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"content": "\u003cp>Among hundreds of HIV-negative people using pre-exposure prophylaxis, known as PrEP, there were no new HIV infections over a two-and-a-half-year period, according to \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/09/01/cid.civ778.abstract\" target=\"_blank\">an analysis \u003c/a>by researchers at Kaiser San Francisco published Wednesday.\u003c/p>\n\u003cp>In the study, researchers at Kaiser San Francisco followed 657 of its patients who were referred for PrEP and then followed the regimen. In an interview, lead author Dr. Jonathan Volk, an infectious disease specialist with Kaiser called the results \"incredibly exciting.\"\u003c/p>\n\u003cp>\"I was optimistic, but this is even more ... reassuring than I had expected initially,\" he said. \"It really reinforces how well this medication can work to help reduce risk for HIV for patients who are using it daily.\"\u003c/p>\n\u003cp>In the study, published in Clinical Infectious Diseases, almost all the participants -- 99 percent -- were men who have sex with men.\u003c/p>\n\u003cp>In 2012, the FDA \u003ca href=\"http://ww2.kqed.org/news/2012/07/16/fda-approves-truvada-as-first-medication-to-reduce-hiv-risk-in-healthy-people\" target=\"_blank\">approved the drug Truvada\u003c/a> to help people who are HIV-negative to avoid becoming infected. While studies showed it to be highly effective, some advocates were concerned that use of the drug would lead to unsafe behavior -- and HIV infection.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"Z3PBxmIAbFpdzMPl82A4D1i3wxvUuOkG\"]Yet in 2014, the U.S. Public Health Service published guidelines for PrEP and in July, President Obama \u003ca href=\"https://www.whitehouse.gov/the-press-office/2015/07/30/fact-sheet-national-hivaids-strategy-updated-2020\" target=\"_blank\">signed an executive order\u003c/a> updating the National HIV/AIDS Strategy to include full access to PrEP for those who want it.\u003c/p>\n\u003cp>Volk said the Kaiser study is significant in part because of the success during real-world application. Researchers tracked condom use and sexually transmitted infections and found that 41 percent of participants reported a decrease in their use of condoms, and half were diagnosed with a sexually transmitted disease in the first year after starting PrEP.\u003c/p>\n\u003cp>\"The fact that we've seen as many sexually transmitted infections as we have and not seen any new HIV infections really reinforces that this medication seems to work very well, even in a high-risk setting,\" Volk said.\u003c/p>\n\u003cp>\u003cstrong>\"Remarkable Study\"\u003c/strong>\u003c/p>\n\u003cp>Dr. Susan Buchbinder is director of the HIV Research Section for the San Francisco Department of Public Health and was not involved with the analysis.\u003c/p>\n\u003cp>\"It's a remarkable study,\" she said. \"It's critically important. This really demonstrates that in a ... very busy clinical setting, the systems can be developed to adequately and accurately screen people for PrEP, put them on PrEP, and follow them over time.\"\u003c/p>\n\u003cp>Paul Marcelin started PrEP in July, 2013 as part of a separate one-year study. When that wrapped up, Marcelin, 40, who lives in Alameda but is a Kaiser San Francisco patient, continued on PrEP with Kaiser.\u003c/p>\n\u003cp>\"It's been wonderful to receive this care from my regular provider,\" he said in an interview.\u003c/p>\n\u003cp>Marcelin's boyfriend of one year is HIV positive. Fifteen years ago, Marcelin said he dated another man who was HIV positive. \"It was a barrier in our sex life and in our intimacy,\" he said. \"It's amazing to think that today I've met a new person, an amazing person, and we don't have any fear. We have a completely natural sex life.\"\u003c/p>\n\u003cp>Marcelin says he's experienced no side effects from taking Truvada. It is recommended that anyone on Truvada is tested for HIV and other sexually transmitted infections every three months. Patients are also monitored for drug side effects, especially changes in kidney function.\u003c/p>\n\u003cp>\u003cstrong>Stigma Remains\u003c/strong>\u003c/p>\n\u003cp>Despite the success of PrEP as a preventive, stigma remains. People who take PrEP are sometimes viewed as promiscuous, Marcelin told me. \"People say, 'Why are you not just using condoms?' ... Sometimes people say, 'You must be slut.' So there's negative stigma.\"\u003c/p>\n\u003cp>Another barrier may be cost -- $15,000 annually or $1,250 per month. Insurance does cover at least some of the cost, but how much is dependent on the type of insurance an individual has. Gilead, which makes Truvada, will reimburse patients up to $300 per month. Marcelin's cost sharing after his Kaiser plan is $35 per month, and he says Gilead reimburses that.\u003c/p>\n\u003cp>[contextly_sidebar id=\"TYpef1eMvxU4HPsSLQDHrpynDtuBeiCQ\"]Buchbinder helps direct an ambitious campaign to eliminate new HIV infections in San Francisco called \u003ca href=\"http://www.gettingtozerosf.org\" target=\"_blank\">Getting to Zero\u003c/a>. For years, new infections have been declining. Between 2006 and 2014, new infections in men who have sex with men fell from 357 to 221, nearly a 40 percent decline. The decline in new infections by race/ethnicity are also significant. Again, new HIV infections declined as follows, from 2006 to 2014:\u003c/p>\n\u003cul>\n\u003cli>Whites: 278 to 136\u003c/li>\n\u003cli>African American: 75 to 33\u003c/li>\n\u003cli>Latino: 113 to 82\u003c/li>\n\u003c/ul>\n\u003cp>PrEP is a strong component of the campaign, but it's \"really the culmination of many, many different things that the city has been doing in particular over the last five years,\" Buchbinder said. \u003cstrong>\u003cem> \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>Kaiser is continuing to monitor its patients on PrEP. Demand for PrEP is growing. Volk said that at the time the analysis was submitted, there were the 600-plus patients, today it's closer to 900.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What is exciting for me as a clinician,\" Volk said \"is now I have many different tools I can use to help prevent HIV, and PrEP is one of them. PrEP is probably not right for all my patients ... but it is for many of them.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Among hundreds of HIV-negative people using pre-exposure prophylaxis, known as PrEP, there were no new HIV infections over a two-and-a-half-year period, according to \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/09/01/cid.civ778.abstract\" target=\"_blank\">an analysis \u003c/a>by researchers at Kaiser San Francisco published Wednesday.\u003c/p>\n\u003cp>In the study, researchers at Kaiser San Francisco followed 657 of its patients who were referred for PrEP and then followed the regimen. In an interview, lead author Dr. Jonathan Volk, an infectious disease specialist with Kaiser called the results \"incredibly exciting.\"\u003c/p>\n\u003cp>\"I was optimistic, but this is even more ... reassuring than I had expected initially,\" he said. \"It really reinforces how well this medication can work to help reduce risk for HIV for patients who are using it daily.\"\u003c/p>\n\u003cp>In the study, published in Clinical Infectious Diseases, almost all the participants -- 99 percent -- were men who have sex with men.\u003c/p>\n\u003cp>In 2012, the FDA \u003ca href=\"http://ww2.kqed.org/news/2012/07/16/fda-approves-truvada-as-first-medication-to-reduce-hiv-risk-in-healthy-people\" target=\"_blank\">approved the drug Truvada\u003c/a> to help people who are HIV-negative to avoid becoming infected. While studies showed it to be highly effective, some advocates were concerned that use of the drug would lead to unsafe behavior -- and HIV infection.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Yet in 2014, the U.S. Public Health Service published guidelines for PrEP and in July, President Obama \u003ca href=\"https://www.whitehouse.gov/the-press-office/2015/07/30/fact-sheet-national-hivaids-strategy-updated-2020\" target=\"_blank\">signed an executive order\u003c/a> updating the National HIV/AIDS Strategy to include full access to PrEP for those who want it.\u003c/p>\n\u003cp>Volk said the Kaiser study is significant in part because of the success during real-world application. Researchers tracked condom use and sexually transmitted infections and found that 41 percent of participants reported a decrease in their use of condoms, and half were diagnosed with a sexually transmitted disease in the first year after starting PrEP.\u003c/p>\n\u003cp>\"The fact that we've seen as many sexually transmitted infections as we have and not seen any new HIV infections really reinforces that this medication seems to work very well, even in a high-risk setting,\" Volk said.\u003c/p>\n\u003cp>\u003cstrong>\"Remarkable Study\"\u003c/strong>\u003c/p>\n\u003cp>Dr. Susan Buchbinder is director of the HIV Research Section for the San Francisco Department of Public Health and was not involved with the analysis.\u003c/p>\n\u003cp>\"It's a remarkable study,\" she said. \"It's critically important. This really demonstrates that in a ... very busy clinical setting, the systems can be developed to adequately and accurately screen people for PrEP, put them on PrEP, and follow them over time.\"\u003c/p>\n\u003cp>Paul Marcelin started PrEP in July, 2013 as part of a separate one-year study. When that wrapped up, Marcelin, 40, who lives in Alameda but is a Kaiser San Francisco patient, continued on PrEP with Kaiser.\u003c/p>\n\u003cp>\"It's been wonderful to receive this care from my regular provider,\" he said in an interview.\u003c/p>\n\u003cp>Marcelin's boyfriend of one year is HIV positive. Fifteen years ago, Marcelin said he dated another man who was HIV positive. \"It was a barrier in our sex life and in our intimacy,\" he said. \"It's amazing to think that today I've met a new person, an amazing person, and we don't have any fear. We have a completely natural sex life.\"\u003c/p>\n\u003cp>Marcelin says he's experienced no side effects from taking Truvada. It is recommended that anyone on Truvada is tested for HIV and other sexually transmitted infections every three months. Patients are also monitored for drug side effects, especially changes in kidney function.\u003c/p>\n\u003cp>\u003cstrong>Stigma Remains\u003c/strong>\u003c/p>\n\u003cp>Despite the success of PrEP as a preventive, stigma remains. People who take PrEP are sometimes viewed as promiscuous, Marcelin told me. \"People say, 'Why are you not just using condoms?' ... Sometimes people say, 'You must be slut.' So there's negative stigma.\"\u003c/p>\n\u003cp>Another barrier may be cost -- $15,000 annually or $1,250 per month. Insurance does cover at least some of the cost, but how much is dependent on the type of insurance an individual has. Gilead, which makes Truvada, will reimburse patients up to $300 per month. Marcelin's cost sharing after his Kaiser plan is $35 per month, and he says Gilead reimburses that.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Buchbinder helps direct an ambitious campaign to eliminate new HIV infections in San Francisco called \u003ca href=\"http://www.gettingtozerosf.org\" target=\"_blank\">Getting to Zero\u003c/a>. For years, new infections have been declining. Between 2006 and 2014, new infections in men who have sex with men fell from 357 to 221, nearly a 40 percent decline. The decline in new infections by race/ethnicity are also significant. Again, new HIV infections declined as follows, from 2006 to 2014:\u003c/p>\n\u003cul>\n\u003cli>Whites: 278 to 136\u003c/li>\n\u003cli>African American: 75 to 33\u003c/li>\n\u003cli>Latino: 113 to 82\u003c/li>\n\u003c/ul>\n\u003cp>PrEP is a strong component of the campaign, but it's \"really the culmination of many, many different things that the city has been doing in particular over the last five years,\" Buchbinder said. \u003cstrong>\u003cem> \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>Kaiser is continuing to monitor its patients on PrEP. Demand for PrEP is growing. Volk said that at the time the analysis was submitted, there were the 600-plus patients, today it's closer to 900.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What is exciting for me as a clinician,\" Volk said \"is now I have many different tools I can use to help prevent HIV, and PrEP is one of them. PrEP is probably not right for all my patients ... but it is for many of them.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Dr. David Sretavan sees many patients who have difficulty seeing him.\u003c/p>\n\u003cp>A professor of ophthalmology at the University of California San Francisco, Sretavan treats nerve damage related to glaucoma, a disease that’s the leading cause of irreversible blindness. It affects approximately 70 million people worldwide.\u003c/p>\n\u003cp>Glaucoma is a complex eye disease without a direct cause. Physicians measure pressure inside the eye to assess glaucoma risk. But that pressure normally fluctuates over time and there’s no easy way to measure pressure regularly, especially for elderly patients who often have a hard time making it to his office.\u003c/p>\n\u003cp>Pressure monitors are “fairly crude,” Sretavan says, and require a skilled operator, so it’s not something patients can do at home. Yet without regular measurements, he says, “we’re operating in the dark ages, in terms of information we can use clinically.”\u003c/p>\n\u003cfigure id=\"attachment_33697\" class=\"wp-caption alignright\" style=\"max-width: 487px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-33697\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/Sretavanresearch1.jpg\" alt=\"A prototype micro-workstation for nerve fiber surgery.\" width=\"487\" height=\"336\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2015/09/Sretavanresearch1.jpg 487w, https://cdn.kqed.org/wp-content/uploads/sites/13/2015/09/Sretavanresearch1-400x276.jpg 400w\" sizes=\"auto, (max-width: 487px) 100vw, 487px\">\u003cfigcaption class=\"wp-caption-text\">A prototype micro-workstation for nerve fiber surgery. \u003ccite>(Dr. David Sretavan )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>To make measuring pressure easier, Sretavan and teams of researchers at UCSF are trying to make their tools smaller. The team is designing a tiny sensor that reflects light and could possibly be anchored into the tissue of the iris. The result would be ocular pressure measurements that wouldn’t require a trip to the doctor’s office.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Sretavan’s ocular sensor is one example of an industry trend that’s driving the convergence of biomedicine and nanotechnology. Tiny, highly sensitive chips could replace otherwise invasive procedures and clunky machinery, while driving down the cost of testing and bringing health care closer to home.\u003c/p>\n\u003cp>“I firmly believe that the next 50 years are going to be the stunning revolution of health,” says Hanmin Lee, professor of surgery and director of the Fetal Treatment Center at UCSF.\u003c/p>\n\u003cp>Many new sensor technologies are being used to monitor medical issues that were otherwise time-consuming for hospital staff. For example, a team of researchers and bioengineers at UCSF has developed a Band-Aid-like pressure sensor to monitor which patients might be at risk for bed sores. Nurses are able to check patients on a digital health platform that monitors patient vital signs.\u003c/p>\n\u003cp>“Nobody thinks of pressure as a vital sign,” Lee says, “but if you have pressure on a body part that leads to huge complication, or in some instances death, why wouldn’t you monitor for it.”\u003c/p>\n\u003caside class=\"pullquote alignright\">“I firmly believe that the next 50 years are going to be the stunning revolution of health.”\u003cbr>\n\u003ccite>Hanmin Lee, professor of surgery and director of the Fetal Treatment Center at UCSF.\u003c/cite>\u003c/aside>\n\u003cp>Other applications for pressure sensors include monitoring the strain put on orthopedic devices, or monitoring the force a child puts on their teeth when wearing a retainer. Plus, Lee adds, a sensor that’s small and robust enough can help a patient avoid the risks associated with surgery.\u003c/p>\n\u003cp>“Pressure’s being monitored invasively in medicine,” he says, “sometimes underneath the skin or body cavity or brain, which is inaccessible and requires invasive surgical measures.”\u003c/p>\n\u003cp>While UCSF professors envision a future for dedicated sensors, a UC San Diego graduate researcher takes a systemic view to the future of biotechnology.\u003c/p>\n\u003cp>“Right now we have all these physical sensors that can monitor heart rate or temperature, but there’s not one single wearable sensor that can monitor several parameters,” says Amay Bandodkar. “When you want to analyze the entire human body you have to monitor several parameters simultaneously.”\u003c/p>\n\u003cp>Bandodkar also points to several sensor projects for monitoring a specific disease. UCSD researchers have developed \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/06/30/this-smart-pen-could-revolutionize-diabetes-treatment/\">conductive inks\u003c/a> that respond to glucose proteins in the skin, allowing people to monitor glucose non-invasively, for diabetes treatment. Others from Columbia University created a \u003ca href=\"http://www.wired.com/2015/02/hiv-diagnostic-tool/\">smartphone accessory to detect HIV\u003c/a>, using a specialized sensor with biomarkers for the disease.\u003c/p>\n\u003cp>Portable sensors that can be integrated directly onto a mobile devices to track specific illnesses will have a high impact on developing nations, Bandodkar says, where medical professionals and resources are scarce.\u003c/p>\n\u003cp>Specialized \u003ca href=\"http://ne.ucsd.edu/faculty/l7zhang/research.php\">drug delivery systems\u003c/a>—for example, microscopic motors that could travel through the bloodstream—will also play a big role in the future of medicine, Bandodkar says. These systems could travel to a particular location in the body to deliver medicine, for example, to clear plaque deposits in arteries, or control infections by screening proteins in the blood.\u003c/p>\n\u003cp>Although advances in manufacturing and cloud computing have made medical sensors a reality, there are roadblocks to mass adoption.\u003c/p>\n\u003cp>One complication is the collaboration that must happen between industries, says Venkat Rajan, global director of visionary healthcare for analyst firm Frost & Sullivan.\u003c/p>\n\u003cp>“If you’re connecting something through a mobile device,” he says, “you’re having to interact with a telecom company or smartphone manufacture. It’s not necessarily something a lot of healthcare companies have done before.”\u003c/p>\n\u003cp>Also, currently the FDA allows many wearable medical devices to be tested and used in trials, without the official federal seal of approval. A change in that policy could impede progress in the engineering field, says Shuvo Roy, who directs UCSF’s Biodesign Laboratory.\u003c/p>\n\u003cp>Nonetheless, Roy and Lee are hopeful about the potential for sensor technologies in medicine.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’re excited about being able to combine two very disparate fields,” Lee says. “I think there’s a lot of other things we’re going to monitor that people haven’t monitored before.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. David Sretavan sees many patients who have difficulty seeing him.\u003c/p>\n\u003cp>A professor of ophthalmology at the University of California San Francisco, Sretavan treats nerve damage related to glaucoma, a disease that’s the leading cause of irreversible blindness. It affects approximately 70 million people worldwide.\u003c/p>\n\u003cp>Glaucoma is a complex eye disease without a direct cause. Physicians measure pressure inside the eye to assess glaucoma risk. But that pressure normally fluctuates over time and there’s no easy way to measure pressure regularly, especially for elderly patients who often have a hard time making it to his office.\u003c/p>\n\u003cp>Pressure monitors are “fairly crude,” Sretavan says, and require a skilled operator, so it’s not something patients can do at home. Yet without regular measurements, he says, “we’re operating in the dark ages, in terms of information we can use clinically.”\u003c/p>\n\u003cfigure id=\"attachment_33697\" class=\"wp-caption alignright\" style=\"max-width: 487px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-33697\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/Sretavanresearch1.jpg\" alt=\"A prototype micro-workstation for nerve fiber surgery.\" width=\"487\" height=\"336\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2015/09/Sretavanresearch1.jpg 487w, https://cdn.kqed.org/wp-content/uploads/sites/13/2015/09/Sretavanresearch1-400x276.jpg 400w\" sizes=\"auto, (max-width: 487px) 100vw, 487px\">\u003cfigcaption class=\"wp-caption-text\">A prototype micro-workstation for nerve fiber surgery. \u003ccite>(Dr. David Sretavan )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>To make measuring pressure easier, Sretavan and teams of researchers at UCSF are trying to make their tools smaller. The team is designing a tiny sensor that reflects light and could possibly be anchored into the tissue of the iris. The result would be ocular pressure measurements that wouldn’t require a trip to the doctor’s office.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sretavan’s ocular sensor is one example of an industry trend that’s driving the convergence of biomedicine and nanotechnology. Tiny, highly sensitive chips could replace otherwise invasive procedures and clunky machinery, while driving down the cost of testing and bringing health care closer to home.\u003c/p>\n\u003cp>“I firmly believe that the next 50 years are going to be the stunning revolution of health,” says Hanmin Lee, professor of surgery and director of the Fetal Treatment Center at UCSF.\u003c/p>\n\u003cp>Many new sensor technologies are being used to monitor medical issues that were otherwise time-consuming for hospital staff. For example, a team of researchers and bioengineers at UCSF has developed a Band-Aid-like pressure sensor to monitor which patients might be at risk for bed sores. Nurses are able to check patients on a digital health platform that monitors patient vital signs.\u003c/p>\n\u003cp>“Nobody thinks of pressure as a vital sign,” Lee says, “but if you have pressure on a body part that leads to huge complication, or in some instances death, why wouldn’t you monitor for it.”\u003c/p>\n\u003caside class=\"pullquote alignright\">“I firmly believe that the next 50 years are going to be the stunning revolution of health.”\u003cbr>\n\u003ccite>Hanmin Lee, professor of surgery and director of the Fetal Treatment Center at UCSF.\u003c/cite>\u003c/aside>\n\u003cp>Other applications for pressure sensors include monitoring the strain put on orthopedic devices, or monitoring the force a child puts on their teeth when wearing a retainer. Plus, Lee adds, a sensor that’s small and robust enough can help a patient avoid the risks associated with surgery.\u003c/p>\n\u003cp>“Pressure’s being monitored invasively in medicine,” he says, “sometimes underneath the skin or body cavity or brain, which is inaccessible and requires invasive surgical measures.”\u003c/p>\n\u003cp>While UCSF professors envision a future for dedicated sensors, a UC San Diego graduate researcher takes a systemic view to the future of biotechnology.\u003c/p>\n\u003cp>“Right now we have all these physical sensors that can monitor heart rate or temperature, but there’s not one single wearable sensor that can monitor several parameters,” says Amay Bandodkar. “When you want to analyze the entire human body you have to monitor several parameters simultaneously.”\u003c/p>\n\u003cp>Bandodkar also points to several sensor projects for monitoring a specific disease. UCSD researchers have developed \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/06/30/this-smart-pen-could-revolutionize-diabetes-treatment/\">conductive inks\u003c/a> that respond to glucose proteins in the skin, allowing people to monitor glucose non-invasively, for diabetes treatment. Others from Columbia University created a \u003ca href=\"http://www.wired.com/2015/02/hiv-diagnostic-tool/\">smartphone accessory to detect HIV\u003c/a>, using a specialized sensor with biomarkers for the disease.\u003c/p>\n\u003cp>Portable sensors that can be integrated directly onto a mobile devices to track specific illnesses will have a high impact on developing nations, Bandodkar says, where medical professionals and resources are scarce.\u003c/p>\n\u003cp>Specialized \u003ca href=\"http://ne.ucsd.edu/faculty/l7zhang/research.php\">drug delivery systems\u003c/a>—for example, microscopic motors that could travel through the bloodstream—will also play a big role in the future of medicine, Bandodkar says. These systems could travel to a particular location in the body to deliver medicine, for example, to clear plaque deposits in arteries, or control infections by screening proteins in the blood.\u003c/p>\n\u003cp>Although advances in manufacturing and cloud computing have made medical sensors a reality, there are roadblocks to mass adoption.\u003c/p>\n\u003cp>One complication is the collaboration that must happen between industries, says Venkat Rajan, global director of visionary healthcare for analyst firm Frost & Sullivan.\u003c/p>\n\u003cp>“If you’re connecting something through a mobile device,” he says, “you’re having to interact with a telecom company or smartphone manufacture. It’s not necessarily something a lot of healthcare companies have done before.”\u003c/p>\n\u003cp>Also, currently the FDA allows many wearable medical devices to be tested and used in trials, without the official federal seal of approval. A change in that policy could impede progress in the engineering field, says Shuvo Roy, who directs UCSF’s Biodesign Laboratory.\u003c/p>\n\u003cp>Nonetheless, Roy and Lee are hopeful about the potential for sensor technologies in medicine.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’re excited about being able to combine two very disparate fields,” Lee says. “I think there’s a lot of other things we’re going to monitor that people haven’t monitored before.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Move Over Poppies, Genetically Engineered Yeast Can Now Make Painkillers Too",
"title": "Move Over Poppies, Genetically Engineered Yeast Can Now Make Painkillers Too",
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"content": "\u003cp>Back in 2007, the New York Times shared\u003ca href=\"http://www.nytimes.com/2007/09/10/health/10pain.html?pagewanted=all&_r=0\"> the story\u003c/a> of Zainabu Sesay, a woman dying of breast cancer. She suffered in terrible pain until the day she died because she had no access to the painkillers that we here in the West take for granted. And she is not alone.\u003c/p>\n\u003cp>As of 2012, an astonishing \u003ca href=\"http://www.who.int/medicines/areas/quality_safety/ACMP_BrNote_PainGLs_EN_Apr2012.pdf\">5.5 billion people\u003c/a> had limited or no access to the painkillers that can deal with the sort of pain that Zainabu endured. And that's one reason why a recent \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26272907\">report\u003c/a> out in the prestigious journal \u003ca href=\"http://www.sciencemag.org/\">Science\u003c/a> is so important.\u003c/p>\n\u003cp>In this report, published earlier this month, a group of Stanford researchers led by \u003ca href=\"https://med.stanford.edu/profiles/christina-smolke\">Dr. Christina Smolke\u003c/a> engineered yeast to make small amounts of an opiate called hydrocodone from sugar. This may ultimately provide an alternative to poppies for developing painkillers, such as morphine.\u003c/p>\n\u003cp>While this yeast makes too little of the opiate to be useful right now, it shouldn’t take too long to coax it into making more.\u003c/p>\n\u003cp>When asked how long it would take to get the yeast to make the 100,000 times more hydrocodone it needs to be competitive with the current crop of poppies, Dr. Smolke said the process \"will be ready for scale up and competitive with poppies in about 2 years.\" But the product won't be ready to enter the market for some time after that.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In other words, we are potentially just a few years away from being able to get opiates from giant vats, instead of from the fields of Afghanistan and Tasmania. And if researchers can get yeast to make it even more cheaply than current procedures, then these medicines may become more accessible to sufferers worldwide.\u003c/p>\n\u003cp>This isn’t the only benefit to making opiates in yeast. Because we can manipulate the genetics of yeast so easily, scientists may be able to more quickly discover new opiates with different and hopefully better properties. Perhaps we will be able to discover less addictive opiates in a shorter time now that we make them in yeast.\u003c/p>\n\u003cfigure id=\"attachment_31892\" class=\"wp-caption alignright\" style=\"max-width: 500px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/WalterWhiteWall.jpg\">\u003cimg class=\"size-full wp-image-31892\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/WalterWhiteWall.jpg\" alt=\"Researchers are doing all they can to keep opiate making strains out of the wrong hands. (Jaroh)\" width=\"500\" height=\"491\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall.jpg 500w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-400x393.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-75x75.jpg 75w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers are doing all they can to keep opiate making strains out of the wrong hands. (\u003ca href=\"https://www.flickr.com/photos/jaroh/10810122433\">Jaroh\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>If scientists can develop a less addictive opiate, this would have a huge global impact. One of the major hurdles in getting people in many countries access to painkillers like morphine is the widespread fear of addiction.\u003c/p>\n\u003cp>But this isn't a perfect solution. Yeast cranking out opiates conjures up an image of Walter White from \u003ca href=\"http://www.amc.com/shows/breaking-bad\">Breaking Bad\u003c/a> growing this strain for some drug cartel somewhere. The only difference would be that the expertise needed in this case would be biology rather than chemistry.\u003c/p>\n\u003cp>The Stanford researchers have done everything in their power to make it difficult for someone to get ahold of this yeast strain. They have also started a dialogue on how best to deal with the pitfalls of this kind of “\u003ca href=\"http://syntheticbiology.org/FAQ.html\">synthetic biology\u003c/a>.”\u003c/p>\n\u003cp>It is a good idea to have these discussions but they shouldn't mask the real good synthetic biology can do. In the very near future we will be using it to discover, improve, and/or make lots of different medicines to treat a wide variety of illnesses. The benefits are almost certainly worth the risks.\u003c/p>\n\u003cp>\u003cstrong>Genetic Tour de Force\u003c/strong>\u003c/p>\n\u003cp>Synthetic biology is essentially the process of engineering living things to perform tasks they can’t do naturally. An early primitive example is \u003ca href=\"http://genetics.thetech.org/ask/ask348\">making human insulin in bacteria\u003c/a>. These engineered bacteria have been around for decades and have been a boon for people suffering from diabetes.\u003c/p>\n\u003cp>These bacteria were tricky to engineer in the 1970’s, but would be pretty straightforward nowadays. In fact, the hope is that eventually engineering-living things will be \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK84446/\">as easy to as creating electrical circuits\u003c/a>.\u003c/p>\n\u003cp>Basically in this \"plug and play\" world, scientists would be able to order sets of standardized biological parts and connect them together to create intricate biological pathways. They'd simply have to grab a circuit they needed off the shelf and plug it into their organism rather than having to make the circuit from scratch.\u003c/p>\n\u003cfigure id=\"attachment_31889\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Circuitry.jpg\">\u003cimg class=\"size-full wp-image-31889\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Circuitry.jpg\" alt=\"We can't make biological circuits as easily as we can elctronic ones. At least not yet. (Wikimedia Commons)\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Circuitry.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Circuitry-400x300.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We can't make biological circuits as easily as we can electronic ones. At least not yet. (\u003ca href=\"https://upload.wikimedia.org/wikipedia/commons/2/21/Roland_TR-77_circuitry.jpg\">Wikimedia Commons\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>There are even \u003ca href=\"https://en.wikipedia.org/wiki/BioBrick\">groups\u003c/a> already creating standardized parts that can be combined to create complicated biological pathways. But making opiates in yeast is just too complicated for this “plug and play” model of genetic engineering.\u003c/p>\n\u003cp>When asked about applying these methods to problems of this magnitude, Dr. Smolke said that it would be some time before \"things at this scale and complexity are plug and play.\"\u003c/p>\n\u003cp>\"For pathways of this complexity there are many unknowns that are encountered,\" she added.\u003c/p>\n\u003cp>In other words, there is just too much going on in a cell and everything is too interconnected to be able to plug and play the 23 genes from rat, various poppies, bacteria and yeast needed to make the opiate hydrocodone in yeast. And it could be quite a while before making something this complicated becomes a trivial task.\u003c/p>\n\u003cp>For example, a key step in the process required the yeast to tweak a molecule called \u003ca href=\"https://en.wikipedia.org/wiki/Reticuline\">(S)-reticuline\u003c/a>. Poppies can do this but scientists didn’t know how they did it. The gene hadn’t been discovered yet that performed this task.\u003c/p>\n\u003cp>So to make this complicated circuit, these researchers had to actually discover and synthesize this new gene. There is no way to get a standardized part from something that hasn’t even been discovered yet! And this is just one example.\u003c/p>\n\u003cp>It took the researchers ten years to get this far. So for now, synthetic biology at this scale is more 'artisan creation' than 'assembly-line.'\u003c/p>\n\u003cp>But scientists keep getting better and better at engineering new traits into living things. And now that researchers have a toehold with a yeast strain that can make at least some hydrocodone, they can work on increasing production -- this is likely an easier task.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>My hope is that yeast-made opiates will soon be in a hospital near you, and eventually throughout the world.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Back in 2007, the New York Times shared\u003ca href=\"http://www.nytimes.com/2007/09/10/health/10pain.html?pagewanted=all&_r=0\"> the story\u003c/a> of Zainabu Sesay, a woman dying of breast cancer. She suffered in terrible pain until the day she died because she had no access to the painkillers that we here in the West take for granted. And she is not alone.\u003c/p>\n\u003cp>As of 2012, an astonishing \u003ca href=\"http://www.who.int/medicines/areas/quality_safety/ACMP_BrNote_PainGLs_EN_Apr2012.pdf\">5.5 billion people\u003c/a> had limited or no access to the painkillers that can deal with the sort of pain that Zainabu endured. And that's one reason why a recent \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26272907\">report\u003c/a> out in the prestigious journal \u003ca href=\"http://www.sciencemag.org/\">Science\u003c/a> is so important.\u003c/p>\n\u003cp>In this report, published earlier this month, a group of Stanford researchers led by \u003ca href=\"https://med.stanford.edu/profiles/christina-smolke\">Dr. Christina Smolke\u003c/a> engineered yeast to make small amounts of an opiate called hydrocodone from sugar. This may ultimately provide an alternative to poppies for developing painkillers, such as morphine.\u003c/p>\n\u003cp>While this yeast makes too little of the opiate to be useful right now, it shouldn’t take too long to coax it into making more.\u003c/p>\n\u003cp>When asked how long it would take to get the yeast to make the 100,000 times more hydrocodone it needs to be competitive with the current crop of poppies, Dr. Smolke said the process \"will be ready for scale up and competitive with poppies in about 2 years.\" But the product won't be ready to enter the market for some time after that.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In other words, we are potentially just a few years away from being able to get opiates from giant vats, instead of from the fields of Afghanistan and Tasmania. And if researchers can get yeast to make it even more cheaply than current procedures, then these medicines may become more accessible to sufferers worldwide.\u003c/p>\n\u003cp>This isn’t the only benefit to making opiates in yeast. Because we can manipulate the genetics of yeast so easily, scientists may be able to more quickly discover new opiates with different and hopefully better properties. Perhaps we will be able to discover less addictive opiates in a shorter time now that we make them in yeast.\u003c/p>\n\u003cfigure id=\"attachment_31892\" class=\"wp-caption alignright\" style=\"max-width: 500px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/WalterWhiteWall.jpg\">\u003cimg class=\"size-full wp-image-31892\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/WalterWhiteWall.jpg\" alt=\"Researchers are doing all they can to keep opiate making strains out of the wrong hands. (Jaroh)\" width=\"500\" height=\"491\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall.jpg 500w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-400x393.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/WalterWhiteWall-75x75.jpg 75w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers are doing all they can to keep opiate making strains out of the wrong hands. (\u003ca href=\"https://www.flickr.com/photos/jaroh/10810122433\">Jaroh\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>If scientists can develop a less addictive opiate, this would have a huge global impact. One of the major hurdles in getting people in many countries access to painkillers like morphine is the widespread fear of addiction.\u003c/p>\n\u003cp>But this isn't a perfect solution. Yeast cranking out opiates conjures up an image of Walter White from \u003ca href=\"http://www.amc.com/shows/breaking-bad\">Breaking Bad\u003c/a> growing this strain for some drug cartel somewhere. The only difference would be that the expertise needed in this case would be biology rather than chemistry.\u003c/p>\n\u003cp>The Stanford researchers have done everything in their power to make it difficult for someone to get ahold of this yeast strain. They have also started a dialogue on how best to deal with the pitfalls of this kind of “\u003ca href=\"http://syntheticbiology.org/FAQ.html\">synthetic biology\u003c/a>.”\u003c/p>\n\u003cp>It is a good idea to have these discussions but they shouldn't mask the real good synthetic biology can do. In the very near future we will be using it to discover, improve, and/or make lots of different medicines to treat a wide variety of illnesses. The benefits are almost certainly worth the risks.\u003c/p>\n\u003cp>\u003cstrong>Genetic Tour de Force\u003c/strong>\u003c/p>\n\u003cp>Synthetic biology is essentially the process of engineering living things to perform tasks they can’t do naturally. An early primitive example is \u003ca href=\"http://genetics.thetech.org/ask/ask348\">making human insulin in bacteria\u003c/a>. These engineered bacteria have been around for decades and have been a boon for people suffering from diabetes.\u003c/p>\n\u003cp>These bacteria were tricky to engineer in the 1970’s, but would be pretty straightforward nowadays. In fact, the hope is that eventually engineering-living things will be \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK84446/\">as easy to as creating electrical circuits\u003c/a>.\u003c/p>\n\u003cp>Basically in this \"plug and play\" world, scientists would be able to order sets of standardized biological parts and connect them together to create intricate biological pathways. They'd simply have to grab a circuit they needed off the shelf and plug it into their organism rather than having to make the circuit from scratch.\u003c/p>\n\u003cfigure id=\"attachment_31889\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Circuitry.jpg\">\u003cimg class=\"size-full wp-image-31889\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Circuitry.jpg\" alt=\"We can't make biological circuits as easily as we can elctronic ones. At least not yet. (Wikimedia Commons)\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Circuitry.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Circuitry-400x300.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We can't make biological circuits as easily as we can electronic ones. At least not yet. (\u003ca href=\"https://upload.wikimedia.org/wikipedia/commons/2/21/Roland_TR-77_circuitry.jpg\">Wikimedia Commons\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>There are even \u003ca href=\"https://en.wikipedia.org/wiki/BioBrick\">groups\u003c/a> already creating standardized parts that can be combined to create complicated biological pathways. But making opiates in yeast is just too complicated for this “plug and play” model of genetic engineering.\u003c/p>\n\u003cp>When asked about applying these methods to problems of this magnitude, Dr. Smolke said that it would be some time before \"things at this scale and complexity are plug and play.\"\u003c/p>\n\u003cp>\"For pathways of this complexity there are many unknowns that are encountered,\" she added.\u003c/p>\n\u003cp>In other words, there is just too much going on in a cell and everything is too interconnected to be able to plug and play the 23 genes from rat, various poppies, bacteria and yeast needed to make the opiate hydrocodone in yeast. And it could be quite a while before making something this complicated becomes a trivial task.\u003c/p>\n\u003cp>For example, a key step in the process required the yeast to tweak a molecule called \u003ca href=\"https://en.wikipedia.org/wiki/Reticuline\">(S)-reticuline\u003c/a>. Poppies can do this but scientists didn’t know how they did it. The gene hadn’t been discovered yet that performed this task.\u003c/p>\n\u003cp>So to make this complicated circuit, these researchers had to actually discover and synthesize this new gene. There is no way to get a standardized part from something that hasn’t even been discovered yet! And this is just one example.\u003c/p>\n\u003cp>It took the researchers ten years to get this far. So for now, synthetic biology at this scale is more 'artisan creation' than 'assembly-line.'\u003c/p>\n\u003cp>But scientists keep getting better and better at engineering new traits into living things. And now that researchers have a toehold with a yeast strain that can make at least some hydrocodone, they can work on increasing production -- this is likely an easier task.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>My hope is that yeast-made opiates will soon be in a hospital near you, and eventually throughout the world.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Freezing Eggs May Reduce A Woman's Odds Of Success With IVF",
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"content": "\u003cp>With egg freezing being touted as a way for women to potentially expand future childbearing options, the viability of those eggs when they're defrosted is still relatively unknown. The latest bit of guardedly good news is a short report in \u003cem>JAMA\u003c/em> indicating that frozen eggs do indeed lead to live births after IVF nearly half the time — but that the odds of a live birth are almost 20 percent higher for IVF using fresh eggs.\u003c/p>\n\u003cp>The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2425734&resultClick=3\" target=\"_blank\">report\u003c/a>, by Vitaly Kushnir and his colleagues at the Center for Human Reproduction in New York, is based on a retrospective analysis of success rates that U.S. fertility clinics send to the \u003ca href=\"http://www.sart.org/\">Society for Assisted Reproductive Technology\u003c/a>. In 2013, donated eggs (as opposed to eggs from the would-be mother herself) were used in 11,148 IVF cycles. Most were fertilized and implanted as soon as they were retrieved, while 20 percent had been frozen after donation and were then thawed and fertilized. Kushnir and his colleagues looked at IVF success rates in terms of eventual live births and compared the rates for those using fresh donor eggs with those using frozen donor eggs.\u003c/p>\n\u003cp>The live birthrates per embryo transferred were 56.1 percent for embryos made with fresh donor eggs and 47.1 percent for those made with frozen donor eggs. In other words, a live birth was 19.1 percent more likely using fresh donor eggs rather than frozen.\u003c/p>\n\u003cp>It's hard to say what might account for this difference, Kushnir said. \"The quality of the eggs could be somehow diminished by freezing and thawing.\" Or it could be explained by the fact that women who use frozen donor eggs get fewer eggs altogether, since they're split among a couple of recipients — and fewer eggs means fewer potential embryos.\u003c/p>\n\u003cp>In most clinics, a woman who uses a donor gets all the fresh eggs the donor produces — which, according to Dr. James Toner, president of SART, is usually about 15 to 20 mature eggs. But if she has to turn to frozen eggs from the egg bank, which he said are typically sold in batches of about half a dozen, she will usually have to share that batch with another woman.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Since fertility clinics these days implant just one or two embryos per cycle, \"I think the difference in initial egg numbers in fresh versus frozen largely explains the difference in pregnancy rate,\" said Toner, who works at the Center for Reproductive Medicine in Atlanta.\u003c/p>\n\u003cp>So if you're using donor eggs, why opt for frozen instead of fresh? Two reasons, according to SART and the American Society of Reproductive Medicine, which issued a \u003ca href=\"http://www.reproductivefacts.org/ASRM_and_SART_released_the_following_comments_on_Outcomes_of_Fresh_and_Cryopreserved_Oocyte_Donation/\">joint statement\u003c/a> in response to the \u003cem>JAMA\u003c/em> report. The first is cost: A cycle of IVF using donor eggs costs roughly half as much if the eggs are frozen — generally about $15,000 to $17,000 for frozen donor eggs, compared with $25,000 to $30,000 for fresh.\u003c/p>\n\u003cp>The second is convenience. As the SART/ASRM statement points out, using frozen donor eggs gives women \"access to a wider field of donors and provides greater flexibility for both donors' and recipients' scheduling and coordination.\" These considerations, the group said, \"may outweigh slightly lower success rates for some patients.\"\u003c/p>\n\u003cp>Unfortunately, it's hard to draw too many conclusions from this study about egg freezing as it's most commonly used these days: on eggs that are about a decade older than typical donor eggs, frozen by women in their late 30s who want to extend their fertility by a few more years.\u003c/p>\n\u003cp>Donor eggs generally come from young women; most fertility clinics look for egg donors in their 20s. Younger donors are preferred because their eggs are more likely to become fertilized in the first place, and once they're fertilized the resulting embryos are more likely to be successfully implanted in a recipient's uterus.\u003c/p>\n\u003cp>Currently, though, the typical cryopreserver is much older — a single woman in her late 30s (one \u003ca href=\"http://www.fertstert.org/article/S0015-0282%2811%2901693-1/pdf\" target=\"_blank\">study\u003c/a> put the average age of elective egg freezing at 37.4). Does the \u003cem>JAMA\u003c/em> report say anything about how likely it is for that woman to have a child once she decides she's ready — which might not be until her 40s?\u003c/p>\n\u003cp>\"That's the same question every other journalist asks,\" Kushnir told me.\u003c/p>\n\u003cp>And what do you tell them?\u003c/p>\n\u003cp>\"Well, we can extrapolate from the data,\" he said, \"but there's no direct evidence in this study\" of how older eggs will fare when they are frozen and then thawed. All he can really say is that the odds of success are lower for frozen eggs than they are for fresh, which is probably as true for older eggs as it is for younger.\u003c/p>\n\u003cp>Older women can improve their chances of getting pregnant post-freezing, Kushnir added, by freezing an embryo instead of an egg, since embryos allow for a greater margin of error when they're defrosted.\u003c/p>\n\u003cp>\"They're approximately the same size,\" he said, \"but an egg is just one big huge cell. If you thaw it and it doesn't thaw well, you lose the whole cell.\" But an embryo is a group of cells, usually eight. \"When you thaw the embryo, if some of those cells die — say, if only six of the eight survive the thaw — those cells are pluripotent and can continue to divide and grow and still produce a pregnancy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But while freezing embryos might be a better option biologically, socially it's pretty much a nonstarter. A 37-year-old woman considering egg freezing generally doesn't have a partner whose sperm she wants to use to create an embryo; if she did, she might be choosing to get pregnant instead. And once you start thinking about using donor sperm to make an embryo to put in the deep freeze, thinking about using a donor egg when you're finally ready to have a baby might not be that far a leap.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Freezing+Eggs+May+Reduce+A+Woman%27s+Odds+Of+Success+With+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With egg freezing being touted as a way for women to potentially expand future childbearing options, the viability of those eggs when they're defrosted is still relatively unknown. The latest bit of guardedly good news is a short report in \u003cem>JAMA\u003c/em> indicating that frozen eggs do indeed lead to live births after IVF nearly half the time — but that the odds of a live birth are almost 20 percent higher for IVF using fresh eggs.\u003c/p>\n\u003cp>The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2425734&resultClick=3\" target=\"_blank\">report\u003c/a>, by Vitaly Kushnir and his colleagues at the Center for Human Reproduction in New York, is based on a retrospective analysis of success rates that U.S. fertility clinics send to the \u003ca href=\"http://www.sart.org/\">Society for Assisted Reproductive Technology\u003c/a>. In 2013, donated eggs (as opposed to eggs from the would-be mother herself) were used in 11,148 IVF cycles. Most were fertilized and implanted as soon as they were retrieved, while 20 percent had been frozen after donation and were then thawed and fertilized. Kushnir and his colleagues looked at IVF success rates in terms of eventual live births and compared the rates for those using fresh donor eggs with those using frozen donor eggs.\u003c/p>\n\u003cp>The live birthrates per embryo transferred were 56.1 percent for embryos made with fresh donor eggs and 47.1 percent for those made with frozen donor eggs. In other words, a live birth was 19.1 percent more likely using fresh donor eggs rather than frozen.\u003c/p>\n\u003cp>It's hard to say what might account for this difference, Kushnir said. \"The quality of the eggs could be somehow diminished by freezing and thawing.\" Or it could be explained by the fact that women who use frozen donor eggs get fewer eggs altogether, since they're split among a couple of recipients — and fewer eggs means fewer potential embryos.\u003c/p>\n\u003cp>In most clinics, a woman who uses a donor gets all the fresh eggs the donor produces — which, according to Dr. James Toner, president of SART, is usually about 15 to 20 mature eggs. But if she has to turn to frozen eggs from the egg bank, which he said are typically sold in batches of about half a dozen, she will usually have to share that batch with another woman.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Since fertility clinics these days implant just one or two embryos per cycle, \"I think the difference in initial egg numbers in fresh versus frozen largely explains the difference in pregnancy rate,\" said Toner, who works at the Center for Reproductive Medicine in Atlanta.\u003c/p>\n\u003cp>So if you're using donor eggs, why opt for frozen instead of fresh? Two reasons, according to SART and the American Society of Reproductive Medicine, which issued a \u003ca href=\"http://www.reproductivefacts.org/ASRM_and_SART_released_the_following_comments_on_Outcomes_of_Fresh_and_Cryopreserved_Oocyte_Donation/\">joint statement\u003c/a> in response to the \u003cem>JAMA\u003c/em> report. The first is cost: A cycle of IVF using donor eggs costs roughly half as much if the eggs are frozen — generally about $15,000 to $17,000 for frozen donor eggs, compared with $25,000 to $30,000 for fresh.\u003c/p>\n\u003cp>The second is convenience. As the SART/ASRM statement points out, using frozen donor eggs gives women \"access to a wider field of donors and provides greater flexibility for both donors' and recipients' scheduling and coordination.\" These considerations, the group said, \"may outweigh slightly lower success rates for some patients.\"\u003c/p>\n\u003cp>Unfortunately, it's hard to draw too many conclusions from this study about egg freezing as it's most commonly used these days: on eggs that are about a decade older than typical donor eggs, frozen by women in their late 30s who want to extend their fertility by a few more years.\u003c/p>\n\u003cp>Donor eggs generally come from young women; most fertility clinics look for egg donors in their 20s. Younger donors are preferred because their eggs are more likely to become fertilized in the first place, and once they're fertilized the resulting embryos are more likely to be successfully implanted in a recipient's uterus.\u003c/p>\n\u003cp>Currently, though, the typical cryopreserver is much older — a single woman in her late 30s (one \u003ca href=\"http://www.fertstert.org/article/S0015-0282%2811%2901693-1/pdf\" target=\"_blank\">study\u003c/a> put the average age of elective egg freezing at 37.4). Does the \u003cem>JAMA\u003c/em> report say anything about how likely it is for that woman to have a child once she decides she's ready — which might not be until her 40s?\u003c/p>\n\u003cp>\"That's the same question every other journalist asks,\" Kushnir told me.\u003c/p>\n\u003cp>And what do you tell them?\u003c/p>\n\u003cp>\"Well, we can extrapolate from the data,\" he said, \"but there's no direct evidence in this study\" of how older eggs will fare when they are frozen and then thawed. All he can really say is that the odds of success are lower for frozen eggs than they are for fresh, which is probably as true for older eggs as it is for younger.\u003c/p>\n\u003cp>Older women can improve their chances of getting pregnant post-freezing, Kushnir added, by freezing an embryo instead of an egg, since embryos allow for a greater margin of error when they're defrosted.\u003c/p>\n\u003cp>\"They're approximately the same size,\" he said, \"but an egg is just one big huge cell. If you thaw it and it doesn't thaw well, you lose the whole cell.\" But an embryo is a group of cells, usually eight. \"When you thaw the embryo, if some of those cells die — say, if only six of the eight survive the thaw — those cells are pluripotent and can continue to divide and grow and still produce a pregnancy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But while freezing embryos might be a better option biologically, socially it's pretty much a nonstarter. A 37-year-old woman considering egg freezing generally doesn't have a partner whose sperm she wants to use to create an embryo; if she did, she might be choosing to get pregnant instead. And once you start thinking about using donor sperm to make an embryo to put in the deep freeze, thinking about using a donor egg when you're finally ready to have a baby might not be that far a leap.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Freezing+Eggs+May+Reduce+A+Woman%27s+Odds+Of+Success+With+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "This Dental Insurer Wants to Reward You for Flossing",
"title": "This Dental Insurer Wants to Reward You for Flossing",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Like most dentists, Shaun Rotenberg, who practices in Columbus, Ohio, sees a full spectrum of patients. Some are hyper-vigilant about flossing and brushing their teeth, while others avoid trips to the dentist like the plague.\u003c/p>\n\u003cp>But until recently, there hasn't been a way to reward the patients who take care of their teeth and are less likely to need costly dental work in the long-term. Dental-related emergency room visits \u003ca href=\"http://healthjournalism.org/blog/2014/04/lack-of-access-to-dental-care-leads-to-expensive-emergency-room-care/\">are on the rise\u003c/a> in the United States, which contributes to health care cost increases.\u003c/p>\n\u003cp>This week, a startup insurance company, in Rotenberg's city of Columbus, called \u003ca href=\"http://www.beam.dental\">Beam Dental \u003c/a>introduced a new nationwide program to reward people for good behavior (if avoiding gum disease, chipped teeth and cavities wasn't reward enough).\u003c/p>\n\u003cp>\"I have dentists in my family, and noticed a real lack of innovation in the industry,\" said Alex Frommeyer, Beam Dental's founder and CEO.\u003c/p>\n\u003cp>Those who sign up to the program through their employer collect \"stars,\" which can be traded in for prizes and incentives, such as cash back. According to Frommeyer, the company may soon offer lower insurance premiums to those who take care of their teeth.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>With its insurance product, Beam competes with some of the largest dental plans in the country, including Delta Dental and MetLife. But the team sees plenty of opportunities to reach the \u003ca href=\"http://health.usnews.com/health-news/health-wellness/articles/2015/05/20/no-dental-insurance-dont-wait-for-something-to-go-wrong\">40 percent of Americans\u003c/a> who forgo dental coverage.\u003c/p>\n\u003cp>Frommeyer declined to disclose how much the Beam plan costs, even an average number, as quotes vary from state to state. But he claims it is typically cheaper for employers than other plans due to Beam's lack of bureaucracy, overhead and its focus on software automation.\u003c/p>\n\u003cp>For now, Beam's insurance isn't available for individuals to select through a state or federal exchange.\u003c/p>\n\u003cfigure id=\"attachment_31140\" class=\"wp-caption alignright\" style=\"max-width: 600px\">\u003cimg class=\"size-medium wp-image-31140\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-600x600.jpg\" alt=\"Beam Dental's team at their offices in Columbus, Ohio.\" width=\"600\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-600x600.jpg 600w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-400x400.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-75x75.jpg 75w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8.jpg 768w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003cfigcaption class=\"wp-caption-text\">Beam Dental's team at their offices in Columbus, Ohio. \u003ccite>(Beam Dental)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But let's be real, most of us have lied to the dentist about how frequently we floss. What's stopping Beam's members from pretending they take care of their teeth in order to access rewards?\u003c/p>\n\u003cp>Well, Beam's first product, its sonic-powered \"smart\" toothbrush and floss, serves as a tracking system of sorts. Its sensors monitor how long you brush your teeth and for how often -- so don't even try to cheat!\u003c/p>\n\u003cp>The brush will then report the data to the Beam iPhone and Android app, which notifies you if you've stopped brushing too early -- dental lore is a full two minutes -- or if you've missed a spot in one of those hard to reach areas.\u003c/p>\n\u003cfigure id=\"attachment_31483\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-31483\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/brush_collection_01-800x537.jpg\" alt='The Beam \"smart brush\" collection ' width=\"800\" height=\"537\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-800x537.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-400x269.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-1180x793.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-1920x1290.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-960x645.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The Beam \"smart brush\" collection \u003ccite>(Beam )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>According to Frommeyer, the data is already showing improvements. Two out of three brushing events with the Beam brush are over two minutes, he said, and the average frequency is 1.75 times per day.\u003c/p>\n\u003cp>The smart toothbrush brush costs $5 per person per month, and includes toothpaste, floss and shipments of replacement brush heads. If your employer signs up to Beam, it costs just $3 a month.\u003c/p>\n\u003cp>Shaun Rotenberg, our dentist from Columbus, has recommended the connected-toothbrush to many of his teen and twenty-something patients.\u003c/p>\n\u003cp>\"It's great for my patients who love apps and are glued to a smartphone,\" he said. \"Really I'll try anything that will get my patients to care about their oral hygiene.\"\u003c/p>\n\u003cp>Beam's plan to provide cash back to those who regularly brush their teeth is not unlike new rewards programs from medical insurance companies. \u003ca href=\"https://www.hioscar.com/\">Oscar Health\u003c/a>, a health insurer based in New York, recently partnered with \u003ca href=\"http://misfit.com/?locale=en\">Misfit,\u003c/a> a Bay Area wearables company known for its jewel-like step-tracking devices. Those who stay physically active can get an Amazon $20 gift card.\u003c/p>\n\u003cp>Frommeyer said this kind of approach makes a lot more sense when applied to oral care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Data from an activity tracker, like a Fitbit or Misfit has some impact on your overall health,\" he said. \"But if you're caring for your teeth on a day to day basis, the relative impact is much greater.\"\u003c/p>\n\n",
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"excerpt": "This week, a Columbus, Ohio-based insurer called Beam Dental introduced a new nationwide program to reward people for good behavior.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Like most dentists, Shaun Rotenberg, who practices in Columbus, Ohio, sees a full spectrum of patients. Some are hyper-vigilant about flossing and brushing their teeth, while others avoid trips to the dentist like the plague.\u003c/p>\n\u003cp>But until recently, there hasn't been a way to reward the patients who take care of their teeth and are less likely to need costly dental work in the long-term. Dental-related emergency room visits \u003ca href=\"http://healthjournalism.org/blog/2014/04/lack-of-access-to-dental-care-leads-to-expensive-emergency-room-care/\">are on the rise\u003c/a> in the United States, which contributes to health care cost increases.\u003c/p>\n\u003cp>This week, a startup insurance company, in Rotenberg's city of Columbus, called \u003ca href=\"http://www.beam.dental\">Beam Dental \u003c/a>introduced a new nationwide program to reward people for good behavior (if avoiding gum disease, chipped teeth and cavities wasn't reward enough).\u003c/p>\n\u003cp>\"I have dentists in my family, and noticed a real lack of innovation in the industry,\" said Alex Frommeyer, Beam Dental's founder and CEO.\u003c/p>\n\u003cp>Those who sign up to the program through their employer collect \"stars,\" which can be traded in for prizes and incentives, such as cash back. According to Frommeyer, the company may soon offer lower insurance premiums to those who take care of their teeth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>With its insurance product, Beam competes with some of the largest dental plans in the country, including Delta Dental and MetLife. But the team sees plenty of opportunities to reach the \u003ca href=\"http://health.usnews.com/health-news/health-wellness/articles/2015/05/20/no-dental-insurance-dont-wait-for-something-to-go-wrong\">40 percent of Americans\u003c/a> who forgo dental coverage.\u003c/p>\n\u003cp>Frommeyer declined to disclose how much the Beam plan costs, even an average number, as quotes vary from state to state. But he claims it is typically cheaper for employers than other plans due to Beam's lack of bureaucracy, overhead and its focus on software automation.\u003c/p>\n\u003cp>For now, Beam's insurance isn't available for individuals to select through a state or federal exchange.\u003c/p>\n\u003cfigure id=\"attachment_31140\" class=\"wp-caption alignright\" style=\"max-width: 600px\">\u003cimg class=\"size-medium wp-image-31140\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-600x600.jpg\" alt=\"Beam Dental's team at their offices in Columbus, Ohio.\" width=\"600\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-600x600.jpg 600w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-400x400.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8-75x75.jpg 75w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/fwEwnny-3tNouEfKwp7u-UEzi_QSmGsh50RKorftpl8.jpg 768w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003cfigcaption class=\"wp-caption-text\">Beam Dental's team at their offices in Columbus, Ohio. \u003ccite>(Beam Dental)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But let's be real, most of us have lied to the dentist about how frequently we floss. What's stopping Beam's members from pretending they take care of their teeth in order to access rewards?\u003c/p>\n\u003cp>Well, Beam's first product, its sonic-powered \"smart\" toothbrush and floss, serves as a tracking system of sorts. Its sensors monitor how long you brush your teeth and for how often -- so don't even try to cheat!\u003c/p>\n\u003cp>The brush will then report the data to the Beam iPhone and Android app, which notifies you if you've stopped brushing too early -- dental lore is a full two minutes -- or if you've missed a spot in one of those hard to reach areas.\u003c/p>\n\u003cfigure id=\"attachment_31483\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-31483\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/brush_collection_01-800x537.jpg\" alt='The Beam \"smart brush\" collection ' width=\"800\" height=\"537\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-800x537.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-400x269.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-1180x793.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-1920x1290.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/brush_collection_01-960x645.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The Beam \"smart brush\" collection \u003ccite>(Beam )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>According to Frommeyer, the data is already showing improvements. Two out of three brushing events with the Beam brush are over two minutes, he said, and the average frequency is 1.75 times per day.\u003c/p>\n\u003cp>The smart toothbrush brush costs $5 per person per month, and includes toothpaste, floss and shipments of replacement brush heads. If your employer signs up to Beam, it costs just $3 a month.\u003c/p>\n\u003cp>Shaun Rotenberg, our dentist from Columbus, has recommended the connected-toothbrush to many of his teen and twenty-something patients.\u003c/p>\n\u003cp>\"It's great for my patients who love apps and are glued to a smartphone,\" he said. \"Really I'll try anything that will get my patients to care about their oral hygiene.\"\u003c/p>\n\u003cp>Beam's plan to provide cash back to those who regularly brush their teeth is not unlike new rewards programs from medical insurance companies. \u003ca href=\"https://www.hioscar.com/\">Oscar Health\u003c/a>, a health insurer based in New York, recently partnered with \u003ca href=\"http://misfit.com/?locale=en\">Misfit,\u003c/a> a Bay Area wearables company known for its jewel-like step-tracking devices. Those who stay physically active can get an Amazon $20 gift card.\u003c/p>\n\u003cp>Frommeyer said this kind of approach makes a lot more sense when applied to oral care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Data from an activity tracker, like a Fitbit or Misfit has some impact on your overall health,\" he said. \"But if you're caring for your teeth on a day to day basis, the relative impact is much greater.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Meet Digital Health's 'Power Users:' Moms",
"title": "Meet Digital Health's 'Power Users:' Moms",
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"content": "\u003cp>Mothers often serve as the “Chief Health Officers” of their families, and now digital technology is driving a fundamental change in the way they fulfill this role.\u003c/p>\n\u003cp>In a 2013 survey, the Kaiser Family Foundation \u003ca href=\"http://files.kff.org/attachment/balancing-on-shaky-ground-women-work-and-family-health-data-note\">found 74 percent of mothers\u003c/a> say they make the decisions about selecting a doctor for the children, and 81 percent of mothers say they take the children for doctor’s appointments.\u003c/p>\n\u003cp>Mothers now have access to an incredible amount of data about their children, as well as about health in general. Mobile devices, social media, online medical resources, and wearables are redefining the way mothers seek out information and make decisions.\u003c/p>\n\u003cp>Lynn Vos, CEO of the Grey Healthcare Group and a former nurse, says the result is that many families are not waiting for a doctor to tell them what to do.\u003c/p>\n\u003cfigure id=\"attachment_31132\" class=\"wp-caption alignright\" style=\"max-width: 574px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Barghava.jpg\">\u003cimg class=\"size-medium wp-image-31132\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Barghava-574x600.jpg\" alt=\"Dr. Hansa Bhargava at the launch of the website, Web MD Fit Kids, a new national initiative aimed at promoting health and wellness and preventing childhood obesity among kids ages 2-18.\" width=\"574\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-574x600.jpg 574w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-400x418.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-960x1004.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava.jpg 979w\" sizes=\"(max-width: 574px) 100vw, 574px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Hansa Bhargava at the launch of the website, Web MD Fit Kids, a new national initiative aimed at promoting health and wellness and preventing childhood obesity among kids ages 2-18. \u003ccite>(Web MD)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Parents are taking their family’s health into their own hands,” Vos says. “Young mothers are actively using technology.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>The Modern Mom\u003c/strong>\u003c/p>\n\u003cp>Dr. Hansa Bhargava is a pediatrician and works as a medical editor with WebMD. She says her practice has changed dramatically because parents, primarily mothers, now come to her armed with information.\u003c/p>\n\u003cp>“A majority of moms go to the Internet to find out health information, before they even book an appointment with a doctor,” she says.\u003c/p>\n\u003cp>“When I leave the room, I come back and they have new questions because they hopped on their phone. They want to be independent and find the information themselves.”\u003c/p>\n\u003cp>Dr. Bhargava says a large amount of WebMD’s parenting information is accessed on mobile devices, because that’s where mothers are. Many are \u003ca href=\"http://www.babycentersolutions.com/docs/BabyCenter_2014_US_Mobile_Powers_Moms_Life.pdf\">highly active mobile users\u003c/a>, and when a question comes up—Timmy develops a weird rash at the park—they can whip out their phone and search for answers.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I’m not sure if parenting is easier or harder now that we have access to all this data.” \u003ccite>Lauren Davis,\u003cbr>\nMom, and Marketing Vice-President for Kinsa\u003c/cite>\u003c/aside>\n\u003cp>Mobile devices not only serve as a portal for health research, but also for improving health literacy. \u003ca href=\"http://www.healthiq.com/\">Health IQ\u003c/a> is a mobile app that measures how health conscious and knowledgeable you are.\u003c/p>\n\u003cp>Cofounder and CEO Munjal Shah says moms represent a core group of Health IQ’s “power users.” Having children is what he calls an “activation” moment when people start to get much more interested in health, even if they were not health conscious before.\u003c/p>\n\u003cp>“No-one is born with a user manual for the body,” he says. “New medical research about things like sugar, BPAs in water bottles, and Red Dye 40 comes out all the time and you have to pay attention.”\u003c/p>\n\u003cp>\u003cstrong>Death by Data\u003c/strong>\u003c/p>\n\u003cp>While in many ways empowering, this font of information can also become a burden.\u003c/p>\n\u003cp>“There is genuinely concern among women that they aren’t doing the right thing,” Vos says. “They deal with this the best they can but they feel a fair amount of guilt when they can’t keep up.”\u003c/p>\n\u003cp>For some mothers, the load of information provides peace of mind.\u003c/p>\n\u003cfigure id=\"attachment_31139\" class=\"wp-caption alignright\" style=\"max-width: 276px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/ghg_Lynn-O-Connor-Vos.gif\">\u003cimg class=\"size-full wp-image-31139\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/ghg_Lynn-O-Connor-Vos.gif\" alt=\"Lynn O'Connor Vos was named Healthcare Businesswomen's Association Woman of the Year in 2005, for her leadership in medicine and marketing.\" width=\"276\" height=\"317\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lynn Vos says many families no longer wait for a doctor to tell them what to do. \u003ccite>(Grey Healthcare Group)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lauren Davis is the VP of Marketing for \u003ca href=\"https://kinsahealth.com/\">Kinsa\u003c/a>, a company that makes a connected thermometer and companion app that parents can use to track symptoms and medications. She is also a mother of two daughters and describes her family as “tech-forward” and “data-driven.”\u003c/p>\n\u003cp>If Davis’ daughter has a temperature, she can research her symptoms, check the elementary school’s forum to see if any illnesses are going around, and then decide if a doctor’s trip is needed and how soon.\u003c/p>\n\u003cp>“I’m not sure if parenting is easier or harder now that we have access to all this data,” Davis says. “It can be a lot easier when you don’t know about all the things that are bad or dangerous, but at the same time, it’s really nice to be worried about something and go online to look it up, or watch the data. I find comfort in all this knowledge.”\u003c/p>\n\u003cp>This capability is particularly valuable for parents of children who have chronic medical conditions or disabilities. Bhargava says these parents can now become informed experts and advocates for their children in a way that just wasn’t possible before.\u003c/p>\n\u003cp>Katherine Gauthier is a mother of four. Her oldest and youngest children both have unique medical needs, and they are 22 years apart in age.\u003c/p>\n\u003cp>“I have an adult son with physical and mental limitations and a 10-year-old son with genetic disorders,” she says. “My oldest son is pre-Internet, so I have dealt with this in two different eras of information.”\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I do see patients that suffer from over-information, but I would not blame it on the fact that there is a lot of information out there. At end of the day, it’s about balance.\"\u003ccite>Dr. Hansa Bhargava, Web MD\u003c/cite>\u003c/aside>\n\u003cp>When Gauthier’s first son was born, she lived in a rural area and her main sources of medical information were family, friends, and a general practitioner. She says she struggled to find the information she needed about rare disorders and unusual symptoms, and ended up visiting a local senator's office because she didn't know where else to ask for help.\u003c/p>\n\u003cp>With her youngest son, Gauthier says, the Internet has been her tool, for good and for ill.\u003c/p>\n\u003cp>“I always go to doctors’ offices as informed as I can be,” Gauthier says. “Back when my oldest was young, common sense prevailed and it wasn’t quite so overwhelming. Now sometimes I worry about death by data. I have to try really hard not to get sucked down this rabbit hole of fears, unknowns and possibilities. Sometimes if I go too far in, I feel my heart beating quickly and my breathing changing, and I know I need to shut it down.”\u003c/p>\n\u003cp>\u003cstrong>Finding Balance\u003c/strong>\u003c/p>\n\u003cp>It’s easy to type a simple word like “headache” into a search of symptoms, and before you know it, become convinced you have brain cancer. Dr. Bhargava says she has had to “talk parents down.”\u003c/p>\n\u003cp>“I do see patients that suffer from over-information, but I would not blame it on the fact that there is a lot of information out there,” she says. “At end of the day, it's about balance.”\u003c/p>\n\u003cp>Vos agrees that access to information isn’t the problem—the challenge is interpreting it, which the average consumer isn’t trained to do. This is what doctors are for, and no amount of “Dr. Google” can replace that, the moms in this story agreed.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I never go in with a self-diagnosis,” Gauthier says. “I don’t lead the doctors and I listen to what they have to say. After they tell me what they think, I may bring up some of the things I learned online in a tactful way. They seem open to that, and appreciate the fact that I do my homework.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mothers often serve as the “Chief Health Officers” of their families, and now digital technology is driving a fundamental change in the way they fulfill this role.\u003c/p>\n\u003cp>In a 2013 survey, the Kaiser Family Foundation \u003ca href=\"http://files.kff.org/attachment/balancing-on-shaky-ground-women-work-and-family-health-data-note\">found 74 percent of mothers\u003c/a> say they make the decisions about selecting a doctor for the children, and 81 percent of mothers say they take the children for doctor’s appointments.\u003c/p>\n\u003cp>Mothers now have access to an incredible amount of data about their children, as well as about health in general. Mobile devices, social media, online medical resources, and wearables are redefining the way mothers seek out information and make decisions.\u003c/p>\n\u003cp>Lynn Vos, CEO of the Grey Healthcare Group and a former nurse, says the result is that many families are not waiting for a doctor to tell them what to do.\u003c/p>\n\u003cfigure id=\"attachment_31132\" class=\"wp-caption alignright\" style=\"max-width: 574px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Barghava.jpg\">\u003cimg class=\"size-medium wp-image-31132\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Barghava-574x600.jpg\" alt=\"Dr. Hansa Bhargava at the launch of the website, Web MD Fit Kids, a new national initiative aimed at promoting health and wellness and preventing childhood obesity among kids ages 2-18.\" width=\"574\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-574x600.jpg 574w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-400x418.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-960x1004.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Barghava.jpg 979w\" sizes=\"(max-width: 574px) 100vw, 574px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Hansa Bhargava at the launch of the website, Web MD Fit Kids, a new national initiative aimed at promoting health and wellness and preventing childhood obesity among kids ages 2-18. \u003ccite>(Web MD)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Parents are taking their family’s health into their own hands,” Vos says. “Young mothers are actively using technology.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>The Modern Mom\u003c/strong>\u003c/p>\n\u003cp>Dr. Hansa Bhargava is a pediatrician and works as a medical editor with WebMD. She says her practice has changed dramatically because parents, primarily mothers, now come to her armed with information.\u003c/p>\n\u003cp>“A majority of moms go to the Internet to find out health information, before they even book an appointment with a doctor,” she says.\u003c/p>\n\u003cp>“When I leave the room, I come back and they have new questions because they hopped on their phone. They want to be independent and find the information themselves.”\u003c/p>\n\u003cp>Dr. Bhargava says a large amount of WebMD’s parenting information is accessed on mobile devices, because that’s where mothers are. Many are \u003ca href=\"http://www.babycentersolutions.com/docs/BabyCenter_2014_US_Mobile_Powers_Moms_Life.pdf\">highly active mobile users\u003c/a>, and when a question comes up—Timmy develops a weird rash at the park—they can whip out their phone and search for answers.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I’m not sure if parenting is easier or harder now that we have access to all this data.” \u003ccite>Lauren Davis,\u003cbr>\nMom, and Marketing Vice-President for Kinsa\u003c/cite>\u003c/aside>\n\u003cp>Mobile devices not only serve as a portal for health research, but also for improving health literacy. \u003ca href=\"http://www.healthiq.com/\">Health IQ\u003c/a> is a mobile app that measures how health conscious and knowledgeable you are.\u003c/p>\n\u003cp>Cofounder and CEO Munjal Shah says moms represent a core group of Health IQ’s “power users.” Having children is what he calls an “activation” moment when people start to get much more interested in health, even if they were not health conscious before.\u003c/p>\n\u003cp>“No-one is born with a user manual for the body,” he says. “New medical research about things like sugar, BPAs in water bottles, and Red Dye 40 comes out all the time and you have to pay attention.”\u003c/p>\n\u003cp>\u003cstrong>Death by Data\u003c/strong>\u003c/p>\n\u003cp>While in many ways empowering, this font of information can also become a burden.\u003c/p>\n\u003cp>“There is genuinely concern among women that they aren’t doing the right thing,” Vos says. “They deal with this the best they can but they feel a fair amount of guilt when they can’t keep up.”\u003c/p>\n\u003cp>For some mothers, the load of information provides peace of mind.\u003c/p>\n\u003cfigure id=\"attachment_31139\" class=\"wp-caption alignright\" style=\"max-width: 276px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/ghg_Lynn-O-Connor-Vos.gif\">\u003cimg class=\"size-full wp-image-31139\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/ghg_Lynn-O-Connor-Vos.gif\" alt=\"Lynn O'Connor Vos was named Healthcare Businesswomen's Association Woman of the Year in 2005, for her leadership in medicine and marketing.\" width=\"276\" height=\"317\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lynn Vos says many families no longer wait for a doctor to tell them what to do. \u003ccite>(Grey Healthcare Group)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lauren Davis is the VP of Marketing for \u003ca href=\"https://kinsahealth.com/\">Kinsa\u003c/a>, a company that makes a connected thermometer and companion app that parents can use to track symptoms and medications. She is also a mother of two daughters and describes her family as “tech-forward” and “data-driven.”\u003c/p>\n\u003cp>If Davis’ daughter has a temperature, she can research her symptoms, check the elementary school’s forum to see if any illnesses are going around, and then decide if a doctor’s trip is needed and how soon.\u003c/p>\n\u003cp>“I’m not sure if parenting is easier or harder now that we have access to all this data,” Davis says. “It can be a lot easier when you don’t know about all the things that are bad or dangerous, but at the same time, it’s really nice to be worried about something and go online to look it up, or watch the data. I find comfort in all this knowledge.”\u003c/p>\n\u003cp>This capability is particularly valuable for parents of children who have chronic medical conditions or disabilities. Bhargava says these parents can now become informed experts and advocates for their children in a way that just wasn’t possible before.\u003c/p>\n\u003cp>Katherine Gauthier is a mother of four. Her oldest and youngest children both have unique medical needs, and they are 22 years apart in age.\u003c/p>\n\u003cp>“I have an adult son with physical and mental limitations and a 10-year-old son with genetic disorders,” she says. “My oldest son is pre-Internet, so I have dealt with this in two different eras of information.”\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I do see patients that suffer from over-information, but I would not blame it on the fact that there is a lot of information out there. At end of the day, it’s about balance.\"\u003ccite>Dr. Hansa Bhargava, Web MD\u003c/cite>\u003c/aside>\n\u003cp>When Gauthier’s first son was born, she lived in a rural area and her main sources of medical information were family, friends, and a general practitioner. She says she struggled to find the information she needed about rare disorders and unusual symptoms, and ended up visiting a local senator's office because she didn't know where else to ask for help.\u003c/p>\n\u003cp>With her youngest son, Gauthier says, the Internet has been her tool, for good and for ill.\u003c/p>\n\u003cp>“I always go to doctors’ offices as informed as I can be,” Gauthier says. “Back when my oldest was young, common sense prevailed and it wasn’t quite so overwhelming. Now sometimes I worry about death by data. I have to try really hard not to get sucked down this rabbit hole of fears, unknowns and possibilities. Sometimes if I go too far in, I feel my heart beating quickly and my breathing changing, and I know I need to shut it down.”\u003c/p>\n\u003cp>\u003cstrong>Finding Balance\u003c/strong>\u003c/p>\n\u003cp>It’s easy to type a simple word like “headache” into a search of symptoms, and before you know it, become convinced you have brain cancer. Dr. Bhargava says she has had to “talk parents down.”\u003c/p>\n\u003cp>“I do see patients that suffer from over-information, but I would not blame it on the fact that there is a lot of information out there,” she says. “At end of the day, it's about balance.”\u003c/p>\n\u003cp>Vos agrees that access to information isn’t the problem—the challenge is interpreting it, which the average consumer isn’t trained to do. This is what doctors are for, and no amount of “Dr. Google” can replace that, the moms in this story agreed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I never go in with a self-diagnosis,” Gauthier says. “I don’t lead the doctors and I listen to what they have to say. After they tell me what they think, I may bring up some of the things I learned online in a tactful way. They seem open to that, and appreciate the fact that I do my homework.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Peek into a Peloton spinning class in New York's posh Chelsea neighborhood and it'll look like most other indoor cycling classes. Sixty stationary bikes are clustered in a dark room, loud music blares to get the heart racing, and a mic-ed up instructor motivates riders.\u003c/p>\n\u003cp>Except this class has one major difference: Instructor Jen Sherman isn't just talking to riders in the classroom. She's also monitoring metrics for riders in places like New Jersey, California, Massachusetts and Kansas. \"Jamie in Wichita, good to see you this morning,\" she says.\u003c/p>\n\u003cp>\"There's an energy in the studio that's amazing, but when you factor in that you've got people that are riding with you from all over the country — all over the world at this point — it just takes it to another level,\" Sherman says.\u003c/p>\n\u003cp>\u003ca href=\"https://www.pelotoncycle.com/company/team\">Peloton CEO John Foley\u003c/a> explains how they do it. \"This is also a television production facility. There are five cameras, one of which rotates on a track around the room,\" he says.\u003c/p>\n\u003cp>Peloton bikes come outfitted with a custom waterproof tablet, enabling home riders to watch the action in Chelsea live as well as monitor their own metrics. It also ranks each rider's output on a virtual leader board.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For $40 a month, home riders have unlimited access to live and archived rides. That's in addition to the $2,000 it costs to buy the bike. It's a high bar for many. Still, more than 10,000 have signed up so far.\u003c/p>\n\u003cp>Greg Vadas from Bethesda, Md., keeps his Peloton bike tucked away in a small room in his basement next to his four real bikes. During a recent class, the instructor tells riders when to adjust their tension to simulate different elevations, but Vadas barely notices. He's only looking at one thing: the leaderboard.\u003c/p>\n\u003cp>\"I have to admit, I don't pay that much attention to the instructor. I'm all about the board!\" he says.\u003c/p>\n\u003cp>Peloton isn't the only company offering virtual instruction. Startup \u003ca href=\"http://www.powhow.com/\">powhow.com\u003c/a> allows fitness trainers to connect directly with clients via video chat and other tools, and that has radically changed home cardio workouts, says CEO Viva Chu.\u003c/p>\n\u003cp>\"Back in the VHS or Beta days, you'd have Jane Fonda in your living room, but we're actually trying to take it one step further than that. It's like, you can not only work out with them on your own time, but you can also develop a personal relationship with them,\" Chu says.\u003c/p>\n\u003cp>While working out in front of a screen may seem weird, it's actually becoming much more the norm, says Cameron Jacobs, a research manager for the Sports and Fitness Industry Association.\u003c/p>\n\u003cp>\"Many believe that technology, social media and physical activity somewhat run in conflict with one another, but that's not the case. Today we are finding being connected is getting people actually more benefits and maximizing their results from getting physically active,\" Jacobs says.\u003c/p>\n\u003cp>Whether it's a Fitbit watch or a metrics screen on a piece of exercise equipment, Jacobs says, the industry is adapting to make working out more interactive and immersive — entering into an exciting new era where classes are becoming fitness experiences and not just workouts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"You need to have fun while you're getting physically active, because if it seems like a chore, it won't stick,\" Jacobs says.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Beyond+Jane+Fonda+Tapes%3A+Home+Workouts+Go+Virtual&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Peek into a Peloton spinning class in New York's posh Chelsea neighborhood and it'll look like most other indoor cycling classes. Sixty stationary bikes are clustered in a dark room, loud music blares to get the heart racing, and a mic-ed up instructor motivates riders.\u003c/p>\n\u003cp>Except this class has one major difference: Instructor Jen Sherman isn't just talking to riders in the classroom. She's also monitoring metrics for riders in places like New Jersey, California, Massachusetts and Kansas. \"Jamie in Wichita, good to see you this morning,\" she says.\u003c/p>\n\u003cp>\"There's an energy in the studio that's amazing, but when you factor in that you've got people that are riding with you from all over the country — all over the world at this point — it just takes it to another level,\" Sherman says.\u003c/p>\n\u003cp>\u003ca href=\"https://www.pelotoncycle.com/company/team\">Peloton CEO John Foley\u003c/a> explains how they do it. \"This is also a television production facility. There are five cameras, one of which rotates on a track around the room,\" he says.\u003c/p>\n\u003cp>Peloton bikes come outfitted with a custom waterproof tablet, enabling home riders to watch the action in Chelsea live as well as monitor their own metrics. It also ranks each rider's output on a virtual leader board.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For $40 a month, home riders have unlimited access to live and archived rides. That's in addition to the $2,000 it costs to buy the bike. It's a high bar for many. Still, more than 10,000 have signed up so far.\u003c/p>\n\u003cp>Greg Vadas from Bethesda, Md., keeps his Peloton bike tucked away in a small room in his basement next to his four real bikes. During a recent class, the instructor tells riders when to adjust their tension to simulate different elevations, but Vadas barely notices. He's only looking at one thing: the leaderboard.\u003c/p>\n\u003cp>\"I have to admit, I don't pay that much attention to the instructor. I'm all about the board!\" he says.\u003c/p>\n\u003cp>Peloton isn't the only company offering virtual instruction. Startup \u003ca href=\"http://www.powhow.com/\">powhow.com\u003c/a> allows fitness trainers to connect directly with clients via video chat and other tools, and that has radically changed home cardio workouts, says CEO Viva Chu.\u003c/p>\n\u003cp>\"Back in the VHS or Beta days, you'd have Jane Fonda in your living room, but we're actually trying to take it one step further than that. It's like, you can not only work out with them on your own time, but you can also develop a personal relationship with them,\" Chu says.\u003c/p>\n\u003cp>While working out in front of a screen may seem weird, it's actually becoming much more the norm, says Cameron Jacobs, a research manager for the Sports and Fitness Industry Association.\u003c/p>\n\u003cp>\"Many believe that technology, social media and physical activity somewhat run in conflict with one another, but that's not the case. Today we are finding being connected is getting people actually more benefits and maximizing their results from getting physically active,\" Jacobs says.\u003c/p>\n\u003cp>Whether it's a Fitbit watch or a metrics screen on a piece of exercise equipment, Jacobs says, the industry is adapting to make working out more interactive and immersive — entering into an exciting new era where classes are becoming fitness experiences and not just workouts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"You need to have fun while you're getting physically active, because if it seems like a chore, it won't stick,\" Jacobs says.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Beyond+Jane+Fonda+Tapes%3A+Home+Workouts+Go+Virtual&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>People whose diabetes requires insulin injections usually have to make a series of visits to the doctor’s office, to fine tune their daily dosage. But many low-income patients can’t afford to take those few hours off to see the doctor. As a result, they often live with chronically elevated blood sugars for weeks or months until they can find time to get to the clinic.\u003c/p>\n\u003cp>Now a new study from New York’s \u003ca href=\"http://www.nyc.gov/html/hhc/bellevue/html/home/home.shtml\">Bellevue Hospital\u003c/a> finds mobile technology can help low-income patients with the process of titrating their dosage, without them having to see a doctor.\u003c/p>\n\u003cp>For people with chronic conditions, \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/07/27/5-digital-health-trends-todays-tech-savvy-doctors-are-adopting/\">mobile technology\u003c/a> can provide crucial support and lower costs. Doctors have used mobile messaging to prompt hypertensive patients to measure their blood pressure, and to remind HIV-positive people to return for regular lab testing. For people tracking their overall health, Apple’s new HealthKit makes it easier for different health and fitness apps to exchange data.\u003c/p>\n\u003cp>So \u003ca href=\"http://www.med.nyu.edu/biosketch/levyn02\">Natalie Levy\u003c/a>, an assistant professor at the New York University School of Medicine and head of Bellevue Hospital’s Diabetes Program, decided to try mobile technology to help her low-income diabetes patients titrate their insulin remotely.\u003c/p>\n\u003cfigure id=\"attachment_30132\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick.jpg\">\u003cimg class=\"size-medium wp-image-30132\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick-800x600.jpg\" alt=\"When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their medication dose is correct.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their dosage is correct. \u003ccite>(frankieleon/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bellevue, which has traditionally served New York’s poor, currently has about 5,000 diabetes patients a year. In a survey Levy conducted, one patient reported that it often took three to four months to return for each follow-up visit during the titration phase.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Many [diabetic patients] have jobs that don’t provide sick leave or they have young children or grandchildren in their care,” she says.\u003c/p>\n\u003cp>Wearables like FitBit or Jawbone cost far too much for most of Levy’s patients, and less than half of this population owns a smartphone. Nearly all of Bellevue’s diabetics, though, have mobile phones with a text messaging feature.\u003c/p>\n\u003cp>Levy’s team designed a pilot study—called the Mobile Insulin Titration Intervention, or MITI (pronounced “mighty”) Study—where a small subset of Bellevue’s insulin-dependent diabetics, 33 patients, got a daily reminder to take a morning blood sugar reading and text that value back. Nurses reviewed the information daily on the web, to check for values that were too high or too low, indicating the insulin dose needed to be adjusted.\u003c/p>\n\u003cp>Once a week, the patients spoke by phone to the diabetes nurse to adjust dosage as needed. This routine lasted 12 weeks. A control group of 27 patients got the usual kind of care and titrated their insulin with in-person office visits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It got my head in the game.\"\u003ccite>Diabetes Patient,\u003cbr>\nBellevue Study Participant\u003c/cite>\u003c/aside>\n\u003cp>The results of the study were \u003ca href=\"http://www.jmir.org/2015/7/e180/\">published\u003c/a> in the \u003ca href=\"http://jmirpublications.com/\">Journal of Medical Internet Research\u003c/a> in July and the differences between the two groups were stark. Of the group that got daily text messages and weekly phone calls, 88 percent were able to get their blood sugars within an acceptable range. Only 37 percent of the comparison group managed to control their blood sugars.\u003c/p>\n\u003cp>Levy and her team also estimated that the remote titration group saved about two hours of time, plus the $15 co-pays that many other participants paid for office visits. The intervention appears feasible, too, since patients sent blood glucose values back more than 80 percent of the time, indicating that the daily task wasn’t too arduous.\u003c/p>\n\u003cp>Moreover, Levy says the mobile titration patients reported feeling more in control of their illness and more accountable for complying with medical advice.\u003c/p>\n\u003cp>“I was actually checking my finger sticks every day,” one participant noted in a post-study survey. Said another, “It got my head in the game.”\u003c/p>\n\u003cfigure id=\"attachment_30154\" class=\"wp-caption alignright\" style=\"max-width: 399px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg\">\u003cimg class=\" wp-image-30154\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg\" alt=\"Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York.\" width=\"399\" height=\"485\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg 494w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-400x486.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg 512w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York. \u003ccite>(Beyond My Ken/Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Levy says mobile tech offers a new avenue for helping patients manage their chronic diseases.\u003c/p>\n\u003cp>“It’s so important for diabetic patients to see the things that they eat,” she says, “their level of activity, their med compliance—all those variables—and their fasting blood sugars the next day.”\u003c/p>\n\u003cp>Dominick Frosch, a patient-care researcher at the \u003ca href=\"https://www.moore.org/\">Gordon and Betty Moore Foundation\u003c/a> in Palo Alto, echoes Levy’s sentiments. He advocates for making patients with chronic diseases the primary managers of their illness. The clinician, he says, is a “consultant” for developing a day-to-day management plan.\u003c/p>\n\u003cp>If doctors don’t take stock of what patients are realistically capable of, Frosch says, “they end up prescribing treatments patients can’t fit into their lives.”\u003c/p>\n\u003cp>Often, minor modifications can make a huge impact. And the more flexible doctors can be at using various media, Frosch says, like phone, email and patient portals, the better they can be at getting patients to manage their own illnesses.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>MITI may soon become a hospital-wide program at Bellevue. The Health and Hospitals Corporation that runs Bellevue and other public hospitals in New York City is now looking into improving the security for sending and receive secure private health information over text messages. Levy is looking forward to when that hurdle is crossed and the MITI protocol can be provided on an ongoing basis to a much larger pool of diabetic patients.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People whose diabetes requires insulin injections usually have to make a series of visits to the doctor’s office, to fine tune their daily dosage. But many low-income patients can’t afford to take those few hours off to see the doctor. As a result, they often live with chronically elevated blood sugars for weeks or months until they can find time to get to the clinic.\u003c/p>\n\u003cp>Now a new study from New York’s \u003ca href=\"http://www.nyc.gov/html/hhc/bellevue/html/home/home.shtml\">Bellevue Hospital\u003c/a> finds mobile technology can help low-income patients with the process of titrating their dosage, without them having to see a doctor.\u003c/p>\n\u003cp>For people with chronic conditions, \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/07/27/5-digital-health-trends-todays-tech-savvy-doctors-are-adopting/\">mobile technology\u003c/a> can provide crucial support and lower costs. Doctors have used mobile messaging to prompt hypertensive patients to measure their blood pressure, and to remind HIV-positive people to return for regular lab testing. For people tracking their overall health, Apple’s new HealthKit makes it easier for different health and fitness apps to exchange data.\u003c/p>\n\u003cp>So \u003ca href=\"http://www.med.nyu.edu/biosketch/levyn02\">Natalie Levy\u003c/a>, an assistant professor at the New York University School of Medicine and head of Bellevue Hospital’s Diabetes Program, decided to try mobile technology to help her low-income diabetes patients titrate their insulin remotely.\u003c/p>\n\u003cfigure id=\"attachment_30132\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick.jpg\">\u003cimg class=\"size-medium wp-image-30132\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick-800x600.jpg\" alt=\"When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their medication dose is correct.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their dosage is correct. \u003ccite>(frankieleon/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bellevue, which has traditionally served New York’s poor, currently has about 5,000 diabetes patients a year. In a survey Levy conducted, one patient reported that it often took three to four months to return for each follow-up visit during the titration phase.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Many [diabetic patients] have jobs that don’t provide sick leave or they have young children or grandchildren in their care,” she says.\u003c/p>\n\u003cp>Wearables like FitBit or Jawbone cost far too much for most of Levy’s patients, and less than half of this population owns a smartphone. Nearly all of Bellevue’s diabetics, though, have mobile phones with a text messaging feature.\u003c/p>\n\u003cp>Levy’s team designed a pilot study—called the Mobile Insulin Titration Intervention, or MITI (pronounced “mighty”) Study—where a small subset of Bellevue’s insulin-dependent diabetics, 33 patients, got a daily reminder to take a morning blood sugar reading and text that value back. Nurses reviewed the information daily on the web, to check for values that were too high or too low, indicating the insulin dose needed to be adjusted.\u003c/p>\n\u003cp>Once a week, the patients spoke by phone to the diabetes nurse to adjust dosage as needed. This routine lasted 12 weeks. A control group of 27 patients got the usual kind of care and titrated their insulin with in-person office visits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It got my head in the game.\"\u003ccite>Diabetes Patient,\u003cbr>\nBellevue Study Participant\u003c/cite>\u003c/aside>\n\u003cp>The results of the study were \u003ca href=\"http://www.jmir.org/2015/7/e180/\">published\u003c/a> in the \u003ca href=\"http://jmirpublications.com/\">Journal of Medical Internet Research\u003c/a> in July and the differences between the two groups were stark. Of the group that got daily text messages and weekly phone calls, 88 percent were able to get their blood sugars within an acceptable range. Only 37 percent of the comparison group managed to control their blood sugars.\u003c/p>\n\u003cp>Levy and her team also estimated that the remote titration group saved about two hours of time, plus the $15 co-pays that many other participants paid for office visits. The intervention appears feasible, too, since patients sent blood glucose values back more than 80 percent of the time, indicating that the daily task wasn’t too arduous.\u003c/p>\n\u003cp>Moreover, Levy says the mobile titration patients reported feeling more in control of their illness and more accountable for complying with medical advice.\u003c/p>\n\u003cp>“I was actually checking my finger sticks every day,” one participant noted in a post-study survey. Said another, “It got my head in the game.”\u003c/p>\n\u003cfigure id=\"attachment_30154\" class=\"wp-caption alignright\" style=\"max-width: 399px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg\">\u003cimg class=\" wp-image-30154\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg\" alt=\"Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York.\" width=\"399\" height=\"485\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg 494w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-400x486.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg 512w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York. \u003ccite>(Beyond My Ken/Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Levy says mobile tech offers a new avenue for helping patients manage their chronic diseases.\u003c/p>\n\u003cp>“It’s so important for diabetic patients to see the things that they eat,” she says, “their level of activity, their med compliance—all those variables—and their fasting blood sugars the next day.”\u003c/p>\n\u003cp>Dominick Frosch, a patient-care researcher at the \u003ca href=\"https://www.moore.org/\">Gordon and Betty Moore Foundation\u003c/a> in Palo Alto, echoes Levy’s sentiments. He advocates for making patients with chronic diseases the primary managers of their illness. The clinician, he says, is a “consultant” for developing a day-to-day management plan.\u003c/p>\n\u003cp>If doctors don’t take stock of what patients are realistically capable of, Frosch says, “they end up prescribing treatments patients can’t fit into their lives.”\u003c/p>\n\u003cp>Often, minor modifications can make a huge impact. And the more flexible doctors can be at using various media, Frosch says, like phone, email and patient portals, the better they can be at getting patients to manage their own illnesses.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>MITI may soon become a hospital-wide program at Bellevue. The Health and Hospitals Corporation that runs Bellevue and other public hospitals in New York City is now looking into improving the security for sending and receive secure private health information over text messages. Levy is looking forward to when that hurdle is crossed and the MITI protocol can be provided on an ongoing basis to a much larger pool of diabetic patients.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Good, the Bad, and the Ugly About Design in Health Care",
"title": "The Good, the Bad, and the Ugly About Design in Health Care",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Imagine a hospital or clinic that took design as seriously as a company like \u003ca href=\"http://www.apple.com/\">Apple\u003c/a>, with its fanatical attention to detail and easy-to-use products.\u003c/p>\n\u003cp>Instead, design is too often an afterthought in most health care circles. Many of us have grappled with 1990s-era websites, incomprehensible medical jargon, and windowless hospital waiting rooms that are reminiscent of a prison.\u003c/p>\n\u003cp>For years, San Francisco-based designer Aaron Sklar has been preaching the importance of design-thinking to entrepreneurs, large health systems and other industry stakeholders. But until recently, he says, this topic rarely came up at top health conferences.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"There's a lot of pointing the finger at the patient. What design can bring to health care isn't just the technology, but the patient-centered approach.\" \u003ccite>Aaron Sklar, Director of Experience Strategy and Design at Healthagen\u003c/cite>\u003c/aside>\n\u003cp>But something's changed. Earlier this month, I caught up with Sklar for coffee to find out more about how design is slowly creeping into health care. Sklar works as a designer at Aetna-owned \u003ca href=\"http://www.healthagen.com/\">Healthagen\u003c/a>, a company that focuses on engaging patients through mobile and web-based tools.\u003c/p>\n\u003cp>This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>In your experience, how is design perceived by top health decision-makers, like hospital executives and doctors? \u003c/strong>\u003c/p>\n\u003cp>Design has not traditionally been viewed as an essential part of health care. To change that, we need to show health systems that good design is worth the investment.\u003c/p>\n\u003cp>In my own work, I try to draw attention to other aspects of design than just physical hospital design and graphic design, which are the most well-known. A lot of what interests me is under the umbrella of 'service design,' meaning the interaction between patients and care providers, and how to make that more effective and delightful. In all these cases, hospitals can save money when patients receive a better experience and are able to heal faster.\u003c/p>\n\u003cp>I am starting to see a growing awareness of design. Six months ago, nobody was really talking about this. But last month, I went to three different symposiums and all had the title of 'design and health care.' It has become a hot topic.\u003c/p>\n\u003cfigure id=\"attachment_28857\" class=\"wp-caption alignright\" style=\"max-width: 435px\">\u003cimg class=\" wp-image-28857\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/aaron-sklar-800x600.jpg\" alt=\"Aaron Sklar is a San Francisco-based designer who focuses on bringing health-technology to patients.\" width=\"435\" height=\"326\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-960x720.jpg 960w\" sizes=\"(max-width: 435px) 100vw, 435px\">\u003cfigcaption class=\"wp-caption-text\">Aaron Sklar worked for 15 years at storied design firm \u003ca href=\"http://www.ideo.com/\">IDEO\u003c/a>, and started a website on health care design, called Prescribe Design. \u003ccite>(Christina Farr / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>How about all this new health technology, which includes mobile apps and digital medical records? Is this an example of great design? \u003c/strong>\u003c/p>\n\u003cp>In the past five years, there has been a flood of technology that is coming into health care. With a limited number of exceptions, it often misses the mark of what it promises. As a designer, it's embarrassing.\u003c/p>\n\u003cp>\u003cstrong>Why did you start your website, \u003ca href=\"http://prescribedesign.com/\">Prescribe Design\u003c/a>, and who are you trying to target?\u003c/strong>\u003c/p>\n\u003cp>We launched the site about six months ago. We see a big potential audience as health care practitioners, who want to make a change. They increasingly see design as an important tool, so we provide case-studies that they can download and use. I started it because I saw first-hand how important technology and design-thinking could be for health care. Magical things can happen.\u003c/p>\n\u003cp>\u003cstrong>How do most health systems view design today?\u003c/strong>\u003c/p>\n\u003cp>It's all about functionality and the minimum viable product, or 'MVP'. The approach has been to put in the least amount of effort and resources to get the product working, and then fix it later. But what's been missing is the follow-through -- and this is certainly true for hospital building-design, which is insanely expensive. When designers get involved in the process, doctors and patients can expect better.\u003c/p>\n\u003cfigure id=\"attachment_28859\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-28859\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/design1-800x533.jpg\" alt=\"Even minor design tweaks can make a big difference to drab hospital rooms. \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Even minor design tweaks can make a big difference to drab hospital rooms. \u003ccite>(Quinn Dombrowski / Flickr )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>What are some inexpensive tweaks that hospitals can make to the physical space to improve the experience for patients?\u003c/strong>\u003c/p>\n\u003cp>Anything from larger windows to make hospital rooms more light-filled, or taking steps to reduce construction noise. Tweaks that require larger investment, but are shown to be beneficial, are things like healing gardens for strolling, an art space or meditation room or a social space on the patient floor. This can all lead to increased philanthropy and loyalty to the hospital, as well as positive brand awareness.\u003c/p>\n\u003cp>\u003cstrong>Products like the iPhone are built to delight the user. Meanwhile, most people dread health care interactions and visits. How long will it take before there's any delight involved with the health care experience? \u003c/strong>\u003c/p>\n\u003cp>This may seem overly optimistic, but I am going to say that in five years it will be common to experience some sort of delight. This will be a critical goal for hospitals. I don't think that hospitals will utterly redesign their buildings, which is very expensive, but they can provide new tools and services that are easy to use. It might be something simple like an online scheduling system, so you don't have to take time out from your workday to call your doctor and sit on hold.\u003c/p>\n\u003cp>\u003cstrong>What's the biggest shift you're seeing in how health systems are approaching design?\u003c/strong>\u003c/p>\n\u003cp>I've seen several major hospitals developing their own innovation and design teams -- in the past, this was typically the R&D group. Some examples include Penn Medicine and Johns Hopkins, which have innovation centers, and Kaiser, which has its \u003ca href=\"https://xnet.kp.org/innovationconsultancy/aboutus.html\">own design consultancy\u003c/a>.\u003c/p>\n\u003cp>Another is this role that is popping up in the new world of 'accountable care.' Now that hospitals are increasingly accountable for patients staying healthy, the case manager has become really important. I love hearing stories about great case managers who make the effort to talk to patients over the phone and find out what's really going on.\u003c/p>\n\u003cp>\u003cstrong>What are the biggest mistakes you see hospitals and clinics make from a design perspective?\u003c/strong>\u003c/p>\n\u003cp>The worst pitfall is bringing design in at the end to make it all look pretty. Design isn't the icing on the cake or an afterthought; it's about user experience. You have to start at the beginning of the process if you want your design to have a tangible impact.\u003c/p>\n\u003cp>\u003cstrong>Have you seen many examples of where patients are perceived as disinterested in their health, because they don't engage with tools that are poorly-designed and difficult to use? \u003c/strong>\u003c/p>\n\u003cp>Yes, many. The entire health care system has been based on this notion that the doctor is the hero. The doctor deduces the problem and sits back and shakes their heads when the patient isn't doing what they were told, whether it's taking their meds or following the right protocols. There's a lot of pointing the finger at the patient. What design can bring to health care isn't just the technology, but the patient-centered approach. How can we meet patients where they are and come up with treatments that will make an impact? How can we use design to help patients follow-through?\u003c/p>\n\u003cp>\u003cstrong>As a designer, what got you interested in health care?\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>I always wanted to work on projects that had social impact. At IDEO, I did all kinds of health-related projects, including work with the Centers for Disease Prevention and Control (CDC) and a bike company, which wanted to improve people's fitness. Wanting to do good has become a mainstream point of view for young designers. In my opinion, a mindset of empathy is inherent in design culture.\u003c/p>\n\n",
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"excerpt": "Imagine a hospital or clinic that used design to improve patient experience and treatment? San Francisco-based designer Aaron Sklar weighs in. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Imagine a hospital or clinic that took design as seriously as a company like \u003ca href=\"http://www.apple.com/\">Apple\u003c/a>, with its fanatical attention to detail and easy-to-use products.\u003c/p>\n\u003cp>Instead, design is too often an afterthought in most health care circles. Many of us have grappled with 1990s-era websites, incomprehensible medical jargon, and windowless hospital waiting rooms that are reminiscent of a prison.\u003c/p>\n\u003cp>For years, San Francisco-based designer Aaron Sklar has been preaching the importance of design-thinking to entrepreneurs, large health systems and other industry stakeholders. But until recently, he says, this topic rarely came up at top health conferences.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"There's a lot of pointing the finger at the patient. What design can bring to health care isn't just the technology, but the patient-centered approach.\" \u003ccite>Aaron Sklar, Director of Experience Strategy and Design at Healthagen\u003c/cite>\u003c/aside>\n\u003cp>But something's changed. Earlier this month, I caught up with Sklar for coffee to find out more about how design is slowly creeping into health care. Sklar works as a designer at Aetna-owned \u003ca href=\"http://www.healthagen.com/\">Healthagen\u003c/a>, a company that focuses on engaging patients through mobile and web-based tools.\u003c/p>\n\u003cp>This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>In your experience, how is design perceived by top health decision-makers, like hospital executives and doctors? \u003c/strong>\u003c/p>\n\u003cp>Design has not traditionally been viewed as an essential part of health care. To change that, we need to show health systems that good design is worth the investment.\u003c/p>\n\u003cp>In my own work, I try to draw attention to other aspects of design than just physical hospital design and graphic design, which are the most well-known. A lot of what interests me is under the umbrella of 'service design,' meaning the interaction between patients and care providers, and how to make that more effective and delightful. In all these cases, hospitals can save money when patients receive a better experience and are able to heal faster.\u003c/p>\n\u003cp>I am starting to see a growing awareness of design. Six months ago, nobody was really talking about this. But last month, I went to three different symposiums and all had the title of 'design and health care.' It has become a hot topic.\u003c/p>\n\u003cfigure id=\"attachment_28857\" class=\"wp-caption alignright\" style=\"max-width: 435px\">\u003cimg class=\" wp-image-28857\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/aaron-sklar-800x600.jpg\" alt=\"Aaron Sklar is a San Francisco-based designer who focuses on bringing health-technology to patients.\" width=\"435\" height=\"326\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/aaron-sklar-960x720.jpg 960w\" sizes=\"(max-width: 435px) 100vw, 435px\">\u003cfigcaption class=\"wp-caption-text\">Aaron Sklar worked for 15 years at storied design firm \u003ca href=\"http://www.ideo.com/\">IDEO\u003c/a>, and started a website on health care design, called Prescribe Design. \u003ccite>(Christina Farr / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>How about all this new health technology, which includes mobile apps and digital medical records? Is this an example of great design? \u003c/strong>\u003c/p>\n\u003cp>In the past five years, there has been a flood of technology that is coming into health care. With a limited number of exceptions, it often misses the mark of what it promises. As a designer, it's embarrassing.\u003c/p>\n\u003cp>\u003cstrong>Why did you start your website, \u003ca href=\"http://prescribedesign.com/\">Prescribe Design\u003c/a>, and who are you trying to target?\u003c/strong>\u003c/p>\n\u003cp>We launched the site about six months ago. We see a big potential audience as health care practitioners, who want to make a change. They increasingly see design as an important tool, so we provide case-studies that they can download and use. I started it because I saw first-hand how important technology and design-thinking could be for health care. Magical things can happen.\u003c/p>\n\u003cp>\u003cstrong>How do most health systems view design today?\u003c/strong>\u003c/p>\n\u003cp>It's all about functionality and the minimum viable product, or 'MVP'. The approach has been to put in the least amount of effort and resources to get the product working, and then fix it later. But what's been missing is the follow-through -- and this is certainly true for hospital building-design, which is insanely expensive. When designers get involved in the process, doctors and patients can expect better.\u003c/p>\n\u003cfigure id=\"attachment_28859\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-28859\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/design1-800x533.jpg\" alt=\"Even minor design tweaks can make a big difference to drab hospital rooms. \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/design1-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Even minor design tweaks can make a big difference to drab hospital rooms. \u003ccite>(Quinn Dombrowski / Flickr )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>What are some inexpensive tweaks that hospitals can make to the physical space to improve the experience for patients?\u003c/strong>\u003c/p>\n\u003cp>Anything from larger windows to make hospital rooms more light-filled, or taking steps to reduce construction noise. Tweaks that require larger investment, but are shown to be beneficial, are things like healing gardens for strolling, an art space or meditation room or a social space on the patient floor. This can all lead to increased philanthropy and loyalty to the hospital, as well as positive brand awareness.\u003c/p>\n\u003cp>\u003cstrong>Products like the iPhone are built to delight the user. Meanwhile, most people dread health care interactions and visits. How long will it take before there's any delight involved with the health care experience? \u003c/strong>\u003c/p>\n\u003cp>This may seem overly optimistic, but I am going to say that in five years it will be common to experience some sort of delight. This will be a critical goal for hospitals. I don't think that hospitals will utterly redesign their buildings, which is very expensive, but they can provide new tools and services that are easy to use. It might be something simple like an online scheduling system, so you don't have to take time out from your workday to call your doctor and sit on hold.\u003c/p>\n\u003cp>\u003cstrong>What's the biggest shift you're seeing in how health systems are approaching design?\u003c/strong>\u003c/p>\n\u003cp>I've seen several major hospitals developing their own innovation and design teams -- in the past, this was typically the R&D group. Some examples include Penn Medicine and Johns Hopkins, which have innovation centers, and Kaiser, which has its \u003ca href=\"https://xnet.kp.org/innovationconsultancy/aboutus.html\">own design consultancy\u003c/a>.\u003c/p>\n\u003cp>Another is this role that is popping up in the new world of 'accountable care.' Now that hospitals are increasingly accountable for patients staying healthy, the case manager has become really important. I love hearing stories about great case managers who make the effort to talk to patients over the phone and find out what's really going on.\u003c/p>\n\u003cp>\u003cstrong>What are the biggest mistakes you see hospitals and clinics make from a design perspective?\u003c/strong>\u003c/p>\n\u003cp>The worst pitfall is bringing design in at the end to make it all look pretty. Design isn't the icing on the cake or an afterthought; it's about user experience. You have to start at the beginning of the process if you want your design to have a tangible impact.\u003c/p>\n\u003cp>\u003cstrong>Have you seen many examples of where patients are perceived as disinterested in their health, because they don't engage with tools that are poorly-designed and difficult to use? \u003c/strong>\u003c/p>\n\u003cp>Yes, many. The entire health care system has been based on this notion that the doctor is the hero. The doctor deduces the problem and sits back and shakes their heads when the patient isn't doing what they were told, whether it's taking their meds or following the right protocols. There's a lot of pointing the finger at the patient. What design can bring to health care isn't just the technology, but the patient-centered approach. How can we meet patients where they are and come up with treatments that will make an impact? How can we use design to help patients follow-through?\u003c/p>\n\u003cp>\u003cstrong>As a designer, what got you interested in health care?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I always wanted to work on projects that had social impact. At IDEO, I did all kinds of health-related projects, including work with the Centers for Disease Prevention and Control (CDC) and a bike company, which wanted to improve people's fitness. Wanting to do good has become a mainstream point of view for young designers. In my opinion, a mindset of empathy is inherent in design culture.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Snooze Alert: A Sleep Disorder May Be Harming Your Body And Brain",
"title": "Snooze Alert: A Sleep Disorder May Be Harming Your Body And Brain",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>It's time for consumers to wake up to the risks of sleep disorders, scientists say.\u003c/p>\n\u003cp>More than 50 million adults in the U.S. have a disorder such as insomnia, restless leg syndrome or sleep apnea, according to an Institute of Medicine \u003ca href=\"http://iom.nationalacademies.org/Reports/2006/Sleep-Disorders-and-Sleep-Deprivation-An-Unmet-Public-Health-Problem.aspx\" target=\"_blank\">report\u003c/a>. And it's now clear that a lack of sleep \"not only increases the risk of errors and accidents, it also has adverse effects on the body and brain,\" according to Charles Czeisler, chief of the division of sleep and circadian disorders at Brigham and Women's Hospital in Boston.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdc.gov/features/dssleep/\" target=\"_blank\">Research\u003c/a> in the past couple of decades has shown that a lack of sleep increases a person's risk for cardiovascular disease, diabetes, infections and maybe even Alzheimer's disease. Yet most sleep disorders go untreated.\u003c/p>\n\u003cp>Michael Arnott, who is now 67, began having sleep problems in his 50s, he says. As a result, he often found himself having trouble staying awake during long drives on the Massachusetts Turnpike.\u003c/p>\n\u003cp>\"I would get groggy and feel like I've got to keep talking, open the window,\" Arnott says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>His wife, Mary White, says being a passenger on those drives could be scary.\u003c/p>\n\u003cp>\"All of a sudden there'd be a change in the speed and I'd look over, and his eyes would be starting to close,\" she remembers.\u003c/p>\n\u003cp>White thought her husband might have sleep \u003ca href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea\" target=\"_blank\">apnea\u003c/a>, which interferes with breathing. But Arnott was in denial. He figured he was free of most risk factors for apnea. He wasn't overweight, he didn't smoke or take sedatives, and he has always stayed in great shape.\u003c/p>\n\u003cp>\"I'm a runner. I've run for more than 40 years,\" he says. \"I used to do marathons. Now I just do 5- and 10-kilometer road races.\"\u003c/p>\n\u003cp>So his wife took the initiative. \"I asked him to see a doctor and he wouldn't,\" she says. In 2012, though, White persuaded him to take part in a sleep research study that paid for his participation, and took place at a sleep lab in Boston, not too far from the couple's home in Cambridge.\u003c/p>\n\u003cp>Doctors found a couple of problems. \"I've got what they call moderate obstructive sleep apnea,\" Arnott says. He also has a form of \u003ca href=\"http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm\" target=\"_blank\">restless leg syndrome\u003c/a> that causes him to kick during sleep.\u003c/p>\n\u003cp>Those conditions, along with his tendency to stay up late and wake up early, meant he wasn't getting enough quality sleep. And research in the past couple of decades has shown that's a problem even if you're not nodding off on the Massachusetts Turnpike.\u003c/p>\n\u003cp>Much of that research was done in the same sleep lab at Brigham and Women's Hospital where Arnott was diagnosed. The lab includes rooms that are completely isolated from the light, sounds and even vibrations of the outside world. As study participants sleep in these rooms, their brain waves, respiration, oxygen levels and other signs can be monitored from a central control room.\u003c/p>\n\u003cp>In highly controlled environments like this one, Czeisler and other researchers have shown that sleep affects everything from blood pressure to memory to metabolism.\u003c/p>\n\u003cp>\"Within 2 1/2 weeks we can take someone who is young, healthy and fit and put them in a pre-diabetic state just by putting them on an irregular schedule,\" Czeisler says.\u003c/p>\n\u003cp>Research also has shown a strong connection between sleep and the immune system, Czeisler says. \"People who are not getting sleep, if they're exposed to a virus like the adenovirus — that causes the common cold — they will have a 200 to 300 percent increased risk of actually catching a cold,\" he says.\u003c/p>\n\u003cp>Many studies suggest that a lack of sleep raises the risk of a heart attack or stroke. And most recently, Czeisler says, scientists have found \u003ca href=\"https://www.alzinfo.org/articles/poor-sleep-may-be-linked-to-alzheimers-disease/\" target=\"_blank\">evidence\u003c/a> that the brain actually needs sleep to stay healthy.\u003c/p>\n\u003cp>\"It's during sleep that we clear out many of the toxins that build up during wakefulness,\" Czeisler says. Among those toxins is beta-amyloid, which produces the sticky plaques that appear in the brains of people with Alzheimer's disease.\u003c/p>\n\u003cp>Most sleep disorders can be treated, but often they aren't. Arnott, the sleepy driver from Cambridge, didn't address his symptoms until his wife pushed him to take part in a sleep study.\u003c/p>\n\u003cfigure id=\"attachment_66824\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-e1440437424497.jpg\">\u003cimg class=\"size-thumbnail wp-image-66824\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-400x266.jpg\" alt=\"When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea.\" width=\"400\" height=\"266\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea. \u003ccite>(Dr. P. Marazzi/Science Source)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"My whole clinic is full of patients who are brought in by their spouses,\" says Dr. Andrew Wellman, a sleep specialist at Harvard and Brigham and Women's who has cared for Arnott.\u003c/p>\n\u003cp>When Wellman is assessing a new patient, he asks a simple question: \"Do your eyelids get heavy when you'd prefer to be awake?\" If the answer is yes, that is a very specific indication that someone isn't getting enough sleep. Symptoms such as fatigue or feeling tired are less specific, and can have other causes, he says.\u003c/p>\n\u003cp>Much of Wellman's practice is devoted to sleep apnea, which affects about 1 in 3 adult men and becomes more common with age.\u003c/p>\n\u003cp>Wellman says a sleep apnea diagnosis usually requires an overnight sleep study to measure the flow of air in and out of the lungs. \"If that flow is diminished, then that is the primary measurement that we use to detect these sleep apnea events,\" he says.\u003c/p>\n\u003cp>The problem can be in the brain — a condition called central apnea. But more often the airway is getting blocked repeatedly during sleep, a disorder called obstructive sleep apnea.\u003c/p>\n\u003cp>Arnott has an unusual variant of obstructive sleep apnea, Wellman says. \"His airway actually collapses at the epiglottis, which is a structure just below the base of the tongue that prevents food from going down in the airway.\"\u003c/p>\n\u003cp>Regardless of the cause, the go-to treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine. Arnott tried one for three months and hated it.\u003c/p>\n\u003cfigure id=\"attachment_66825\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\">\u003cimg class=\"size-full wp-image-66825\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\" alt='Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\"' width=\"1920\" height=\"1279\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\" \u003ccite>(M. Scott Bauer for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You have to have a mask on your face; you have a machine making noise all night, and you have to have electricity,\" he says. \"We hike. We go to places in the White Mountains of New Hampshire and Maine, where electricity is not always there.\"\u003c/p>\n\u003cp>Complaints like those are pretty common among people using CPAP machines, Wellman says. \"Somewhere around 50 percent of patients don't adhere to their therapy. Probably there are many people that don't even come to the sleep lab because they know they might get that breathing machine, and they don't want it.\"\u003c/p>\n\u003cp>One alternative is surgery to help keep the airway open. Another is an oral appliance that moves the lower jaw forward.\u003c/p>\n\u003cp>Arnott eventually switched to an oral appliance and has made a series of other changes. He sleeps on his side, which reduces apnea. He tries to get to bed at the same time each night. And he has begun doing yoga before bedtime, which he says helps with his restless leg syndrome.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Those steps have made a big difference, Arnott says. For one thing, he no longer falls asleep at the wheel. And now, he says, \"There are times on long trips when Mary actually says, 'I'm getting groggy. You drive.' \"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Snooze+Alert%3A+A+Sleep+Disorder+May+Be+Harming+Your+Body+And+Brain&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's time for consumers to wake up to the risks of sleep disorders, scientists say.\u003c/p>\n\u003cp>More than 50 million adults in the U.S. have a disorder such as insomnia, restless leg syndrome or sleep apnea, according to an Institute of Medicine \u003ca href=\"http://iom.nationalacademies.org/Reports/2006/Sleep-Disorders-and-Sleep-Deprivation-An-Unmet-Public-Health-Problem.aspx\" target=\"_blank\">report\u003c/a>. And it's now clear that a lack of sleep \"not only increases the risk of errors and accidents, it also has adverse effects on the body and brain,\" according to Charles Czeisler, chief of the division of sleep and circadian disorders at Brigham and Women's Hospital in Boston.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdc.gov/features/dssleep/\" target=\"_blank\">Research\u003c/a> in the past couple of decades has shown that a lack of sleep increases a person's risk for cardiovascular disease, diabetes, infections and maybe even Alzheimer's disease. Yet most sleep disorders go untreated.\u003c/p>\n\u003cp>Michael Arnott, who is now 67, began having sleep problems in his 50s, he says. As a result, he often found himself having trouble staying awake during long drives on the Massachusetts Turnpike.\u003c/p>\n\u003cp>\"I would get groggy and feel like I've got to keep talking, open the window,\" Arnott says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>His wife, Mary White, says being a passenger on those drives could be scary.\u003c/p>\n\u003cp>\"All of a sudden there'd be a change in the speed and I'd look over, and his eyes would be starting to close,\" she remembers.\u003c/p>\n\u003cp>White thought her husband might have sleep \u003ca href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea\" target=\"_blank\">apnea\u003c/a>, which interferes with breathing. But Arnott was in denial. He figured he was free of most risk factors for apnea. He wasn't overweight, he didn't smoke or take sedatives, and he has always stayed in great shape.\u003c/p>\n\u003cp>\"I'm a runner. I've run for more than 40 years,\" he says. \"I used to do marathons. Now I just do 5- and 10-kilometer road races.\"\u003c/p>\n\u003cp>So his wife took the initiative. \"I asked him to see a doctor and he wouldn't,\" she says. In 2012, though, White persuaded him to take part in a sleep research study that paid for his participation, and took place at a sleep lab in Boston, not too far from the couple's home in Cambridge.\u003c/p>\n\u003cp>Doctors found a couple of problems. \"I've got what they call moderate obstructive sleep apnea,\" Arnott says. He also has a form of \u003ca href=\"http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm\" target=\"_blank\">restless leg syndrome\u003c/a> that causes him to kick during sleep.\u003c/p>\n\u003cp>Those conditions, along with his tendency to stay up late and wake up early, meant he wasn't getting enough quality sleep. And research in the past couple of decades has shown that's a problem even if you're not nodding off on the Massachusetts Turnpike.\u003c/p>\n\u003cp>Much of that research was done in the same sleep lab at Brigham and Women's Hospital where Arnott was diagnosed. The lab includes rooms that are completely isolated from the light, sounds and even vibrations of the outside world. As study participants sleep in these rooms, their brain waves, respiration, oxygen levels and other signs can be monitored from a central control room.\u003c/p>\n\u003cp>In highly controlled environments like this one, Czeisler and other researchers have shown that sleep affects everything from blood pressure to memory to metabolism.\u003c/p>\n\u003cp>\"Within 2 1/2 weeks we can take someone who is young, healthy and fit and put them in a pre-diabetic state just by putting them on an irregular schedule,\" Czeisler says.\u003c/p>\n\u003cp>Research also has shown a strong connection between sleep and the immune system, Czeisler says. \"People who are not getting sleep, if they're exposed to a virus like the adenovirus — that causes the common cold — they will have a 200 to 300 percent increased risk of actually catching a cold,\" he says.\u003c/p>\n\u003cp>Many studies suggest that a lack of sleep raises the risk of a heart attack or stroke. And most recently, Czeisler says, scientists have found \u003ca href=\"https://www.alzinfo.org/articles/poor-sleep-may-be-linked-to-alzheimers-disease/\" target=\"_blank\">evidence\u003c/a> that the brain actually needs sleep to stay healthy.\u003c/p>\n\u003cp>\"It's during sleep that we clear out many of the toxins that build up during wakefulness,\" Czeisler says. Among those toxins is beta-amyloid, which produces the sticky plaques that appear in the brains of people with Alzheimer's disease.\u003c/p>\n\u003cp>Most sleep disorders can be treated, but often they aren't. Arnott, the sleepy driver from Cambridge, didn't address his symptoms until his wife pushed him to take part in a sleep study.\u003c/p>\n\u003cfigure id=\"attachment_66824\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-e1440437424497.jpg\">\u003cimg class=\"size-thumbnail wp-image-66824\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-400x266.jpg\" alt=\"When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea.\" width=\"400\" height=\"266\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea. \u003ccite>(Dr. P. Marazzi/Science Source)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"My whole clinic is full of patients who are brought in by their spouses,\" says Dr. Andrew Wellman, a sleep specialist at Harvard and Brigham and Women's who has cared for Arnott.\u003c/p>\n\u003cp>When Wellman is assessing a new patient, he asks a simple question: \"Do your eyelids get heavy when you'd prefer to be awake?\" If the answer is yes, that is a very specific indication that someone isn't getting enough sleep. Symptoms such as fatigue or feeling tired are less specific, and can have other causes, he says.\u003c/p>\n\u003cp>Much of Wellman's practice is devoted to sleep apnea, which affects about 1 in 3 adult men and becomes more common with age.\u003c/p>\n\u003cp>Wellman says a sleep apnea diagnosis usually requires an overnight sleep study to measure the flow of air in and out of the lungs. \"If that flow is diminished, then that is the primary measurement that we use to detect these sleep apnea events,\" he says.\u003c/p>\n\u003cp>The problem can be in the brain — a condition called central apnea. But more often the airway is getting blocked repeatedly during sleep, a disorder called obstructive sleep apnea.\u003c/p>\n\u003cp>Arnott has an unusual variant of obstructive sleep apnea, Wellman says. \"His airway actually collapses at the epiglottis, which is a structure just below the base of the tongue that prevents food from going down in the airway.\"\u003c/p>\n\u003cp>Regardless of the cause, the go-to treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine. Arnott tried one for three months and hated it.\u003c/p>\n\u003cfigure id=\"attachment_66825\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\">\u003cimg class=\"size-full wp-image-66825\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\" alt='Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\"' width=\"1920\" height=\"1279\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\" \u003ccite>(M. Scott Bauer for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You have to have a mask on your face; you have a machine making noise all night, and you have to have electricity,\" he says. \"We hike. We go to places in the White Mountains of New Hampshire and Maine, where electricity is not always there.\"\u003c/p>\n\u003cp>Complaints like those are pretty common among people using CPAP machines, Wellman says. \"Somewhere around 50 percent of patients don't adhere to their therapy. Probably there are many people that don't even come to the sleep lab because they know they might get that breathing machine, and they don't want it.\"\u003c/p>\n\u003cp>One alternative is surgery to help keep the airway open. Another is an oral appliance that moves the lower jaw forward.\u003c/p>\n\u003cp>Arnott eventually switched to an oral appliance and has made a series of other changes. He sleeps on his side, which reduces apnea. He tries to get to bed at the same time each night. And he has begun doing yoga before bedtime, which he says helps with his restless leg syndrome.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Those steps have made a big difference, Arnott says. For one thing, he no longer falls asleep at the wheel. And now, he says, \"There are times on long trips when Mary actually says, 'I'm getting groggy. You drive.' \"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Snooze+Alert%3A+A+Sleep+Disorder+May+Be+Harming+Your+Body+And+Brain&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust",
"title": "Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust",
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"content": "\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220309181\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/220309181&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/220309181'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Scientists Create Vomiting Machine to Learn How Norovirus Spreads",
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"content": "\u003cp>Norovirus is a huge public health problem, sickening \u003ca href=\"http://www.cdc.gov/norovirus/trends-outbreaks.html\">as many as 21 million people a year\u003c/a> in the U.S. But for all the gastric distress it causes, there are still some basic, unanswered questions about the virus.\u003c/p>\n\u003cp>One biggie: When an ill person vomits, does norovirus become aerosolized? That is, can an ill person's vomiting launch tiny viral particles into the air, where they might waft into your mouth or onto surfaces that you would later touch?\u003c/p>\n\u003caside class=\"pullquote alignright\">A person sick with norovirus can spread billions of infectious particles, and only 18 are enough to make another person ill.\u003ccite>Centers for Disease Prevention and Control\u003c/cite>\u003c/aside>\n\u003cp>If you're now grossed out, you have good reason. Studies of the infection patterns that occur in outbreaks suggest that norovirus can indeed be aerosolized. And now there's some experimental evidence to add to that.\u003c/p>\n\u003cp>Researchers at North Carolina State and Wake Forest universities wanted to know what happens to norovirus when it's vomited out.\u003c/p>\n\u003cp>\"We first talked to a gastroenterologist and looked through the literature about what's known about vomiting,\" says \u003ca href=\"http://fbns.ncsu.edu/faculty-directory/lee-ann-jaykus/\">Lee-Ann Jaykus\u003c/a>, a food microbiologist at N.C. State and an author of the study. Not as much as you might think, it turns out. So the researchers worked with a civil engineer to construct a one-quarter scale vomiting device based on what \u003cem>is\u003c/em> known about pressure, volume and other vomit metrics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The device allowed the researchers to control the volume, viscosity and pressure of the simulated vomiting incidents. Jell-O instant pudding was added to make the lab vomit thicker.\u003c/p>\n\u003cp>Then they ran a series of experiments, changing the variables to simulate a range of vomiting behavior. They even ran one series of incidents with post-vomit retches.\u003c/p>\n\u003cfigure id=\"attachment_28726\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-28726\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/vomit-machine-1_custom-aa79d2130a323c615c415048d9e664e284beeeea-s800-c85-800x495.jpg\" alt=\"The vomit machine and vomit chamber.\" width=\"800\" height=\"495\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/vomit-machine-1_custom-aa79d2130a323c615c415048d9e664e284beeeea-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/vomit-machine-1_custom-aa79d2130a323c615c415048d9e664e284beeeea-s800-c85-400x248.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The vomit machine and vomit chamber. \u003ccite>(Courtesy of Grace Tung-Thompson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Though they conducted the experiments in a sealed Plexiglas box under a biosafety hood, norovirus was still too dangerous to use. A person sick with norovirus can spread billions of infectious particles, and only 18 are enough to make another person ill, the Centers for Disease Control and Prevention \u003ca href=\"http://www.cdc.gov/norovirus/hcp/clinical-overview.html\">says\u003c/a>.\u003c/p>\n\u003cp>So the researchers enlisted a harmless stand-in, a bacteriophage that is often used in place of norovirus in experiments. Only a fraction of virus particles were aerosolized during a typical vomiting incident. But there were definitely enough to make you sick.\u003c/p>\n\u003cp>The results \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134277\">appear\u003c/a> in the journal \u003cem>PLOS ONE\u003c/em>.\u003c/p>\n\u003cp>Another \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25900175\">recent study\u003c/a> collected air samples from eight health care facilities during norovirus outbreaks and found viral particles outside patient rooms.\u003c/p>\n\u003cp>\"Taken together, they start to paint a pretty good picture of why norovirus is so atrociously infectious,\" says \u003ca href=\"http://healthcare.utah.edu/fad/mddetail.php?physicianID=u0028338\">Andrew Pavia\u003c/a>, chief of the division of pediatric infectious diseases at the University of Utah and a spokesman for the Infectious Diseases Society of America.\u003c/p>\n\u003cp>Of course, though the researchers did their best to simulate human vomiting, they didn't do a complete mock-up of the human digestive system. (A robot named \u003ca href=\"http://www.npr.org/sections/health-shots/2013/01/04/168608466/as-norovirus-rages-a-robot-named-vomiting-larry-gets-a-closeup\">Vomiting Larry\u003c/a> is more anatomically accurate, but is less precise with regard to pressure, says Pavia.) And while the bacteriophage was chosen because of its similarity to norovirus, it may not behave the same way when aerosolized, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Katherine Hobson is a freelance health and science writer based in Brooklyn, N.Y. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/katherinehobson\">@katherinehobson\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Scientists+Create+Vomiting+Machine+To+Learn+How+Norovirus+Spreads&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"excerpt": "To investigate whether norovirus particles might form an infectious aerosol spray when a sick person vomits, researchers built a simulator that uses Jell-O instant pudding in explosive experiments.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Norovirus is a huge public health problem, sickening \u003ca href=\"http://www.cdc.gov/norovirus/trends-outbreaks.html\">as many as 21 million people a year\u003c/a> in the U.S. But for all the gastric distress it causes, there are still some basic, unanswered questions about the virus.\u003c/p>\n\u003cp>One biggie: When an ill person vomits, does norovirus become aerosolized? That is, can an ill person's vomiting launch tiny viral particles into the air, where they might waft into your mouth or onto surfaces that you would later touch?\u003c/p>\n\u003caside class=\"pullquote alignright\">A person sick with norovirus can spread billions of infectious particles, and only 18 are enough to make another person ill.\u003ccite>Centers for Disease Prevention and Control\u003c/cite>\u003c/aside>\n\u003cp>If you're now grossed out, you have good reason. Studies of the infection patterns that occur in outbreaks suggest that norovirus can indeed be aerosolized. And now there's some experimental evidence to add to that.\u003c/p>\n\u003cp>Researchers at North Carolina State and Wake Forest universities wanted to know what happens to norovirus when it's vomited out.\u003c/p>\n\u003cp>\"We first talked to a gastroenterologist and looked through the literature about what's known about vomiting,\" says \u003ca href=\"http://fbns.ncsu.edu/faculty-directory/lee-ann-jaykus/\">Lee-Ann Jaykus\u003c/a>, a food microbiologist at N.C. State and an author of the study. Not as much as you might think, it turns out. So the researchers worked with a civil engineer to construct a one-quarter scale vomiting device based on what \u003cem>is\u003c/em> known about pressure, volume and other vomit metrics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The device allowed the researchers to control the volume, viscosity and pressure of the simulated vomiting incidents. Jell-O instant pudding was added to make the lab vomit thicker.\u003c/p>\n\u003cp>Then they ran a series of experiments, changing the variables to simulate a range of vomiting behavior. They even ran one series of incidents with post-vomit retches.\u003c/p>\n\u003cfigure id=\"attachment_28726\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-28726\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/vomit-machine-1_custom-aa79d2130a323c615c415048d9e664e284beeeea-s800-c85-800x495.jpg\" alt=\"The vomit machine and vomit chamber.\" width=\"800\" height=\"495\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/vomit-machine-1_custom-aa79d2130a323c615c415048d9e664e284beeeea-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/vomit-machine-1_custom-aa79d2130a323c615c415048d9e664e284beeeea-s800-c85-400x248.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The vomit machine and vomit chamber. \u003ccite>(Courtesy of Grace Tung-Thompson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Though they conducted the experiments in a sealed Plexiglas box under a biosafety hood, norovirus was still too dangerous to use. A person sick with norovirus can spread billions of infectious particles, and only 18 are enough to make another person ill, the Centers for Disease Control and Prevention \u003ca href=\"http://www.cdc.gov/norovirus/hcp/clinical-overview.html\">says\u003c/a>.\u003c/p>\n\u003cp>So the researchers enlisted a harmless stand-in, a bacteriophage that is often used in place of norovirus in experiments. Only a fraction of virus particles were aerosolized during a typical vomiting incident. But there were definitely enough to make you sick.\u003c/p>\n\u003cp>The results \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134277\">appear\u003c/a> in the journal \u003cem>PLOS ONE\u003c/em>.\u003c/p>\n\u003cp>Another \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25900175\">recent study\u003c/a> collected air samples from eight health care facilities during norovirus outbreaks and found viral particles outside patient rooms.\u003c/p>\n\u003cp>\"Taken together, they start to paint a pretty good picture of why norovirus is so atrociously infectious,\" says \u003ca href=\"http://healthcare.utah.edu/fad/mddetail.php?physicianID=u0028338\">Andrew Pavia\u003c/a>, chief of the division of pediatric infectious diseases at the University of Utah and a spokesman for the Infectious Diseases Society of America.\u003c/p>\n\u003cp>Of course, though the researchers did their best to simulate human vomiting, they didn't do a complete mock-up of the human digestive system. (A robot named \u003ca href=\"http://www.npr.org/sections/health-shots/2013/01/04/168608466/as-norovirus-rages-a-robot-named-vomiting-larry-gets-a-closeup\">Vomiting Larry\u003c/a> is more anatomically accurate, but is less precise with regard to pressure, says Pavia.) And while the bacteriophage was chosen because of its similarity to norovirus, it may not behave the same way when aerosolized, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Katherine Hobson is a freelance health and science writer based in Brooklyn, N.Y. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/katherinehobson\">@katherinehobson\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Scientists+Create+Vomiting+Machine+To+Learn+How+Norovirus+Spreads&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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},
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"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
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},
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},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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},
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"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
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"order": 10
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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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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},
"closealltabs": {
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"order": 1
},
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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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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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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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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"freakonomics-radio": {
"id": "freakonomics-radio",
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"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"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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"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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"meta": {
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"source": "NPR"
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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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"hyphenacion": {
"id": "hyphenacion",
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"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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"order": 15
},
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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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"order": 18
},
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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/",
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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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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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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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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
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