vaccine Study Center \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/05/15/peds.2012-3836.abstract\">tested the waning immunity hypothesis\u003c/a>: the possibility that protection from the vaccine fades with time.\u003c/p>\n\u003cfigure id=\"attachment_3483\" class=\"wp-caption alignleft\" style=\"max-width: 960px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/incidence-graph.jpg\" rel=\"attachment wp-att-3483\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/incidence-graph.jpg\" alt=\"Cases of whooping cough dropped precipitously after introduction of the vaccine in the 1940s. The disease has been on the rise since health officials replaced the old vaccine with a newer version with fewer side effects. (Source: CDC)\" width=\"960\" height=\"720\" class=\"size-full wp-image-3483\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Outbreaks of whooping cough became less and less common after introduction of the vaccine in the 1940s. The disease has been on the rise since health officials replaced the old vaccine with a newer version with fewer side effects. (Source: CDC)\u003c/figcaption>\u003c/figure>\n\u003cp>Before vaccines targeting \u003cem>B. pertussis\u003c/em> were introduced in the 1940s, pertussis was a major cause of infant death worldwide, \u003ca href=\"http://www.kdheks.gov/immunize/download/What_the_US_Needs_Now_Pertussis_Boosters.pdf\">killing more children\u003c/a> than polio, measles and tuberculosis combined. The original pertussis vaccine was made from killing the bacteria with chemicals, and combining the whole bacterium with weakened diphtheria and tetanus toxins in a vaccine called DTwP— “w” for “whole cell.” After concerns about the vaccine’s adverse effects—both real (episodes of high fever, fever with seizure, irritability, and a scary though short-lived condition called \u003ca href=\"http://pediatrics.aappublications.org/content/106/4/e52.long\">hypotonic hyporesponsive syndrome\u003c/a>, in which children appear limp, unresponsive and pale) and unsupported by science (\u003ca href=\"http://jid.oxfordjournals.org/content/174/Supplement_3/S259.long\">long term brain damage\u003c/a>)—led to rising rates of vaccine refusal in the 1980s, vaccine developers formulated an acellular vaccine, DTaP, using isolated components of the pathogen. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>By the late 1990s, the acellular version was used for all five recommended childhood doses. Although both vaccines offer protection against pertussis for a number of years, several studies suggest that immunity fades faster following DTaP vaccination. That’s why in 2005 the U.S. Advisory Committee on Immunization Practices started recommending booster shots for children 11 years and older and \u003ca href=\"http://www.cdph.ca.gov/healthinfo/discond/pages/pertussis.aspx\">California now requires a pertussis booster\u003c/a> for students entering seventh grade.\u003c/p>\n\u003cp>To determine the relative effectiveness of the two vaccines, the Kaiser researchers studied the health records of teenagers born between 1994 and 1999 to see if the vaccines they received as babies and toddlers affected their risk of getting pertussis during the 2010 epidemic. Because the new whole cell vaccine was phased in gradually, some children received just the old vaccine, some received both, and some got just the new vaccine. During the epidemic, 138 of the children in the study contracted pertussis.\u003c/p>\n\u003cp>The researchers found that children vaccinated with the acellular vaccine were nearly six times more likely to get the disease than children vaccinated with the discontinued whole cell vaccine. Protection appeared to be dose-related, the team noted, as children who received mixed vaccines faced an intermediate level of risk.The “Tdap” booster shot failed to bridge the gap in protection between those who received only whole cell vaccines and those who got just the acellular version. \u003c/p>\n\u003cp>Anytime a new vaccine is developed, scientists work to balance the vaccine’s effectiveness with the risk of side effects. “This is a very complex issue,” says pediatrician Nicola Klein, who led the Kaiser study. Health officials may need to add additional boosters of the acellular vaccine to compensate for waning immunity, for example. “But I don’t think there’s a willingness to go back to the whole cell vaccines, so the long-term strategy would be to develop new vaccines with reliable and lasting immunity.”\u003c/p>\n\u003cp>But that task will not be easy. It’s not exactly clear what components from the bacteria need to be included in the vaccine to produce a long-term effect on immunity, Klein says. “We thought the acellular vaccine would provide that. Clearly it’s not.”\u003c/p>\n\u003cp>Some researchers think pertussis strains are adapting to vaccination, either by producing more aggressive toxins or acquiring mutations that create a mismatch between the vaccine and the pathogen. Frits Mooi, a pertussis expert with the Netherlands Centre for Infectious Disease Control who was not involved in the Kaiser study, says that several studies now show that whole cell vaccines afford much longer protection than acelluar vaccines. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23406868\">But strain adaptation\u003c/a> also increases the speed at which immunity wanes, he says.\u003c/p>\n\u003cp>“I think waning immunity is the compound effect of intrinsic qualities of the vaccine and pathogen adaptation,” Mooi says. What’s needed, he argues, is an integrated approach that accounts for interactions beween the vaccines and evolving pathogens. As \u003ca href=\"http://iai.asm.org/content/66/2/670.full\">far back as 1998\u003c/a>, Mooi suggested that incorporating pertussis variants identified in circulating bacterial populations into a new acellular vaccine could make it more effective. Using genetic rather than chemical methods to detoxify pertussis toxins in vaccines could also prove more effective because genetically neutralized toxins can trigger a stronger immune response in our bodies. \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Until a new vaccine is developed, Klein urges parents to vaccinate their children. Pertussis outbreaks cycle in three to five years and it’s been three years since California’s historic epidemic. “The take-home message for parents is that they really need to continue to get their kids vaccinated and to get them vaccinated on the recommended schedules,” she says. That includes ensuring that adolescents get their Tdap booster shot. “We know the acellular vaccine works. It just doesn’t last as long as we’d hoped.”\u003c/p>\n\n",
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"excerpt": "The past few years have seen the worst outbreaks of whooping cough since the pre-vaccine days. A recent study adds to other research suggesting that though the newer aceullar vaccines have fewer side effects than the old whole cell versions, they don't last as long.",
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"description": "The past few years have seen the worst outbreaks of whooping cough since the pre-vaccine days. A recent study adds to other research suggesting that though the newer aceullar vaccines have fewer side effects than the old whole cell versions, they don't last as long.",
"title": "Whooping Cough Remains a Formidable Opponent Against Vaccination | KQED",
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"headline": "Whooping Cough Remains a Formidable Opponent Against Vaccination",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3471\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/pertussis.jpg\" rel=\"attachment wp-att-3471\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/pertussis.jpg\" alt=\"Electron microscope image of the bacterium (Bordetella pertussis) responsible for pertussis (whooping cough).\" width=\"640\" height=\"360\" class=\"size-full wp-image-3471\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Electron microscope image of the bacterium (Bordetella pertussis) responsible for pertussis (whooping cough).\u003cbr>Image: \u003ca href=\"http://www.flickr.com/photos/sanofi-pasteur/5280262078/\" target=\"_blank\" rel=\"noopener\">Sanofi Pasteur via Flickr\u003c/a>, CC BY-NC-ND 2.0\u003c/figcaption>\u003c/figure>\n\u003cp>In 1976, public health officials celebrated when whooping cough cases dropped to 1,010—the fewest ever reported. Before widespread vaccination against whooping cough, the disease infected up to 270,000 people a year, killing as many as 10,000, mostly infants. Just five years earlier, widespread vaccination against smallpox had worked so well that health officials retired the vaccine, raising hopes that whooping cough might follow a similar path. But whooping cough, or pertussis—named after the pathogenic bacterium \u003cem>Bordetella pertussis\u003c/em>—has proven a far more formidable opponent. \u003c/p>\n\u003cp>In recent years, despite relatively high vaccination rates, the pathogen has come roaring back to infect people in numbers not seen since the pre-vaccine days. Several states \u003ca href=\"http://www.cdc.gov/pertussis/outbreaks/trends.html\">suffered outbreaks\u003c/a> last year, with more than 41,000 cases reported across the country. \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/PertussisReport2011-11-10.pdf\">California’s epidemic hit in 2010\u003c/a>, when more than 9,000 people fell ill—the highest number in more than 60 years—and 10 infants died. Pertussis has also rebounded in Europe. England and Wales saw a \u003ca href=\"http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2013PressReleases/130201Casesofwhoopingcoughdeclineafterrecordnumbers/\">record number of cases in 2012\u003c/a>, with more than 9,700 cases and 14 infant deaths. \u003c/p>\n\u003cp>Pertussis attacks the respiratory track to cause spasmodic coughing, vomiting and severe breathing problems as thick mucus clogs the lungs. Most deaths occur in babies because the buildup of mucus quickly overwhelms their still-developing blood vessels, depriving their lungs of oxygen. “It’s like they’re being strangled to death by this particular bacteria,” \u003ca href=\"http://www.youtube.com/watch?v=CkE7w_DiWUY\">pediatrician Paul Offit says\u003c/a> of watching a stricken child. \u003c/p>\n\u003cp>Although vaccination protects infants, babies younger than two months old—too young to receive the first of five recommended vaccinations—face the greatest risk of death. Nine of the 10 children who died during the California epidemic were less than two months old. \u003c/p>\n\u003cp>Several factors may account for recent pertussis outbreaks, including waning effectiveness of the vaccine, the \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22293463\">evolution of more aggressive pathogens\u003c/a>, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/10905967?dopt=Abstract\">mismatch between the vaccine\u003c/a> and the bacterium and \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1209051\">increased awareness \u003c/a>among health professionals. Following the California epidemic, researchers at Kaiser Permanente’s Vaccine Study Center \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/05/15/peds.2012-3836.abstract\">tested the waning immunity hypothesis\u003c/a>: the possibility that protection from the vaccine fades with time.\u003c/p>\n\u003cfigure id=\"attachment_3483\" class=\"wp-caption alignleft\" style=\"max-width: 960px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/incidence-graph.jpg\" rel=\"attachment wp-att-3483\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/incidence-graph.jpg\" alt=\"Cases of whooping cough dropped precipitously after introduction of the vaccine in the 1940s. The disease has been on the rise since health officials replaced the old vaccine with a newer version with fewer side effects. (Source: CDC)\" width=\"960\" height=\"720\" class=\"size-full wp-image-3483\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Outbreaks of whooping cough became less and less common after introduction of the vaccine in the 1940s. The disease has been on the rise since health officials replaced the old vaccine with a newer version with fewer side effects. (Source: CDC)\u003c/figcaption>\u003c/figure>\n\u003cp>Before vaccines targeting \u003cem>B. pertussis\u003c/em> were introduced in the 1940s, pertussis was a major cause of infant death worldwide, \u003ca href=\"http://www.kdheks.gov/immunize/download/What_the_US_Needs_Now_Pertussis_Boosters.pdf\">killing more children\u003c/a> than polio, measles and tuberculosis combined. The original pertussis vaccine was made from killing the bacteria with chemicals, and combining the whole bacterium with weakened diphtheria and tetanus toxins in a vaccine called DTwP— “w” for “whole cell.” After concerns about the vaccine’s adverse effects—both real (episodes of high fever, fever with seizure, irritability, and a scary though short-lived condition called \u003ca href=\"http://pediatrics.aappublications.org/content/106/4/e52.long\">hypotonic hyporesponsive syndrome\u003c/a>, in which children appear limp, unresponsive and pale) and unsupported by science (\u003ca href=\"http://jid.oxfordjournals.org/content/174/Supplement_3/S259.long\">long term brain damage\u003c/a>)—led to rising rates of vaccine refusal in the 1980s, vaccine developers formulated an acellular vaccine, DTaP, using isolated components of the pathogen. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>By the late 1990s, the acellular version was used for all five recommended childhood doses. Although both vaccines offer protection against pertussis for a number of years, several studies suggest that immunity fades faster following DTaP vaccination. That’s why in 2005 the U.S. Advisory Committee on Immunization Practices started recommending booster shots for children 11 years and older and \u003ca href=\"http://www.cdph.ca.gov/healthinfo/discond/pages/pertussis.aspx\">California now requires a pertussis booster\u003c/a> for students entering seventh grade.\u003c/p>\n\u003cp>To determine the relative effectiveness of the two vaccines, the Kaiser researchers studied the health records of teenagers born between 1994 and 1999 to see if the vaccines they received as babies and toddlers affected their risk of getting pertussis during the 2010 epidemic. Because the new whole cell vaccine was phased in gradually, some children received just the old vaccine, some received both, and some got just the new vaccine. During the epidemic, 138 of the children in the study contracted pertussis.\u003c/p>\n\u003cp>The researchers found that children vaccinated with the acellular vaccine were nearly six times more likely to get the disease than children vaccinated with the discontinued whole cell vaccine. Protection appeared to be dose-related, the team noted, as children who received mixed vaccines faced an intermediate level of risk.The “Tdap” booster shot failed to bridge the gap in protection between those who received only whole cell vaccines and those who got just the acellular version. \u003c/p>\n\u003cp>Anytime a new vaccine is developed, scientists work to balance the vaccine’s effectiveness with the risk of side effects. “This is a very complex issue,” says pediatrician Nicola Klein, who led the Kaiser study. Health officials may need to add additional boosters of the acellular vaccine to compensate for waning immunity, for example. “But I don’t think there’s a willingness to go back to the whole cell vaccines, so the long-term strategy would be to develop new vaccines with reliable and lasting immunity.”\u003c/p>\n\u003cp>But that task will not be easy. It’s not exactly clear what components from the bacteria need to be included in the vaccine to produce a long-term effect on immunity, Klein says. “We thought the acellular vaccine would provide that. Clearly it’s not.”\u003c/p>\n\u003cp>Some researchers think pertussis strains are adapting to vaccination, either by producing more aggressive toxins or acquiring mutations that create a mismatch between the vaccine and the pathogen. Frits Mooi, a pertussis expert with the Netherlands Centre for Infectious Disease Control who was not involved in the Kaiser study, says that several studies now show that whole cell vaccines afford much longer protection than acelluar vaccines. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23406868\">But strain adaptation\u003c/a> also increases the speed at which immunity wanes, he says.\u003c/p>\n\u003cp>“I think waning immunity is the compound effect of intrinsic qualities of the vaccine and pathogen adaptation,” Mooi says. What’s needed, he argues, is an integrated approach that accounts for interactions beween the vaccines and evolving pathogens. As \u003ca href=\"http://iai.asm.org/content/66/2/670.full\">far back as 1998\u003c/a>, Mooi suggested that incorporating pertussis variants identified in circulating bacterial populations into a new acellular vaccine could make it more effective. Using genetic rather than chemical methods to detoxify pertussis toxins in vaccines could also prove more effective because genetically neutralized toxins can trigger a stronger immune response in our bodies. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Until a new vaccine is developed, Klein urges parents to vaccinate their children. Pertussis outbreaks cycle in three to five years and it’s been three years since California’s historic epidemic. “The take-home message for parents is that they really need to continue to get their kids vaccinated and to get them vaccinated on the recommended schedules,” she says. That includes ensuring that adolescents get their Tdap booster shot. “We know the acellular vaccine works. It just doesn’t last as long as we’d hoped.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Young Adults Will Make or Break Obamacare in California",
"title": "Young Adults Will Make or Break Obamacare in California",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cem>\u003c/em>\u003cstrong>By Mina Kim, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12967\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12967 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/RS4926_photo-Dave2-300x225.jpg\" alt=\"David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003cfigcaption class=\"wp-caption-text\">David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. He is considering whether to buy insurance on the health care marketplace if he doesn't have employer-based coverage next year. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Most of us know someone who doesn’t have health insurance. In my case, it’s my little brother, David Kim.\u003c/p>\n\u003cp>David is 29-years-old and recently earned an advanced degree in international relations. He hasn’t been able to land a full-time job with health benefits. The two jobs he has now are temporary, and with such a precarious work situation, he just doesn’t think he can afford health insurance.\u003c/p>\n\u003cp>“I’m totally aware that if I get sick then I’m doomed financially,” Dave told me over a lunch break. “And maybe that's not a very financially sound decision to make, but it is nonetheless a risk that, for the time being, I’m prepared to take.”\u003c/p>\n\u003cp>Young adults —18 to 34-year-olds — make up \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/C/PDF%20CaliforniaUninsured2012.pdf\" target=\"_blank\">more than 40 percent\u003c/a> of California’s uninsured, though they make up less than 30 percent of the population. And according to many health reform advocates, they’re the ones who could make or break Obamacare.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“If we get only sick people, and don’t get the young, healthy people into the insurance system, it’s going to mean premiums are much higher.” \u003c/aside>\n\u003cp>“The success of this law really does depend on getting young people insured, and frankly getting everyone insured,” said Larry Levitt, a health policy and insurance expert for the Kaiser Family Foundation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In less than five months, a key piece of Obamacare will go live: state-based insurance marketplaces, called Covered California here. That means millions of Californians looking for coverage for themselves or their families will be able to go online and enroll in qualified health plans regardless of their medical history. Many will get help from federal subsidies. But if the exchange doesn't enroll enough young, healthy people, insurers will have to hike everyone’s premiums.\u003c!--more-->\u003c/p>\n\u003cp>“Insurance premiums are set based on the pool of people who are buying coverage,” Levitt said. “If we get only sick people, and don’t get the young, healthy people into the insurance system, it’s going to mean premiums are much higher.”\u003c/p>\n\u003cp>On Thursday, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">released plans and premiums\u003c/a> for 2014.\u003c/p>\n\u003cp>\u003cstrong>Obamacare's Incentives for Young Adults\u003c/strong>\u003c/p>\n\u003cp>The health law has plenty of incentives to engage young people in insurance. They can stay on a parent's health plan until they’re 26-years-old. Some will qualify for expanded Medi-Cal, the state’s health insurance program for the poor. On Covered California, there will be federal tax credits to help people buy insurance. Individuals who make up to about $46,000 a year (or about $94,000 for a family of four) are eligible for the tax credits. People under 30 will also have the option of buying bare-bones, catastrophic plans with low premiums.\u003c/p>\n\u003cfigure id=\"attachment_12946\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12946\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/RS4928_Tamika-Butler-300x225.jpg\" alt=\"Tamika Butler shows off a mobile app that explains the federal health law's benefits for young people. Butler runs the California chapter of Young Invincibles, an advocacy group. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003cfigcaption class=\"wp-caption-text\">Tamika Butler shows off a mobile app that explains the federal health law's benefits for young people. Butler runs the California chapter of Young Invincibles, an advocacy group. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Still, getting young adults to buy insurance won’t be easy, Levitt warns. The financial penalty for not having coverage next year is fairly small -- $95 or one percent of income, whichever is greater. Also, fears abound that young people’s premiums will skyrocket because the health law limits the difference in price between plans for the young and old. And there's still just a lot of confusion about health reform.\u003c/p>\n\u003cp>“This generation has very low levels of insurance literacy,\" Tamika Butler tells me. She runs the Los Angeles-based chapter of Young Invincibles, a nonprofit advocacy group trying to get the word out about the health law’s benefits. Her group has launched a \u003ca href=\"https://www.facebook.com/together.invincible\" target=\"_blank\">social media\u003c/a> \u003ca href=\"https://twitter.com/YI_Care\" target=\"_blank\">outreach campaign\u003c/a> and a \u003ca href=\"http://younginvincibles.org/promotion/young-invincibles-theres-an-app-for-that/\" target=\"_blank\">mobile app\u003c/a> that helps people find and rate cheap health care and answer questions about the Affordable Care Act. According to Butler, young adults are gateways to getting hard-to-reach minority communities insured.\u003c/p>\n\u003cp>“Young adults are really the leaders of their communities, of their families,” Butler said. “You see it when there's a young child translating for a parent at school, or helping them figure out a complicated financial aid form, and it’s the same for health care.”\u003c/p>\n\u003cp>Butler said it’s a misconception that most young people shun health insurance because they believe they’re indestructible. She says her groups’ polls and outreach activities have shown that the more young people learn about coverage, the more they want it.\u003c/p>\n\u003cp>Peter Lee who runs Covered California said the exchange is planning to launch a major media campaign aimed at young people this summer and to reach out to students on college campuses, at trade schools and those who work at low-wage jobs.\u003c/p>\n\u003cp>“We’ve been having focus groups, surveys and young people throughout California aren’t saying they don’t want to have health insurance,” Lee said. “They’re saying they can’t afford it, and they are looking for the security that health insurance provides.”\u003c/p>\n\u003cp>My brother David said he has felt a bit vulnerable without health coverage and will look into plans on the exchange.\u003c/p>\n\u003cp>“Just the other day I went ice skating,\" David said. “I went at the wall like full speed, and my skate edge slipped. I almost [went] face first into the wall, and at that point I was reminded that I don’t have health insurance.”\u003c/p>\n\u003cp>Covered California officials unveiled Thursday, a list of the health plans and rates they expect to offer on the exchange in October. The enrollment period will run through March 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's Story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201305230850a.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201305230850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "Most of us know someone who doesn’t have health insurance. In my case, it’s my little brother, David Kim.\r\n\r\nDavid is 29-years-old and recently earned an advanced degree in international relations. He hasn’t been able to land a full-time job with health benefits. The two jobs he has now are temporary, and with such a precarious work situation, he just doesn’t think he can afford health insurance.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003c/em>\u003cstrong>By Mina Kim, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12967\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12967 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/RS4926_photo-Dave2-300x225.jpg\" alt=\"David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003cfigcaption class=\"wp-caption-text\">David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. He is considering whether to buy insurance on the health care marketplace if he doesn't have employer-based coverage next year. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Most of us know someone who doesn’t have health insurance. In my case, it’s my little brother, David Kim.\u003c/p>\n\u003cp>David is 29-years-old and recently earned an advanced degree in international relations. He hasn’t been able to land a full-time job with health benefits. The two jobs he has now are temporary, and with such a precarious work situation, he just doesn’t think he can afford health insurance.\u003c/p>\n\u003cp>“I’m totally aware that if I get sick then I’m doomed financially,” Dave told me over a lunch break. “And maybe that's not a very financially sound decision to make, but it is nonetheless a risk that, for the time being, I’m prepared to take.”\u003c/p>\n\u003cp>Young adults —18 to 34-year-olds — make up \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/C/PDF%20CaliforniaUninsured2012.pdf\" target=\"_blank\">more than 40 percent\u003c/a> of California’s uninsured, though they make up less than 30 percent of the population. And according to many health reform advocates, they’re the ones who could make or break Obamacare.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“If we get only sick people, and don’t get the young, healthy people into the insurance system, it’s going to mean premiums are much higher.” \u003c/aside>\n\u003cp>“The success of this law really does depend on getting young people insured, and frankly getting everyone insured,” said Larry Levitt, a health policy and insurance expert for the Kaiser Family Foundation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In less than five months, a key piece of Obamacare will go live: state-based insurance marketplaces, called Covered California here. That means millions of Californians looking for coverage for themselves or their families will be able to go online and enroll in qualified health plans regardless of their medical history. Many will get help from federal subsidies. But if the exchange doesn't enroll enough young, healthy people, insurers will have to hike everyone’s premiums.\u003c!--more-->\u003c/p>\n\u003cp>“Insurance premiums are set based on the pool of people who are buying coverage,” Levitt said. “If we get only sick people, and don’t get the young, healthy people into the insurance system, it’s going to mean premiums are much higher.”\u003c/p>\n\u003cp>On Thursday, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">released plans and premiums\u003c/a> for 2014.\u003c/p>\n\u003cp>\u003cstrong>Obamacare's Incentives for Young Adults\u003c/strong>\u003c/p>\n\u003cp>The health law has plenty of incentives to engage young people in insurance. They can stay on a parent's health plan until they’re 26-years-old. Some will qualify for expanded Medi-Cal, the state’s health insurance program for the poor. On Covered California, there will be federal tax credits to help people buy insurance. Individuals who make up to about $46,000 a year (or about $94,000 for a family of four) are eligible for the tax credits. People under 30 will also have the option of buying bare-bones, catastrophic plans with low premiums.\u003c/p>\n\u003cfigure id=\"attachment_12946\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12946\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/RS4928_Tamika-Butler-300x225.jpg\" alt=\"Tamika Butler shows off a mobile app that explains the federal health law's benefits for young people. Butler runs the California chapter of Young Invincibles, an advocacy group. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003cfigcaption class=\"wp-caption-text\">Tamika Butler shows off a mobile app that explains the federal health law's benefits for young people. Butler runs the California chapter of Young Invincibles, an advocacy group. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Still, getting young adults to buy insurance won’t be easy, Levitt warns. The financial penalty for not having coverage next year is fairly small -- $95 or one percent of income, whichever is greater. Also, fears abound that young people’s premiums will skyrocket because the health law limits the difference in price between plans for the young and old. And there's still just a lot of confusion about health reform.\u003c/p>\n\u003cp>“This generation has very low levels of insurance literacy,\" Tamika Butler tells me. She runs the Los Angeles-based chapter of Young Invincibles, a nonprofit advocacy group trying to get the word out about the health law’s benefits. Her group has launched a \u003ca href=\"https://www.facebook.com/together.invincible\" target=\"_blank\">social media\u003c/a> \u003ca href=\"https://twitter.com/YI_Care\" target=\"_blank\">outreach campaign\u003c/a> and a \u003ca href=\"http://younginvincibles.org/promotion/young-invincibles-theres-an-app-for-that/\" target=\"_blank\">mobile app\u003c/a> that helps people find and rate cheap health care and answer questions about the Affordable Care Act. According to Butler, young adults are gateways to getting hard-to-reach minority communities insured.\u003c/p>\n\u003cp>“Young adults are really the leaders of their communities, of their families,” Butler said. “You see it when there's a young child translating for a parent at school, or helping them figure out a complicated financial aid form, and it’s the same for health care.”\u003c/p>\n\u003cp>Butler said it’s a misconception that most young people shun health insurance because they believe they’re indestructible. She says her groups’ polls and outreach activities have shown that the more young people learn about coverage, the more they want it.\u003c/p>\n\u003cp>Peter Lee who runs Covered California said the exchange is planning to launch a major media campaign aimed at young people this summer and to reach out to students on college campuses, at trade schools and those who work at low-wage jobs.\u003c/p>\n\u003cp>“We’ve been having focus groups, surveys and young people throughout California aren’t saying they don’t want to have health insurance,” Lee said. “They’re saying they can’t afford it, and they are looking for the security that health insurance provides.”\u003c/p>\n\u003cp>My brother David said he has felt a bit vulnerable without health coverage and will look into plans on the exchange.\u003c/p>\n\u003cp>“Just the other day I went ice skating,\" David said. “I went at the wall like full speed, and my skate edge slipped. I almost [went] face first into the wall, and at that point I was reminded that I don’t have health insurance.”\u003c/p>\n\u003cp>Covered California officials unveiled Thursday, a list of the health plans and rates they expect to offer on the exchange in October. The enrollment period will run through March 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's Story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201305230850a.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201305230850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "L-carnitine: Heart Disease's Chemical Culprit?",
"headTitle": "L-carnitine: Heart Disease’s Chemical Culprit? | KQED",
"content": "\u003cfigure id=\"attachment_3021\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/535612522_IwateBuddy_flickr_640x360.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/535612522_IwateBuddy_flickr_640x360.jpg\" alt=\"http://www.flickr.com/photos/brucewood/535612522/\" width=\"640\" height=\"360\" class=\"size-full wp-image-3021\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of \u003ca href=\"http://www.flickr.com/photos/brucewood/535612522/\" target=\"_blank\" rel=\"noopener\">IwateBuddy\u003c/a> via Creative Commons licensing\u003c/figcaption>\u003c/figure>\n\u003cp>Research involving the diet seems complicated. One study says that drinking wine or eating chocolate is bad for you. The next says \u003ca href=\"http://science.kqed.org/quest/video/the-sweet-science-of-chocolate/\" target=\"_blank\" rel=\"noopener\">it is good for you in moderation\u003c/a>. Wait, no it’s bad. This yo-yo effect often continues, arising from the limitations of each study. But there are some foods with a more consistent reputation. Eating green vegetables, for instance, is generally considered to be healthy. And eating a lot of red meat is thought to be unhealthy.\u003c/p>\n\u003cp>Overall \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/\" title=\"Trends in meat consumption in the United States\">meat consumption\u003c/a> continues to rise in the U.S., and 58% of the meat consumed is red meat. People in the U.S. eat 5 ounces of meat per day on average, while the \u003ca href=\"http://www.choosemyplate.gov/food-groups/\" title=\"USDA dietary recommendations: choose my plate\">USDA recommends\u003c/a> that adults take in about 6 ounces daily from the entire meat/beans group: meat, fish, poultry, eggs, nuts, seeds, beans and peas.\u003c/p>\n\u003cp>Eating a lot of red meat is known to contribute to heart disease, presumably due to the large amount of saturated fats and cholesterol in the meat. Or that is what we used to think. New research \u003ca href=\"http://www.nature.com/nm/journal/v19/n5/full/nm.3145.html\" title=\"Nature Medicine journal article\">published in \u003cem>Nature Medicine\u003c/em> \u003c/a>indicates that the real culprit is a chemical in the red meat called L-carnitine. In a series of experiments on humans and mice, the researchers found that L-carnitine is broken down by gut bacteria to produce trimethylamine-N-oxide (TMAO), which previous research has linked to heart and artery damage. TMAO alters how cholesterol is metabolized so less is eliminated from the body, allowing more cholesterol to deposit and harden into the artery walls (atherosclerosis).\u003c/p>\n\u003cp>But the researchers also found that frequent meat eaters produced significantly more TMAO than vegetarians after consuming the same amount of L-carnitine. For instance, L-carnitine supplements (250 mg) were given to 80 healthy volunteers, including 24 who were long-term vegetarians or vegans. Several of the meat eaters and 1 committed vegan were also given an 8-ounce steak, containing 180 mg of L-carnitine. The lab tests showed that consuming L-carnitine increased the level of TMAO in the blood, but meat eaters made far more TMAO than vegetarians or vegans.\u003c/p>\n\u003cp>Fecal studies also showed that meat eaters and vegetarians had different types of bacteria in their guts, and the meat eaters had more of the bacteria involved in breaking down L-carnitine into TMAO. This was confirmed by giving the volunteers antibiotics for one week to suppress the gut bacteria, then repeating the L-carnitine supplement experiment. With suppressed levels of gut bacteria, the volunteers produced very little TMAO. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp> “The bacteria living in our digestive tracts are dictated by our long-term dietary patterns,” explained the lead researcher Dr. Stanley Hazen in a \u003ca href=\"http://www.eurekalert.org/pub_releases/2013-04/cc-ccr040513.php\" title=\"Cleveland Clinic press release\">press release\u003c/a>. “A diet high in carnitine actually shifts our gut microbe composition to those that like carnitine, making meat eaters even more susceptible to forming TMAO and its artery-clogging effects.” \u003c/p>\n\u003cp>The main \u003ca href=\"http://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/\" title=\"Office of Dietary Supplements: carnitine fact sheet\">food sources for carnitine\u003c/a> are red meat and full-fat dairy products. It is also found in fish, poultry, tempeh, wheat, asparagus, avocados and peanut butter. L-carnitine is also commonly available as a dietary supplement, which is advertised as a weight loss and body building tool despite a lack of supporting scientific evidence. Plus L-carnitine is added to many energy drinks.\u003c/p>\n\u003cp>So eating all this L-carnitine is bad, right? Unfortunately it isn’t that simple. \u003c/p>\n\u003cp>Carnitine plays a vital and complex role in cardiac metabolism. Some people have diseases that cause a carnitine deficiency, so they need to take carnitine supplements. Studies have also shown that carnitine may help treat some heart conditions, such as angina, arrhythmias, heart attacks and heart failure. For instance, a meta-analysis \u003ca href=\"http://download.journals.elsevierhealth.com/pdfs/journals/0025-6196/PIIS0025619613001274.pdf\" title=\"Mayo Clinic Proceedings journal article\">review study\u003c/a> in the \u003cem>Mayo Clinic Proceedings\u003c/em> recently showed that taking L-carnitine supplements reduces your risk of ventricular arrythmias by 65% and risk of angina by 40%, although no reduction in risk was seen for heart attacks and heart failure. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In general, scientific studies have shown both positive and negative effects on cardiac health from taking carnitine. These discrepant findings may be due to differences in how the carnitine is administered and the dose. For instance, carnitine given by an intravenous or intramuscular injection would bypass the gut bacteria, so it may not form TMAO. Larger carnitine studies are needed, which also take into account the volunteers’ long-term diet and the bacteria ecosystem in their guts.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3021\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/535612522_IwateBuddy_flickr_640x360.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/05/535612522_IwateBuddy_flickr_640x360.jpg\" alt=\"http://www.flickr.com/photos/brucewood/535612522/\" width=\"640\" height=\"360\" class=\"size-full wp-image-3021\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of \u003ca href=\"http://www.flickr.com/photos/brucewood/535612522/\" target=\"_blank\" rel=\"noopener\">IwateBuddy\u003c/a> via Creative Commons licensing\u003c/figcaption>\u003c/figure>\n\u003cp>Research involving the diet seems complicated. One study says that drinking wine or eating chocolate is bad for you. The next says \u003ca href=\"http://science.kqed.org/quest/video/the-sweet-science-of-chocolate/\" target=\"_blank\" rel=\"noopener\">it is good for you in moderation\u003c/a>. Wait, no it’s bad. This yo-yo effect often continues, arising from the limitations of each study. But there are some foods with a more consistent reputation. Eating green vegetables, for instance, is generally considered to be healthy. And eating a lot of red meat is thought to be unhealthy.\u003c/p>\n\u003cp>Overall \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/\" title=\"Trends in meat consumption in the United States\">meat consumption\u003c/a> continues to rise in the U.S., and 58% of the meat consumed is red meat. People in the U.S. eat 5 ounces of meat per day on average, while the \u003ca href=\"http://www.choosemyplate.gov/food-groups/\" title=\"USDA dietary recommendations: choose my plate\">USDA recommends\u003c/a> that adults take in about 6 ounces daily from the entire meat/beans group: meat, fish, poultry, eggs, nuts, seeds, beans and peas.\u003c/p>\n\u003cp>Eating a lot of red meat is known to contribute to heart disease, presumably due to the large amount of saturated fats and cholesterol in the meat. Or that is what we used to think. New research \u003ca href=\"http://www.nature.com/nm/journal/v19/n5/full/nm.3145.html\" title=\"Nature Medicine journal article\">published in \u003cem>Nature Medicine\u003c/em> \u003c/a>indicates that the real culprit is a chemical in the red meat called L-carnitine. In a series of experiments on humans and mice, the researchers found that L-carnitine is broken down by gut bacteria to produce trimethylamine-N-oxide (TMAO), which previous research has linked to heart and artery damage. TMAO alters how cholesterol is metabolized so less is eliminated from the body, allowing more cholesterol to deposit and harden into the artery walls (atherosclerosis).\u003c/p>\n\u003cp>But the researchers also found that frequent meat eaters produced significantly more TMAO than vegetarians after consuming the same amount of L-carnitine. For instance, L-carnitine supplements (250 mg) were given to 80 healthy volunteers, including 24 who were long-term vegetarians or vegans. Several of the meat eaters and 1 committed vegan were also given an 8-ounce steak, containing 180 mg of L-carnitine. The lab tests showed that consuming L-carnitine increased the level of TMAO in the blood, but meat eaters made far more TMAO than vegetarians or vegans.\u003c/p>\n\u003cp>Fecal studies also showed that meat eaters and vegetarians had different types of bacteria in their guts, and the meat eaters had more of the bacteria involved in breaking down L-carnitine into TMAO. This was confirmed by giving the volunteers antibiotics for one week to suppress the gut bacteria, then repeating the L-carnitine supplement experiment. With suppressed levels of gut bacteria, the volunteers produced very little TMAO. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> “The bacteria living in our digestive tracts are dictated by our long-term dietary patterns,” explained the lead researcher Dr. Stanley Hazen in a \u003ca href=\"http://www.eurekalert.org/pub_releases/2013-04/cc-ccr040513.php\" title=\"Cleveland Clinic press release\">press release\u003c/a>. “A diet high in carnitine actually shifts our gut microbe composition to those that like carnitine, making meat eaters even more susceptible to forming TMAO and its artery-clogging effects.” \u003c/p>\n\u003cp>The main \u003ca href=\"http://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/\" title=\"Office of Dietary Supplements: carnitine fact sheet\">food sources for carnitine\u003c/a> are red meat and full-fat dairy products. It is also found in fish, poultry, tempeh, wheat, asparagus, avocados and peanut butter. L-carnitine is also commonly available as a dietary supplement, which is advertised as a weight loss and body building tool despite a lack of supporting scientific evidence. Plus L-carnitine is added to many energy drinks.\u003c/p>\n\u003cp>So eating all this L-carnitine is bad, right? Unfortunately it isn’t that simple. \u003c/p>\n\u003cp>Carnitine plays a vital and complex role in cardiac metabolism. Some people have diseases that cause a carnitine deficiency, so they need to take carnitine supplements. Studies have also shown that carnitine may help treat some heart conditions, such as angina, arrhythmias, heart attacks and heart failure. For instance, a meta-analysis \u003ca href=\"http://download.journals.elsevierhealth.com/pdfs/journals/0025-6196/PIIS0025619613001274.pdf\" title=\"Mayo Clinic Proceedings journal article\">review study\u003c/a> in the \u003cem>Mayo Clinic Proceedings\u003c/em> recently showed that taking L-carnitine supplements reduces your risk of ventricular arrythmias by 65% and risk of angina by 40%, although no reduction in risk was seen for heart attacks and heart failure. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In general, scientific studies have shown both positive and negative effects on cardiac health from taking carnitine. These discrepant findings may be due to differences in how the carnitine is administered and the dose. For instance, carnitine given by an intravenous or intramuscular injection would bypass the gut bacteria, so it may not form TMAO. Larger carnitine studies are needed, which also take into account the volunteers’ long-term diet and the bacteria ecosystem in their guts.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Calif's Health Insurance Exchange Sets Plans, Premiums; No Apparent 'Rate Shock'",
"title": "Calif's Health Insurance Exchange Sets Plans, Premiums; No Apparent 'Rate Shock'",
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"content": "\u003cfigure id=\"attachment_14199\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\" wp-image-14199\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/RS170_108160554-scr-640x426.jpg\" alt=\"RS170_108160554-scr\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">(Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update: Aug. 7, 2013: \u003c/strong>Covered California announced Wednesday that 12 insurance companies have formally signed contracts with the agency to offer plans on the new marketplace. Since the initial announcement (below), one company, Ventura County Health Plan, has withdrawn from offering coverage on the marketplace. The following companies will offer plans on the marketplace, although not all companies will offer plans in every region of California:\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare; check out KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>· Alameda Alliance for Health\u003c/p>\n\u003cp>· Anthem Blue Cross of California\u003c/p>\n\u003cp>· Blue Shield of California\u003c/p>\n\u003cp>· Chinese Community Health Plan\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>· Contra Costa Health Plan\u003c/p>\n\u003cp>· Health Net\u003c/p>\n\u003cp>· Kaiser Permanente\u003c/p>\n\u003cp>· L.A. Care Health Plan\u003c/p>\n\u003cp>· Molina Healthcare\u003c/p>\n\u003cp>· Sharp Health Plan\u003c/p>\n\u003cp>· Valley Health Plan\u003c/p>\n\u003cp>· Western Health Advantage\u003c/p>\n\u003cp>Last week, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/01/covered-california-sets-small-business-marketplace-plans-premiums/\" target=\"_blank\">announced\u003c/a> tentative plans and premiums for its small business marketplace, also called SHOP.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>The state's health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to millions of Californians.\u003c/p>\n\u003cp>And what everyone wants to know is: how much will it cost. Experts had warned of \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/\">rate shock\u003c/a>,\" that premiums might skyrocket for all kinds of reasons. That has not happened.\u003c/p>\n\u003cp>Covered California says that individuals will pay an average premium of $321 per month for a \"silver\" plan. (More on silver plans below.) Many people will be eligible for subsidies to reduce that cost further.\u003c/p>\n\u003cp>Across the state, people who had been working toward this day seemed to heave a collective sigh of relief.\u003c/p>\n\u003cp>\"This is a home run for consumers in every region of California,\" said Peter Lee, executive director of Covered California, in a release to reporters. \"Californians should be proud of how not only health plans in this state, but doctors, medical groups and hospitals have stepped up -- creating a market that will allow millions of consumers to enroll in affordably priced products.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.coveredca.com/news/PDFs/CC_Health_Plans_Booklet.pdf\">Look up a sample of plans, premiums offered in your area.\u003c/a> \u003c/aside>\n\u003cp>Charles Bacchi, executive vice president with the California Association of Health Plans called it an \"important day\" and commended both insurance companies and providers for working together \"to deliver quality, affordable health care. We couldn't have done this without providers willing to join us to make the Affordable Care Act a success,\" he said in a reference to provider groups working to keep rates low.\u003c/p>\n\u003cp>The plans on the exchange are required to offer a standard set of comprehensive benefits. It's hard to compare premiums next year to what's in place this year, since there is no standard set of benefits at present. Covered California chose as the best comparison the average premium for a small business plan. The rates in Covered California range from 2 percent above to 29 percent below that benchmark.\u003c!--more-->\u003c/p>\n\u003cp>\"It's nice to have a good news day in California,\" said Daniel Zingale, senior vice president of The California Endowment. \"It turns out there's power in numbers when it comes to … health plans.\"\u003c/p>\n\u003cp>\u003cstrong>13 Plans Selected for the Insurance Exchange\u003c/strong>\u003c/p>\n\u003cp>The selected plans and premiums are still subject to review by state regulators. Covered California has picked 13 plans, including Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser as well as many regional plans and some country-sponsored health plans. Those include Alameda Alliance for Health, Chinese Community Health Plan, Contra Costa Health Services, L.A. Care Health Plan, Molina Helathcare, Sharp Health Paln, Valley Health Plan, Ventura County Health Care Plan and Western Health Advantage. \u003ca href=\"http://www.coveredca.com/news/PDFs/CC_Health_Plans_Booklet.pdf\">You can look up your own region\u003c/a> and see what plans and premiums you can choose from.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Everything will be quite standardized and literally charted out. So you can look across lines and compare plans.\" -- \u003cem>Betsy Imholz, Consumers Union\u003c/em>\u003c/aside>\n\u003cp>Plans will be offered in tiers of coverage: platinum, gold, silver, bronze. The platinum plans have the highest premiums but you will pay less when you see the doctor; the bronze plans have the lowest premium, meaning you will pay more when you see the doctor.\u003c/p>\n\u003cp>The \"silver\" plan mentioned above is in the middle. It has the same standard set of benefits as the other plans, and has a $2,000 annual deductible. Still, preventive care and some other services are outside the deductible -- people would pay only a co-pay when they see the doctor.\u003c/p>\n\u003cp>When setting an individual's premium, insurance plans in the exchange may look at only three factors: age, where you live and family size. Insurance companies may no longer use your health condition or your health history to set premiums. People may no longer be turned down for pre-existing conditions.\u003c/p>\n\u003cp>Subsidies are available for people making from 138 to 400 percent of the federal poverty level – or about $15,500 to $45,000 for an individual or about $31,000 to $92,000 for a family of four.\u003c/p>\n\u003cp>\u003cstrong>Breakdown on Premiums, Before and After Subsidy\u003c/strong>\u003c/p>\n\u003cp>Covered California provided tables of average rates for a 21-year-old and a 40-year-old single person. For the 21-year-old buying the most affordable silver plan, the premium is $216 per month. But depending on income, the 21-year-old may get a subsidy, making the price that person would pay range from $44 per month to $216 per month.\u003c/p>\n\u003cp>The premium for a 40-year-old buying the most affordable silver plan will be $276. But depending on the subsidy, that 40-year-old will pay from $40 to the full $276.\u003c/p>\n\u003cp>Starting this fall, people will be able to go online and look up plans and rates across the board for themselves or their families.\u003c/p>\n\u003cp>\"Everything will be quite standardized and literally charted out,\" said Betsy Imholz, special projects director for Consumers Union. \"So you can look across lines and compare plans.\"\u003c/p>\n\u003cp>On average, people in the larger metropolitan areas in California will be able to choose from among five different plans. Covered California says that even in rural areas where options have typically been sparse, people will have two or three health plans to choose from.\u003c/p>\n\u003cp>\"We were particularly concerned about Californians in rural parts of the state,\" Zingale said. \"So it's a relief to see that they will have doctors, hospitals and health benefits available in those areas.\"\u003c/p>\n\u003cp>But not everyone was delighted. Jay Nelson is a 33-year-old attorney who lives with his wife and three children in Oakland. Nelson does not have employer-based insurance, although his firm is looking into options. He has been unable to afford insurance for his family. Nelson said he was disappointed the premiums were not cheaper.\u003c/p>\n\u003cp>\"We're exactly in that income level that is essentially uninsurable,\" he said. \"We make too much money to qualify for any help, but we don't make enough money to pay for this … comfortably.\"\u003c/p>\n\u003cp>Bacchi acknowledged that while the Covered California premiums are generally \"positive news,\" that's not the case for everyone. \"The reality is that there are some people who will pay more than they currently pay. That's because the Affordable Care Act requires increased benefits and it also imposes less cost sharing on the enrollee through deductibles and co-pays.\"\u003c/p>\n\u003cp>Plans and premiums for Covered California's small business exchange are expected to be announced in June, and a major \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/californias-health-insurance-exchange-builds-critical-outreach-network/\">education and outreach campaign\u003c/a> will launch this summer.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Listen to a discussion of the new plans and premiums on KQED's Forum:\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201305240900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201305240900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "The state's health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to people statewide to millions of Californians.\r\n\r\nAnd what everyone wants to know is: how much will it cost. Experts had warned of \"rate shock,\" that premiums might skyrocket for all kinds of reasons.\r\n\r\nThat does not appear to be the case. Covered California says that individuals will pay an average premium of $321 per month for a \"silver\" plan.",
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"description": "The state's health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to people statewide to millions of Californians.\r\n\r\nAnd what everyone wants to know is: how much will it cost. Experts had warned of "rate shock," that premiums might skyrocket for all kinds of reasons.\r\n\r\nThat does not appear to be the case. Covered California says that individuals will pay an average premium of $321 per month for a "silver" plan.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14199\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\" wp-image-14199\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/RS170_108160554-scr-640x426.jpg\" alt=\"RS170_108160554-scr\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">(Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update: Aug. 7, 2013: \u003c/strong>Covered California announced Wednesday that 12 insurance companies have formally signed contracts with the agency to offer plans on the new marketplace. Since the initial announcement (below), one company, Ventura County Health Plan, has withdrawn from offering coverage on the marketplace. The following companies will offer plans on the marketplace, although not all companies will offer plans in every region of California:\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare; check out KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>· Alameda Alliance for Health\u003c/p>\n\u003cp>· Anthem Blue Cross of California\u003c/p>\n\u003cp>· Blue Shield of California\u003c/p>\n\u003cp>· Chinese Community Health Plan\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>· Contra Costa Health Plan\u003c/p>\n\u003cp>· Health Net\u003c/p>\n\u003cp>· Kaiser Permanente\u003c/p>\n\u003cp>· L.A. Care Health Plan\u003c/p>\n\u003cp>· Molina Healthcare\u003c/p>\n\u003cp>· Sharp Health Plan\u003c/p>\n\u003cp>· Valley Health Plan\u003c/p>\n\u003cp>· Western Health Advantage\u003c/p>\n\u003cp>Last week, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/01/covered-california-sets-small-business-marketplace-plans-premiums/\" target=\"_blank\">announced\u003c/a> tentative plans and premiums for its small business marketplace, also called SHOP.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>The state's health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to millions of Californians.\u003c/p>\n\u003cp>And what everyone wants to know is: how much will it cost. Experts had warned of \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/27/health-care-overhaul-actuaries-say-costs-could-go-up-32-percent/\">rate shock\u003c/a>,\" that premiums might skyrocket for all kinds of reasons. That has not happened.\u003c/p>\n\u003cp>Covered California says that individuals will pay an average premium of $321 per month for a \"silver\" plan. (More on silver plans below.) Many people will be eligible for subsidies to reduce that cost further.\u003c/p>\n\u003cp>Across the state, people who had been working toward this day seemed to heave a collective sigh of relief.\u003c/p>\n\u003cp>\"This is a home run for consumers in every region of California,\" said Peter Lee, executive director of Covered California, in a release to reporters. \"Californians should be proud of how not only health plans in this state, but doctors, medical groups and hospitals have stepped up -- creating a market that will allow millions of consumers to enroll in affordably priced products.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.coveredca.com/news/PDFs/CC_Health_Plans_Booklet.pdf\">Look up a sample of plans, premiums offered in your area.\u003c/a> \u003c/aside>\n\u003cp>Charles Bacchi, executive vice president with the California Association of Health Plans called it an \"important day\" and commended both insurance companies and providers for working together \"to deliver quality, affordable health care. We couldn't have done this without providers willing to join us to make the Affordable Care Act a success,\" he said in a reference to provider groups working to keep rates low.\u003c/p>\n\u003cp>The plans on the exchange are required to offer a standard set of comprehensive benefits. It's hard to compare premiums next year to what's in place this year, since there is no standard set of benefits at present. Covered California chose as the best comparison the average premium for a small business plan. The rates in Covered California range from 2 percent above to 29 percent below that benchmark.\u003c!--more-->\u003c/p>\n\u003cp>\"It's nice to have a good news day in California,\" said Daniel Zingale, senior vice president of The California Endowment. \"It turns out there's power in numbers when it comes to … health plans.\"\u003c/p>\n\u003cp>\u003cstrong>13 Plans Selected for the Insurance Exchange\u003c/strong>\u003c/p>\n\u003cp>The selected plans and premiums are still subject to review by state regulators. Covered California has picked 13 plans, including Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser as well as many regional plans and some country-sponsored health plans. Those include Alameda Alliance for Health, Chinese Community Health Plan, Contra Costa Health Services, L.A. Care Health Plan, Molina Helathcare, Sharp Health Paln, Valley Health Plan, Ventura County Health Care Plan and Western Health Advantage. \u003ca href=\"http://www.coveredca.com/news/PDFs/CC_Health_Plans_Booklet.pdf\">You can look up your own region\u003c/a> and see what plans and premiums you can choose from.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Everything will be quite standardized and literally charted out. So you can look across lines and compare plans.\" -- \u003cem>Betsy Imholz, Consumers Union\u003c/em>\u003c/aside>\n\u003cp>Plans will be offered in tiers of coverage: platinum, gold, silver, bronze. The platinum plans have the highest premiums but you will pay less when you see the doctor; the bronze plans have the lowest premium, meaning you will pay more when you see the doctor.\u003c/p>\n\u003cp>The \"silver\" plan mentioned above is in the middle. It has the same standard set of benefits as the other plans, and has a $2,000 annual deductible. Still, preventive care and some other services are outside the deductible -- people would pay only a co-pay when they see the doctor.\u003c/p>\n\u003cp>When setting an individual's premium, insurance plans in the exchange may look at only three factors: age, where you live and family size. Insurance companies may no longer use your health condition or your health history to set premiums. People may no longer be turned down for pre-existing conditions.\u003c/p>\n\u003cp>Subsidies are available for people making from 138 to 400 percent of the federal poverty level – or about $15,500 to $45,000 for an individual or about $31,000 to $92,000 for a family of four.\u003c/p>\n\u003cp>\u003cstrong>Breakdown on Premiums, Before and After Subsidy\u003c/strong>\u003c/p>\n\u003cp>Covered California provided tables of average rates for a 21-year-old and a 40-year-old single person. For the 21-year-old buying the most affordable silver plan, the premium is $216 per month. But depending on income, the 21-year-old may get a subsidy, making the price that person would pay range from $44 per month to $216 per month.\u003c/p>\n\u003cp>The premium for a 40-year-old buying the most affordable silver plan will be $276. But depending on the subsidy, that 40-year-old will pay from $40 to the full $276.\u003c/p>\n\u003cp>Starting this fall, people will be able to go online and look up plans and rates across the board for themselves or their families.\u003c/p>\n\u003cp>\"Everything will be quite standardized and literally charted out,\" said Betsy Imholz, special projects director for Consumers Union. \"So you can look across lines and compare plans.\"\u003c/p>\n\u003cp>On average, people in the larger metropolitan areas in California will be able to choose from among five different plans. Covered California says that even in rural areas where options have typically been sparse, people will have two or three health plans to choose from.\u003c/p>\n\u003cp>\"We were particularly concerned about Californians in rural parts of the state,\" Zingale said. \"So it's a relief to see that they will have doctors, hospitals and health benefits available in those areas.\"\u003c/p>\n\u003cp>But not everyone was delighted. Jay Nelson is a 33-year-old attorney who lives with his wife and three children in Oakland. Nelson does not have employer-based insurance, although his firm is looking into options. He has been unable to afford insurance for his family. Nelson said he was disappointed the premiums were not cheaper.\u003c/p>\n\u003cp>\"We're exactly in that income level that is essentially uninsurable,\" he said. \"We make too much money to qualify for any help, but we don't make enough money to pay for this … comfortably.\"\u003c/p>\n\u003cp>Bacchi acknowledged that while the Covered California premiums are generally \"positive news,\" that's not the case for everyone. \"The reality is that there are some people who will pay more than they currently pay. That's because the Affordable Care Act requires increased benefits and it also imposes less cost sharing on the enrollee through deductibles and co-pays.\"\u003c/p>\n\u003cp>Plans and premiums for Covered California's small business exchange are expected to be announced in June, and a major \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/californias-health-insurance-exchange-builds-critical-outreach-network/\">education and outreach campaign\u003c/a> will launch this summer.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Listen to a discussion of the new plans and premiums on KQED's Forum:\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201305240900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201305240900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "More Single Boomers Share Homes -- and Health Support",
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"content": "\u003cp>By Julie Rovner, \u003ca href=\"http://www.npr.org/blogs/health/2013/05/22/183903991/Boomer-Housemates-Have-More-Fun\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_12895\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12895\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/goldengirls_01-a6aea59e62f67d0b27c946f3e4fd27bf9061a677-s3-300x224.jpg\" alt='Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)' width=\"300\" height=\"224\">\u003cfigcaption class=\"wp-caption-text\">Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are \u003ca href=\"http://www.geron.org/About%20Us/press-room/Archived%20Press%20Releases/80-2012-press-releases/1329-single-baby-boomers-facing-increased-challenges-as-they-age\">disproportionately women\u003c/a>. As this vast generation rushes into retirement, there's a growing concern among experts on aging: Who will take care of all these people when they're too old to care for themselves?\u003c/p>\n\u003cp>It's a question many of the experts take personally. \"\u003cem>That\u003c/em> is what scares me,\" says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. \"Because I am one of those people,\" she says, \"and I do think about it.\"\u003c/p>\n\u003cp>\"Oh, I've got wonderful nieces and nephews,\" Rix says, noting that's what a lot of her boomer peers claim, too. \"Well, in fact, they've got their families. They've got their in-laws. They've got their parents. And I don't think it's reasonable to expect much out of them.\"\u003c/p>\n\u003cp>Kathleen Kelly, who runs the \u003ca href=\"http://www.caregiver.org/caregiver/jsp/home.jsp\">Family Caregiver Alliance and the National Center on Caregiving in San Francisco\u003c/a>, says she's seeing the same sort of concern in her social circle. \"I'm in my 50s, and my friends are all talking about, 'Could we all move in together? Could we buy an apartment building and all live together?' There are all sorts of permutations of this conversation,\" Kelly says. \"But it really is something that people are thinking about, particularly women.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And, because boomers are boomers, some are doing more than just thinking about it. Already, there's a small but apparently growing movement of boomer women forming group houses with their single peers.\u003c!--more-->\u003c/p>\n\u003cp>One of those homes belongs to Bonnie Moore. She's a pert, 60-something divorcee who lives in a well-kept, five-bedroom house in Bowie, Md., a cozy suburb of Washington, D.C.\u003c/p>\n\u003cp>In order to stay in her house after her divorce, Moore needed financial help. But she wanted to do more than just add boarders who would help pay the bills, she says. The home she's organized instead is \"a little bit like family, a little bit like roommates, a little bit like a sorority house,\" she says from the sofa of her softly lit living room. \"It just evolves.\"\u003c/p>\n\u003cp>Moore, an attorney, isn't actually childless. She has a grown son who lives in Utah and has been urging Moore to move there to be closer to him and his family. \"He's just sort of saying, 'Well, Mom you're old now; we have to take care of you,' \" Moore says. \"And I'm saying, 'I'm not old. I've got 20 years out there in my yard, thank you very much,' \" she says with a laugh.\u003c/p>\n\u003cp>Moore has been careful about selecting as housemates women who get along, but who also have a sense of independence. \"All of us, we have our own separate lives,\" she says. \"We do our own separate things, but we'll meet up in the kitchen and chitchat. And then we'll all go our different ways, which makes it nice. None of us are joined at the hip, and yet we all live together and do our own thing and live in the same house.\"\u003c/p>\n\u003cp>Lorene Solivan is one of Moore's three current roommates — \"the youngest,\" Solivan says proudly, having just turned 60.\u003c/p>\n\u003cp>Solivan, an event manager for a food company, had been living in an apartment in Northern Virginia. But she was having financial troubles of her own and was looking to downsize.\u003c/p>\n\u003cp>\"And then I saw the ad on Craigslist: GOLDEN GIRLS HOUSE. I said, 'Oh, that looks like fun,' \" she says.\u003c/p>\n\u003cp>Solivan, who does much of the group's cooking, says it's been a nice transition for her. To live with a built-in social group of people your own age is \"a big plus,\" she says, \"whether you're 20, 40, or 60 — whatever the case may be.\"\u003c/p>\n\u003cp>That's why Bonnie Moore is trying to take her concept and expand it. She already has a \u003ca href=\"http://www.goldengirlsnetwork.org/\">website\u003c/a> and is working on a guide to help other single boomer women set up houses like hers. \"I think it'll be fun,\" she says. \"And I'd like to be part of various seminars and workshops for women [about] the whole idea of living communally and learning to get along in this kind of environment.\"\u003c/p>\n\u003cp>Still, there are a lot of obstacles. One big one is that most boomers don't realize they might need help getting or paying for long-term care if their health falters.\u003c/p>\n\u003cp>\"I call it the 70-70-70 conundrum,\" says Bruce Chernof, president and CEO of \u003ca href=\"http://thescanfoundation.org/\">The SCAN Foundation\u003c/a>, which focuses on long-term health care issues. \"Seventy percent of people over the age of 65 will need some form of long-term care supports as they age,\" he says. But when you look at polling, \"roughly 70 percent of Americans don't actually think they're likely to need it, and roughly 70 percent think Medicare will probably cover it when they get there.\"\u003c/p>\n\u003cp>The problem, of course, he adds, is that \"those last two 70 percents are not true.\"\u003c/p>\n\u003cp>Then there's the numbers problem. \"We know that ... about a third of baby boomers are single,\" says Kathleen Kelly. \"But we also know that there's a large percentage of those that are in their 50s and 60s [who] are getting divorced, and so we're going to have more single individuals in the future. We just haven't seen this before.\"\u003c/p>\n\u003cp>At the same time, most boomers have had fewer children than previous generations did, and many boomers have no children.\u003c/p>\n\u003cp>\"So there's less adult children to take the place of the caregiving cohort that currently is providing ... caregiving to their parents,\" she says. And today, family caregiving provides an estimated $450 billion a year worth of unpaid care.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Sara Rix of AARP says a big problem for single boomer women is that they're not financially prepared to hire the caregivers they might need if they don't have family members to volunteer the time. \"[These single women] are still likely to be concentrated in what we've traditionally called the 'pink collar' jobs,\" she says, which are \"the lower wage, low benefit occupations. So when they reach old age, they often reach old age without pension coverage.\"\u003c/p>\n\u003cp>Most of these women will have Social Security, Rix says — assuming that they are eligible, and that the rules don't change between now and when they retire. But for many older women, that will be all, or nearly all the money they have to live on, she says, \"and it's not going to pay for a lot of care — formal care. So it's a frightening future for a lot of women.\"\u003c/p>\n\u003cp>There are things women can do to make that future a little less frightening, says Kelly. Some suggestions are pretty obvious, like maintaining a healthy, active lifestyle.\u003c/p>\n\u003cp>But another bit of advice may be less intuitive, Kelly says, \"and that is to invest in social relationships and networks.\" She doesn't mean the sort of social networks people create on the Internet, but rather, \"a community of individuals [living with or near you, so] that you may be able to share tasks and responsibilities as you grow older.\"\u003c/p>\n\u003cp>That brings us back to Bonnie Moore, who says that deciding to form a group house was about more than just financial necessity. \"I think women naturally are more community oriented,\" Moore says. \"It's just part of the woman's nature.\"\u003c/p>\n\u003cp>And besides, she adds, \"to come home and have someone say, 'Hi, how was your day?' ... That's really nice sometimes.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So if you're a boomer and you liked that group house you shared in college or just after, good for you. The United States is one of the few developed nations that has no organized public policy for providing long-term care — so group living may be in your future as well as your past.\u003c/p>\n\n",
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"excerpt": "Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are disproportionately women. As this vast generation rushes into retirement, there's a growing concern among experts on aging: Who will take care of all these people when they're too old to care for themselves?\r\n\r\nIt's a question many of the experts take personally. \"That is what scares me,\" says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. \"Because I am one of those people,\" she says, \"and I do think about it.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Julie Rovner, \u003ca href=\"http://www.npr.org/blogs/health/2013/05/22/183903991/Boomer-Housemates-Have-More-Fun\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_12895\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12895\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/goldengirls_01-a6aea59e62f67d0b27c946f3e4fd27bf9061a677-s3-300x224.jpg\" alt='Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)' width=\"300\" height=\"224\">\u003cfigcaption class=\"wp-caption-text\">Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are \u003ca href=\"http://www.geron.org/About%20Us/press-room/Archived%20Press%20Releases/80-2012-press-releases/1329-single-baby-boomers-facing-increased-challenges-as-they-age\">disproportionately women\u003c/a>. As this vast generation rushes into retirement, there's a growing concern among experts on aging: Who will take care of all these people when they're too old to care for themselves?\u003c/p>\n\u003cp>It's a question many of the experts take personally. \"\u003cem>That\u003c/em> is what scares me,\" says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. \"Because I am one of those people,\" she says, \"and I do think about it.\"\u003c/p>\n\u003cp>\"Oh, I've got wonderful nieces and nephews,\" Rix says, noting that's what a lot of her boomer peers claim, too. \"Well, in fact, they've got their families. They've got their in-laws. They've got their parents. And I don't think it's reasonable to expect much out of them.\"\u003c/p>\n\u003cp>Kathleen Kelly, who runs the \u003ca href=\"http://www.caregiver.org/caregiver/jsp/home.jsp\">Family Caregiver Alliance and the National Center on Caregiving in San Francisco\u003c/a>, says she's seeing the same sort of concern in her social circle. \"I'm in my 50s, and my friends are all talking about, 'Could we all move in together? Could we buy an apartment building and all live together?' There are all sorts of permutations of this conversation,\" Kelly says. \"But it really is something that people are thinking about, particularly women.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And, because boomers are boomers, some are doing more than just thinking about it. Already, there's a small but apparently growing movement of boomer women forming group houses with their single peers.\u003c!--more-->\u003c/p>\n\u003cp>One of those homes belongs to Bonnie Moore. She's a pert, 60-something divorcee who lives in a well-kept, five-bedroom house in Bowie, Md., a cozy suburb of Washington, D.C.\u003c/p>\n\u003cp>In order to stay in her house after her divorce, Moore needed financial help. But she wanted to do more than just add boarders who would help pay the bills, she says. The home she's organized instead is \"a little bit like family, a little bit like roommates, a little bit like a sorority house,\" she says from the sofa of her softly lit living room. \"It just evolves.\"\u003c/p>\n\u003cp>Moore, an attorney, isn't actually childless. She has a grown son who lives in Utah and has been urging Moore to move there to be closer to him and his family. \"He's just sort of saying, 'Well, Mom you're old now; we have to take care of you,' \" Moore says. \"And I'm saying, 'I'm not old. I've got 20 years out there in my yard, thank you very much,' \" she says with a laugh.\u003c/p>\n\u003cp>Moore has been careful about selecting as housemates women who get along, but who also have a sense of independence. \"All of us, we have our own separate lives,\" she says. \"We do our own separate things, but we'll meet up in the kitchen and chitchat. And then we'll all go our different ways, which makes it nice. None of us are joined at the hip, and yet we all live together and do our own thing and live in the same house.\"\u003c/p>\n\u003cp>Lorene Solivan is one of Moore's three current roommates — \"the youngest,\" Solivan says proudly, having just turned 60.\u003c/p>\n\u003cp>Solivan, an event manager for a food company, had been living in an apartment in Northern Virginia. But she was having financial troubles of her own and was looking to downsize.\u003c/p>\n\u003cp>\"And then I saw the ad on Craigslist: GOLDEN GIRLS HOUSE. I said, 'Oh, that looks like fun,' \" she says.\u003c/p>\n\u003cp>Solivan, who does much of the group's cooking, says it's been a nice transition for her. To live with a built-in social group of people your own age is \"a big plus,\" she says, \"whether you're 20, 40, or 60 — whatever the case may be.\"\u003c/p>\n\u003cp>That's why Bonnie Moore is trying to take her concept and expand it. She already has a \u003ca href=\"http://www.goldengirlsnetwork.org/\">website\u003c/a> and is working on a guide to help other single boomer women set up houses like hers. \"I think it'll be fun,\" she says. \"And I'd like to be part of various seminars and workshops for women [about] the whole idea of living communally and learning to get along in this kind of environment.\"\u003c/p>\n\u003cp>Still, there are a lot of obstacles. One big one is that most boomers don't realize they might need help getting or paying for long-term care if their health falters.\u003c/p>\n\u003cp>\"I call it the 70-70-70 conundrum,\" says Bruce Chernof, president and CEO of \u003ca href=\"http://thescanfoundation.org/\">The SCAN Foundation\u003c/a>, which focuses on long-term health care issues. \"Seventy percent of people over the age of 65 will need some form of long-term care supports as they age,\" he says. But when you look at polling, \"roughly 70 percent of Americans don't actually think they're likely to need it, and roughly 70 percent think Medicare will probably cover it when they get there.\"\u003c/p>\n\u003cp>The problem, of course, he adds, is that \"those last two 70 percents are not true.\"\u003c/p>\n\u003cp>Then there's the numbers problem. \"We know that ... about a third of baby boomers are single,\" says Kathleen Kelly. \"But we also know that there's a large percentage of those that are in their 50s and 60s [who] are getting divorced, and so we're going to have more single individuals in the future. We just haven't seen this before.\"\u003c/p>\n\u003cp>At the same time, most boomers have had fewer children than previous generations did, and many boomers have no children.\u003c/p>\n\u003cp>\"So there's less adult children to take the place of the caregiving cohort that currently is providing ... caregiving to their parents,\" she says. And today, family caregiving provides an estimated $450 billion a year worth of unpaid care.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Sara Rix of AARP says a big problem for single boomer women is that they're not financially prepared to hire the caregivers they might need if they don't have family members to volunteer the time. \"[These single women] are still likely to be concentrated in what we've traditionally called the 'pink collar' jobs,\" she says, which are \"the lower wage, low benefit occupations. So when they reach old age, they often reach old age without pension coverage.\"\u003c/p>\n\u003cp>Most of these women will have Social Security, Rix says — assuming that they are eligible, and that the rules don't change between now and when they retire. But for many older women, that will be all, or nearly all the money they have to live on, she says, \"and it's not going to pay for a lot of care — formal care. So it's a frightening future for a lot of women.\"\u003c/p>\n\u003cp>There are things women can do to make that future a little less frightening, says Kelly. Some suggestions are pretty obvious, like maintaining a healthy, active lifestyle.\u003c/p>\n\u003cp>But another bit of advice may be less intuitive, Kelly says, \"and that is to invest in social relationships and networks.\" She doesn't mean the sort of social networks people create on the Internet, but rather, \"a community of individuals [living with or near you, so] that you may be able to share tasks and responsibilities as you grow older.\"\u003c/p>\n\u003cp>That brings us back to Bonnie Moore, who says that deciding to form a group house was about more than just financial necessity. \"I think women naturally are more community oriented,\" Moore says. \"It's just part of the woman's nature.\"\u003c/p>\n\u003cp>And besides, she adds, \"to come home and have someone say, 'Hi, how was your day?' ... That's really nice sometimes.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Easy to Do, Inexpensive; Music Calms Some ICU Patients",
"title": "Easy to Do, Inexpensive; Music Calms Some ICU Patients",
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"content": "\u003cp>\u003cstrong>By Leslie Harris O'Hanlon\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12826\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-12826 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AA004801-620x452.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">(Ryan McVay/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The adage stems from the 18th century: music has charms to sooth the savage breast. It's probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Patients in the music group received 38 percent fewer doses of sedatives.\u003c/aside>\n\u003cp>Researchers at Ohio State University looked at ICU patients on mechanical ventilators for respiratory failure. Those who listened to the music of their choice not only had greater reduction in anxiety but also used fewer sedation drugs and lower doses compared to patients who did not have access to music -- they received usual ICU care. Mechanical ventilation, or ventilatory support, is when a patient is connected to a machine, called a ventilator, to help him or her breath.\u003c/p>\n\u003cp>Researchers call this \"patient-directed music\" because patients could select their own music and put headphones on whenever they wanted.\u003c/p>\n\u003cp>The \"intervention empowered patients to use music to manage their own anxiety whenever they felt they needed the use of music to help them relax or when they desired some quiet time,” said lead author Professor Linda L. Chlan at Ohio State. “Music does not induce adverse side effects, which are sometimes evident with sedative agents administered to these patients.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The clinical trial included 373 patients on ventilators. Researchers looked at 12 intensive care units in the Minneapolis-St. Paul area; the study went on for nearly five years. Patients were put into three groups: those who picked their own musical selections with the help of a music therapist, those who used noise-canceling headphones and those who received usual care.\u003c/p>\n\u003cp>Researchers measured anxiety daily by asking patients the question: “How are you feeling today?” The amount and frequency of sedative drugs were also measured. Patients in the music group listened to music for an average of 80 minutes per day.\u003c/p>\n\u003cp>Analysis showed that patients in the music group had an anxiety score that was 19.5 points lower than patients in the usual care group. Also, patients in the music group received fewer doses of sedatives -- 38 percent fewer doses.\u003c/p>\n\u003cp>Researchers published comments that patients or family members made to nurses. For example:\u003c/p>\n\u003cul>\n\u003cli>\"Patient looks very peaceful and states she like the music.\"\u003c/li>\n\u003cli>\"After putting headphones on, patient appears less anxious.\"\u003c/li>\n\u003cli>\"Evening was quieter. Patient put headphones on which seemed to help a lot.\"\u003c/li>\n\u003c/ul>\n\u003cp>Not surprisingly, people on ventilators in an ICU are often under a great deal of stress. Potent sedatives are usually given to these patients to help them feel less anxious, the study authors wrote. But those drugs can have harsh side effects, including weakness, delirium and a lowering a blood pressure. That lower blood pressure can prevent the heart, brain and other parts of the body from getting enough blood.\u003c/p>\n\u003cp>“Mechanically ventilated patients have little control over (drug) interventions to relieve anxiety,\" Chlan wrote in an email. \"Dosing and frequency of sedative and analgesic medications are controlled by intensive care unit (ICU) clinicians. ... Interventions are needed that reduce anxiety, actively involve patients, and minimize the use of sedative medications.”\u003c/p>\n\u003cp>This isn’t the first study to highlight how music can help alleviate stress. A large scale review of 400 research papers\u003ca href=\"http://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(13)00049-1\" target=\"_blank\"> published in Trends in Cognitive Sciences\u003c/a> found that music can improve the function of the body's immune system and reduce levels of stress. Further, listening to music was more successful than prescription drugs in decreasing a person's anxiety before undergoing surgery. In a 2012 paper \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22071366\" target=\"_blank\">published in The Journal of Pain\u003c/a>, researchers from the University of Utah Pain Research Center found that listening to music could lessen pain by distracting people’s attention away from the pain. Also, according to the American Cancer Society, there is evidence that when used with conventional treatment, music therapy can help to reduce pain and relieve chemotherapy-induced nausea and vomiting in cancer patients. Music therapy, which can include making or listening to music or writing songs, may also relieve stress and provide an overall sense of well-being.\u003c/p>\n\u003cp>The current JAMA study had some limitations, said Dr. Elie Azoulay with the Sorbonne in Paris who wrote an accompanying editorial in JAMA. Azoulay says the effects of listening to music were only studied short term, and the use of sedatives was not standardized across all ICUs in the study. Azoulay added that conducting in-depth interviews with patients after they were discharged could help researchers better understand the impact music had on those patients’ anxiety levels.\u003c/p>\n\u003cp>Still, the ability of music to help patients in distress is an area worth exploring further, he said, especially since it’s low cost and easy to incorporate.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Patient's anxiety can be reduced and by a means that can be accessible for all ICUs all over the world,” he said.\u003c/p>\n\n",
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"excerpt": "The adage stems from the 18th century: music has charms to sooth the savage beast. It's probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Leslie Harris O'Hanlon\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12826\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-12826 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AA004801-620x452.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">(Ryan McVay/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The adage stems from the 18th century: music has charms to sooth the savage breast. It's probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Patients in the music group received 38 percent fewer doses of sedatives.\u003c/aside>\n\u003cp>Researchers at Ohio State University looked at ICU patients on mechanical ventilators for respiratory failure. Those who listened to the music of their choice not only had greater reduction in anxiety but also used fewer sedation drugs and lower doses compared to patients who did not have access to music -- they received usual ICU care. Mechanical ventilation, or ventilatory support, is when a patient is connected to a machine, called a ventilator, to help him or her breath.\u003c/p>\n\u003cp>Researchers call this \"patient-directed music\" because patients could select their own music and put headphones on whenever they wanted.\u003c/p>\n\u003cp>The \"intervention empowered patients to use music to manage their own anxiety whenever they felt they needed the use of music to help them relax or when they desired some quiet time,” said lead author Professor Linda L. Chlan at Ohio State. “Music does not induce adverse side effects, which are sometimes evident with sedative agents administered to these patients.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The clinical trial included 373 patients on ventilators. Researchers looked at 12 intensive care units in the Minneapolis-St. Paul area; the study went on for nearly five years. Patients were put into three groups: those who picked their own musical selections with the help of a music therapist, those who used noise-canceling headphones and those who received usual care.\u003c/p>\n\u003cp>Researchers measured anxiety daily by asking patients the question: “How are you feeling today?” The amount and frequency of sedative drugs were also measured. Patients in the music group listened to music for an average of 80 minutes per day.\u003c/p>\n\u003cp>Analysis showed that patients in the music group had an anxiety score that was 19.5 points lower than patients in the usual care group. Also, patients in the music group received fewer doses of sedatives -- 38 percent fewer doses.\u003c/p>\n\u003cp>Researchers published comments that patients or family members made to nurses. For example:\u003c/p>\n\u003cul>\n\u003cli>\"Patient looks very peaceful and states she like the music.\"\u003c/li>\n\u003cli>\"After putting headphones on, patient appears less anxious.\"\u003c/li>\n\u003cli>\"Evening was quieter. Patient put headphones on which seemed to help a lot.\"\u003c/li>\n\u003c/ul>\n\u003cp>Not surprisingly, people on ventilators in an ICU are often under a great deal of stress. Potent sedatives are usually given to these patients to help them feel less anxious, the study authors wrote. But those drugs can have harsh side effects, including weakness, delirium and a lowering a blood pressure. That lower blood pressure can prevent the heart, brain and other parts of the body from getting enough blood.\u003c/p>\n\u003cp>“Mechanically ventilated patients have little control over (drug) interventions to relieve anxiety,\" Chlan wrote in an email. \"Dosing and frequency of sedative and analgesic medications are controlled by intensive care unit (ICU) clinicians. ... Interventions are needed that reduce anxiety, actively involve patients, and minimize the use of sedative medications.”\u003c/p>\n\u003cp>This isn’t the first study to highlight how music can help alleviate stress. A large scale review of 400 research papers\u003ca href=\"http://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(13)00049-1\" target=\"_blank\"> published in Trends in Cognitive Sciences\u003c/a> found that music can improve the function of the body's immune system and reduce levels of stress. Further, listening to music was more successful than prescription drugs in decreasing a person's anxiety before undergoing surgery. In a 2012 paper \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22071366\" target=\"_blank\">published in The Journal of Pain\u003c/a>, researchers from the University of Utah Pain Research Center found that listening to music could lessen pain by distracting people’s attention away from the pain. Also, according to the American Cancer Society, there is evidence that when used with conventional treatment, music therapy can help to reduce pain and relieve chemotherapy-induced nausea and vomiting in cancer patients. Music therapy, which can include making or listening to music or writing songs, may also relieve stress and provide an overall sense of well-being.\u003c/p>\n\u003cp>The current JAMA study had some limitations, said Dr. Elie Azoulay with the Sorbonne in Paris who wrote an accompanying editorial in JAMA. Azoulay says the effects of listening to music were only studied short term, and the use of sedatives was not standardized across all ICUs in the study. Azoulay added that conducting in-depth interviews with patients after they were discharged could help researchers better understand the impact music had on those patients’ anxiety levels.\u003c/p>\n\u003cp>Still, the ability of music to help patients in distress is an area worth exploring further, he said, especially since it’s low cost and easy to incorporate.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Patient's anxiety can be reduced and by a means that can be accessible for all ICUs all over the world,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "What's a BRCA Gene Anyway?",
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"content": "\u003cfigure id=\"attachment_12777\" class=\"wp-caption aligncenter\" style=\"max-width: 432px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4839882457/\">\u003cimg class=\"size-full wp-image-12777\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg\" alt=\"(Gage Skidmore/Flickr)\" width=\"432\" height=\"386\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg 432w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-400x357.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-320x286.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The first thing you need to know about the BRCA gene is that you have it.\u003c/p>\n\u003cp>Don't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We all have two copies of the BRCA genes. Men, too.\u003c/aside>\n\u003cp>The problem is what happens when they don't function normally. We'll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.\u003c/p>\n\u003cp>For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are \"like sentences,\" Nussbaum said. \"They are made up of words.\" When they're spelled right, all is well.\u003c/p>\n\u003cp>But \"you can have all kinds of misspellings,\" Nussbaum said. \"Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If you've ever texted or sent an email or written anything on a computer, you know that there are misspellings that don't change the meaning of what you're trying to say. Nussbaum used the example of \"gray\" and \"grey\". The change in spelling does not change the meaning.\u003c/p>\n\u003cp>With the BRCA genes, there are \"thousands\" of ways the gene can be misspelled, Nussbaum said. But just like gray/grey doesn't matter, neither do many of those BRCA misspellings or what Angelina Jolie correctly called a mutation.\u003c/p>\n\u003cp>Then there are the ones that do matter. Sadly, they matter way too much. On Tuesday Angelina Jolie said \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0\" target=\"_blank\">she had a mutation\u003c/a> that gave her an 87 percent risk of developing breast cancer, which is why she decided to undergo a preventive double mastectomy.\u003c/p>\n\u003cp>In general, women who have inherited the harmful mutations have about\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> 60 percent risk\u003c/a> of developing breast cancer over their lifetimes, according to the National Cancer Institute. They are also at much higher risk of ovarian cancer. And men who inherit the gene have a dramatically increased risk of male breast cancer as well as pancreatic and prostate cancers.\u003c/p>\n\u003cp>Still, only about 10 percent of all breast cancers are associated with these mutations. Or, to put it the opposite way, roughly 90 percent of all breast cancers are not related to BRCA mutations. They just happen, for reasons doctors and scientists cannot fully explain.\u003c/p>\n\u003cp>I just googled \"Angelina Jolie\" and \"mastectomy\" and got 736 million results. It's probably safe to say countless women are thinking about BRCA testing right now. But before you run to a lab, Nussbaum said they start with an \"accurate and complete\" family history, including on the father's side. Remember that you get one copy of all your genes, including the BRCA1 and 2 genes, from your dad.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While \"thousands\" of mutations cause harm and \"thousands\" more have no effect at all, Nussbaum then pointed to a third category, \"variance of uncertain significance,\" he said. Doctors see the mutation, but cannot determine if it damages the gene's function or not. \"So there is no such thing as 'the BRCA1 mutation.' There are thousands. Some are deleterious. Some are not. Some we don't know.\"\u003c/p>\n\n",
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"excerpt": "The first thing you need to know about the BRCA gene is that you have it.\r\n\r\nDon't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12777\" class=\"wp-caption aligncenter\" style=\"max-width: 432px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4839882457/\">\u003cimg class=\"size-full wp-image-12777\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg\" alt=\"(Gage Skidmore/Flickr)\" width=\"432\" height=\"386\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg 432w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-400x357.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-320x286.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The first thing you need to know about the BRCA gene is that you have it.\u003c/p>\n\u003cp>Don't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We all have two copies of the BRCA genes. Men, too.\u003c/aside>\n\u003cp>The problem is what happens when they don't function normally. We'll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.\u003c/p>\n\u003cp>For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are \"like sentences,\" Nussbaum said. \"They are made up of words.\" When they're spelled right, all is well.\u003c/p>\n\u003cp>But \"you can have all kinds of misspellings,\" Nussbaum said. \"Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you've ever texted or sent an email or written anything on a computer, you know that there are misspellings that don't change the meaning of what you're trying to say. Nussbaum used the example of \"gray\" and \"grey\". The change in spelling does not change the meaning.\u003c/p>\n\u003cp>With the BRCA genes, there are \"thousands\" of ways the gene can be misspelled, Nussbaum said. But just like gray/grey doesn't matter, neither do many of those BRCA misspellings or what Angelina Jolie correctly called a mutation.\u003c/p>\n\u003cp>Then there are the ones that do matter. Sadly, they matter way too much. On Tuesday Angelina Jolie said \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0\" target=\"_blank\">she had a mutation\u003c/a> that gave her an 87 percent risk of developing breast cancer, which is why she decided to undergo a preventive double mastectomy.\u003c/p>\n\u003cp>In general, women who have inherited the harmful mutations have about\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> 60 percent risk\u003c/a> of developing breast cancer over their lifetimes, according to the National Cancer Institute. They are also at much higher risk of ovarian cancer. And men who inherit the gene have a dramatically increased risk of male breast cancer as well as pancreatic and prostate cancers.\u003c/p>\n\u003cp>Still, only about 10 percent of all breast cancers are associated with these mutations. Or, to put it the opposite way, roughly 90 percent of all breast cancers are not related to BRCA mutations. They just happen, for reasons doctors and scientists cannot fully explain.\u003c/p>\n\u003cp>I just googled \"Angelina Jolie\" and \"mastectomy\" and got 736 million results. It's probably safe to say countless women are thinking about BRCA testing right now. But before you run to a lab, Nussbaum said they start with an \"accurate and complete\" family history, including on the father's side. Remember that you get one copy of all your genes, including the BRCA1 and 2 genes, from your dad.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While \"thousands\" of mutations cause harm and \"thousands\" more have no effect at all, Nussbaum then pointed to a third category, \"variance of uncertain significance,\" he said. Doctors see the mutation, but cannot determine if it damages the gene's function or not. \"So there is no such thing as 'the BRCA1 mutation.' There are thousands. Some are deleterious. Some are not. Some we don't know.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Are Doughnuts Destroying Forests?",
"title": "Are Doughnuts Destroying Forests?",
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"content": "\u003ch2>\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/RS_DSCN1134.jpg\">\u003cimg class=\"alignleft size-full wp-image-54069\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/RS_DSCN1134.jpg\" alt=\"RS_DSCN1134\" width=\"604\" height=\"340\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2013/03/RS_DSCN1134.jpg 604w, https://ww2.kqed.org/app/uploads/sites/39/2013/03/RS_DSCN1134-400x225.jpg 400w\" sizes=\"(max-width: 604px) 100vw, 604px\">\u003c/a>\u003c/h2>\n\u003ch2>\u003cspan style=\"color: #808080\">An Expert Opinion:\u003c/span> Frances Seymour\u003c/h2>\n\u003ch3>\u003c/h3>\n\u003ch4>\u003cem>The former Director General at the \u003ca href=\"http://www.cifor.org/\">Center for International Forestry Research\u003c/a>, Frances Seymour has been a world leader in the effort to understand and address the impacts of tropical deforestation for 20 years. Or as she puts it, since Ben and Jerry’s released their Rainforest Crunch ice cream.\u003c/em>\u003c/h4>\n\u003cp>\u003cstrong>\u003cimg class=\"alignright size-medium wp-image-53764\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/young_frances-173x253.jpg\" alt=\"young_frances\" width=\"161\" height=\"234\">\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>What got you interested in forests in the first place?\u003c/strong>\u003c/p>\n\u003cp>Growing up in Chapel Hill, [North Carolina] I was always interested in nature and I tried to think of careers that could enable me to indulge that hobby. So when I was at UNC, I majored in zoology and thought about being a wildlife veterinarian as a way to be outside. I was in graduate school at the time when tropical forests were just exploding onto the international consciousness. This was back in the era of Rainforest Crunch and the lead-up to the first \u003ca href=\"http://www.worldsummit2002.org/index.htm?http://www.worldsummit2002.org/guide/unced.htm\">Rio Earth Summit\u003c/a> in 1992, when everybody was concerned about tropical biodiversity and indigenous peoples. So I ended up being caught up in all that and making a career out of it.\u003c/p>\n\u003cp>\u003cstrong>What are some of the human and ecological costs of deforestation?\u003c/strong>\u003c/p>\n\u003cp>When forests are lost, that means the loss of a lot of things that local communities depend on. At the local level this includes access to timber and non-timber forest products. At the landscape level forests provide various ecosystem services, like keeping clean waters in streams year-round and regulating rainfall patterns. Last but not least are the global-level human impacts. It’s estimated that greenhouse gas emissions from tropical deforestation and other land-use changes are a \u003ca href=\"http://scitechdaily.com/deforestation-adds-more-atmospheric-co2-than-the-sum-total-of-cars-trucks-on-the-worlds-roads/\">greater source of [C02] release\u003c/a> than all of the planes, trains, automobiles emissions combined.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>What poses the biggest risk to our forests: chopsticks, toothpicks, or toilet paper?\u003c/strong>\u003c/p>\n\u003cp>I would say “none of the above,” because some of the fastest and most damaging deforestation taking place right now is caused by the palm oil industry. So maybe the answer would be “your doughnuts.”\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/IMG_6852.jpg\">\u003cimg class=\"alignleft size-medium wp-image-54321\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/IMG_6852-337x253.jpg\" alt=\"IMG_6852\" width=\"337\" height=\"253\">\u003c/a>Palm oil is one of those commodities that is mostly used as an edible oil. In Asia, it’s the most commonly used oil for frying things. But in our supermarkets, it’s in, like, half the products, ranging from shampoo to peanut butter to doughnuts. And so that’s probably the greatest threat to tropical forests right now.\u003c/p>\n\u003cp>\u003cstrong>Is palm oil a relatively new commodity, at least on this scale?\u003c/strong>\u003c/p>\n\u003cp>Palm oil has been produced on an industrial scale in Indonesia and Malaysia for a long time, but the price of it has rapidly escalated. The prospect of new markets for palm oil-based biodiesel have also come on the horizon and so the incentives to invest in palm plantations have increased in recent years.\u003c/p>\n\u003cfigure id=\"attachment_54323\" class=\"wp-caption alignright\" style=\"max-width: 378px\">\u003cimg class=\"size-medium wp-image-54323\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/5701875645_79296910b5_b-378x253.jpg\" alt=\"Photo by Ryan Woo/CIFOR\" width=\"378\" height=\"253\">\u003cfigcaption class=\"wp-caption-text\">Photo by Ryan Woo/CIFOR\u003c/figcaption>\u003c/figure>\n\u003cfigure id=\"attachment_54324\" class=\"wp-caption alignright\" style=\"max-width: 380px\">\u003cimg class=\"size-medium wp-image-54324\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/5038663408_7f760da960_b-380x253.jpg\" alt=\"Photo by Daniel Murdiyarso/CIFOR\" width=\"380\" height=\"253\">\u003cfigcaption class=\"wp-caption-text\">Photo by Daniel Murdiyarso/CIFOR\u003c/figcaption>\u003c/figure>\n\u003cp>Palm oil production is responsible for significant deforestation in both of those places and, most recently, it’s begun to expand to other regions. It feels like almost every day I read a news release about another deal being done for tens or hundreds of thousands of hectares in Central Africa to be converted to an oil palm plantation. And the particular concern in a place like Indonesia is that a lot of this palm oil is being planted on peatland swamp forests. These peat swamps can be standing on layers of organic matter that has accumulated over thousands of years. They can be more than 30 feet deep.\u003c/p>\n\u003cp>\u003cstrong>Thirty feet deep. That’s incredible.\u003c/strong>\u003c/p>\n\u003cp>Think about that for a minute. When you drain and burn a peatland forest in order to plant palm oil or pulp and paper—not only do you have the pulse of emissions from the initial burning of the surface vegetation going into the atmosphere, but that organic matter that was locked up underground is suddenly liberated, releasing greenhouse gases into the air as it oxidizes and decomposes. And so the amount of carbon per hectare released into the atmosphere is many, many, many times greater than an equivalent hectare of forest not on peat swamp soils.\u003c/p>\n\u003cp>\u003cstrong>What’s the best way to balance sustaining the health of a forest and giving forest-dependent communities control of their resources?\u003c/strong>\u003c/p>\n\u003cp>\u003cimg class=\"alignleft size-medium wp-image-53769\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/DSCN0831-198x253.jpg\" alt=\"DSCN0831\" width=\"153\" height=\"197\">I guess I would challenge the premise of the question in the following way: one of the great misconceptions about tropical deforestation is that it’s the local people who are responsible for deforestation. Communities don’t need to be convinced of the value of forest because they’re the ones who hunt in the forest and fish in the forest and gather rattan from the forest. They’re the ones who suffer when the logging trucks come in. So it’s kind of galling to blame deforestation on local communities when, in fact, the people who are profiting from deforestation tend to be elites from capital cities.\u003c/p>\n\u003cp>\u003cstrong>I love that you challenged me on that.\u003c/strong>\u003c/p>\n\u003cp>You can tell I’m not shy.\u003c/p>\n\u003cp>\u003cstrong>Agriculture, specifically livestock grazing, contributes to deforestation. Are you a vegetarian?\u003c/strong>\u003c/p>\n\u003cp>[LAUGHS] No, I’m not. Yes, it is true overall that agricultural expansion is one of the key drivers of deforestation around the world. In terms of the cattle production in the Amazon, there’s been a big effort recently to try to \u003ca href=\"http://grsbeef.org/\">shift beef production to deforestation-free methods\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>People that are reading this might want to know what they can do to prevent deforestation. Should they buy forest-certified lumber? Eat local meat? Eat fewer doughnuts?\u003c/strong>\u003c/p>\n\u003cp>With specific reference to tropical deforestation, I think there are two things: One is to be a constituency for active U.S. engagement. And then, as individual consumers, yes, it does make a difference. Buy sustainably produced \u003ca href=\"https://us.fsc.org/\">FSC-certified\u003c/a> wood products. And hopefully, over time, we’ll have credible certification systems for some of these other commodities that can be certified deforestation-free.\u003c/p>\n\u003cp>\u003cstrong>Did you read The Giving Tree as a kid?\u003c/strong>\u003c/p>\n\u003cp>Did not.\u003c/p>\n\u003cp>\u003cstrong>\u003cimg class=\"alignright size-medium wp-image-53771\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/Malinau-DG-168x253.jpg\" alt=\"Malinau-DG\" width=\"160\" height=\"240\">If trees could talk, what would they say to the humans right now on this planet?\u003c/strong>\u003cbr>\nTrees have a self-interest in controlling climate change. So in addition to, “Don’t cut me down,” trees would also say, “Please protect the climate,” because forests are also vulnerable to climate change. With a changing climate, forests are experiencing drought and new invasions of pests that we have haven’t seen before. And so they would be saying, “If you want to keep forests around, you need to protect the climate.” So it’s sort of the opposite of what we’ve been talking about, “If you want to protect the climate, protect forests,” but it works the other way too.\u003c/p>\n\u003cp>\u003cem>*This interview has been condensed and edited.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ch2>\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/RS_DSCN1134.jpg\">\u003cimg class=\"alignleft size-full wp-image-54069\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/RS_DSCN1134.jpg\" alt=\"RS_DSCN1134\" width=\"604\" height=\"340\" srcset=\"https://ww2.kqed.org/app/uploads/sites/39/2013/03/RS_DSCN1134.jpg 604w, https://ww2.kqed.org/app/uploads/sites/39/2013/03/RS_DSCN1134-400x225.jpg 400w\" sizes=\"(max-width: 604px) 100vw, 604px\">\u003c/a>\u003c/h2>\n\u003ch2>\u003cspan style=\"color: #808080\">An Expert Opinion:\u003c/span> Frances Seymour\u003c/h2>\n\u003ch3>\u003c/h3>\n\u003ch4>\u003cem>The former Director General at the \u003ca href=\"http://www.cifor.org/\">Center for International Forestry Research\u003c/a>, Frances Seymour has been a world leader in the effort to understand and address the impacts of tropical deforestation for 20 years. Or as she puts it, since Ben and Jerry’s released their Rainforest Crunch ice cream.\u003c/em>\u003c/h4>\n\u003cp>\u003cstrong>\u003cimg class=\"alignright size-medium wp-image-53764\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/young_frances-173x253.jpg\" alt=\"young_frances\" width=\"161\" height=\"234\">\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>What got you interested in forests in the first place?\u003c/strong>\u003c/p>\n\u003cp>Growing up in Chapel Hill, [North Carolina] I was always interested in nature and I tried to think of careers that could enable me to indulge that hobby. So when I was at UNC, I majored in zoology and thought about being a wildlife veterinarian as a way to be outside. I was in graduate school at the time when tropical forests were just exploding onto the international consciousness. This was back in the era of Rainforest Crunch and the lead-up to the first \u003ca href=\"http://www.worldsummit2002.org/index.htm?http://www.worldsummit2002.org/guide/unced.htm\">Rio Earth Summit\u003c/a> in 1992, when everybody was concerned about tropical biodiversity and indigenous peoples. So I ended up being caught up in all that and making a career out of it.\u003c/p>\n\u003cp>\u003cstrong>What are some of the human and ecological costs of deforestation?\u003c/strong>\u003c/p>\n\u003cp>When forests are lost, that means the loss of a lot of things that local communities depend on. At the local level this includes access to timber and non-timber forest products. At the landscape level forests provide various ecosystem services, like keeping clean waters in streams year-round and regulating rainfall patterns. Last but not least are the global-level human impacts. It’s estimated that greenhouse gas emissions from tropical deforestation and other land-use changes are a \u003ca href=\"http://scitechdaily.com/deforestation-adds-more-atmospheric-co2-than-the-sum-total-of-cars-trucks-on-the-worlds-roads/\">greater source of [C02] release\u003c/a> than all of the planes, trains, automobiles emissions combined.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What poses the biggest risk to our forests: chopsticks, toothpicks, or toilet paper?\u003c/strong>\u003c/p>\n\u003cp>I would say “none of the above,” because some of the fastest and most damaging deforestation taking place right now is caused by the palm oil industry. So maybe the answer would be “your doughnuts.”\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/IMG_6852.jpg\">\u003cimg class=\"alignleft size-medium wp-image-54321\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/IMG_6852-337x253.jpg\" alt=\"IMG_6852\" width=\"337\" height=\"253\">\u003c/a>Palm oil is one of those commodities that is mostly used as an edible oil. In Asia, it’s the most commonly used oil for frying things. But in our supermarkets, it’s in, like, half the products, ranging from shampoo to peanut butter to doughnuts. And so that’s probably the greatest threat to tropical forests right now.\u003c/p>\n\u003cp>\u003cstrong>Is palm oil a relatively new commodity, at least on this scale?\u003c/strong>\u003c/p>\n\u003cp>Palm oil has been produced on an industrial scale in Indonesia and Malaysia for a long time, but the price of it has rapidly escalated. The prospect of new markets for palm oil-based biodiesel have also come on the horizon and so the incentives to invest in palm plantations have increased in recent years.\u003c/p>\n\u003cfigure id=\"attachment_54323\" class=\"wp-caption alignright\" style=\"max-width: 378px\">\u003cimg class=\"size-medium wp-image-54323\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/5701875645_79296910b5_b-378x253.jpg\" alt=\"Photo by Ryan Woo/CIFOR\" width=\"378\" height=\"253\">\u003cfigcaption class=\"wp-caption-text\">Photo by Ryan Woo/CIFOR\u003c/figcaption>\u003c/figure>\n\u003cfigure id=\"attachment_54324\" class=\"wp-caption alignright\" style=\"max-width: 380px\">\u003cimg class=\"size-medium wp-image-54324\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/5038663408_7f760da960_b-380x253.jpg\" alt=\"Photo by Daniel Murdiyarso/CIFOR\" width=\"380\" height=\"253\">\u003cfigcaption class=\"wp-caption-text\">Photo by Daniel Murdiyarso/CIFOR\u003c/figcaption>\u003c/figure>\n\u003cp>Palm oil production is responsible for significant deforestation in both of those places and, most recently, it’s begun to expand to other regions. It feels like almost every day I read a news release about another deal being done for tens or hundreds of thousands of hectares in Central Africa to be converted to an oil palm plantation. And the particular concern in a place like Indonesia is that a lot of this palm oil is being planted on peatland swamp forests. These peat swamps can be standing on layers of organic matter that has accumulated over thousands of years. They can be more than 30 feet deep.\u003c/p>\n\u003cp>\u003cstrong>Thirty feet deep. That’s incredible.\u003c/strong>\u003c/p>\n\u003cp>Think about that for a minute. When you drain and burn a peatland forest in order to plant palm oil or pulp and paper—not only do you have the pulse of emissions from the initial burning of the surface vegetation going into the atmosphere, but that organic matter that was locked up underground is suddenly liberated, releasing greenhouse gases into the air as it oxidizes and decomposes. And so the amount of carbon per hectare released into the atmosphere is many, many, many times greater than an equivalent hectare of forest not on peat swamp soils.\u003c/p>\n\u003cp>\u003cstrong>What’s the best way to balance sustaining the health of a forest and giving forest-dependent communities control of their resources?\u003c/strong>\u003c/p>\n\u003cp>\u003cimg class=\"alignleft size-medium wp-image-53769\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/DSCN0831-198x253.jpg\" alt=\"DSCN0831\" width=\"153\" height=\"197\">I guess I would challenge the premise of the question in the following way: one of the great misconceptions about tropical deforestation is that it’s the local people who are responsible for deforestation. Communities don’t need to be convinced of the value of forest because they’re the ones who hunt in the forest and fish in the forest and gather rattan from the forest. They’re the ones who suffer when the logging trucks come in. So it’s kind of galling to blame deforestation on local communities when, in fact, the people who are profiting from deforestation tend to be elites from capital cities.\u003c/p>\n\u003cp>\u003cstrong>I love that you challenged me on that.\u003c/strong>\u003c/p>\n\u003cp>You can tell I’m not shy.\u003c/p>\n\u003cp>\u003cstrong>Agriculture, specifically livestock grazing, contributes to deforestation. Are you a vegetarian?\u003c/strong>\u003c/p>\n\u003cp>[LAUGHS] No, I’m not. Yes, it is true overall that agricultural expansion is one of the key drivers of deforestation around the world. In terms of the cattle production in the Amazon, there’s been a big effort recently to try to \u003ca href=\"http://grsbeef.org/\">shift beef production to deforestation-free methods\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>People that are reading this might want to know what they can do to prevent deforestation. Should they buy forest-certified lumber? Eat local meat? Eat fewer doughnuts?\u003c/strong>\u003c/p>\n\u003cp>With specific reference to tropical deforestation, I think there are two things: One is to be a constituency for active U.S. engagement. And then, as individual consumers, yes, it does make a difference. Buy sustainably produced \u003ca href=\"https://us.fsc.org/\">FSC-certified\u003c/a> wood products. And hopefully, over time, we’ll have credible certification systems for some of these other commodities that can be certified deforestation-free.\u003c/p>\n\u003cp>\u003cstrong>Did you read The Giving Tree as a kid?\u003c/strong>\u003c/p>\n\u003cp>Did not.\u003c/p>\n\u003cp>\u003cstrong>\u003cimg class=\"alignright size-medium wp-image-53771\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2013/03/Malinau-DG-168x253.jpg\" alt=\"Malinau-DG\" width=\"160\" height=\"240\">If trees could talk, what would they say to the humans right now on this planet?\u003c/strong>\u003cbr>\nTrees have a self-interest in controlling climate change. So in addition to, “Don’t cut me down,” trees would also say, “Please protect the climate,” because forests are also vulnerable to climate change. With a changing climate, forests are experiencing drought and new invasions of pests that we have haven’t seen before. And so they would be saying, “If you want to keep forests around, you need to protect the climate.” So it’s sort of the opposite of what we’ve been talking about, “If you want to protect the climate, protect forests,” but it works the other way too.\u003c/p>\n\u003cp>\u003cem>*This interview has been condensed and edited.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours ",
"title": "Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours ",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_12715\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/foreignoffice/7296732418/\">\u003cimg class=\"size-large wp-image-12715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/angelinajolie_foreignandcommonwealthoffice-620x603.jpg\" alt=\"(Foreign and Commonwealth Office/Flickr)\" width=\"620\" height=\"603\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Foreign and Commonwealth Office/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, \"\u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">My Medical Choice\u003c/a>.\"\u003c/p>\n\u003cp>But the key here is a\u003cem> specific\u003c/em> BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that \"the risk is different in the case of each woman.\"\u003c/p>\n\u003cp>About \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">10 percent\u003c/a> of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, \u003ca href=\"http://acspressroom.wordpress.com/2013/05/14/jolie/\" target=\"_blank\">explains in more detail\u003c/a> what individual women should consider, in a response to Jolie's piece:\u003c/p>\n\u003cblockquote>\u003cp>This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.\u003c!--more-->\u003c/p>\n\u003cp>Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.\u003c/p>\n\u003cp>A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.\u003c/p>\n\u003cp>Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer.\u003c/p>\n\u003cp>Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that 'only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.' Nonetheless, after careful consideration, this might be the right choice for some women.\u003c/p>\u003c/blockquote>\n\u003cp>For some women, yes. But, while mutations in the BRCA genes are fairly rare, the majority of women opting for preventive mastectomy are not at elevated risk, as \u003ca href=\"http://www.npr.org/blogs/health/2013/05/14/183892507/angelina-jolie-and-the-rise-of-preventive-mastectomies\" target=\"_blank\">NPR's Shots blog notes\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"We found that women who have cancer in one breast overestimate their risk of cancer in the other breast by sixfold,\" says \u003ca href=\"http://www.surg.umn.edu/Faculty_Alpha/tuttle_todd_m/home.html\">Todd Tuttle\u003c/a>, chief of surgical oncology at the University of Minnesota. \"It's very exaggerated.\" ...\u003c/p>\n\u003cp>Increased awareness of breast cancer due to the ubiquitous pink ribbon campaigns could be fueling the rise in prophylactic mastectomies, some people say. \"Women have this exaggerated perceived risk of getting breast cancer,\" Tuttle told Shots. \"They see breast cancer everywhere.\"\u003c/p>\n\u003cp>There has not been an increase in prophylactic mastectomy in Europe, Tuttle notes, though women there have access to the same surgery and reconstruction. \"I wonder if part of the difference is this hyperawareness of breast cancer.\"\u003c/p>\u003c/blockquote>\n\u003cp>Berkeley-based journalist Peggy Orenstein \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">took on the hyperawareness\u003c/a> of breast cancer in another New York Times venue, its Sunday magazine. Orenstein was first diagnosed with breast cancer 16 years ago. She had a lumpectomy plus radiation, then suffered a recurrence last year. Her only option was mastectomy, which she had on the affected breast. Yet she opted against preventive mastectomy on the other side. \u003ca href=\"http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0\" target=\"_blank\">From her article\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>My first instinct this round was to have my other breast removed as well — I never wanted to go through this again. My oncologist argued against it. The tamoxifen would lower my risk of future disease to that of an average woman, he said. Would an average woman cut off her breasts? I could have preventive surgery if I wanted to, he added, but it would be a psychological decision, not a medical one.\u003c/p>\n\u003cp>I weighed the options as my hospital date approached. Average risk, after all, is not zero. Could I live with that? Part of me still wanted to extinguish all threat. I have a 9-year-old daughter; I would do anything — I need to do \u003cem>everything\u003c/em> — to keep from dying. Yet, if death was the issue, the greatest danger wasn’t my other breast. It is that, despite treatment and a good prognosis, the cancer I’ve already had has metastasized. Preventive mastectomy wouldn’t change that; nor would it entirely eliminate the possibility of new disease, because there’s always some tissue left behind.\u003c/p>\n\u003cp>What did doing “everything” mean, anyway? There are days when I skip sunscreen. I don’t exercise as much as I should. I haven’t given up aged Gouda despite my latest cholesterol count; I don’t get enough calcium. And, oh, yeah, my house is six blocks from a fault line. Is living with a certain amount of breast-cancer risk really so different? I decided to take my doctor’s advice, to do only what had to be done.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, at Breast Cancer Action, spokeswoman Angela Wall points out that Jolie had access to \"all the information she needs.\" But in the interest of stating the obvious, that is not the case for every woman.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The genetic test for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/12/breast-cancer-gene-mutations-at-heart-of-supreme-court-case/\" target=\"_blank\">BRCA mutations\u003c/a> is held tightly by Myriad Genetics, so tightly that \u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\">a case questioning whether human genes are patentabl\u003c/a>e has made it the U.S. Supreme Court. Wall says that laboratories across the country could offer a comparable test for a fraction of the cost -- potentially opening up the test to more women -- but Myriad will not license it, making its $3,000 test a monopoly.\u003c/p>\n\u003cp>While Wall is supportive of Jolie's decision (\"This is an impossible decision and women do not make this choice lightly\"), she says the answer to breast cancer is not prophylactic mastectomy, it's prevention.\u003c/p>\n\u003cp>\"It we want to get really serious about preventing breast cancer,\" she practically fumed over the phone, \"we need to do a lot more than celebrating a woman who has preventive mastectomy. ... What about all the other risk factors? The environmental risk factors?\" She advocates that what is needed are strong regulations to limit or ban known toxins that cause breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://health.clevelandclinic.org/2012/10/breast-cancer-do-your-genes-put-you-at-risk/?utm_campaign=cc+tweets&utm_medium=social&utm_source=twitter&utm_content=130514+breast+cancer+genes&dynid=twitter-_-cc+tweets-_-social-_-social-_-130514+breast+cancer+genes\" target=\"_blank\">Breast Cancer -- Do Your Genes Put You At Risk? \u003c/a>(Cleveland Clinic)\u003c/p>\n\n",
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"excerpt": "Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times op-ed piece.\r\n\r\nBut the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolile is very careful to walk through all her personal decisions stemming from her unusually high risk but qualifies that \"the risk is different in the case of each woman.\"",
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"description": "Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times op-ed piece.\r\n\r\nBut the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolile is very careful to walk through all her personal decisions stemming from her unusually high risk but qualifies that "the risk is different in the case of each woman."",
"title": "Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12715\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/foreignoffice/7296732418/\">\u003cimg class=\"size-large wp-image-12715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/angelinajolie_foreignandcommonwealthoffice-620x603.jpg\" alt=\"(Foreign and Commonwealth Office/Flickr)\" width=\"620\" height=\"603\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Foreign and Commonwealth Office/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, \"\u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">My Medical Choice\u003c/a>.\"\u003c/p>\n\u003cp>But the key here is a\u003cem> specific\u003c/em> BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that \"the risk is different in the case of each woman.\"\u003c/p>\n\u003cp>About \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">10 percent\u003c/a> of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, \u003ca href=\"http://acspressroom.wordpress.com/2013/05/14/jolie/\" target=\"_blank\">explains in more detail\u003c/a> what individual women should consider, in a response to Jolie's piece:\u003c/p>\n\u003cblockquote>\u003cp>This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.\u003c!--more-->\u003c/p>\n\u003cp>Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.\u003c/p>\n\u003cp>A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.\u003c/p>\n\u003cp>Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer.\u003c/p>\n\u003cp>Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that 'only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.' Nonetheless, after careful consideration, this might be the right choice for some women.\u003c/p>\u003c/blockquote>\n\u003cp>For some women, yes. But, while mutations in the BRCA genes are fairly rare, the majority of women opting for preventive mastectomy are not at elevated risk, as \u003ca href=\"http://www.npr.org/blogs/health/2013/05/14/183892507/angelina-jolie-and-the-rise-of-preventive-mastectomies\" target=\"_blank\">NPR's Shots blog notes\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"We found that women who have cancer in one breast overestimate their risk of cancer in the other breast by sixfold,\" says \u003ca href=\"http://www.surg.umn.edu/Faculty_Alpha/tuttle_todd_m/home.html\">Todd Tuttle\u003c/a>, chief of surgical oncology at the University of Minnesota. \"It's very exaggerated.\" ...\u003c/p>\n\u003cp>Increased awareness of breast cancer due to the ubiquitous pink ribbon campaigns could be fueling the rise in prophylactic mastectomies, some people say. \"Women have this exaggerated perceived risk of getting breast cancer,\" Tuttle told Shots. \"They see breast cancer everywhere.\"\u003c/p>\n\u003cp>There has not been an increase in prophylactic mastectomy in Europe, Tuttle notes, though women there have access to the same surgery and reconstruction. \"I wonder if part of the difference is this hyperawareness of breast cancer.\"\u003c/p>\u003c/blockquote>\n\u003cp>Berkeley-based journalist Peggy Orenstein \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">took on the hyperawareness\u003c/a> of breast cancer in another New York Times venue, its Sunday magazine. Orenstein was first diagnosed with breast cancer 16 years ago. She had a lumpectomy plus radiation, then suffered a recurrence last year. Her only option was mastectomy, which she had on the affected breast. Yet she opted against preventive mastectomy on the other side. \u003ca href=\"http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0\" target=\"_blank\">From her article\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>My first instinct this round was to have my other breast removed as well — I never wanted to go through this again. My oncologist argued against it. The tamoxifen would lower my risk of future disease to that of an average woman, he said. Would an average woman cut off her breasts? I could have preventive surgery if I wanted to, he added, but it would be a psychological decision, not a medical one.\u003c/p>\n\u003cp>I weighed the options as my hospital date approached. Average risk, after all, is not zero. Could I live with that? Part of me still wanted to extinguish all threat. I have a 9-year-old daughter; I would do anything — I need to do \u003cem>everything\u003c/em> — to keep from dying. Yet, if death was the issue, the greatest danger wasn’t my other breast. It is that, despite treatment and a good prognosis, the cancer I’ve already had has metastasized. Preventive mastectomy wouldn’t change that; nor would it entirely eliminate the possibility of new disease, because there’s always some tissue left behind.\u003c/p>\n\u003cp>What did doing “everything” mean, anyway? There are days when I skip sunscreen. I don’t exercise as much as I should. I haven’t given up aged Gouda despite my latest cholesterol count; I don’t get enough calcium. And, oh, yeah, my house is six blocks from a fault line. Is living with a certain amount of breast-cancer risk really so different? I decided to take my doctor’s advice, to do only what had to be done.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, at Breast Cancer Action, spokeswoman Angela Wall points out that Jolie had access to \"all the information she needs.\" But in the interest of stating the obvious, that is not the case for every woman.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
},
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"title": "Forum",
"tagline": "The conversation starts here",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"meta": {
"site": "radio",
"source": "WNYC"
},
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
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"link": "/radio/program/hidden-brain",
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"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
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"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
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"officialWebsiteLink": "/perspectives/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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