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"content": "\u003cp>Like many health conscious Americans, Dr. Rosalind Picard wears a fitness tracker on her wrist. But hers doesn't just track steps, it has an extra sensor that gathers medical information.\u003c/p>\n\u003cp>Picard hopes the sensor, which measures the skin's electrical response, will soon save lives by predicting major health events such as epileptic seizures. As a leading engineer at the MIT Media Lab, Dr. Picard researches the autonomic nervous system, which includes heart rate, respiration, digestion, perspiration, and the fight-or-flight response.\u003c/p>\n\u003cp>Picard’s smartwatch, developed by her company \u003ca href=\"https://www.empatica.com/about\">Empatica\u003c/a>, records electrodermal (EDA) activity and wirelessly sends the data to a smartphone. The technology isn’t new, versions of the sensors have been used in polygraph tests for decades.\u003c/p>\n\u003cp>But new, highly sensitive sensor technology can now provide a continuous reading on our emotional states, linking the tiniest increase in sweating to psychological or physiological arousal.\u003c/p>\n\u003cp>Picard calls this idea of using tech to help bridge the gap between human emotions and technology, ‘Affective Computing’ and she has been driving this field of study for several years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She takes her research personally, and wears her wristband sensor every day. It shows when she’s stressed, and when she’s calm, and yields surprising insights. When Picard compares her data with other researchers wearing the sensor, she notes that her tolerance of stress is higher than average. “We find individual differences in stress points,” Picard explained. “I tend to thrive on thrill-seeking high stress situations, but other people would go nuts with what I do.”\u003c/p>\n\u003cp>\u003cstrong>Using Sensors for Autism\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">“If an autistic kid is lying on the floor motionless, but his EDA sensor reads that his signals are through the roof, caregivers can make better decisions about how to respond.\"\u003ccite>Rosalind Picard, founder of the Affective Computing Research Group at the MIT Media Lab \u003c/cite>\u003c/aside>\n\u003cp>The insight Picard has gleaned from electrodermal sensors go far beyond mood tracking. For people with autism, Picard’s lab has shown that the sensors can reveal emotional episodes that they might not be able to express verbally. “A person with autism gets overloaded and they shut down and retreat into their own little world,” she said.\u003c/p>\n\u003cp>Picard explained that autistic responses to difficult situations can seem non-intuitive and sudden to observers and might involve head banging, other self-injury, or catatonic behavior. “In some instances, they are doing this to release a neurotransmitter that can quell the pain.” Picard explains, \"if an autistic kid is lying on the floor motionless, but his EDA sensor reads that his signals are through the roof, caregivers can make better decisions about how to respond.\"\u003c/p>\n\u003cp>\u003cstrong>Predicting Seizures \u003c/strong>\u003c/p>\n\u003cp>Electrodermal sensors also have important implications for youth with epilepsy, which Picard discovered when one of her students placed the sensors on his brother. Twenty minutes before his brother had a \u003ca href=\"http://www.mayoclinic.org/diseases-conditions/grand-mal-seizure/basics/definition/con-20021356\">Grand Mal seizure\u003c/a>, the sensors registered off-the-charts skin conductance.\u003c/p>\n\u003cp>After further study, Picard and her collaborators were able to show in peer-reviewed scientific publications that EDA sensors could provide reliable warning for seizures in some patients.\u003c/p>\n\u003cp>During very serious and possibly life-threatening seizures, respiration can be affected and even stopped. Known as sudden unexpected death in epilepsy (SUDEP), this is a risk especially for children, affecting 3 in 100 epileptics, often during sleep. “That risk is a lot higher than other causes of death. SUDEP kills more people than house fires, more than AIDS, and it is very stigmatized,” said Picard. “But we believe it is preventable in most cases.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last fall, Picard’s company, Empatica, launched a \u003ca href=\"https://www.indiegogo.com/projects/embrace-a-gorgeous-watch-designed-to-save-lives#/story\">crowdfunding campaign on Indiegogo \u003c/a> and raised over $700,000. The smartwatch, called Embrace, combines technology from fitness trackers with EDA and heart rate sensors to measure stress, epileptic seizures, activity and sleep. The company’s challenge now is to complete the FDA approval process and finish production on the first models that will go to backers of the campaign, many of whom are epileptics.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She takes her research personally, and wears her wristband sensor every day. It shows when she’s stressed, and when she’s calm, and yields surprising insights. When Picard compares her data with other researchers wearing the sensor, she notes that her tolerance of stress is higher than average. “We find individual differences in stress points,” Picard explained. “I tend to thrive on thrill-seeking high stress situations, but other people would go nuts with what I do.”\u003c/p>\n\u003cp>\u003cstrong>Using Sensors for Autism\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">“If an autistic kid is lying on the floor motionless, but his EDA sensor reads that his signals are through the roof, caregivers can make better decisions about how to respond.\"\u003ccite>Rosalind Picard, founder of the Affective Computing Research Group at the MIT Media Lab \u003c/cite>\u003c/aside>\n\u003cp>The insight Picard has gleaned from electrodermal sensors go far beyond mood tracking. For people with autism, Picard’s lab has shown that the sensors can reveal emotional episodes that they might not be able to express verbally. “A person with autism gets overloaded and they shut down and retreat into their own little world,” she said.\u003c/p>\n\u003cp>Picard explained that autistic responses to difficult situations can seem non-intuitive and sudden to observers and might involve head banging, other self-injury, or catatonic behavior. “In some instances, they are doing this to release a neurotransmitter that can quell the pain.” Picard explains, \"if an autistic kid is lying on the floor motionless, but his EDA sensor reads that his signals are through the roof, caregivers can make better decisions about how to respond.\"\u003c/p>\n\u003cp>\u003cstrong>Predicting Seizures \u003c/strong>\u003c/p>\n\u003cp>Electrodermal sensors also have important implications for youth with epilepsy, which Picard discovered when one of her students placed the sensors on his brother. Twenty minutes before his brother had a \u003ca href=\"http://www.mayoclinic.org/diseases-conditions/grand-mal-seizure/basics/definition/con-20021356\">Grand Mal seizure\u003c/a>, the sensors registered off-the-charts skin conductance.\u003c/p>\n\u003cp>After further study, Picard and her collaborators were able to show in peer-reviewed scientific publications that EDA sensors could provide reliable warning for seizures in some patients.\u003c/p>\n\u003cp>During very serious and possibly life-threatening seizures, respiration can be affected and even stopped. Known as sudden unexpected death in epilepsy (SUDEP), this is a risk especially for children, affecting 3 in 100 epileptics, often during sleep. “That risk is a lot higher than other causes of death. SUDEP kills more people than house fires, more than AIDS, and it is very stigmatized,” said Picard. “But we believe it is preventable in most cases.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last fall, Picard’s company, Empatica, launched a \u003ca href=\"https://www.indiegogo.com/projects/embrace-a-gorgeous-watch-designed-to-save-lives#/story\">crowdfunding campaign on Indiegogo \u003c/a> and raised over $700,000. The smartwatch, called Embrace, combines technology from fitness trackers with EDA and heart rate sensors to measure stress, epileptic seizures, activity and sleep. The company’s challenge now is to complete the FDA approval process and finish production on the first models that will go to backers of the campaign, many of whom are epileptics.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>During a recent physical, Jeff Gordon’s doctor told him he may be pre-diabetic. It was a quick mention, mixed in with a review of blood pressure numbers, other vital statistics like his heart rate, height and weight, and details about his prescription for cholesterol medication. Normally, Gordon, 70, a food broker who lives in Washington, D.C., would have paid it little attention.\u003c/p>\n\u003cp>But his physician, who recently joined MedStar Health, uses the system’s Web portal that allows him to share his office notes with patients. For Gordon, seeing the word “pre-diabetic” in writing made it difficult to ignore, and he took action.\u003c/p>\n\u003cp>He contacted MedStar about joining a pre-diabetes clinical study. In the course of taking the tests required to participate, the otherwise healthy septuagenarian found out his blood sugar wasn’t elevated enough to qualify.\u003c/p>\n\u003cp>Still, the experience of seeing the term in his doctor’s notes was a “wake-up call,” inspiring him to pay more attention to his diet and exercise. “It’s harder to ignore when it’s in your face,” he said.\u003c/p>\n\u003cp>This kind of note-sharing got a kick-start five years ago when researchers from Harvard Medical School joined forces with the Pennsylvania-based Geisinger Health System and Harborview Medical Center in Seattle to launch a high-profile pilot program called Open Notes. The initiative focused on encouraging health care providers to give patients access to doctors’ office notes and then tracked what happened when patients read them. Even before the project, some providers had independently shared notes, but since the organized effort began, interest has grown.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.myopennotes.org/\" target=\"_blank\">Open Notes\u003c/a> estimates about 5 million people see physicians who share notes as part of the initiative, said Tom Delbanco, a professor at Harvard Medical School who has been with the project since it launched. That includes doctors from more than 20 institutions across the country, consisting of major academic medical centers and health systems ranging from the Cleveland Clinic to the Veterans Health Administration to Wellspan, in Maryland and Pennsylvania. And even beyond the project’s participants, there is a trend among physicians — such as Gordon’s doctor — to move in this direction, too.\u003c/p>\n\u003cp>It’s part of the health system’s growing focus on patient engagement – the idea that more informed people will take better care of themselves, improving their health while lowering costs. This emphasis is driven in part by the federal health law, which links Medicare payments to how well hospitals and doctors do at getting and keeping patients healthy.\u003c/p>\n\u003cp>The trend is also fueled, experts suggest, by components in the health law and the earlier financial stimulus law that set out financial incentives for doctors to use electronic health records and better connect with patients online.\u003c/p>\n\u003cp>Advocates say open notes could fundamentally shift the doctor-patient relationship by making it less paternalistic, putting patients in a position to catch mistakes and have more informed conversations with their physicians. But others worry the practice could curb honesty in what doctors write about their patients, or cause confusion if patients misinterpret what’s written.\u003c/p>\n\u003cp>What doctors write is hardly the stuff of state secrets. Some portions are technical to the point of dullness. Other portions offer clear, valuable advice.\u003c/p>\n\u003cp>In one note, shared by a patient who requested his name be withheld due to privacy reasons, a doctor wrote, in the context of a potential diagnosis of a hand deformity condition called Dupuytren’s contracture, that the patient’s “sensation is intact in the medial, ulnar and radial nerve distribution.” Hard to understand, yes, but still helpful to the patient for tracking the condition. Even more helpful, perhaps, is the physician’s summary of the condition: “It is very early, so we just need to monitor it.”\u003c/p>\n\u003cp>Some health care providers, though, worry patients might misuse the information – attempting to diagnose themselves or declining beneficial treatment because they misunderstand what’s written. That isn’t out of the question, said Jan Walker, an assistant professor of medicine at Harvard Medical School, who also worked on the Open Notes project. “We certainly believe so far, the good far outweighs the bad,” she said.\u003c/p>\n\u003cp>Kenneth Burman, director of endocrinology at MedStar Washington Hospital Center, said he independently began sharing his notes with patients years ago, mailing them a private copy. When patients read their notes, he said, they can actually “understand the diagnosis and the recommendations.” Patients will look things up, he added, and occasionally correct references to things like family history, or add relevant details he might have missed.\u003c/p>\n\u003cp>Though he can’t document it, he said patients are generally better about following through with treatment if they get to read their notes. “It helps the patient understand the disease process and what the course of action should be,” Burman said.\u003c/p>\n\u003cp>How patients respond to this disclosure varies. Some use notes as helpful reminders while others use the information to challenge a physician’s recommendation and help rule out a diagnoses.\u003c/p>\n\u003cp>For Kent Snyder, 63, a lawyer from Portland, Ore., note-sharing was particularly helpful when he developed arthritis-like symptoms and vision trouble – part of an autoimmune condition doctors still haven’t been able to figure out.\u003c/p>\n\u003cp>Reading what his doctors had written, Snyder said, helped him focus conversations on “key salient issues” – for instance, correcting physicians about symptoms he’d actually experienced, which in turn allowed them to rule out potential diagnoses.\u003c/p>\n\u003cp>Looking at his notes, Snyder added, meant he better understood why doctors ordered certain procedures or treatments.\u003c/p>\n\u003cp>“It’s not just money – I don’t want to take an antibiotic unless I absolutely have to,” he said. “I don’t want to have a test if I don’t need it.”\u003c/p>\n\u003cp>Patients’ abilities to fix errors in their records could encourage providers to adopt note-sharing, especially if it could reduce the odds of doctor mistakes, said Steven Weinberger, CEO of the American College of Physicians, which represents internal medicine doctors.\u003c/p>\n\u003cp>But while doctors and patients said they knew anecdotally of patients finding and fixing mistakes when looking at their notes, Walker said there’s no research measuring how common it is and what effect it could have on patient outcomes or satisfaction.\u003c/p>\n\u003cp>Some physicians worry sharing notes could require them to change what they write so it’s easier for patients to understand, Weinberger said. Peter Elias, an Auburn, Maine-based doctor, said colleagues often worry they might have to omit things for fear of confusing or upsetting patients. But, he added, sharing notes makes him have important conversations he might otherwise have skipped.\u003c/p>\n\u003cp>When patients see what doctors write, he said, “it makes the difficult conversations essential. You can’t skip them anymore.”\u003c/p>\n\u003cp>\u003cem>Corrected, June 2 – An earlier version of this story misidentified Jan Walker. She is an an assistant professor of medicine at Harvard Medical School.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong>This story originally appeared on \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/strong>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>During a recent physical, Jeff Gordon’s doctor told him he may be pre-diabetic. It was a quick mention, mixed in with a review of blood pressure numbers, other vital statistics like his heart rate, height and weight, and details about his prescription for cholesterol medication. Normally, Gordon, 70, a food broker who lives in Washington, D.C., would have paid it little attention.\u003c/p>\n\u003cp>But his physician, who recently joined MedStar Health, uses the system’s Web portal that allows him to share his office notes with patients. For Gordon, seeing the word “pre-diabetic” in writing made it difficult to ignore, and he took action.\u003c/p>\n\u003cp>He contacted MedStar about joining a pre-diabetes clinical study. In the course of taking the tests required to participate, the otherwise healthy septuagenarian found out his blood sugar wasn’t elevated enough to qualify.\u003c/p>\n\u003cp>Still, the experience of seeing the term in his doctor’s notes was a “wake-up call,” inspiring him to pay more attention to his diet and exercise. “It’s harder to ignore when it’s in your face,” he said.\u003c/p>\n\u003cp>This kind of note-sharing got a kick-start five years ago when researchers from Harvard Medical School joined forces with the Pennsylvania-based Geisinger Health System and Harborview Medical Center in Seattle to launch a high-profile pilot program called Open Notes. The initiative focused on encouraging health care providers to give patients access to doctors’ office notes and then tracked what happened when patients read them. Even before the project, some providers had independently shared notes, but since the organized effort began, interest has grown.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.myopennotes.org/\" target=\"_blank\">Open Notes\u003c/a> estimates about 5 million people see physicians who share notes as part of the initiative, said Tom Delbanco, a professor at Harvard Medical School who has been with the project since it launched. That includes doctors from more than 20 institutions across the country, consisting of major academic medical centers and health systems ranging from the Cleveland Clinic to the Veterans Health Administration to Wellspan, in Maryland and Pennsylvania. And even beyond the project’s participants, there is a trend among physicians — such as Gordon’s doctor — to move in this direction, too.\u003c/p>\n\u003cp>It’s part of the health system’s growing focus on patient engagement – the idea that more informed people will take better care of themselves, improving their health while lowering costs. This emphasis is driven in part by the federal health law, which links Medicare payments to how well hospitals and doctors do at getting and keeping patients healthy.\u003c/p>\n\u003cp>The trend is also fueled, experts suggest, by components in the health law and the earlier financial stimulus law that set out financial incentives for doctors to use electronic health records and better connect with patients online.\u003c/p>\n\u003cp>Advocates say open notes could fundamentally shift the doctor-patient relationship by making it less paternalistic, putting patients in a position to catch mistakes and have more informed conversations with their physicians. But others worry the practice could curb honesty in what doctors write about their patients, or cause confusion if patients misinterpret what’s written.\u003c/p>\n\u003cp>What doctors write is hardly the stuff of state secrets. Some portions are technical to the point of dullness. Other portions offer clear, valuable advice.\u003c/p>\n\u003cp>In one note, shared by a patient who requested his name be withheld due to privacy reasons, a doctor wrote, in the context of a potential diagnosis of a hand deformity condition called Dupuytren’s contracture, that the patient’s “sensation is intact in the medial, ulnar and radial nerve distribution.” Hard to understand, yes, but still helpful to the patient for tracking the condition. Even more helpful, perhaps, is the physician’s summary of the condition: “It is very early, so we just need to monitor it.”\u003c/p>\n\u003cp>Some health care providers, though, worry patients might misuse the information – attempting to diagnose themselves or declining beneficial treatment because they misunderstand what’s written. That isn’t out of the question, said Jan Walker, an assistant professor of medicine at Harvard Medical School, who also worked on the Open Notes project. “We certainly believe so far, the good far outweighs the bad,” she said.\u003c/p>\n\u003cp>Kenneth Burman, director of endocrinology at MedStar Washington Hospital Center, said he independently began sharing his notes with patients years ago, mailing them a private copy. When patients read their notes, he said, they can actually “understand the diagnosis and the recommendations.” Patients will look things up, he added, and occasionally correct references to things like family history, or add relevant details he might have missed.\u003c/p>\n\u003cp>Though he can’t document it, he said patients are generally better about following through with treatment if they get to read their notes. “It helps the patient understand the disease process and what the course of action should be,” Burman said.\u003c/p>\n\u003cp>How patients respond to this disclosure varies. Some use notes as helpful reminders while others use the information to challenge a physician’s recommendation and help rule out a diagnoses.\u003c/p>\n\u003cp>For Kent Snyder, 63, a lawyer from Portland, Ore., note-sharing was particularly helpful when he developed arthritis-like symptoms and vision trouble – part of an autoimmune condition doctors still haven’t been able to figure out.\u003c/p>\n\u003cp>Reading what his doctors had written, Snyder said, helped him focus conversations on “key salient issues” – for instance, correcting physicians about symptoms he’d actually experienced, which in turn allowed them to rule out potential diagnoses.\u003c/p>\n\u003cp>Looking at his notes, Snyder added, meant he better understood why doctors ordered certain procedures or treatments.\u003c/p>\n\u003cp>“It’s not just money – I don’t want to take an antibiotic unless I absolutely have to,” he said. “I don’t want to have a test if I don’t need it.”\u003c/p>\n\u003cp>Patients’ abilities to fix errors in their records could encourage providers to adopt note-sharing, especially if it could reduce the odds of doctor mistakes, said Steven Weinberger, CEO of the American College of Physicians, which represents internal medicine doctors.\u003c/p>\n\u003cp>But while doctors and patients said they knew anecdotally of patients finding and fixing mistakes when looking at their notes, Walker said there’s no research measuring how common it is and what effect it could have on patient outcomes or satisfaction.\u003c/p>\n\u003cp>Some physicians worry sharing notes could require them to change what they write so it’s easier for patients to understand, Weinberger said. Peter Elias, an Auburn, Maine-based doctor, said colleagues often worry they might have to omit things for fear of confusing or upsetting patients. But, he added, sharing notes makes him have important conversations he might otherwise have skipped.\u003c/p>\n\u003cp>When patients see what doctors write, he said, “it makes the difficult conversations essential. You can’t skip them anymore.”\u003c/p>\n\u003cp>\u003cem>Corrected, June 2 – An earlier version of this story misidentified Jan Walker. She is an an assistant professor of medicine at Harvard Medical School.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "You Have a Dominant Trait that Tends to Cause Disease. Should you Tell Your Partner?",
"title": "You Have a Dominant Trait that Tends to Cause Disease. Should you Tell Your Partner?",
"headTitle": "Contributor | KQED Future of You | KQED Science",
"content": "\u003cp>\u003cem>Editors' Note: Over Memorial Day, we put out a call on Twitter and Facebook for readers to share their niggling questions about genetics using the hashtag #futureofyou. And boy, did we get some fantastic responses. Your questions ranged from wondering why \u003ca href=\"https://twitter.com/Element_Tim/status/603259672108359681\">spinach tasted like tinfoil \u003c/a>to the \u003ca href=\"https://twitter.com/hill_charlotte/status/601804082739695616\">potential of administering genetic tests to pregnant women and its possible harm\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>We passed on these questions to Dr. Barry Starr, who writes regular columns for KQED about the ever-evolving field of genetics. He's selected three to tackle this week, but will return to some of your questions in upcoming posts. \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/05/22/heres-your-chance-to-ask-our-geneticist-anything/\">More on Starr and our experiment here. \u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Over to you, Barry...\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Question 1: \"What's your responsibility as spouse if you know you've a dominant trait that tends to cause disease?\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_3625\" class=\"wp-caption alignright\" style=\"max-width: 307px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Couple400.jpg\">\u003cimg class=\" wp-image-3625\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Couple400.jpg\" alt=\"How much should they reveal to each other about their personal genetics? (Pixabay)\" width=\"307\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">How much should this couple reveal to each other about their personal genetics? \u003ccite>(Pixabay)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Barry Starr: \u003c/strong>That's a very tricky\u003cstrong> \u003c/strong>question! This will be a big discussion going forward as we continue to gain more and more information about our genetic make-up.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As I \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/05/05/a-geneticists-take-on-cheaper-tests-for-breast-and-ovarian-cancer-risk/\">wrote recently\u003c/a>, a new genetic test makes it easier than ever to see if you are at a higher risk for breast cancer. There are also diseases like Huntington’s disease that are fatal but not until later in life. Each child of a person with the gene has a 50 percent chance of having it as well. Should you notify your spouse or spouse-to-be?\u003c/p>\n\u003cp>After digging around the Internet, I found a fascinating \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152490/pdf/nihms314687.pdf\">study \u003c/a>from 2011 on what people actually do with this information in dating situations. The study involved 64 people who have dominant conditions that could either affect them or their future children.\u003c/p>\n\u003cp>Some decided not to date at all to avoid the complication. Some opted to be straight with their partner, while others didn’t share the truth about their disease risk because they were afraid of rejection. Those who kept this information under wraps struggled with when and how to bring it up.\u003c/p>\n\u003cp>As a scientist, it's difficult for me to generalize about how people should act. So I turned to my colleague, \u003ca href=\"https://www.law.stanford.edu/profile/henry-t-greely\">Hank Greely\u003c/a>, the director of the Center for Law and the Biosciences at Stanford, for a more thorough explanation:\u003c/p>\n\u003cp>\"I don’t think you’ve got any legal responsibility unless you affirmatively misrepresented your status to your spouse and he or she relied on that misrepresentation in some way that caused harm,\" Greely told me.\u003c/p>\n\u003cp>To win a court case, Greely said there would likely need to be evidence that you didn't share the information. \"I think you might need a situation where the other spouse asked you something like, “So, your father has Huntington’s disease, which I’ve read puts you at 50 percent risk. Have you been tested?\" Even in a situation like this, Greely isn't sure what the damages would amount to.\u003c/p>\n\u003cp>Ethically, it's a different story. \"As an ethical matter, I think you need to reveal any serious health risks you’ve got to your partner before marriage, domestic partnership, or a decision to have kids together,\" he said.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Question #2: How can my parents and I be on the shorter side but my 2 younger brothers be 6 foot tall?\u003c/strong>\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_3756\" class=\"wp-caption alignright\" style=\"max-width: 345px\">\u003cimg class=\" wp-image-3756\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/carly-667x600.jpg\" alt=\"Carly Severn, who asked the question, with her mother and brothers \" width=\"345\" height=\"310\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-667x600.jpg 667w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-400x360.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-1180x1061.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-960x863.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly.jpg 1306w\" sizes=\"(max-width: 345px) 100vw, 345px\">\u003cfigcaption class=\"wp-caption-text\">Carly Severn (who asked the question) with her mother and brothers \u003ccite>(Carly Severn )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That's a question I'm sure a lot of folks are wondering! Height is a surprisingly complex genetic trait. Your final height is the result of the combination of genes you get from your parents \u003cem>and\u003c/em> the environment.\u003c/p>\n\u003cp>Like lots of other complex traits, height is the result of many different genes working together. In the \u003ca href=\"http://www.reuters.com/article/2014/10/05/us-science-height-idUSKCN0HU0QI20141005\">most recent tally I could find\u003c/a>, scientists found 697 gene variants in 424 gene regions (with more sure to follow). Each of these contributes a bit towards your final height. This makes for a lot of possible combinations! So it could be that your parents have a mix of many variants that make them shorter and a few that make them taller. By chance you ended up with more of the “shorter” versions and your brothers more of the “taller” ones.\u003c/p>\n\u003cp>As it turns out, around 80 percent of height is hereditary and the rest is environmental. An example of this is the huge \u003ca href=\"http://www.nytimes.com/2001/02/01/world/tokyo-journal-the-japanese-it-seems-are-outgrowing-japan.html\">changes in the average height of the Japanese\u003c/a> since World War II. In the last 50 years, the average eleven year old in Japan has gained 5.5 inches. This is way too fast for genetics and is probably explained by better nutrition. Another possibility is that one or both of your parents are shorter than their DNA says because of poor nutrition growing up. They did not reach their height potential, but passed that potential on to your brothers. (You still got the short end of the genes.) \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/ethnic-groups-and-height\">More on the genetics of height here.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Question #3: How come I didn't have any red headed children? My husband has red hair, I have brown hair. Am I not a redhead gene carrier?\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_3578\" class=\"wp-caption alignright\" style=\"max-width: 331px\">\u003cimg class=\" wp-image-3578\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/FiveBlondes.jpg\" alt='Some of these women may inherited \"red hair\" genes from both parents and still not have red hair. ' width=\"331\" height=\"210\">\u003cfigcaption class=\"wp-caption-text\">Some of these women may inherited \"red hair\" genes from both parents and still not have red hair. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Most of the time redheads have red hair because they got the necessary gene from both parents, a \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/blood-type-parent-o-blood-type-child\">classic recessive trait\u003c/a>. Since your husband has red hair, we know he passed a red hair gene to his kids. Because red hair is usually recessive, most likely that is all he has to give.\u003c/p>\n\u003cp>If you do not have a red hair gene, then your kids obviously can’t get one from you. They will get one red from your husband and one not-red from you. They will all be carriers because of your husband.\u003c/p>\n\u003cp>They will not have red hair but can pass a gene for red hair down to their kids. If their partners also pass one down, you’ll have red-headed grandkids.\u003c/p>\n\u003cp>Another possibility has to do with simple statistics. In this case you \u003cem>are\u003c/em> a carrier but you just happened not to pass the red hair gene down to any of your kids. Each child of a carrier has a 50 percent chance of getting the “red hair” gene from that parent. This does not mean, however, that 50 percent of the carrier’s kids will get it. All the kids might get it or none of them.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Note that red hair is also not a perfectly recessive trait. It is way more predictable than tongue rolling, ear lobe attachment, widow’s peak, hitchhiker thumb and so on, but there are still plenty of exceptions. A \u003ca href=\"http://hmg.oxfordjournals.org/content/16/18/2249.long\">study \u003c/a>from 2007 showed that a surprising number of people with two red hair genes do not have red hair. So it might be the case that your children did indeed get a red hair gene from you but still didn’t end up with red hair. \u003ca href=\"http://genetics.thetech.org/ask/ask44\">More on red hair genetics here\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editors' Note: Over Memorial Day, we put out a call on Twitter and Facebook for readers to share their niggling questions about genetics using the hashtag #futureofyou. And boy, did we get some fantastic responses. Your questions ranged from wondering why \u003ca href=\"https://twitter.com/Element_Tim/status/603259672108359681\">spinach tasted like tinfoil \u003c/a>to the \u003ca href=\"https://twitter.com/hill_charlotte/status/601804082739695616\">potential of administering genetic tests to pregnant women and its possible harm\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>We passed on these questions to Dr. Barry Starr, who writes regular columns for KQED about the ever-evolving field of genetics. He's selected three to tackle this week, but will return to some of your questions in upcoming posts. \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/05/22/heres-your-chance-to-ask-our-geneticist-anything/\">More on Starr and our experiment here. \u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Over to you, Barry...\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Question 1: \"What's your responsibility as spouse if you know you've a dominant trait that tends to cause disease?\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_3625\" class=\"wp-caption alignright\" style=\"max-width: 307px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Couple400.jpg\">\u003cimg class=\" wp-image-3625\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Couple400.jpg\" alt=\"How much should they reveal to each other about their personal genetics? (Pixabay)\" width=\"307\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">How much should this couple reveal to each other about their personal genetics? \u003ccite>(Pixabay)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Barry Starr: \u003c/strong>That's a very tricky\u003cstrong> \u003c/strong>question! This will be a big discussion going forward as we continue to gain more and more information about our genetic make-up.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As I \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/05/05/a-geneticists-take-on-cheaper-tests-for-breast-and-ovarian-cancer-risk/\">wrote recently\u003c/a>, a new genetic test makes it easier than ever to see if you are at a higher risk for breast cancer. There are also diseases like Huntington’s disease that are fatal but not until later in life. Each child of a person with the gene has a 50 percent chance of having it as well. Should you notify your spouse or spouse-to-be?\u003c/p>\n\u003cp>After digging around the Internet, I found a fascinating \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152490/pdf/nihms314687.pdf\">study \u003c/a>from 2011 on what people actually do with this information in dating situations. The study involved 64 people who have dominant conditions that could either affect them or their future children.\u003c/p>\n\u003cp>Some decided not to date at all to avoid the complication. Some opted to be straight with their partner, while others didn’t share the truth about their disease risk because they were afraid of rejection. Those who kept this information under wraps struggled with when and how to bring it up.\u003c/p>\n\u003cp>As a scientist, it's difficult for me to generalize about how people should act. So I turned to my colleague, \u003ca href=\"https://www.law.stanford.edu/profile/henry-t-greely\">Hank Greely\u003c/a>, the director of the Center for Law and the Biosciences at Stanford, for a more thorough explanation:\u003c/p>\n\u003cp>\"I don’t think you’ve got any legal responsibility unless you affirmatively misrepresented your status to your spouse and he or she relied on that misrepresentation in some way that caused harm,\" Greely told me.\u003c/p>\n\u003cp>To win a court case, Greely said there would likely need to be evidence that you didn't share the information. \"I think you might need a situation where the other spouse asked you something like, “So, your father has Huntington’s disease, which I’ve read puts you at 50 percent risk. Have you been tested?\" Even in a situation like this, Greely isn't sure what the damages would amount to.\u003c/p>\n\u003cp>Ethically, it's a different story. \"As an ethical matter, I think you need to reveal any serious health risks you’ve got to your partner before marriage, domestic partnership, or a decision to have kids together,\" he said.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Question #2: How can my parents and I be on the shorter side but my 2 younger brothers be 6 foot tall?\u003c/strong>\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_3756\" class=\"wp-caption alignright\" style=\"max-width: 345px\">\u003cimg class=\" wp-image-3756\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/carly-667x600.jpg\" alt=\"Carly Severn, who asked the question, with her mother and brothers \" width=\"345\" height=\"310\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-667x600.jpg 667w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-400x360.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-1180x1061.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly-960x863.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/carly.jpg 1306w\" sizes=\"(max-width: 345px) 100vw, 345px\">\u003cfigcaption class=\"wp-caption-text\">Carly Severn (who asked the question) with her mother and brothers \u003ccite>(Carly Severn )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That's a question I'm sure a lot of folks are wondering! Height is a surprisingly complex genetic trait. Your final height is the result of the combination of genes you get from your parents \u003cem>and\u003c/em> the environment.\u003c/p>\n\u003cp>Like lots of other complex traits, height is the result of many different genes working together. In the \u003ca href=\"http://www.reuters.com/article/2014/10/05/us-science-height-idUSKCN0HU0QI20141005\">most recent tally I could find\u003c/a>, scientists found 697 gene variants in 424 gene regions (with more sure to follow). Each of these contributes a bit towards your final height. This makes for a lot of possible combinations! So it could be that your parents have a mix of many variants that make them shorter and a few that make them taller. By chance you ended up with more of the “shorter” versions and your brothers more of the “taller” ones.\u003c/p>\n\u003cp>As it turns out, around 80 percent of height is hereditary and the rest is environmental. An example of this is the huge \u003ca href=\"http://www.nytimes.com/2001/02/01/world/tokyo-journal-the-japanese-it-seems-are-outgrowing-japan.html\">changes in the average height of the Japanese\u003c/a> since World War II. In the last 50 years, the average eleven year old in Japan has gained 5.5 inches. This is way too fast for genetics and is probably explained by better nutrition. Another possibility is that one or both of your parents are shorter than their DNA says because of poor nutrition growing up. They did not reach their height potential, but passed that potential on to your brothers. (You still got the short end of the genes.) \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/ethnic-groups-and-height\">More on the genetics of height here.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Question #3: How come I didn't have any red headed children? My husband has red hair, I have brown hair. Am I not a redhead gene carrier?\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_3578\" class=\"wp-caption alignright\" style=\"max-width: 331px\">\u003cimg class=\" wp-image-3578\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/FiveBlondes.jpg\" alt='Some of these women may inherited \"red hair\" genes from both parents and still not have red hair. ' width=\"331\" height=\"210\">\u003cfigcaption class=\"wp-caption-text\">Some of these women may inherited \"red hair\" genes from both parents and still not have red hair. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Most of the time redheads have red hair because they got the necessary gene from both parents, a \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/blood-type-parent-o-blood-type-child\">classic recessive trait\u003c/a>. Since your husband has red hair, we know he passed a red hair gene to his kids. Because red hair is usually recessive, most likely that is all he has to give.\u003c/p>\n\u003cp>If you do not have a red hair gene, then your kids obviously can’t get one from you. They will get one red from your husband and one not-red from you. They will all be carriers because of your husband.\u003c/p>\n\u003cp>They will not have red hair but can pass a gene for red hair down to their kids. If their partners also pass one down, you’ll have red-headed grandkids.\u003c/p>\n\u003cp>Another possibility has to do with simple statistics. In this case you \u003cem>are\u003c/em> a carrier but you just happened not to pass the red hair gene down to any of your kids. Each child of a carrier has a 50 percent chance of getting the “red hair” gene from that parent. This does not mean, however, that 50 percent of the carrier’s kids will get it. All the kids might get it or none of them.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Note that red hair is also not a perfectly recessive trait. It is way more predictable than tongue rolling, ear lobe attachment, widow’s peak, hitchhiker thumb and so on, but there are still plenty of exceptions. A \u003ca href=\"http://hmg.oxfordjournals.org/content/16/18/2249.long\">study \u003c/a>from 2007 showed that a surprising number of people with two red hair genes do not have red hair. So it might be the case that your children did indeed get a red hair gene from you but still didn’t end up with red hair. \u003ca href=\"http://genetics.thetech.org/ask/ask44\">More on red hair genetics here\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Hearing Technology Brings Sound to a Little Girl",
"title": "New Hearing Technology Brings Sound to a Little Girl",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003cem>[Editors' note: \u003ca href=\"http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=83\">The first cochlear implant was approved\u003c/a> by federal regulators in 1984. The technology is considered one of the greatest medical achievements of the past 30 years, but it doesn't work for all patients. Now an experimental \u003cspan class=\"s1\">auditory brainstem implant may offer new hope for some.]\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Jiya Bavishi \u003ca href=\"#_msocom_1\" name=\"_msoanchor_1\">\u003c/a>was born deaf. For five years, she couldn't hear and she couldn't speak at all. But when I first meet her, all she wants to do is say hello. The 6-year-old is bouncing around the room at her speech therapy session in Dallas\u003ca href=\"#_msocom_2\" name=\"_msoanchor_2\">\u003c/a>. She's wearing a bright pink top; her tiny gold earrings flash as she waves her arms.\u003c/p>\n\u003cp>\"Hi,\" she says, and then uses sign language to ask who I am and talk about the ice cream her father bought for her.\u003c/p>\n\u003cp>Jiya is taking part in a clinical trial testing a new hearing technology. At 12 months, she was given a \u003ca href=\"http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx\">cochlear implant\u003c/a>. These surgically implanted devices send signals directly to the nerves used to hear. But cochlear implants don't work for everyone, and they didn't work for Jiya.\u003c/p>\n\u003cp>\"The physician was able to get all of the electrodes into her cochlea,\" says Linda Daniel, a certified auditory-verbal therapist and rehabilitative audiologist with \u003ca href=\"http://hearindallas.com/\" target=\"_blank\">HEAR\u003c/a>, a rehabilitation clinic in Dallas. Daniel has been working with Jiya since she was a baby. \"However, you have to have a sufficient or healthy auditory nerve to connect the cochlea and the electrodes up to the brainstem.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jiya's connection between the cochlea and the brainstem was too thin. There was no way for sounds to make that final leg of the journey and reach her brain.\u003c/p>\n\u003cp>Usually, the story would end here. If cochlear implants don't work, you turn to sign language. And the Bavishis did -- for years they communicated with their daughter through sign language. But then they heard about an experimental procedure called an auditory brainstem implant.\u003c/p>\n\u003cp>It is a very rare procedure, according to \u003ca href=\"http://www.masseyeandear.org/find-a-physician/details?physician_id=945050\" target=\"_blank\">Dr. Daniel Lee\u003c/a>, director of the pediatric ear, hearing and balance center at Harvard Medical School. \"There have been less than 200 of these implanted worldwide in children,\" he says. In the U.S., auditory brainstem implants are\u003ca href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm089750.htm\"> approved by the Food and Drug Administration\u003c/a> for adults and teenagers who have lost their hearing due to nerve damage, but they have not been approved for use in younger children.\u003c/p>\n\u003cp>Surgeons in Europe have pioneered the use of the auditory brainstem implant in children who are born deaf and can't receive a cochlear implant, Lee says. \"And those data look pretty encouraging.\"\u003c/p>\n\u003cp>So in 2013, the FDA approved the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT01904448?term=auditory+brainstem+implant&rank=6\">clinical trial\u003c/a> in the U.S. for young children. The Bavishis decided to apply for Jiya. It wasn't an easy decision. It would involve surgery to place a tiny microchip into Jiya's brainstem.\u003c/p>\n\u003cp>\"The family was at a crossroads,\" Daniel says. Did they want to take a chance on a risky, experimental procedure to give their daughter a chance to hear? They decided to try the procedure and traveled from their home in Frisco, Texas, to Chapel Hill, N.C., for the eight-hour surgery. The University of North Carolina is one of four institutions investigating the implant.\u003c/p>\n\u003cp>Jiya's mom, Jigna Bavishi, pulls back her daughter's purple headband to reveal two of the three parts of the device.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Even though she’s doing so good right now, we have to still be careful where we set our expectations.\"\u003cbr>\n\u003ccite>Jigna Bavishi, Jiya's Mom\u003c/cite>\u003c/aside>\n\u003cp>There's the piece that sits on her ear, which works like a microphone to pick up sounds. That microphone is attached to a small black magnet that rests on her head. What you can't see is what the magnet is connected to. And this is what makes it different from a cochlear implant. Below the skin, there's a receiver, and down in the brain stem is the microchip\u003ca href=\"#_msocom_3\" name=\"_msoanchor_3\">\u003c/a>. The idea is that the sounds picked up from the microphone on her ear end up in the implant in the brainstem.\u003c/p>\n\u003cp>\"It's a rectangular shaped element,\" says rehabilitative audiologist Linda Daniel. \"It has two rows of electrodes and each electrode is responsible for a band of frequencies.\" The electrodes transmit signals directly into the brain.\u003c/p>\n\u003cp>Daniel says we don't know exactly what Jiya hears.\u003c/p>\n\u003cp>\"I think we could assume that it doesn't sound crisp, distinct, clearly interpretable,\" she says. \"It would take longer to learn to interpret the sound.\"\u003c/p>\n\u003cp>Doctors told the Bavishis not to expect any changes for a year or two. But Jiya didn't take that long to start recognizing and mimicking sounds. On the day I visit, Jiya is playing with a yellow toy car. \"Beep, beep,\" she says.\u003c/p>\n\u003cp>\"They actually had to tell us, even though she's doing so good right now, we have to still be careful where we set our expectations,\" says Jigna.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will monitor Jiya, and four other children taking part in the study, for the next few years. They'll be studying how their brains develop and incorporate sounds and speech. There are two other clinical trials investigating auditory brainstem implants in children: one at \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02102256?term=auditory+brainstem+implant&rank=5\">Children's Hospital\u003c/a> in Los Angeles, and the other at the New York \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02310399?term=auditory+brainstem+implant&rank=3\">University School of Medicine\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 KERA Unlimited. To see more, visit \u003ca href=\"http://www.kera.org/\">http://www.kera.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=New+Hearing+Technology+Brings+Sound+To+A+Little+Girl&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n",
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"excerpt": "Jiya Bavishi is one of a handful of children in the United States testing an experimental hearing device, a tiny implant in her brainstem. Jiya is now able to hear and repeat some sounds.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>[Editors' note: \u003ca href=\"http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=83\">The first cochlear implant was approved\u003c/a> by federal regulators in 1984. The technology is considered one of the greatest medical achievements of the past 30 years, but it doesn't work for all patients. Now an experimental \u003cspan class=\"s1\">auditory brainstem implant may offer new hope for some.]\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Jiya Bavishi \u003ca href=\"#_msocom_1\" name=\"_msoanchor_1\">\u003c/a>was born deaf. For five years, she couldn't hear and she couldn't speak at all. But when I first meet her, all she wants to do is say hello. The 6-year-old is bouncing around the room at her speech therapy session in Dallas\u003ca href=\"#_msocom_2\" name=\"_msoanchor_2\">\u003c/a>. She's wearing a bright pink top; her tiny gold earrings flash as she waves her arms.\u003c/p>\n\u003cp>\"Hi,\" she says, and then uses sign language to ask who I am and talk about the ice cream her father bought for her.\u003c/p>\n\u003cp>Jiya is taking part in a clinical trial testing a new hearing technology. At 12 months, she was given a \u003ca href=\"http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx\">cochlear implant\u003c/a>. These surgically implanted devices send signals directly to the nerves used to hear. But cochlear implants don't work for everyone, and they didn't work for Jiya.\u003c/p>\n\u003cp>\"The physician was able to get all of the electrodes into her cochlea,\" says Linda Daniel, a certified auditory-verbal therapist and rehabilitative audiologist with \u003ca href=\"http://hearindallas.com/\" target=\"_blank\">HEAR\u003c/a>, a rehabilitation clinic in Dallas. Daniel has been working with Jiya since she was a baby. \"However, you have to have a sufficient or healthy auditory nerve to connect the cochlea and the electrodes up to the brainstem.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jiya's connection between the cochlea and the brainstem was too thin. There was no way for sounds to make that final leg of the journey and reach her brain.\u003c/p>\n\u003cp>Usually, the story would end here. If cochlear implants don't work, you turn to sign language. And the Bavishis did -- for years they communicated with their daughter through sign language. But then they heard about an experimental procedure called an auditory brainstem implant.\u003c/p>\n\u003cp>It is a very rare procedure, according to \u003ca href=\"http://www.masseyeandear.org/find-a-physician/details?physician_id=945050\" target=\"_blank\">Dr. Daniel Lee\u003c/a>, director of the pediatric ear, hearing and balance center at Harvard Medical School. \"There have been less than 200 of these implanted worldwide in children,\" he says. In the U.S., auditory brainstem implants are\u003ca href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm089750.htm\"> approved by the Food and Drug Administration\u003c/a> for adults and teenagers who have lost their hearing due to nerve damage, but they have not been approved for use in younger children.\u003c/p>\n\u003cp>Surgeons in Europe have pioneered the use of the auditory brainstem implant in children who are born deaf and can't receive a cochlear implant, Lee says. \"And those data look pretty encouraging.\"\u003c/p>\n\u003cp>So in 2013, the FDA approved the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT01904448?term=auditory+brainstem+implant&rank=6\">clinical trial\u003c/a> in the U.S. for young children. The Bavishis decided to apply for Jiya. It wasn't an easy decision. It would involve surgery to place a tiny microchip into Jiya's brainstem.\u003c/p>\n\u003cp>\"The family was at a crossroads,\" Daniel says. Did they want to take a chance on a risky, experimental procedure to give their daughter a chance to hear? They decided to try the procedure and traveled from their home in Frisco, Texas, to Chapel Hill, N.C., for the eight-hour surgery. The University of North Carolina is one of four institutions investigating the implant.\u003c/p>\n\u003cp>Jiya's mom, Jigna Bavishi, pulls back her daughter's purple headband to reveal two of the three parts of the device.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Even though she’s doing so good right now, we have to still be careful where we set our expectations.\"\u003cbr>\n\u003ccite>Jigna Bavishi, Jiya's Mom\u003c/cite>\u003c/aside>\n\u003cp>There's the piece that sits on her ear, which works like a microphone to pick up sounds. That microphone is attached to a small black magnet that rests on her head. What you can't see is what the magnet is connected to. And this is what makes it different from a cochlear implant. Below the skin, there's a receiver, and down in the brain stem is the microchip\u003ca href=\"#_msocom_3\" name=\"_msoanchor_3\">\u003c/a>. The idea is that the sounds picked up from the microphone on her ear end up in the implant in the brainstem.\u003c/p>\n\u003cp>\"It's a rectangular shaped element,\" says rehabilitative audiologist Linda Daniel. \"It has two rows of electrodes and each electrode is responsible for a band of frequencies.\" The electrodes transmit signals directly into the brain.\u003c/p>\n\u003cp>Daniel says we don't know exactly what Jiya hears.\u003c/p>\n\u003cp>\"I think we could assume that it doesn't sound crisp, distinct, clearly interpretable,\" she says. \"It would take longer to learn to interpret the sound.\"\u003c/p>\n\u003cp>Doctors told the Bavishis not to expect any changes for a year or two. But Jiya didn't take that long to start recognizing and mimicking sounds. On the day I visit, Jiya is playing with a yellow toy car. \"Beep, beep,\" she says.\u003c/p>\n\u003cp>\"They actually had to tell us, even though she's doing so good right now, we have to still be careful where we set our expectations,\" says Jigna.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will monitor Jiya, and four other children taking part in the study, for the next few years. They'll be studying how their brains develop and incorporate sounds and speech. There are two other clinical trials investigating auditory brainstem implants in children: one at \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02102256?term=auditory+brainstem+implant&rank=5\">Children's Hospital\u003c/a> in Los Angeles, and the other at the New York \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02310399?term=auditory+brainstem+implant&rank=3\">University School of Medicine\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 KERA Unlimited. To see more, visit \u003ca href=\"http://www.kera.org/\">http://www.kera.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=New+Hearing+Technology+Brings+Sound+To+A+Little+Girl&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Training Doctors to Talk about Vaccines Fails to Sway Parents",
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"content": "\u003cp>After years of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">increasing rates\u003c/a> of parents voluntarily choosing to skip vaccinations for their children, public health professionals and researchers have been looking at new ways to ease the concerns of parents who are vaccine hesitant.\u003c/p>\n\u003cp>But that turns out to be tough to do. Simply educating parents about the safety and efficacy of vaccines \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365.abstract?sid=4c82b05f-5ad9-4ab5-b91e-b187e909c237\" target=\"_blank\">doesn't increase \u003c/a>their likelihood of vaccinating their children.\u003c/p>\n\u003cp>Group Health Research Institute in Seattle tried a different approach. Since \u003ca href=\"http://www.researchgate.net/publication/6716211_Association_between_health_care_providers'_influence_on_parents_who_have_concerns_about_vaccine_safety_and_vaccination_coverage\" target=\"_blank\">numerous studies\u003c/a> show that doctors are the most trusted communicators of information about vaccines, researchers tried an intervention aimed at improving how doctors and other providers communicate with vaccine-hesitant mothers about vaccines.\u003c/p>\n\u003cp>\"The intervention was designed to involve parents and respect where they were coming from, respect that they wanted what was best for their child, and the provider wanted that, too,\" said the study's lead author, Nora Henrikson, Ph.D., a research associate with the institute. The goal, she said, was to help doctors address parents' concerns, but \"still make a strong recommendation for vaccines.\"\u003c/p>\n\u003cp>It was a lofty goal, but the upshot is this: It didn't work.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There was no sign that what the researchers did in the study helped to reduce vaccine hesitancy.\u003c/p>\n\u003cp>But that's not the end of this approach.\u003c/p>\n\u003cp>Scientists like to say that finding out something doesn't work can be just as important as finding out when something does. Not only researchers involved with the study -- but also those who had nothing to do with it -- say that's the case here.\u003c/p>\n\u003cp>Let's look first at what Group Health Research did in its study, which they say is the first randomized trial to test improving hesitancy about vaccination -- by directly targeting doctors.\u003c/p>\n\u003cp>The centerpiece of the new approach was a 45-minute training of a \"novel communication strategy\" with doctors and providers, It was based on \"best practices in physican-patient communication, adapted to vaccine conversations,\" the authors wrote. Doctors also received written support material, monthly emails and assistance upon request.\u003c/p>\n\u003cp>The parents themselves did not receive training. The goal was to see if giving doctors better tools in communicating about vaccines would reduce hesitancy in mothers.\u003c/p>\n\u003cp>In the study, 347 mothers of healthy newborn babies were randomized into two groups: Some received care in clinics where doctors had received the training, and the rest went to clinics that did not.\u003c/p>\n\u003cp>The study lasted six months, and vaccine hesitancy declined somewhat in both groups, but there was no statistically significant difference between the two. During the study period, there was a whooping cough outbreak in Washington, as well as a new law requiring a doctor's note before opting out of vaccines. The decline in vaccine hesitancy may have been related to those events, rather than anything in the study.\u003c/p>\n\u003cp>The study was published in the journal Pediatrics and was funded by the Group Health Foundation and the Bill and Melinda Gates Foundation.\u003c/p>\n\u003cp>\"Obviously, we were hopeful that it would improve vaccine hesitancy, so we would have preferred to see a different effect,\" Henrikson said, \"but it really raised more questions about what other projects we could do moving forward.\"\u003c/p>\n\u003cp>Brendan Nyhan, a professor of government at Dartmouth, has been looking at vaccines and testing different approaches of educating parents. He was also positive about the research.\u003c/p>\n\u003cp>\"We're headed in the right direction,\" he told State of Health. \"We're starting to ask better questions, and part of real science is that sometimes our experiments don't work out the way we expect.\"\u003c/p>\n\u003cp>In any accompanying editorial, Julie Leask, Ph.D., with the University of Sydney's School of Public Health, and Paul Kinnersley, M.D., at the Institute of Medical Education at the University of Cardiff in Wales, said the study \"required careful consideration and should be seen as the start, not the end of the story.\" It pointed to a \"clear need to develop new approaches to vaccine consultation.\"\u003c/p>\n\u003cp>One of Henrikson's big questions was whether the 45-minute training was \"a big enough dose of the intervention. It's not a bad intervention,\" she said, \"but a more intense version of it might be able to make a difference.\"\u003c/p>\n\u003cp>Since the overwhelming majority of parents do vaccinate their children, Henrikson said another area for future research could be identifying ways to \"help providers make time for parents who do have more questions and need more time.\"\u003c/p>\n\u003cp>She pointed out that concerns about vaccines are not an all-or-nothing proposition. It's a continuum, she says. On one end are people who support vaccines and ensure their children receive all recommended vaccinations. On the other end are people who refuse all vaccines.\u003c/p>\n\u003cp>\"Then there are people in between,\" Henrikson said, \"and we're still understanding that. And at what point do people really have all the information they need?\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What we want to do is build a body of evidence about how doctors can communicate about vaccines,\" Nyhan said. \"Each time we do this, we'll learn more.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">increasing rates\u003c/a> of parents voluntarily choosing to skip vaccinations for their children, public health professionals and researchers have been looking at new ways to ease the concerns of parents who are vaccine hesitant.\u003c/p>\n\u003cp>But that turns out to be tough to do. Simply educating parents about the safety and efficacy of vaccines \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365.abstract?sid=4c82b05f-5ad9-4ab5-b91e-b187e909c237\" target=\"_blank\">doesn't increase \u003c/a>their likelihood of vaccinating their children.\u003c/p>\n\u003cp>Group Health Research Institute in Seattle tried a different approach. Since \u003ca href=\"http://www.researchgate.net/publication/6716211_Association_between_health_care_providers'_influence_on_parents_who_have_concerns_about_vaccine_safety_and_vaccination_coverage\" target=\"_blank\">numerous studies\u003c/a> show that doctors are the most trusted communicators of information about vaccines, researchers tried an intervention aimed at improving how doctors and other providers communicate with vaccine-hesitant mothers about vaccines.\u003c/p>\n\u003cp>\"The intervention was designed to involve parents and respect where they were coming from, respect that they wanted what was best for their child, and the provider wanted that, too,\" said the study's lead author, Nora Henrikson, Ph.D., a research associate with the institute. The goal, she said, was to help doctors address parents' concerns, but \"still make a strong recommendation for vaccines.\"\u003c/p>\n\u003cp>It was a lofty goal, but the upshot is this: It didn't work.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There was no sign that what the researchers did in the study helped to reduce vaccine hesitancy.\u003c/p>\n\u003cp>But that's not the end of this approach.\u003c/p>\n\u003cp>Scientists like to say that finding out something doesn't work can be just as important as finding out when something does. Not only researchers involved with the study -- but also those who had nothing to do with it -- say that's the case here.\u003c/p>\n\u003cp>Let's look first at what Group Health Research did in its study, which they say is the first randomized trial to test improving hesitancy about vaccination -- by directly targeting doctors.\u003c/p>\n\u003cp>The centerpiece of the new approach was a 45-minute training of a \"novel communication strategy\" with doctors and providers, It was based on \"best practices in physican-patient communication, adapted to vaccine conversations,\" the authors wrote. Doctors also received written support material, monthly emails and assistance upon request.\u003c/p>\n\u003cp>The parents themselves did not receive training. The goal was to see if giving doctors better tools in communicating about vaccines would reduce hesitancy in mothers.\u003c/p>\n\u003cp>In the study, 347 mothers of healthy newborn babies were randomized into two groups: Some received care in clinics where doctors had received the training, and the rest went to clinics that did not.\u003c/p>\n\u003cp>The study lasted six months, and vaccine hesitancy declined somewhat in both groups, but there was no statistically significant difference between the two. During the study period, there was a whooping cough outbreak in Washington, as well as a new law requiring a doctor's note before opting out of vaccines. The decline in vaccine hesitancy may have been related to those events, rather than anything in the study.\u003c/p>\n\u003cp>The study was published in the journal Pediatrics and was funded by the Group Health Foundation and the Bill and Melinda Gates Foundation.\u003c/p>\n\u003cp>\"Obviously, we were hopeful that it would improve vaccine hesitancy, so we would have preferred to see a different effect,\" Henrikson said, \"but it really raised more questions about what other projects we could do moving forward.\"\u003c/p>\n\u003cp>Brendan Nyhan, a professor of government at Dartmouth, has been looking at vaccines and testing different approaches of educating parents. He was also positive about the research.\u003c/p>\n\u003cp>\"We're headed in the right direction,\" he told State of Health. \"We're starting to ask better questions, and part of real science is that sometimes our experiments don't work out the way we expect.\"\u003c/p>\n\u003cp>In any accompanying editorial, Julie Leask, Ph.D., with the University of Sydney's School of Public Health, and Paul Kinnersley, M.D., at the Institute of Medical Education at the University of Cardiff in Wales, said the study \"required careful consideration and should be seen as the start, not the end of the story.\" It pointed to a \"clear need to develop new approaches to vaccine consultation.\"\u003c/p>\n\u003cp>One of Henrikson's big questions was whether the 45-minute training was \"a big enough dose of the intervention. It's not a bad intervention,\" she said, \"but a more intense version of it might be able to make a difference.\"\u003c/p>\n\u003cp>Since the overwhelming majority of parents do vaccinate their children, Henrikson said another area for future research could be identifying ways to \"help providers make time for parents who do have more questions and need more time.\"\u003c/p>\n\u003cp>She pointed out that concerns about vaccines are not an all-or-nothing proposition. It's a continuum, she says. On one end are people who support vaccines and ensure their children receive all recommended vaccinations. On the other end are people who refuse all vaccines.\u003c/p>\n\u003cp>\"Then there are people in between,\" Henrikson said, \"and we're still understanding that. And at what point do people really have all the information they need?\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What we want to do is build a body of evidence about how doctors can communicate about vaccines,\" Nyhan said. \"Each time we do this, we'll learn more.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Earlier this spring, headlines around the world trumpeted an exciting bit of news that seemed too good to be true: \"Eating that bar of chocolate can HELP you lose weight,\" as Britain's \u003cem>Daily Mail\u003c/em> put it.\u003c/p>\n\u003cp>From India to Australia and Texas to Germany, news organizations shared \u003ca href=\"http://instituteofdiet.com/2015/03/24/international-archives-of-medicine-chocolate-with-high-cocoa-content-as-a-weight-loss-accelerator/\" target=\"_blank\">findings\u003c/a> published in the \u003cem>International Archives of Medicine\u003c/em> in late March.\u003c/p>\n\u003cp>The problem? The study they were based on was pure junk. And the person behind it, \u003ca href=\"http://www.johnbohannon.org/\">John Bohannon\u003c/a>, would be the first to tell you that.\u003c/p>\n\u003cp>In fact, that's exactly what he did Wednesday, in a \u003ca href=\"http://io9.com/i-fooled-millions-into-thinking-chocolate-helps-weight-1707251800\" target=\"_blank\">story for io9\u003c/a> that's gone viral. Bohannon, a science journalist who also has a Ph.D., lays out how he carried out an elaborate hoax to expose just how easily bad nutrition science gets disseminated in the mainstream media.\u003c/p>\n\u003cp>Diet science, Bohannon stresses, is still science – and reporters need to know how to cover it. \"You have to know how to read a scientific paper — and actually bother to do it,\" he writes. \"For far too long, the people who cover this beat have treated it like gossip, echoing whatever they find in press releases. Hopefully our little experiment will make reporters and readers alike more skeptical.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To be clear, the study involved was real — a randomized controlled trial. Bohannon and his partners, a German television reporter and his collaborator, really did recruit 16 people for a study on dieting. And they found that the ones who followed a low-carb diet and also ate a 1.5-ounce bar of dark chocolate daily lost weight faster than the control group that was dieting alone.\u003c/p>\n\u003cp>So what's the problem, you ask? There are plenty.\u003c/p>\n\u003cp>For starters, as Bohannon explains in great detail, the study design itself was flawed — it had too few subjects, and the research measured too many factors, making it likelier that some random factor would appear to have statistical significance. (Bohannon does an excellent job of explaining the specifics himself.)\u003c/p>\n\u003cp>Then there's the journal that published it — a so-called pay-for-play publication, which failed to carry out peer review of the findings. As Bohannon himself \u003ca href=\"http://www.npr.org/sections/health-shots/2013/10/03/228859954/some-online-journals-will-publish-fake-science-for-a-fee\" target=\"_blank\">exposed\u003c/a> in another sting for the journal \u003cem>Science\u003c/em> a couple of years ago, there are lots of these publications that will publish bad research for a fee.\u003c/p>\n\u003cp>And finally, none of the reporters who covered it asked an outside expert to weigh in on the research – standard operating procedure in good science journalism. If they had, an astute scientist would have spotted the problems with the study design immediately. Indeed, just this week, our sister blog, Shots, ran a \u003ca href=\"http://www.npr.org/sections/health-shots/2015/05/27/408767323/did-a-study-overreach-when-it-said-a-vaccine-prevents-leukemia\" target=\"_blank\">great post\u003c/a> by Tara Haelle explaining how this process of tapping independent experts helped steer her from reporting on a flawed study suggesting that a childhood vaccine prevents leukemia.\u003c/p>\n\u003cp>Bohannon's full story is long, but worth the read as an explanation of the pitfalls that plague science communication – especially nutrition information – in today's media climate.\u003c/p>\n\u003cp>And the problem is \u003cem>massive\u003c/em>, says \u003ca href=\"http://www.healthnewsreview.org/about-us/reviewers/gary-schwitzer/\" target=\"_blank\">Gary Schwitzer\u003c/a>, the publisher of \u003ca href=\"http://www.healthnewsreview.org/\" target=\"_blank\">Health News Review\u003c/a>. For the past nine years, the site has been dedicated to critiquing the media's coverage of health in an effort to improve it.\u003c/p>\n\u003cp>\"He's really only scratching the surface of a much broader, much deeper problem,\" Schwitzer says. \"We have examples of journalists reporting on a study that was never done. We have news releases from medical journals, academic institutions and industry that mislead journalists, who then mislead the public.\" And the pressure to publish or perish, he says, can lead well-intentioned scientists to frame their work in ways that aren't completely accurate or balanced or supported by the facts.\u003c/p>\n\u003cp>\"We are really mired in a mess, the boundaries of which few people really have a sense for,\" says Schwitzer.\u003c/p>\n\u003cp>Schwitzer says it's appropriate that Bohannon chose chocolate for his diet study stunt. From claims that chocolate can \u003ca href=\"http://www.healthnewsreview.org/news-release-review/sweet-nothing-no-evidence-costs-or-quantification-in-release-about-cocoa-and-cognitive-function/\" target=\"_blank\">boost memory\u003c/a> to press releases that \u003ca href=\"http://www.healthnewsreview.org/2011/08/the-bmj-news-release-that-keeps-on-giving-the-gift-of-chocolate-hype/\" target=\"_blank\">oversell its benefit\u003c/a> to heart health, the sweet stuff is the subject of many of the news stories Schwitzer's site criticizes.\u003c/p>\n\u003cp>But does Bohannon's stunt reveal the credibility crisis in nutrition science journalism or add to it?\u003c/p>\n\u003cp>\"I think it's a little of both,\" Schwitzer says.\u003c/p>\n\u003cp>Schwitzer is a fan of Bohannon's message – but he \u003ca href=\"http://retractionwatch.com/2015/05/28/should-the-chocolate-diet-sting-study-be-retracted-and-why-the-coverage-doesnt-surprise-a-news-watchdog/\" target=\"_blank\">worries\u003c/a> that it will get lost in our rapid churn, 24-hour news cycle, and the journalists who need to be schooled in proper nutrition science reporting will have already moved on to the next thing.\u003c/p>\n\u003cp>And there are others who aren't taking kindly to Bohannon's work. On Twitter last night, some scientists raised concerns about the ethics of running a study with human subjects with the ultimate intent to deceive, and whether participants could give informed consent if they didn't know that aim.\u003c/p>\n\u003cp>\u003ca href=\"http://www.med.nyu.edu/pophealth/faculty/caplaa01\">Art Caplan\u003c/a>, a bioethicist with the New York University Langone Medical Center, says Bohannon's experiment straddles the line between journalism and research.\u003c/p>\n\u003cp>\"I'm a fan of the study,\" he tells The Salt, \"because I think it shows certain issues in understanding media reports about nutrition.\"\u003c/p>\n\u003cp>But, he says, participants should have been debriefed at the end of the study period about what Bohannon intended to do with the data. (Note: We've reached out to Bohannon to ask about what participants were told and will post an update if we get more details.)\u003c/p>\n\u003cp>And not everyone agrees that Bohannon's ends justify his means.\u003c/p>\n\u003cp>\"It's totally not ethical. It's deliberate deception in a way that could harm people,\" says \u003ca href=\"http://about.poynter.org/about-us/our-people/kelly-mcbride\">Kelly McBride\u003c/a>, a media ethicist with the Poynter Institute. She adds: \"There's so much bad information out there, especially around diet and science, that when you make it worse you become part of the problem.\"\u003c/p>\n\u003cp>About two months have gone by since the headlines touting Bohannon's study first appeared. By now, as McBride notes, many of the people who read the news stories touting chocolate's weight-loss benefits have moved on – and may not ever come across updates explaining it was all a ruse in the service of better nutrition journalism.\u003c/p>\n\u003cp>As for the journalists for whom this exercise was intended? McBride doubts they've learned their lesson, either.\u003c/p>\n\u003cp>\"It's not a great teaching tool to humiliate people,\" she says, \"because people learn when they have a need to learn something, not when they're embarrassed or fear being embarrassed. That's not how adults learn.\" (Update: Some of the media outlets that covered the chocolate study are starting to post updates to their original stories.)\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>But in an environment saturated with news, this kind of extreme measure, Schwitzer argues, might be exactly what's needed to highlight a big problem.\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=Why+A+Journalist+Scammed+The+Media+Into+Spreading+Bad+Chocolate+Science&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Earlier this spring, headlines around the world trumpeted an exciting bit of news that seemed too good to be true: \"Eating that bar of chocolate can HELP you lose weight,\" as Britain's \u003cem>Daily Mail\u003c/em> put it.\u003c/p>\n\u003cp>From India to Australia and Texas to Germany, news organizations shared \u003ca href=\"http://instituteofdiet.com/2015/03/24/international-archives-of-medicine-chocolate-with-high-cocoa-content-as-a-weight-loss-accelerator/\" target=\"_blank\">findings\u003c/a> published in the \u003cem>International Archives of Medicine\u003c/em> in late March.\u003c/p>\n\u003cp>The problem? The study they were based on was pure junk. And the person behind it, \u003ca href=\"http://www.johnbohannon.org/\">John Bohannon\u003c/a>, would be the first to tell you that.\u003c/p>\n\u003cp>In fact, that's exactly what he did Wednesday, in a \u003ca href=\"http://io9.com/i-fooled-millions-into-thinking-chocolate-helps-weight-1707251800\" target=\"_blank\">story for io9\u003c/a> that's gone viral. Bohannon, a science journalist who also has a Ph.D., lays out how he carried out an elaborate hoax to expose just how easily bad nutrition science gets disseminated in the mainstream media.\u003c/p>\n\u003cp>Diet science, Bohannon stresses, is still science – and reporters need to know how to cover it. \"You have to know how to read a scientific paper — and actually bother to do it,\" he writes. \"For far too long, the people who cover this beat have treated it like gossip, echoing whatever they find in press releases. Hopefully our little experiment will make reporters and readers alike more skeptical.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To be clear, the study involved was real — a randomized controlled trial. Bohannon and his partners, a German television reporter and his collaborator, really did recruit 16 people for a study on dieting. And they found that the ones who followed a low-carb diet and also ate a 1.5-ounce bar of dark chocolate daily lost weight faster than the control group that was dieting alone.\u003c/p>\n\u003cp>So what's the problem, you ask? There are plenty.\u003c/p>\n\u003cp>For starters, as Bohannon explains in great detail, the study design itself was flawed — it had too few subjects, and the research measured too many factors, making it likelier that some random factor would appear to have statistical significance. (Bohannon does an excellent job of explaining the specifics himself.)\u003c/p>\n\u003cp>Then there's the journal that published it — a so-called pay-for-play publication, which failed to carry out peer review of the findings. As Bohannon himself \u003ca href=\"http://www.npr.org/sections/health-shots/2013/10/03/228859954/some-online-journals-will-publish-fake-science-for-a-fee\" target=\"_blank\">exposed\u003c/a> in another sting for the journal \u003cem>Science\u003c/em> a couple of years ago, there are lots of these publications that will publish bad research for a fee.\u003c/p>\n\u003cp>And finally, none of the reporters who covered it asked an outside expert to weigh in on the research – standard operating procedure in good science journalism. If they had, an astute scientist would have spotted the problems with the study design immediately. Indeed, just this week, our sister blog, Shots, ran a \u003ca href=\"http://www.npr.org/sections/health-shots/2015/05/27/408767323/did-a-study-overreach-when-it-said-a-vaccine-prevents-leukemia\" target=\"_blank\">great post\u003c/a> by Tara Haelle explaining how this process of tapping independent experts helped steer her from reporting on a flawed study suggesting that a childhood vaccine prevents leukemia.\u003c/p>\n\u003cp>Bohannon's full story is long, but worth the read as an explanation of the pitfalls that plague science communication – especially nutrition information – in today's media climate.\u003c/p>\n\u003cp>And the problem is \u003cem>massive\u003c/em>, says \u003ca href=\"http://www.healthnewsreview.org/about-us/reviewers/gary-schwitzer/\" target=\"_blank\">Gary Schwitzer\u003c/a>, the publisher of \u003ca href=\"http://www.healthnewsreview.org/\" target=\"_blank\">Health News Review\u003c/a>. For the past nine years, the site has been dedicated to critiquing the media's coverage of health in an effort to improve it.\u003c/p>\n\u003cp>\"He's really only scratching the surface of a much broader, much deeper problem,\" Schwitzer says. \"We have examples of journalists reporting on a study that was never done. We have news releases from medical journals, academic institutions and industry that mislead journalists, who then mislead the public.\" And the pressure to publish or perish, he says, can lead well-intentioned scientists to frame their work in ways that aren't completely accurate or balanced or supported by the facts.\u003c/p>\n\u003cp>\"We are really mired in a mess, the boundaries of which few people really have a sense for,\" says Schwitzer.\u003c/p>\n\u003cp>Schwitzer says it's appropriate that Bohannon chose chocolate for his diet study stunt. From claims that chocolate can \u003ca href=\"http://www.healthnewsreview.org/news-release-review/sweet-nothing-no-evidence-costs-or-quantification-in-release-about-cocoa-and-cognitive-function/\" target=\"_blank\">boost memory\u003c/a> to press releases that \u003ca href=\"http://www.healthnewsreview.org/2011/08/the-bmj-news-release-that-keeps-on-giving-the-gift-of-chocolate-hype/\" target=\"_blank\">oversell its benefit\u003c/a> to heart health, the sweet stuff is the subject of many of the news stories Schwitzer's site criticizes.\u003c/p>\n\u003cp>But does Bohannon's stunt reveal the credibility crisis in nutrition science journalism or add to it?\u003c/p>\n\u003cp>\"I think it's a little of both,\" Schwitzer says.\u003c/p>\n\u003cp>Schwitzer is a fan of Bohannon's message – but he \u003ca href=\"http://retractionwatch.com/2015/05/28/should-the-chocolate-diet-sting-study-be-retracted-and-why-the-coverage-doesnt-surprise-a-news-watchdog/\" target=\"_blank\">worries\u003c/a> that it will get lost in our rapid churn, 24-hour news cycle, and the journalists who need to be schooled in proper nutrition science reporting will have already moved on to the next thing.\u003c/p>\n\u003cp>And there are others who aren't taking kindly to Bohannon's work. On Twitter last night, some scientists raised concerns about the ethics of running a study with human subjects with the ultimate intent to deceive, and whether participants could give informed consent if they didn't know that aim.\u003c/p>\n\u003cp>\u003ca href=\"http://www.med.nyu.edu/pophealth/faculty/caplaa01\">Art Caplan\u003c/a>, a bioethicist with the New York University Langone Medical Center, says Bohannon's experiment straddles the line between journalism and research.\u003c/p>\n\u003cp>\"I'm a fan of the study,\" he tells The Salt, \"because I think it shows certain issues in understanding media reports about nutrition.\"\u003c/p>\n\u003cp>But, he says, participants should have been debriefed at the end of the study period about what Bohannon intended to do with the data. (Note: We've reached out to Bohannon to ask about what participants were told and will post an update if we get more details.)\u003c/p>\n\u003cp>And not everyone agrees that Bohannon's ends justify his means.\u003c/p>\n\u003cp>\"It's totally not ethical. It's deliberate deception in a way that could harm people,\" says \u003ca href=\"http://about.poynter.org/about-us/our-people/kelly-mcbride\">Kelly McBride\u003c/a>, a media ethicist with the Poynter Institute. She adds: \"There's so much bad information out there, especially around diet and science, that when you make it worse you become part of the problem.\"\u003c/p>\n\u003cp>About two months have gone by since the headlines touting Bohannon's study first appeared. By now, as McBride notes, many of the people who read the news stories touting chocolate's weight-loss benefits have moved on – and may not ever come across updates explaining it was all a ruse in the service of better nutrition journalism.\u003c/p>\n\u003cp>As for the journalists for whom this exercise was intended? McBride doubts they've learned their lesson, either.\u003c/p>\n\u003cp>\"It's not a great teaching tool to humiliate people,\" she says, \"because people learn when they have a need to learn something, not when they're embarrassed or fear being embarrassed. That's not how adults learn.\" (Update: Some of the media outlets that covered the chocolate study are starting to post updates to their original stories.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But in an environment saturated with news, this kind of extreme measure, Schwitzer argues, might be exactly what's needed to highlight a big problem.\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=Why+A+Journalist+Scammed+The+Media+Into+Spreading+Bad+Chocolate+Science&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "How Virtual Reality Worlds Can Help Reduce Pain",
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"content": "\u003cp class=\"p1\">Imagine being an otter in a virtual world where colors and landscapes unfold in endless possibilities. You engage in a game of paintball with other frisky otters. You follow a river as it travels through time and seasons, and the environment responds to your mood, calming anxiety and reinforcing relaxation.\u003c/p>\n\u003cp>This fantastical landscape is a game developed by \u003ca href=\"http://deepstreamvr.com/\">DeepStream VR\u003c/a>, a virtual reality software company based in Seattle.\u003c/p>\n\u003cp>Founded by \u003cspan class=\"s1\">Ari Hollander\u003c/span> and Howard Rose, the company aims to implement VR games for pain relief and rehabilitation. One of its earlier games, \u003ca href=\"http://www.nbcnews.com/video/rock-center/49849152#49849152\">SnowWorld\u003c/a>, has been used extensively during wound care for burn victims as well as with children undergoing painful medical procedures.\u003c/p>\n\u003cfigure id=\"attachment_3562\" class=\"wp-caption alignright\" style=\"max-width: 378px\">\u003cimg class=\" wp-image-3562\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/image003.jpg\" alt=\"This virtual reality game was developed to alleviate stress and anxiety \" width=\"378\" height=\"224\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/image003.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/image003-400x237.jpg 400w\" sizes=\"(max-width: 378px) 100vw, 378px\">\u003cfigcaption class=\"wp-caption-text\">This virtual reality game was developed to alleviate stress and anxiety \u003ccite>(Cool! )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The otter game, called Cool!, is built to address anxiety, pain and the helplessness or loss of control that people feel during painful experiences. These factors have a cumulative effect on pain, and can also slow recovery. That’s why Cool! was written with artificial intelligence that can detect your nerve state as you play, and evolve with you.\u003c/p>\n\u003cp>This may sound like science fiction, but it isn’t. \u003ca href=\"http://www.researchgate.net/publication/221514493_Immersive_VR_a_non-pharmacological_analgesic_for_chronic_pain\">Research shows\u003c/a> that using meditative techniques, combined with play within a virtual reality landscape, can reduce reliance on opioids.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Virtual Reality Distracts From Pain\u003c/strong>\u003c/p>\n\u003cp>Most use of virtual reality for pain management has been for acute pain. That is, VR is used to distract the patient from the pain. \u003ca href=\"https://depts.washington.edu/anesth/research/labs/sharar/sharar-bio.shtml\">Dr. Sam Sharar\u003c/a>, an anesthesiologist at University of Washington, and his team have \u003ca href=\"http://www.hitl.washington.edu/projects/vrpain/\">amassed research\u003c/a> into the analgesic effects of distraction in pain management.\u003c/p>\n\u003cp>“Cognitive distraction during a painful experience takes some of the conscious attention away from the painful stimulus,” Sharar says. If a patient’s attention can be consumed in an immersive virtual world, they experience less pain.\u003c/p>\n\u003cfigure id=\"attachment_3528\" class=\"wp-caption alignright\" style=\"max-width: 311px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/fMRI.jpg\">\u003cimg class=\" wp-image-3528\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/fMRI.jpg\" alt=\"These images from an fMRI scan show areas of the brain affected by pain, and how they shrink when the patient is immersed in a virtual reality world. (Courtesy Dr. Sam Sharar/University of Washington)\" width=\"311\" height=\"194\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/fMRI.jpg 401w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/fMRI-400x249.jpg 400w\" sizes=\"(max-width: 311px) 100vw, 311px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">These images from an fMRI scan show areas of the brain affected by pain, and how they shrink when the patient is immersed in a virtual reality world. \u003ccite>(Dr. Sam Sharar/University of Washington)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>SnowWorld, for example, was designed specifically with burn victims in mind. The environment is blue and white, with icy hues and ice cliffs. Within the arctic world, the player plays with engages with snowmen, throws snowballs, moves through snowy ravines with icicles. The design surrounds the perceptual field; music further immerses the patient in the virtual world.\u003c/p>\n\u003cp>One hypothesis as to why VR works is that immersion in the virtual world produces endorphins that help mask the pain experience.\u003c/p>\n\u003cp>Sharar’s team tested that theory using naloxone, a narcotic inhibitor. If endorphins were causing reduced pain, the naloxone would have reversed that affect and the pain would have elevated again, even during VR immersion. This wasn’t the case. Scientists still don’t know exactly why VR works the way it does to diminish the experience of pain.\u003c/p>\n\u003cp>\u003cstrong>What About Chronic Pain?\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://books.nap.edu/openbook.php?record_id=13172&page=1.\">More than 100 million Americans\u003c/a> suffer from chronic pain. It may last for months or years and is often accompanied by a cascading variety of other health issues. People suffering from chronic pain experience isolation, fear and frustration from the lack of social understanding about the severity of the condition.\u003c/p>\n\u003cp>“It is a systemic, degenerative disease,” says Dr. Diane Gromala, Canada Research Chair and Professor at the Simon Fraser University in Vancouver.\u003c/p>\n\u003cp>[Watch Dr. Gromala speak at a recent TED conference in the video below.]\u003c/p>\n\u003caside class=\"pullquote alignright\">“Pain is a more terrible lord of mankind than even death itself.”\u003cbr>\n\u003ccite>Nobel Laureate Albert Schweitzer, 1931\u003c/cite>\u003c/aside>\n\u003cp>The total \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK92521/\">financial cost of chronic pain\u003c/a> in the U.S., including lower wages, lost days of work and cost of health care, ranges from $560 to $635 billion and is higher than the annual cost of heart disease, cancer, or diabetes. People who were formerly successful, active and happy have been toppled and rendered paralyzed by this disease.\u003c/p>\n\u003cp>Yet medical treatment for chronic pain is abysmal, relying intensively on opioid prescriptions that are ineffectual for long-term pain management. Prescriptions and sales of opioids in America have \u003ca href=\"http://www.nytimes.com/interactive/2013/06/23/sunday-review/the-soaring-cost-of-the-opioid-economy.html?smid=fb-share&_r=0\">risen dramatically\u003c/a> in the last 10 years, by 33% and 110% respectively. Yet people with chronic pain have an overwhelming sense of not being in control of it, especially when they experience breakthrough pain, which can severely impact their quality of life and overall sense of well-being.\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=cRdarMz--Pw&w=560&h=315]\u003c/p>\n\u003cp>\u003cstrong>New Ways To Manage Chronic Pain\u003c/strong>\u003c/p>\n\u003cp>Dr. Sean Mackey, an anesthesiologist at Stanford, experiments with perceptions of chronic pain using the fMRI scanner. His work, combined with Dr. Christopher deCharms’ efforts, has changed focus from how the nerves sense pain to how the brain processes it. Comprehending pain in this way—as a cognitive process that, like other cognitive processes, can be re-wired—is at the heart of their work.\u003c/p>\n\u003cp>With this foundation, they use the fMRI as both a diagnostic and therapeutic tool. Mackey and deCharms help patients master control over their pain by showing them real-time images of their pain digitally manifested on a screen.\u003c/p>\n\u003cp>Understanding where and how pain exists informs Gromala’s team at the \u003ca href=\"https://www.sfu.ca/vpresearch/centres/Chronic%20Pain%20Research%20Institute.html\">Chronic Pain Research Institute\u003c/a>.\u003c/p>\n\u003cp>What’s significant about Gromala’s work is that she both incorporates virtual reality as a distraction from acute pain, and also designs worlds aimed at taking advantage of the brain’s neuroplasticity. That is, she wants to interrupt the cognitive processes that make pain be experienced in a debilitating way.\u003c/p>\n\u003cp>Gromala—a chronic pain sufferer herself—and her team have developed immersive experiences that include biofeedback in order to ask people to focus on pain in order to produce thoughts about it, and better manage it. The \u003ca href=\"http://painstudieslab.com/projects/virtual-meditative-walk/\">Virtual Meditative Walk\u003c/a> uses biofeedback sensors that measure physiological symptoms like heart rate, skin temperature, or respiration along with sound, and virtual reality to enable people suffering from chronic pain to better practice \u003ca href=\"http://en.wikipedia.org/wiki/Mindfulness-based_stress_reduction\">Mindfulness-Based Stress Reduction\u003c/a>.\u003c/p>\n\u003cp>Rather than ignoring or repressing pain, the virtual environment coupled with immediate biofeedback teaches patients how much attention their pain consumes. Virtual reality doesn’t so much remove you from your world as it provides you the tools and training in which to more effectively focus and control it.\u003c/p>\n\u003cp>“It is based on a mind-body practice that scientists have studied and that humans have used for hundreds of years,” Gromala says.\u003c/p>\n\u003cp>“Technology isn’t necessary for mindful practices, but our VR system gives users immediate feedback in a number of sensory and perceptual ways. That makes it less mysterious, and users often say they feel confident that they can affect their pain, instead of feeling they are victims to it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cem>\u003cspan class=\"s1\">Susan E. Williams is a writer and consultant who specializes in science, technology and healthcare. She provides critical research to efforts including Arizona State University's Project HoneyBee, an initiative focused on validating the clinical utility of continuous physiological monitoring with consumer wearable devices. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"excerpt": "Patients can find pain relief through immersive virtual reality -- without the side effects of opioids.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">Imagine being an otter in a virtual world where colors and landscapes unfold in endless possibilities. You engage in a game of paintball with other frisky otters. You follow a river as it travels through time and seasons, and the environment responds to your mood, calming anxiety and reinforcing relaxation.\u003c/p>\n\u003cp>This fantastical landscape is a game developed by \u003ca href=\"http://deepstreamvr.com/\">DeepStream VR\u003c/a>, a virtual reality software company based in Seattle.\u003c/p>\n\u003cp>Founded by \u003cspan class=\"s1\">Ari Hollander\u003c/span> and Howard Rose, the company aims to implement VR games for pain relief and rehabilitation. One of its earlier games, \u003ca href=\"http://www.nbcnews.com/video/rock-center/49849152#49849152\">SnowWorld\u003c/a>, has been used extensively during wound care for burn victims as well as with children undergoing painful medical procedures.\u003c/p>\n\u003cfigure id=\"attachment_3562\" class=\"wp-caption alignright\" style=\"max-width: 378px\">\u003cimg class=\" wp-image-3562\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/image003.jpg\" alt=\"This virtual reality game was developed to alleviate stress and anxiety \" width=\"378\" height=\"224\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/image003.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/image003-400x237.jpg 400w\" sizes=\"(max-width: 378px) 100vw, 378px\">\u003cfigcaption class=\"wp-caption-text\">This virtual reality game was developed to alleviate stress and anxiety \u003ccite>(Cool! )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The otter game, called Cool!, is built to address anxiety, pain and the helplessness or loss of control that people feel during painful experiences. These factors have a cumulative effect on pain, and can also slow recovery. That’s why Cool! was written with artificial intelligence that can detect your nerve state as you play, and evolve with you.\u003c/p>\n\u003cp>This may sound like science fiction, but it isn’t. \u003ca href=\"http://www.researchgate.net/publication/221514493_Immersive_VR_a_non-pharmacological_analgesic_for_chronic_pain\">Research shows\u003c/a> that using meditative techniques, combined with play within a virtual reality landscape, can reduce reliance on opioids.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Virtual Reality Distracts From Pain\u003c/strong>\u003c/p>\n\u003cp>Most use of virtual reality for pain management has been for acute pain. That is, VR is used to distract the patient from the pain. \u003ca href=\"https://depts.washington.edu/anesth/research/labs/sharar/sharar-bio.shtml\">Dr. Sam Sharar\u003c/a>, an anesthesiologist at University of Washington, and his team have \u003ca href=\"http://www.hitl.washington.edu/projects/vrpain/\">amassed research\u003c/a> into the analgesic effects of distraction in pain management.\u003c/p>\n\u003cp>“Cognitive distraction during a painful experience takes some of the conscious attention away from the painful stimulus,” Sharar says. If a patient’s attention can be consumed in an immersive virtual world, they experience less pain.\u003c/p>\n\u003cfigure id=\"attachment_3528\" class=\"wp-caption alignright\" style=\"max-width: 311px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/fMRI.jpg\">\u003cimg class=\" wp-image-3528\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/fMRI.jpg\" alt=\"These images from an fMRI scan show areas of the brain affected by pain, and how they shrink when the patient is immersed in a virtual reality world. (Courtesy Dr. Sam Sharar/University of Washington)\" width=\"311\" height=\"194\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/fMRI.jpg 401w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/fMRI-400x249.jpg 400w\" sizes=\"(max-width: 311px) 100vw, 311px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">These images from an fMRI scan show areas of the brain affected by pain, and how they shrink when the patient is immersed in a virtual reality world. \u003ccite>(Dr. Sam Sharar/University of Washington)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>SnowWorld, for example, was designed specifically with burn victims in mind. The environment is blue and white, with icy hues and ice cliffs. Within the arctic world, the player plays with engages with snowmen, throws snowballs, moves through snowy ravines with icicles. The design surrounds the perceptual field; music further immerses the patient in the virtual world.\u003c/p>\n\u003cp>One hypothesis as to why VR works is that immersion in the virtual world produces endorphins that help mask the pain experience.\u003c/p>\n\u003cp>Sharar’s team tested that theory using naloxone, a narcotic inhibitor. If endorphins were causing reduced pain, the naloxone would have reversed that affect and the pain would have elevated again, even during VR immersion. This wasn’t the case. Scientists still don’t know exactly why VR works the way it does to diminish the experience of pain.\u003c/p>\n\u003cp>\u003cstrong>What About Chronic Pain?\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://books.nap.edu/openbook.php?record_id=13172&page=1.\">More than 100 million Americans\u003c/a> suffer from chronic pain. It may last for months or years and is often accompanied by a cascading variety of other health issues. People suffering from chronic pain experience isolation, fear and frustration from the lack of social understanding about the severity of the condition.\u003c/p>\n\u003cp>“It is a systemic, degenerative disease,” says Dr. Diane Gromala, Canada Research Chair and Professor at the Simon Fraser University in Vancouver.\u003c/p>\n\u003cp>[Watch Dr. Gromala speak at a recent TED conference in the video below.]\u003c/p>\n\u003caside class=\"pullquote alignright\">“Pain is a more terrible lord of mankind than even death itself.”\u003cbr>\n\u003ccite>Nobel Laureate Albert Schweitzer, 1931\u003c/cite>\u003c/aside>\n\u003cp>The total \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK92521/\">financial cost of chronic pain\u003c/a> in the U.S., including lower wages, lost days of work and cost of health care, ranges from $560 to $635 billion and is higher than the annual cost of heart disease, cancer, or diabetes. People who were formerly successful, active and happy have been toppled and rendered paralyzed by this disease.\u003c/p>\n\u003cp>Yet medical treatment for chronic pain is abysmal, relying intensively on opioid prescriptions that are ineffectual for long-term pain management. Prescriptions and sales of opioids in America have \u003ca href=\"http://www.nytimes.com/interactive/2013/06/23/sunday-review/the-soaring-cost-of-the-opioid-economy.html?smid=fb-share&_r=0\">risen dramatically\u003c/a> in the last 10 years, by 33% and 110% respectively. Yet people with chronic pain have an overwhelming sense of not being in control of it, especially when they experience breakthrough pain, which can severely impact their quality of life and overall sense of well-being.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/cRdarMz--Pw'\n title='//www.youtube.com/embed/cRdarMz--Pw'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>New Ways To Manage Chronic Pain\u003c/strong>\u003c/p>\n\u003cp>Dr. Sean Mackey, an anesthesiologist at Stanford, experiments with perceptions of chronic pain using the fMRI scanner. His work, combined with Dr. Christopher deCharms’ efforts, has changed focus from how the nerves sense pain to how the brain processes it. Comprehending pain in this way—as a cognitive process that, like other cognitive processes, can be re-wired—is at the heart of their work.\u003c/p>\n\u003cp>With this foundation, they use the fMRI as both a diagnostic and therapeutic tool. Mackey and deCharms help patients master control over their pain by showing them real-time images of their pain digitally manifested on a screen.\u003c/p>\n\u003cp>Understanding where and how pain exists informs Gromala’s team at the \u003ca href=\"https://www.sfu.ca/vpresearch/centres/Chronic%20Pain%20Research%20Institute.html\">Chronic Pain Research Institute\u003c/a>.\u003c/p>\n\u003cp>What’s significant about Gromala’s work is that she both incorporates virtual reality as a distraction from acute pain, and also designs worlds aimed at taking advantage of the brain’s neuroplasticity. That is, she wants to interrupt the cognitive processes that make pain be experienced in a debilitating way.\u003c/p>\n\u003cp>Gromala—a chronic pain sufferer herself—and her team have developed immersive experiences that include biofeedback in order to ask people to focus on pain in order to produce thoughts about it, and better manage it. The \u003ca href=\"http://painstudieslab.com/projects/virtual-meditative-walk/\">Virtual Meditative Walk\u003c/a> uses biofeedback sensors that measure physiological symptoms like heart rate, skin temperature, or respiration along with sound, and virtual reality to enable people suffering from chronic pain to better practice \u003ca href=\"http://en.wikipedia.org/wiki/Mindfulness-based_stress_reduction\">Mindfulness-Based Stress Reduction\u003c/a>.\u003c/p>\n\u003cp>Rather than ignoring or repressing pain, the virtual environment coupled with immediate biofeedback teaches patients how much attention their pain consumes. Virtual reality doesn’t so much remove you from your world as it provides you the tools and training in which to more effectively focus and control it.\u003c/p>\n\u003cp>“It is based on a mind-body practice that scientists have studied and that humans have used for hundreds of years,” Gromala says.\u003c/p>\n\u003cp>“Technology isn’t necessary for mindful practices, but our VR system gives users immediate feedback in a number of sensory and perceptual ways. That makes it less mysterious, and users often say they feel confident that they can affect their pain, instead of feeling they are victims to it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cem>\u003cspan class=\"s1\">Susan E. Williams is a writer and consultant who specializes in science, technology and healthcare. She provides critical research to efforts including Arizona State University's Project HoneyBee, an initiative focused on validating the clinical utility of continuous physiological monitoring with consumer wearable devices. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Delayed Umbilical Cord Clamping May Benefit Children Years Later",
"title": "Delayed Umbilical Cord Clamping May Benefit Children Years Later",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>A couple extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later, a study suggests.\u003c/p>\n\u003cp>Children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ.\u003c/p>\n\u003cp>\"There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth,\" said \u003ca href=\"http://www.sussex.ac.uk/profiles/197709\" target=\"_blank\">Dr. Heike Rabe\u003c/a>, a neonatologist at Brighton & Sussex Medical School in England. Rabe's editorial accompanied the \u003ca href=\"http://dx.doi.org/10.1001/jamapediatrics.2015.0358\" target=\"_blank\">study\u003c/a> published Tuesday in the journal \u003cem>JAMA Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Delaying the clamping of the cord allows more blood to transfer from the placenta to the infant, sometimes increasing the infant's blood volume by up to a third. The iron in the blood increases infants' iron storage, and iron is essential for healthy brain development.\u003c/p>\n\u003cp>\"The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world,\" Rabe said. \"Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Past studies have shown \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">higher levels of iron\u003c/a> and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">other positive effects\u003c/a> later in infancy among babies whose cords were clamped after several minutes, but few studies have looked at results past infancy.\u003c/p>\n\u003cp>In this study, researchers randomly assigned half of 263 healthy Swedish full-term newborns to have their cords clamped more than three minutes after birth. The other half were clamped less than 10 seconds after birth.\u003c/p>\n\u003cp>Four years later, the children underwent a series of assessments for IQ, motor skills, social skills, problem-solving, communication skills and behavior. Those with delayed cord clamping showed modestly higher scores in social skills and fine motor skills. When separated by sex, only the boys showed statistically significant improvement.\u003c/p>\n\u003cp>\"We don't know exactly why, but speculate that girls receive extra protection through higher estrogen levels whilst being in the womb,\" Rabe said. \"The results in term infants are consistent with those of follow-up in preterm infants.\"\u003c/p>\n\u003cp>Delayed cord clamping has garnered more attention in the past few years for its potential benefits to the newborn. Until recently, clinicians believed early clamping reduced the risk of hemorrhaging in the mother, but \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25404605\" target=\"_blank\">research hasn't borne\u003c/a> that out.\u003c/p>\n\u003cp>Much of the research has focused on \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984654\" target=\"_blank\">preterm infants,\u003c/a> who appear to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24901269\" target=\"_blank\">benefit most\u003c/a> from delayed cord clamping, Rabe said. Preemies who had delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain and have a lower risk of \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001148.htm\" target=\"_blank\">necrotizing enterocolitis\u003c/a>, a life-threatening bowel injury, she said.\u003c/p>\n\u003cp>This study is among the few looking at healthy, full-term infants in a country high in resources, as opposed to developing countries where iron deficiency may be more likely.\u003c/p>\n\u003cp>The American Congress of Obstetricians and Gynecologists has \u003ca href=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth\" target=\"_blank\">not yet endorsed the practice\u003c/a>, citing \u003ca href=\"http://www.acog.org/About-ACOG/News-Room/News-Releases/2012/Time-to-Clamp-the-Cord\">insufficient\u003c/a> evidence for full-term infants. The World Health Organization \u003ca href=\"http://www.who.int/elena/titles/full_recommendations/cord_clamping/en/\" target=\"_blank\">recommends delayed cord clamping\u003c/a> of not less than one minute.\u003c/p>\n\u003cp>It is unclear if the practice could harm infants' health. Some studies have found a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">higher risk of jaundice\u003c/a>, a build-up of bilirubin in the blood from the breakdown of red blood cells. Jaundice is treated with blue light therapy and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">rarely has serious complications\u003c/a>.\u003c/p>\n\u003cp>Another potential risk is a condition called polycythemia, a very high red blood cell count, said \u003ca href=\"http://www.chop.edu/doctors/lorch-scott-a#.VWR3YtJVhBc\">Dr. Scott Lorch\u003c/a>, an associate professor of pediatrics at the University of Pennsylvania Perelman School of Medicine.\u003c/p>\n\u003cp>\"Polycythemia can have medical consequences for the infant, including blood clots, respiratory distress and even strokes in the worst case scenario,\" Lorch said. Some studies have found \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/17307809\" target=\"_blank\">higher levels of red blood cells\u003c/a> in babies with delayed cord clamping, but there were no complications.\u003c/p>\n\u003cp>Lorch also pointed out that this study involved a mostly homogenous population in a country outside the U.S.\u003c/p>\n\u003cp>\"We should see whether similar effects are seen in higher-risk populations, such as the low socioeconomic population, racial and ethnic minorities and those at higher risk for neurodevelopmental delay,\" Lorch said.\u003c/p>\n\u003cp>So far, studies on delayed cord clamping have excluded infants born in distress, such as those with breathing difficulties or other problems. But Rabe said these infants may actually benefit most from the practice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>These babies often need more blood volume to help with blood pressure, breathing and circulation problems, Rabe said. \"Also, the placental blood is rich with stem cells, which could help to repair any brain damage the baby might have suffered during a difficult birth,\" she added. \"Milking of the cord would be the easiest way to get the extra blood into the baby quickly in an emergency situation.\"\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=Delayed+Umbilical+Cord+Clamping+May+Benefit+Children+Years+Later&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A couple extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later, a study suggests.\u003c/p>\n\u003cp>Children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ.\u003c/p>\n\u003cp>\"There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth,\" said \u003ca href=\"http://www.sussex.ac.uk/profiles/197709\" target=\"_blank\">Dr. Heike Rabe\u003c/a>, a neonatologist at Brighton & Sussex Medical School in England. Rabe's editorial accompanied the \u003ca href=\"http://dx.doi.org/10.1001/jamapediatrics.2015.0358\" target=\"_blank\">study\u003c/a> published Tuesday in the journal \u003cem>JAMA Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Delaying the clamping of the cord allows more blood to transfer from the placenta to the infant, sometimes increasing the infant's blood volume by up to a third. The iron in the blood increases infants' iron storage, and iron is essential for healthy brain development.\u003c/p>\n\u003cp>\"The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world,\" Rabe said. \"Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Past studies have shown \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">higher levels of iron\u003c/a> and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">other positive effects\u003c/a> later in infancy among babies whose cords were clamped after several minutes, but few studies have looked at results past infancy.\u003c/p>\n\u003cp>In this study, researchers randomly assigned half of 263 healthy Swedish full-term newborns to have their cords clamped more than three minutes after birth. The other half were clamped less than 10 seconds after birth.\u003c/p>\n\u003cp>Four years later, the children underwent a series of assessments for IQ, motor skills, social skills, problem-solving, communication skills and behavior. Those with delayed cord clamping showed modestly higher scores in social skills and fine motor skills. When separated by sex, only the boys showed statistically significant improvement.\u003c/p>\n\u003cp>\"We don't know exactly why, but speculate that girls receive extra protection through higher estrogen levels whilst being in the womb,\" Rabe said. \"The results in term infants are consistent with those of follow-up in preterm infants.\"\u003c/p>\n\u003cp>Delayed cord clamping has garnered more attention in the past few years for its potential benefits to the newborn. Until recently, clinicians believed early clamping reduced the risk of hemorrhaging in the mother, but \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25404605\" target=\"_blank\">research hasn't borne\u003c/a> that out.\u003c/p>\n\u003cp>Much of the research has focused on \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984654\" target=\"_blank\">preterm infants,\u003c/a> who appear to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24901269\" target=\"_blank\">benefit most\u003c/a> from delayed cord clamping, Rabe said. Preemies who had delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain and have a lower risk of \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001148.htm\" target=\"_blank\">necrotizing enterocolitis\u003c/a>, a life-threatening bowel injury, she said.\u003c/p>\n\u003cp>This study is among the few looking at healthy, full-term infants in a country high in resources, as opposed to developing countries where iron deficiency may be more likely.\u003c/p>\n\u003cp>The American Congress of Obstetricians and Gynecologists has \u003ca href=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth\" target=\"_blank\">not yet endorsed the practice\u003c/a>, citing \u003ca href=\"http://www.acog.org/About-ACOG/News-Room/News-Releases/2012/Time-to-Clamp-the-Cord\">insufficient\u003c/a> evidence for full-term infants. The World Health Organization \u003ca href=\"http://www.who.int/elena/titles/full_recommendations/cord_clamping/en/\" target=\"_blank\">recommends delayed cord clamping\u003c/a> of not less than one minute.\u003c/p>\n\u003cp>It is unclear if the practice could harm infants' health. Some studies have found a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">higher risk of jaundice\u003c/a>, a build-up of bilirubin in the blood from the breakdown of red blood cells. Jaundice is treated with blue light therapy and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">rarely has serious complications\u003c/a>.\u003c/p>\n\u003cp>Another potential risk is a condition called polycythemia, a very high red blood cell count, said \u003ca href=\"http://www.chop.edu/doctors/lorch-scott-a#.VWR3YtJVhBc\">Dr. Scott Lorch\u003c/a>, an associate professor of pediatrics at the University of Pennsylvania Perelman School of Medicine.\u003c/p>\n\u003cp>\"Polycythemia can have medical consequences for the infant, including blood clots, respiratory distress and even strokes in the worst case scenario,\" Lorch said. Some studies have found \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/17307809\" target=\"_blank\">higher levels of red blood cells\u003c/a> in babies with delayed cord clamping, but there were no complications.\u003c/p>\n\u003cp>Lorch also pointed out that this study involved a mostly homogenous population in a country outside the U.S.\u003c/p>\n\u003cp>\"We should see whether similar effects are seen in higher-risk populations, such as the low socioeconomic population, racial and ethnic minorities and those at higher risk for neurodevelopmental delay,\" Lorch said.\u003c/p>\n\u003cp>So far, studies on delayed cord clamping have excluded infants born in distress, such as those with breathing difficulties or other problems. But Rabe said these infants may actually benefit most from the practice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>These babies often need more blood volume to help with blood pressure, breathing and circulation problems, Rabe said. \"Also, the placental blood is rich with stem cells, which could help to repair any brain damage the baby might have suffered during a difficult birth,\" she added. \"Milking of the cord would be the easiest way to get the extra blood into the baby quickly in an emergency situation.\"\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=Delayed+Umbilical+Cord+Clamping+May+Benefit+Children+Years+Later&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The state Senate has passed a bill that would require virtually all California schoolchildren to be vaccinated.\u003c/p>\n\u003cp>\u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" target=\"_blank\" rel=\"noopener\">SB277\u003c/a> would end the “personal belief exemption” that allows parents to opt out of vaccines on behalf of their children and send their kids to school with some vaccinations or none at all. The Senate voted 25-10, mostly on partisan lines, after a long debate Thursday morning.\u003c/p>\n\u003cp>The bill’s co-author, Sen. Richard Pan (D-Sacramento), introduced the bill in the wake of a measles outbreak earlier this year that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\" rel=\"noopener\">started at Disneyland\u003c/a>.\u003c/p>\n\u003cp>While statewide vaccination rates are high — over 90 percent — some communities have high rates of children with a personal belief exemption on file with their school districts. In some schools, the rate of personal belief exemptions can be \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/look-up-the-vaccine-opt-out-rate-at-your-childs-school/\" target=\"_blank\" rel=\"noopener\">50 percent or much higher\u003c/a>.\u003c/p>\n\u003cp>“When you have pockets of low vaccination,” Pan said, “we need to do more to protect our communities. … This is a matter of public safety.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Several sets of amendments to the bill — including a religious exemption and a requirement to disclose vaccine ingredients — were introduced and then tabled after votes by the full Senate.\u003c/p>\n\u003cp>“Getting a religious exemption is not unreasonable,” said Sen. Joel Anderson, R-San Diego. “Don’t get caught up with zeal. … You can gain more with honey than you can with vinegar.”\u003c/p>\n\u003cp>But Pan said that he had not received any letters from mainstream religious organizations opposing the bill. He and SB277 co-author Ben Allen (D-Santa Monica) have “had our own conversations with religious leaders, including the Catholic Church, and they do not oppose vaccination or this bill,” he said.\u003c/p>\n\u003cp>A religious exemption could become an issue with Gov. Jerry Brown, who \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/11/how-californias-law-to-encourage-vaccination-could-backfire/\" target=\"_blank\" rel=\"noopener\">added a religious exemption in 2012 \u003c/a>when he signed into law another Pan vaccine bill — AB2109, which required those wanting a personal belief exemption to first meet with a health care provider.\u003c/p>\n\u003cp>Pan said he was open to talking with the governor about a religious exemption, but said he had not heard from Brown’s office.\u003c/p>\n\u003cp>If Pan’s bill becomes law, California would become only the third state without both a religious and personal exemption to vaccines. It would mean that children not fully vaccinated against 10 specified diseases could only be home-schooled. The bill applies to all students in public, private and parochial schools.\u003c/p>\n\u003cp>Children who cannot be vaccinated for medical reasons would be able to obtain an exemption. This includes children being treated for cancer or those with a compromised immune system.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill heads next to the Assembly.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state Senate has passed a bill that would require virtually all California schoolchildren to be vaccinated.\u003c/p>\n\u003cp>\u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" target=\"_blank\" rel=\"noopener\">SB277\u003c/a> would end the “personal belief exemption” that allows parents to opt out of vaccines on behalf of their children and send their kids to school with some vaccinations or none at all. The Senate voted 25-10, mostly on partisan lines, after a long debate Thursday morning.\u003c/p>\n\u003cp>The bill’s co-author, Sen. Richard Pan (D-Sacramento), introduced the bill in the wake of a measles outbreak earlier this year that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\" rel=\"noopener\">started at Disneyland\u003c/a>.\u003c/p>\n\u003cp>While statewide vaccination rates are high — over 90 percent — some communities have high rates of children with a personal belief exemption on file with their school districts. In some schools, the rate of personal belief exemptions can be \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/look-up-the-vaccine-opt-out-rate-at-your-childs-school/\" target=\"_blank\" rel=\"noopener\">50 percent or much higher\u003c/a>.\u003c/p>\n\u003cp>“When you have pockets of low vaccination,” Pan said, “we need to do more to protect our communities. … This is a matter of public safety.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Several sets of amendments to the bill — including a religious exemption and a requirement to disclose vaccine ingredients — were introduced and then tabled after votes by the full Senate.\u003c/p>\n\u003cp>“Getting a religious exemption is not unreasonable,” said Sen. Joel Anderson, R-San Diego. “Don’t get caught up with zeal. … You can gain more with honey than you can with vinegar.”\u003c/p>\n\u003cp>But Pan said that he had not received any letters from mainstream religious organizations opposing the bill. He and SB277 co-author Ben Allen (D-Santa Monica) have “had our own conversations with religious leaders, including the Catholic Church, and they do not oppose vaccination or this bill,” he said.\u003c/p>\n\u003cp>A religious exemption could become an issue with Gov. Jerry Brown, who \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/11/how-californias-law-to-encourage-vaccination-could-backfire/\" target=\"_blank\" rel=\"noopener\">added a religious exemption in 2012 \u003c/a>when he signed into law another Pan vaccine bill — AB2109, which required those wanting a personal belief exemption to first meet with a health care provider.\u003c/p>\n\u003cp>Pan said he was open to talking with the governor about a religious exemption, but said he had not heard from Brown’s office.\u003c/p>\n\u003cp>If Pan’s bill becomes law, California would become only the third state without both a religious and personal exemption to vaccines. It would mean that children not fully vaccinated against 10 specified diseases could only be home-schooled. The bill applies to all students in public, private and parochial schools.\u003c/p>\n\u003cp>Children who cannot be vaccinated for medical reasons would be able to obtain an exemption. This includes children being treated for cancer or those with a compromised immune system.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill heads next to the Assembly.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Back in the 1960s, the U.S. started vaccinating kids for measles. As expected, children stopped getting measles.\u003c/p>\n\u003cp>But something else happened.\u003c/p>\n\u003cp>Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.\u003c/p>\n\u003cp>Scientists saw the same phenomenon when the vaccine came to England and parts of Europe. And they see it today when developing countries introduce the vaccine.\u003c/p>\n\u003cp>\"In some developing countries, where infectious diseases are very high, the reduction in mortality has been up to 80 percent,\" says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"So it's really been a mystery,\" he says. \"Why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine?\"\u003c/p>\n\u003cp>Mina and his colleagues think they now might have an explanation. And they \u003ca title=\"http://www.sciencemag.org/content/348/6235/694.abstract\" href=\"http://www.sciencemag.org/content/348/6235/694.abstract\" target=\"_blank\">published their evidence \u003c/a>recently in the journal Science.\u003c/p>\n\u003cp>There's an obvious answer to the mystery: Children who get the measles vaccine are probably more likely to get better health care in general — maybe more antibiotics and other vaccines. And it's true that health care in the U.S. has improved since the 1960s.\u003c/p>\n\u003cp>But Mina and his colleagues have found there's more going on than that simple answer.\u003c/p>\n\u003cp>The team obtained epidemiological data from the U.S., Denmark, Wales and England dating back to the 1940s. Using computer models, they found that the number of measles cases in these countries predicted the number of deaths from other infections two to three years later.\u003c/p>\n\u003cp>\"We found measles predisposes children to all other infectious diseases for up to a few years,\" Mina says.\u003c/p>\n\u003cp>And the virus seems to do it in a sneaky way.\u003c/p>\n\u003cp>Like many viruses, measles is known to suppress the immune system for a few weeks after an infection. But previous studies in monkeys have suggested that measles takes this suppression to a whole new level: It erases immune protection to other diseases, Mina says.\u003c/p>\n\u003cp>So what does that mean? Well, say you get the chicken pox when you're 4 years old. Your immune system figures out how to fight it. So you don't get it again. But if you get measles when you're 5 years old, it could wipe out the memory of how to beat back the chicken pox. It's like the immune system has amnesia, Mina says.\u003c/p>\n\u003cp>\"The immune system kind of comes back. The only problem is that it has forgotten what it once knew,\" he says.\u003c/p>\n\u003cp>So after an infection, a child's immune system has to almost start over, rebuilding its immune protection against diseases it has already seen before.\u003c/p>\n\u003cp>This idea of \"immune amnesia\" is still just a hypothesis and needs more testing, says epidemiologist William Moss, who has studied the measles vaccine for more than a decade at Johns Hopkins University.\u003c/p>\n\u003cp>But the new study, he says, provides \"compelling evidence\" that measles affects the immune system for two to three years. That's much longer than previously thought.\u003c/p>\n\u003cp>\"Hence the reduction in overall child mortality that follows measles vaccination is much greater than previously believed,\" says Moss, who wasn't involved in the study.\u003c/p>\n\u003cp>That finding should give parents more motivation to vaccinate their kids, he says. \"I think this paper will provide additional evidence — if it's needed — of the public health benefits of measles vaccine,\" Moss says. \"That's an important message in the U.S. right now and in countries continuing to see measles outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because if the world can eliminate measles, it will help protect kids from many other infections, too.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Back in the 1960s, the U.S. started vaccinating kids for measles. As expected, children stopped getting measles.\u003c/p>\n\u003cp>But something else happened.\u003c/p>\n\u003cp>Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.\u003c/p>\n\u003cp>Scientists saw the same phenomenon when the vaccine came to England and parts of Europe. And they see it today when developing countries introduce the vaccine.\u003c/p>\n\u003cp>\"In some developing countries, where infectious diseases are very high, the reduction in mortality has been up to 80 percent,\" says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"So it's really been a mystery,\" he says. \"Why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine?\"\u003c/p>\n\u003cp>Mina and his colleagues think they now might have an explanation. And they \u003ca title=\"http://www.sciencemag.org/content/348/6235/694.abstract\" href=\"http://www.sciencemag.org/content/348/6235/694.abstract\" target=\"_blank\">published their evidence \u003c/a>recently in the journal Science.\u003c/p>\n\u003cp>There's an obvious answer to the mystery: Children who get the measles vaccine are probably more likely to get better health care in general — maybe more antibiotics and other vaccines. And it's true that health care in the U.S. has improved since the 1960s.\u003c/p>\n\u003cp>But Mina and his colleagues have found there's more going on than that simple answer.\u003c/p>\n\u003cp>The team obtained epidemiological data from the U.S., Denmark, Wales and England dating back to the 1940s. Using computer models, they found that the number of measles cases in these countries predicted the number of deaths from other infections two to three years later.\u003c/p>\n\u003cp>\"We found measles predisposes children to all other infectious diseases for up to a few years,\" Mina says.\u003c/p>\n\u003cp>And the virus seems to do it in a sneaky way.\u003c/p>\n\u003cp>Like many viruses, measles is known to suppress the immune system for a few weeks after an infection. But previous studies in monkeys have suggested that measles takes this suppression to a whole new level: It erases immune protection to other diseases, Mina says.\u003c/p>\n\u003cp>So what does that mean? Well, say you get the chicken pox when you're 4 years old. Your immune system figures out how to fight it. So you don't get it again. But if you get measles when you're 5 years old, it could wipe out the memory of how to beat back the chicken pox. It's like the immune system has amnesia, Mina says.\u003c/p>\n\u003cp>\"The immune system kind of comes back. The only problem is that it has forgotten what it once knew,\" he says.\u003c/p>\n\u003cp>So after an infection, a child's immune system has to almost start over, rebuilding its immune protection against diseases it has already seen before.\u003c/p>\n\u003cp>This idea of \"immune amnesia\" is still just a hypothesis and needs more testing, says epidemiologist William Moss, who has studied the measles vaccine for more than a decade at Johns Hopkins University.\u003c/p>\n\u003cp>But the new study, he says, provides \"compelling evidence\" that measles affects the immune system for two to three years. That's much longer than previously thought.\u003c/p>\n\u003cp>\"Hence the reduction in overall child mortality that follows measles vaccination is much greater than previously believed,\" says Moss, who wasn't involved in the study.\u003c/p>\n\u003cp>That finding should give parents more motivation to vaccinate their kids, he says. \"I think this paper will provide additional evidence — if it's needed — of the public health benefits of measles vaccine,\" Moss says. \"That's an important message in the U.S. right now and in countries continuing to see measles outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because if the world can eliminate measles, it will help protect kids from many other infections, too.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Whooping Cough Vaccine Effectiveness Fades -- and Fast",
"title": "Whooping Cough Vaccine Effectiveness Fades -- and Fast",
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"content": "\u003cp>Lately, Californians have been focused on a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">significant measles outbreak\u003c/a> that just ended. But in the last five years, state health officials have declared an epidemic of whooping cough (also known as pertussis) twice -- in 2010 and in 2014, when \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" target=\"_blank\">11,000 people were sickened\u003c/a> and three infants died.\u003c/p>\n\u003cp>Now an analysis from a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine used to fight whooping cough waned significantly. For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. That rate plummeted to 34 percent within two to four years.\u003c/p>\n\u003cp>\"(T)his waning is likely contributing to the increase in pertussis among adolescents,\" the authors wrote.\u003c/p>\n\u003cp>Tdap protects against three diseases: tetanus, diphtheria and pertussis. The pertussis protection is from the acellular pertussis vaccine. It was introduced in 1997 to replace the whole-cell vaccine, which caused more side effects. Monday's report\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" target=\"_blank\"> confirms an earlier analysis\u003c/a> that the acellular pertussis may be safer, but less effective, than the old one.\u003c/p>\n\u003cp>\u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" target=\"_blank\">The study\u003c/a> was published Monday in the journal Pediatrics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The take-home message is that the waning is there,\" said Dr. Art Reingold, a UC Berkeley professor of public health. \"You're protected initially but it wanes over time.\"\u003c/p>\n\u003cp>It doesn't mean anyone should skip the vaccine. Someone who is vaccinated, but becomes sick with whooping cough, should have a less severe course of illness.\u003c/p>\n\u003cp>The authors said that new vaccines are \"likely needed to reduce the burden of pertussis disease.\" But Reingold, who leads the CDC's Advisory Committee on Immunization Practices (ACIP) group on pertussis, said he doesn't know of any pertussis vaccine development in the pipeline.\u003c/p>\n\u003cp>He also said that adding another dose of the vaccine at a later age would not help much, based on research that was presented to the ACIP group. \"(An additional dose) would have very little impact on pertussis,\" he said, \"in terms of cases prevented.\"\u003c/p>\n\u003cp>The most severe cases are in very young infants, Reingold said. Babies cannot be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" target=\"_blank\">until they are 2 months old\u003c/a>. To protect newborns before they can be vaccinated, the CDC recommends that women be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" target=\"_blank\">during the last trimester of every pregnancy\u003c/a> -- even if they received a vaccine before they became pregnant.\u003c/p>\n\u003cp>\"Babies will be born with circulating antibodies,\" Reingold said, \"and there's pretty good evidence that that will reduce the risk of hospitalization and death in babies.\"\u003c/p>\n\u003cp>In an \u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" target=\"_blank\">accompanying commentary\u003c/a>, Dr. James Cherry at UCLA said the findings about Tdap effectiveness were \"disappointing,\" but he also pointed to other drivers of recent pertussis outbreaks, including increased awareness and better, more sensitive, testing.\u003c/p>\n\u003cp>Previous reports have shown that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">vaccine refusal\u003c/a> played a role in the 2010 whooping cough epidemic in California.\u003c/p>\n\u003cp>Reingold also drew an interesting distinction between measles and pertussis having to do with herd immunity. If a great enough percentage of the population is immunized against measles, both individuals and the broader community are protected against outbreak. That's because the measles vaccine protects people against the virus that actually causes the measles illness.\u003c/p>\n\u003cp>But in pertussis, the disease is caused by toxins that are released by bacteria. The pertussis vaccine protects people against those toxins, but may not prevent you from spreading the bacteria to others -- and causing illness in them.\u003c/p>\n\u003cp>The outbreak of measles earlier this year was likely caused by someone who brought the disease back from abroad. Measles was eliminated in the United States in 2000.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Pertussis is not going to go away with the current vaccine,\" Reingold said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lately, Californians have been focused on a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">significant measles outbreak\u003c/a> that just ended. But in the last five years, state health officials have declared an epidemic of whooping cough (also known as pertussis) twice -- in 2010 and in 2014, when \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" target=\"_blank\">11,000 people were sickened\u003c/a> and three infants died.\u003c/p>\n\u003cp>Now an analysis from a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine used to fight whooping cough waned significantly. For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. That rate plummeted to 34 percent within two to four years.\u003c/p>\n\u003cp>\"(T)his waning is likely contributing to the increase in pertussis among adolescents,\" the authors wrote.\u003c/p>\n\u003cp>Tdap protects against three diseases: tetanus, diphtheria and pertussis. The pertussis protection is from the acellular pertussis vaccine. It was introduced in 1997 to replace the whole-cell vaccine, which caused more side effects. Monday's report\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" target=\"_blank\"> confirms an earlier analysis\u003c/a> that the acellular pertussis may be safer, but less effective, than the old one.\u003c/p>\n\u003cp>\u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" target=\"_blank\">The study\u003c/a> was published Monday in the journal Pediatrics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The take-home message is that the waning is there,\" said Dr. Art Reingold, a UC Berkeley professor of public health. \"You're protected initially but it wanes over time.\"\u003c/p>\n\u003cp>It doesn't mean anyone should skip the vaccine. Someone who is vaccinated, but becomes sick with whooping cough, should have a less severe course of illness.\u003c/p>\n\u003cp>The authors said that new vaccines are \"likely needed to reduce the burden of pertussis disease.\" But Reingold, who leads the CDC's Advisory Committee on Immunization Practices (ACIP) group on pertussis, said he doesn't know of any pertussis vaccine development in the pipeline.\u003c/p>\n\u003cp>He also said that adding another dose of the vaccine at a later age would not help much, based on research that was presented to the ACIP group. \"(An additional dose) would have very little impact on pertussis,\" he said, \"in terms of cases prevented.\"\u003c/p>\n\u003cp>The most severe cases are in very young infants, Reingold said. Babies cannot be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" target=\"_blank\">until they are 2 months old\u003c/a>. To protect newborns before they can be vaccinated, the CDC recommends that women be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" target=\"_blank\">during the last trimester of every pregnancy\u003c/a> -- even if they received a vaccine before they became pregnant.\u003c/p>\n\u003cp>\"Babies will be born with circulating antibodies,\" Reingold said, \"and there's pretty good evidence that that will reduce the risk of hospitalization and death in babies.\"\u003c/p>\n\u003cp>In an \u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" target=\"_blank\">accompanying commentary\u003c/a>, Dr. James Cherry at UCLA said the findings about Tdap effectiveness were \"disappointing,\" but he also pointed to other drivers of recent pertussis outbreaks, including increased awareness and better, more sensitive, testing.\u003c/p>\n\u003cp>Previous reports have shown that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">vaccine refusal\u003c/a> played a role in the 2010 whooping cough epidemic in California.\u003c/p>\n\u003cp>Reingold also drew an interesting distinction between measles and pertussis having to do with herd immunity. If a great enough percentage of the population is immunized against measles, both individuals and the broader community are protected against outbreak. That's because the measles vaccine protects people against the virus that actually causes the measles illness.\u003c/p>\n\u003cp>But in pertussis, the disease is caused by toxins that are released by bacteria. The pertussis vaccine protects people against those toxins, but may not prevent you from spreading the bacteria to others -- and causing illness in them.\u003c/p>\n\u003cp>The outbreak of measles earlier this year was likely caused by someone who brought the disease back from abroad. Measles was eliminated in the United States in 2000.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Pertussis is not going to go away with the current vaccine,\" Reingold said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_29879\" class=\"wp-caption alignleft\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/04/Brown_MilkenInst.edit_-1024x723.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-29879\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/04/Brown_MilkenInst.edit_-1024x723.jpg\" alt=\"Governor Brown discussing his new greenhouse gas targets in Los Angeles. (Credit: Milken Inst.)\" width=\"1024\" height=\"723\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Governor Brown discussing his new greenhouse gas targets in Los Angeles. (Credit: Milken Inst.)\u003c/figcaption>\u003c/figure>\n\u003cp>Governor Jerry Brown is pursuing a new set of targets for reducing the amount of greenhouse gas released in the state.\u003c/p>\n\u003cp>Here’s the Associated Press \u003ca href=\"http://ww2.kqed.org/news/2015/04/29/brown-orders-ambitious-new-cuts-in-greenhouse-gases\">write-up\u003c/a>, and \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-jerry-brown-orders-emission-targets-for-climate-change-20150429-story.html\">this\u003c/a> from the Los Angeles Times.\u003c/p>\n\u003cp>But in a nutshell:\u003c/p>\n\u003cp>Brown’s plan is an extension of the state’s original “\u003ca href=\"http://blogs.kqed.org/climatewatch/?s=AB32\">AB 32\u003c/a>” goals – passed into law when Arnold Schwarzenegger was governor – that called for the state to return to its 1990 levels of carbon pollution by 2020. A follow-up Schwarzenegger plan tightened the screws even further, calling for an eighty-percent reduction by 2050.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“When Hitler was marching on Germany, we didn’t have any airplane factories…we transformed the whole economy.”\u003c/aside>\n\u003cp>\u003ca href=\"http://documents.latimes.com/gov-jerry-browns-executive-order-greenhouse-gas-emissions/\">Yesterday’s executive order\u003c/a> sets a concrete “intermediate target” between those two goals. By 2030, Brown wants California – “the state of imagination” as he put it — to be putting out 40 percent less greenhouse gas than we did in 1990.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://www.milkeninstitute.org/events/conferences/global-conference/global-conference-2015/panel-detail/5462\">Speaking \u003c/a>at the Milken Institute in Los Angeles, Brown compared the fight against climate change to World War II, railed against climate change deniers in Washington, and suggested Californians might need to open their minds to the idea of drinking recycled toilet water, among other things.\u003c/p>\n\u003cp>Some highlights:\u003c/p>\n\u003cp>Expressing contempt for lawmakers in Washington who still debate whether climate change is real or driven by human activity:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“In California, there is something called global warming. We’re four degrees warmer than we were historically. Our forest fire season is months longer. It’s almost year-round. This is real stuff.”\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>The new plan is ambitious, sure, he said. But we’ve done it before.\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“When Hitler was marching on Germany [sic], we didn’t have any airplane factories going and tank factories. But with Roosevelt leading, we transformed the whole economy. Dealing with the threat of climate change is going to require an analogous mobilization.” \u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>Meeting the new goals and responding to California’s epic drought will require cleaner cars, greater energy efficiency, and coming to terms with new \u003ca href=\"http://science.kqed.org/quest/audio/toilet-to-tap/\">sources of drinking water\u003c/a> that may make some Californians squeamish.\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“They don’t like to think of toilet to tap. You know, like drinking your toilet water. But you can make it as clean as the water on that table! You have to confidence in this filtration system!”\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>Comparing the slow crisis of climate change to headline news like the recent events in Baltimore:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“\u003c/em>\u003cem>You’ve got the problems in the Middle East, Iranian nuclear deal and all that…we’ve got violence in Baltimore. Those are hot and they’re immediate. But we’ve got a slow, rolling crisis that if we don’t deal with it, before we know it we will have passed a tipping point, an irreversible tendency that will be melting the Antarctic ice cap in Greenland, raising sea level, causing temperature rises. I don’t want to go through all the parade of horribles. But it’s serious, it’s catastrophic and it’s longer term.\u003cbr>\n\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>And finally, whether he, a self-described “old fogey,” can appreciate the kind of radical innovation it will take for Californians to find solutions for its drought woes and other environmental crises:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“I’m very optimistic on California because we’re not bound by the obvious. We’re not hampered by so many old-fogey ideas. And even though I’m kind of an old fogey, I’m still a radical thinker when it comes to California and what we can do.” \u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Brown has not specified how to achieve his new emissions target. His 2030 target adds to an \u003ca title=\"Q-Sci - post\" href=\"http://ww2.kqed.org/science/2015/01/05/governor-unveils-ambitious-new-climate-goals/\">ambitious list of climate goals\u003c/a> that he outlined in his State of the State address in January.\u003c/p>\n\n",
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"excerpt": "In promoting his new greenhouse gas reduction targets, the governor invokes World War II, climate-change deniers in Washington, and the recycled toilet water in our future.",
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"description": "In promoting his new greenhouse gas reduction targets, the governor invokes World War II, climate-change deniers in Washington, and the recycled toilet water in our future.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_29879\" class=\"wp-caption alignleft\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/04/Brown_MilkenInst.edit_-1024x723.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-29879\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/04/Brown_MilkenInst.edit_-1024x723.jpg\" alt=\"Governor Brown discussing his new greenhouse gas targets in Los Angeles. (Credit: Milken Inst.)\" width=\"1024\" height=\"723\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Governor Brown discussing his new greenhouse gas targets in Los Angeles. (Credit: Milken Inst.)\u003c/figcaption>\u003c/figure>\n\u003cp>Governor Jerry Brown is pursuing a new set of targets for reducing the amount of greenhouse gas released in the state.\u003c/p>\n\u003cp>Here’s the Associated Press \u003ca href=\"http://ww2.kqed.org/news/2015/04/29/brown-orders-ambitious-new-cuts-in-greenhouse-gases\">write-up\u003c/a>, and \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-jerry-brown-orders-emission-targets-for-climate-change-20150429-story.html\">this\u003c/a> from the Los Angeles Times.\u003c/p>\n\u003cp>But in a nutshell:\u003c/p>\n\u003cp>Brown’s plan is an extension of the state’s original “\u003ca href=\"http://blogs.kqed.org/climatewatch/?s=AB32\">AB 32\u003c/a>” goals – passed into law when Arnold Schwarzenegger was governor – that called for the state to return to its 1990 levels of carbon pollution by 2020. A follow-up Schwarzenegger plan tightened the screws even further, calling for an eighty-percent reduction by 2050.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“When Hitler was marching on Germany, we didn’t have any airplane factories…we transformed the whole economy.”\u003c/aside>\n\u003cp>\u003ca href=\"http://documents.latimes.com/gov-jerry-browns-executive-order-greenhouse-gas-emissions/\">Yesterday’s executive order\u003c/a> sets a concrete “intermediate target” between those two goals. By 2030, Brown wants California – “the state of imagination” as he put it — to be putting out 40 percent less greenhouse gas than we did in 1990.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.milkeninstitute.org/events/conferences/global-conference/global-conference-2015/panel-detail/5462\">Speaking \u003c/a>at the Milken Institute in Los Angeles, Brown compared the fight against climate change to World War II, railed against climate change deniers in Washington, and suggested Californians might need to open their minds to the idea of drinking recycled toilet water, among other things.\u003c/p>\n\u003cp>Some highlights:\u003c/p>\n\u003cp>Expressing contempt for lawmakers in Washington who still debate whether climate change is real or driven by human activity:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“In California, there is something called global warming. We’re four degrees warmer than we were historically. Our forest fire season is months longer. It’s almost year-round. This is real stuff.”\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>The new plan is ambitious, sure, he said. But we’ve done it before.\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“When Hitler was marching on Germany [sic], we didn’t have any airplane factories going and tank factories. But with Roosevelt leading, we transformed the whole economy. Dealing with the threat of climate change is going to require an analogous mobilization.” \u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>Meeting the new goals and responding to California’s epic drought will require cleaner cars, greater energy efficiency, and coming to terms with new \u003ca href=\"http://science.kqed.org/quest/audio/toilet-to-tap/\">sources of drinking water\u003c/a> that may make some Californians squeamish.\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“They don’t like to think of toilet to tap. You know, like drinking your toilet water. But you can make it as clean as the water on that table! You have to confidence in this filtration system!”\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>Comparing the slow crisis of climate change to headline news like the recent events in Baltimore:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“\u003c/em>\u003cem>You’ve got the problems in the Middle East, Iranian nuclear deal and all that…we’ve got violence in Baltimore. Those are hot and they’re immediate. But we’ve got a slow, rolling crisis that if we don’t deal with it, before we know it we will have passed a tipping point, an irreversible tendency that will be melting the Antarctic ice cap in Greenland, raising sea level, causing temperature rises. I don’t want to go through all the parade of horribles. But it’s serious, it’s catastrophic and it’s longer term.\u003cbr>\n\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>And finally, whether he, a self-described “old fogey,” can appreciate the kind of radical innovation it will take for Californians to find solutions for its drought woes and other environmental crises:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>“I’m very optimistic on California because we’re not bound by the obvious. We’re not hampered by so many old-fogey ideas. And even though I’m kind of an old fogey, I’m still a radical thinker when it comes to California and what we can do.” \u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Brown has not specified how to achieve his new emissions target. His 2030 target adds to an \u003ca title=\"Q-Sci - post\" href=\"http://ww2.kqed.org/science/2015/01/05/governor-unveils-ambitious-new-climate-goals/\">ambitious list of climate goals\u003c/a> that he outlined in his State of the State address in January.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"id": "commonwealth-club",
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"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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"order": 9
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"airtime": "SUN 7:30pm-8pm",
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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. ",
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"order": 15
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"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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"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",
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"source": "American Public Media"
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"masters-of-scale": {
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"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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},
"mindshift": {
"id": "mindshift",
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"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>",
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
"id": "morning-edition",
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"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.",
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"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?",
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"order": 11
},
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"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
"id": "pbs-newshour",
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},
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"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
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},
"perspectives": {
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"order": 14
},
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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},
"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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