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"disqusTitle": "Sonoma County Has Highest Whooping Cough Rate in Statewide Epidemic",
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"content": "\u003cfigure id=\"attachment_20212\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/ethansparrow/4957499682/in/photolist-8y5tWs-8iYQHE-7T23S8-mhYq6b-e8s4T4-ejD8mX-bmq17n-5Xdf3C-dmfcNe-fngGKR-8y6kE5-ay3keW-bDwxda-frnE1E-eRVdxu-iGj2s3-4PaZm3-ejD8n8-9mbH2q-fr8ms2-6ijRSy-bMNTGn-9sVBc2-byNCUs-e96wUn-9XuUWF-cufQ97-hYXu5g-aqrdSm-cD8TMf-8ucatF-eg4g1e-6KNycu-bWMYNR-94zxe7-enWety-cLhR67-eZDpUb-dNg7wp-ebjL8c-itAX6Q-dNGjyE-ebqoZA-m3j1fV-nKV4E6-6HsnSH-hP5Hfv-7Gjpkm-awim1M-af5Whz\">\u003cimg class=\"wp-image-20212 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/4957499682_c983513f8a_bcrop-640x388.jpg\" alt=\"Napa has the second highest rate of the disease. (Esparrow1/Flickr)\" width=\"640\" height=\"388\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Napa has the second highest rate of the disease. (Esparrow1/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lynne Shallcross\u003c/strong>\u003c/p>\n\u003cp>It’s been a little over a month since California \u003ca href=\"http://ww2.kqed.org/news/2014/06/13/whooping-cough-reaches-epidemic-level-in-california/\" target=\"_blank\">declared a whooping cough epidemic\u003c/a>, and according to the most recent data from the state, three neighboring Bay Area counties have the highest rates of the disease statewide: Sonoma, Napa and Marin.\u003c/p>\n\u003cp>Sonoma County's rate of whooping cough, also known as pertussis, is almost 120 cases per 100,000 people. Napa County's rate is 90 per 100,000, and Marin's rate is 65 per 100,000.\u003c/p>\n\u003cp>Sonoma County's interim health officer, Karen Holbrook, says the number of cases reported each week has peaked and is now declining.\u003c/p>\n\u003cp>“It’s not what the state is experiencing as a whole, but we are coming down,” Holbrook says. “Will that hold indefinitely remains to be seen.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Holbrook says California is seeing a whooping cough epidemic partly because the disease is cyclical, with cases spiking every three to five years.\u003c!--more-->\u003c/p>\n\u003cp>Additionally, Holbrook says, the immunity from the current vaccine, introduced in the 1990s, \u003ca 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\">fades more quickly\u003c/a> than the previous version. The current vaccine has fewer side effects.\u003c/p>\n\u003cp>Holbrook says she also thinks clinicians in her county are doing a good job of recognizing and diagnosing cases. “I can’t prove that relative to the other counties, but I honestly feel that that’s contributing to our (higher) rate,” she said.\u003c/p>\n\u003cp>Marin County Public Health Officer Matthew Willis says not all communities will have the same incidence of pertussis because of different factors and vulnerabilities, both known and unknown. Of the known factors, Willis echoes Holbrook’s points — and adds one more: vaccination rates.\u003c/p>\n\u003cp>“In Marin, it’s likely that pertussis was able to establish more of a foothold because of lower vaccination rates,” Willis says. \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">Marin’s rate of personal belief exemptions\u003c/a>, which allow parents to opt out of vaccines for their children, is among the highest in the state, according to statewide data.\u003c/p>\n\u003cp>One thing is clear, he says: Vaccination is the most effective way to prevent pertussis. The vaccine does not provide lifetime immunity and boosters are needed.\u003c/p>\n\u003cp>Of those who should be vaccinated, babies and pregnant women are of particular importance, says Jennifer Henn, an epidemiologist with Napa County's Public Health Division. “Infants, especially infants under six months of age, are especially vulnerable to severe disease and even death if they become infected with the pertussis bacteria.”\u003c/p>\n\u003cp>Infants generally cannot get their first pertussis vaccine until they are eight weeks, but in light of the epidemic, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/27/whooping-cough-epidemic-continues-1100-new-cases-in-last-two-weeks/\" target=\"_blank\">state health officers said \u003c/a>babies can be vaccinated as young as six weeks. Pregnant mothers should be vaccinated in the third trimester of every pregnancy in order for their children to receive antibodies in the womb. People who are around infants, such as other members of the household or caregivers, should also be vaccinated.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/159002693&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"Ng1M7L5S1Gy1LBl1ZTFiYhPZNt6CsCYd\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20212\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/ethansparrow/4957499682/in/photolist-8y5tWs-8iYQHE-7T23S8-mhYq6b-e8s4T4-ejD8mX-bmq17n-5Xdf3C-dmfcNe-fngGKR-8y6kE5-ay3keW-bDwxda-frnE1E-eRVdxu-iGj2s3-4PaZm3-ejD8n8-9mbH2q-fr8ms2-6ijRSy-bMNTGn-9sVBc2-byNCUs-e96wUn-9XuUWF-cufQ97-hYXu5g-aqrdSm-cD8TMf-8ucatF-eg4g1e-6KNycu-bWMYNR-94zxe7-enWety-cLhR67-eZDpUb-dNg7wp-ebjL8c-itAX6Q-dNGjyE-ebqoZA-m3j1fV-nKV4E6-6HsnSH-hP5Hfv-7Gjpkm-awim1M-af5Whz\">\u003cimg class=\"wp-image-20212 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/4957499682_c983513f8a_bcrop-640x388.jpg\" alt=\"Napa has the second highest rate of the disease. (Esparrow1/Flickr)\" width=\"640\" height=\"388\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Napa has the second highest rate of the disease. (Esparrow1/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lynne Shallcross\u003c/strong>\u003c/p>\n\u003cp>It’s been a little over a month since California \u003ca href=\"http://ww2.kqed.org/news/2014/06/13/whooping-cough-reaches-epidemic-level-in-california/\" target=\"_blank\">declared a whooping cough epidemic\u003c/a>, and according to the most recent data from the state, three neighboring Bay Area counties have the highest rates of the disease statewide: Sonoma, Napa and Marin.\u003c/p>\n\u003cp>Sonoma County's rate of whooping cough, also known as pertussis, is almost 120 cases per 100,000 people. Napa County's rate is 90 per 100,000, and Marin's rate is 65 per 100,000.\u003c/p>\n\u003cp>Sonoma County's interim health officer, Karen Holbrook, says the number of cases reported each week has peaked and is now declining.\u003c/p>\n\u003cp>“It’s not what the state is experiencing as a whole, but we are coming down,” Holbrook says. “Will that hold indefinitely remains to be seen.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Holbrook says California is seeing a whooping cough epidemic partly because the disease is cyclical, with cases spiking every three to five years.\u003c!--more-->\u003c/p>\n\u003cp>Additionally, Holbrook says, the immunity from the current vaccine, introduced in the 1990s, \u003ca 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\">fades more quickly\u003c/a> than the previous version. The current vaccine has fewer side effects.\u003c/p>\n\u003cp>Holbrook says she also thinks clinicians in her county are doing a good job of recognizing and diagnosing cases. “I can’t prove that relative to the other counties, but I honestly feel that that’s contributing to our (higher) rate,” she said.\u003c/p>\n\u003cp>Marin County Public Health Officer Matthew Willis says not all communities will have the same incidence of pertussis because of different factors and vulnerabilities, both known and unknown. Of the known factors, Willis echoes Holbrook’s points — and adds one more: vaccination rates.\u003c/p>\n\u003cp>“In Marin, it’s likely that pertussis was able to establish more of a foothold because of lower vaccination rates,” Willis says. \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">Marin’s rate of personal belief exemptions\u003c/a>, which allow parents to opt out of vaccines for their children, is among the highest in the state, according to statewide data.\u003c/p>\n\u003cp>One thing is clear, he says: Vaccination is the most effective way to prevent pertussis. The vaccine does not provide lifetime immunity and boosters are needed.\u003c/p>\n\u003cp>Of those who should be vaccinated, babies and pregnant women are of particular importance, says Jennifer Henn, an epidemiologist with Napa County's Public Health Division. “Infants, especially infants under six months of age, are especially vulnerable to severe disease and even death if they become infected with the pertussis bacteria.”\u003c/p>\n\u003cp>Infants generally cannot get their first pertussis vaccine until they are eight weeks, but in light of the epidemic, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/27/whooping-cough-epidemic-continues-1100-new-cases-in-last-two-weeks/\" target=\"_blank\">state health officers said \u003c/a>babies can be vaccinated as young as six weeks. Pregnant mothers should be vaccinated in the third trimester of every pregnancy in order for their children to receive antibodies in the womb. People who are around infants, such as other members of the household or caregivers, should also be vaccinated.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/159002693&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"Ng1M7L5S1Gy1LBl1ZTFiYhPZNt6CsCYd\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Work as Refuge? Working Mothers Report Better Health ",
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"content": "\u003cfigure id=\"attachment_20188\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/479941429.jpg\">\u003cimg class=\"size-large wp-image-20188\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/479941429-640x461.jpg\" alt=\"Life at the office can look really appealing sometimes. (Getty Images)\" width=\"640\" height=\"461\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Life at the office can look really appealing sometimes. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>I love it when my job intersects with the rest of my life.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/blogs/health/2014/07/15/330191097/when-work-becomes-a-haven-from-stress-at-home\" target=\"_blank\">NPR is reporting Tuesday\u003c/a> about a fascinating survey that found that women who work full time \"reported significantly better physical and mental health than moms who part time.\" They heard from more than 2,500 mothers in the\u003ca href=\"http://hsb.sagepub.com/content/53/4/396.abstract\" target=\"_blank\"> 2012 survey\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">In addition, people appear to be more stressed at home than they are at work.\u003c/aside>\n\u003cp>Oh, and mothers who worked part time said they enjoyed better health than their counterparts who didn't work at all.\u003c/p>\n\u003cp>Really? As the mother of two children who worked part time for several years before taking this job, I was all-in on this story. Could I really be enjoying peak health while working full time and -- yes -- still raising those kids. (Disclosure that my husband does help: Thanks, dear!)\u003c!--more-->\u003c/p>\n\u003cp>NPR pointed out that one explanation could be self-selection.\u003ca href=\"http://www.npr.org/blogs/health/2014/07/15/330191097/when-work-becomes-a-haven-from-stress-at-home\" target=\"_blank\"> From the story\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Mothers who were in better health to begin with may have chosen to work regularly. Researchers Adrianne Frech and Sarah Damaske, who conducted the 2012 study, also found that moms who worked steadily had other advantages. They were more likely to have grown up with two married parents, more likely to have completed high school and more likely to be in a stable relationship before the birth of their first child.\u003c/p>\u003c/blockquote>\n\u003cp>Those last three items are true for me.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a separate study of 122 working folks, both men and women, Damaske had volunteers collect saliva samples during the day. Researchers then measured the levels of cortisol, a stress hormone.\u003c/p>\n\u003cp>The levels were fine during the day -- and spiked when the people got home.\u003c/p>\n\u003cp>Low-income people and those without children were especially likely to report lower levels of the stress hormone when they were at work.\u003c/p>\n\u003cp>Damaske has new research that sheds light on another factor that might be in play:\u003c/p>\n\u003cblockquote>\u003cp>It's a factor that sociologists such as [UC Berkeley's] \u003ca href=\"http://sociology.berkeley.edu/professor-emeritus/arlie-r-hochschild\" target=\"_blank\">Arlie Hochschild\u003c/a> and psychiatrists such as Sigmund Freud have examined in the past. Hochschild, for one, found that many people find work to be less stressful than their home lives. Work was, in fact, a haven. Freud once said work and love were two wellsprings of emotional satisfaction in life.\u003c/p>\u003c/blockquote>\n\u003cp>Damaske also pointed out that work can be less stressful \"because we are emotionally entangled at home in a way that we aren't at work.\"\u003c/p>\n\u003cp>Um, yes. I admit to being more emotionally entangled at home than I am at work.\u003c/p>\n\u003cp>More from NPR:\u003c/p>\n\u003cblockquote>\u003cp>Damaske said the study offered a different window into why women who work steady jobs might experience better physical and mental health than those who work part time, or not at all. It is still possible that women who are healthier to begin with are more likely to hold steady jobs, but Damaske said it might also be the case that work had positive effects on women's health.\u003c/p>\u003c/blockquote>\n\u003cp>Last week NPR published the results of\u003ca href=\"http://www.npr.org/blogs/health/2014/07/07/323351759/for-many-americans-stress-takes-a-toll-on-health-and-family\" target=\"_blank\"> its nationwide poll\u003c/a> on stress -- and reported that \"juggling busy family schedules\" ranked right up there as a top source of stress for many people -- other sources were the death of a loved one and health problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So why are tough jobs and difficult bosses such a common topic of conversation? Damaske told NPR that it could be because it's more socially acceptable to complain about work than to discuss health problems or troubles at home.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20188\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/479941429.jpg\">\u003cimg class=\"size-large wp-image-20188\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/479941429-640x461.jpg\" alt=\"Life at the office can look really appealing sometimes. (Getty Images)\" width=\"640\" height=\"461\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Life at the office can look really appealing sometimes. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>I love it when my job intersects with the rest of my life.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/blogs/health/2014/07/15/330191097/when-work-becomes-a-haven-from-stress-at-home\" target=\"_blank\">NPR is reporting Tuesday\u003c/a> about a fascinating survey that found that women who work full time \"reported significantly better physical and mental health than moms who part time.\" They heard from more than 2,500 mothers in the\u003ca href=\"http://hsb.sagepub.com/content/53/4/396.abstract\" target=\"_blank\"> 2012 survey\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">In addition, people appear to be more stressed at home than they are at work.\u003c/aside>\n\u003cp>Oh, and mothers who worked part time said they enjoyed better health than their counterparts who didn't work at all.\u003c/p>\n\u003cp>Really? As the mother of two children who worked part time for several years before taking this job, I was all-in on this story. Could I really be enjoying peak health while working full time and -- yes -- still raising those kids. (Disclosure that my husband does help: Thanks, dear!)\u003c!--more-->\u003c/p>\n\u003cp>NPR pointed out that one explanation could be self-selection.\u003ca href=\"http://www.npr.org/blogs/health/2014/07/15/330191097/when-work-becomes-a-haven-from-stress-at-home\" target=\"_blank\"> From the story\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Mothers who were in better health to begin with may have chosen to work regularly. Researchers Adrianne Frech and Sarah Damaske, who conducted the 2012 study, also found that moms who worked steadily had other advantages. They were more likely to have grown up with two married parents, more likely to have completed high school and more likely to be in a stable relationship before the birth of their first child.\u003c/p>\u003c/blockquote>\n\u003cp>Those last three items are true for me.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a separate study of 122 working folks, both men and women, Damaske had volunteers collect saliva samples during the day. Researchers then measured the levels of cortisol, a stress hormone.\u003c/p>\n\u003cp>The levels were fine during the day -- and spiked when the people got home.\u003c/p>\n\u003cp>Low-income people and those without children were especially likely to report lower levels of the stress hormone when they were at work.\u003c/p>\n\u003cp>Damaske has new research that sheds light on another factor that might be in play:\u003c/p>\n\u003cblockquote>\u003cp>It's a factor that sociologists such as [UC Berkeley's] \u003ca href=\"http://sociology.berkeley.edu/professor-emeritus/arlie-r-hochschild\" target=\"_blank\">Arlie Hochschild\u003c/a> and psychiatrists such as Sigmund Freud have examined in the past. Hochschild, for one, found that many people find work to be less stressful than their home lives. Work was, in fact, a haven. Freud once said work and love were two wellsprings of emotional satisfaction in life.\u003c/p>\u003c/blockquote>\n\u003cp>Damaske also pointed out that work can be less stressful \"because we are emotionally entangled at home in a way that we aren't at work.\"\u003c/p>\n\u003cp>Um, yes. I admit to being more emotionally entangled at home than I am at work.\u003c/p>\n\u003cp>More from NPR:\u003c/p>\n\u003cblockquote>\u003cp>Damaske said the study offered a different window into why women who work steady jobs might experience better physical and mental health than those who work part time, or not at all. It is still possible that women who are healthier to begin with are more likely to hold steady jobs, but Damaske said it might also be the case that work had positive effects on women's health.\u003c/p>\u003c/blockquote>\n\u003cp>Last week NPR published the results of\u003ca href=\"http://www.npr.org/blogs/health/2014/07/07/323351759/for-many-americans-stress-takes-a-toll-on-health-and-family\" target=\"_blank\"> its nationwide poll\u003c/a> on stress -- and reported that \"juggling busy family schedules\" ranked right up there as a top source of stress for many people -- other sources were the death of a loved one and health problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So why are tough jobs and difficult bosses such a common topic of conversation? Damaske told NPR that it could be because it's more socially acceptable to complain about work than to discuss health problems or troubles at home.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20121\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/480197193crop.jpg\">\u003cimg class=\"size-large wp-image-20121\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/480197193crop-640x428.jpg\" alt=\"A stress system gone awry can quite literally make people sick. (Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A stress system gone awry can quite literally make people sick. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Richard Harris,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/07/09/325216030/like-all-animals-we-need-stress-just-not-too-much\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ask somebody about stress, and you're likely to hear an outpouring about all the bad things that cause it — and the bad things that result. But if you ask a biologist, you'll hear that stress can be good.\u003c/p>\n\u003cp>In fact, it's essential.\u003c/p>\n\u003caside class=\"pullquote alignleft\">But people who responded to NPR's poll talked mostly about the downside of stress.\u003c/aside>\n\u003cp>For example, the adrenal glands of all animals have evolved to pump out \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/\" target=\"_blank\">stress hormones\u003c/a> in unexpected situations — the hormones spur action and increase fuel to the brain, helping the animal react to danger appropriately. Those hormones also flow to memory centers in the brain, to help the critter remember those notable moments and places.\u003c/p>\n\u003cp>\"If it turns out to be dangerous and if the animal actually turns out to survive danger, then it will be aware of this as a potentially dangerous place,\" explains Bruce McEwen, head of the neuroendocrinology laboratory at The Rockefeller University. \"In that sense, stress is good.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>People also experience this good kind of stress. It's your body's reaction as you get pumped up to speak in public, for example, or compete in an athletic event.\u003c/p>\n\u003cp>\"We do something that takes a little bit of a risk and has a good outcome, we feel exhilarated — that's good stress,\" McEwen says.\u003c/p>\n\u003cp>Of course, that's not what most people were thinking of when pollsters called them earlier this year. \u003ca href=\"http://www.npr.org/blogs/health/2014/07/07/327322187/stressed-out-americans-tell-us-about-stress-in-their-lives\" target=\"_blank\">NPR conducted a poll\u003c/a> that focused on stress in America, with the Robert Wood Johnson Foundation and the Harvard School of Public Health.\u003c/p>\n\u003cp>Those responding talked mostly about the downside of stress — the sort that comes from tension at work or family friction. The biological mechanisms that help us in the short run, it turns out, aren't so useful when the stress grinds on for weeks or months.\u003c/p>\n\u003cp>McEwen, who wrote The End of Stress As We Know It, says often people find ways to tolerate that stress. But it can also be overwhelming, \"and then, we have something that's been called toxic stress,\" he says.\u003c/p>\n\u003cp>The stress system gone awry can literally make you sick.\u003c/p>\n\u003cp>\"When stress is sustained or repeating or extreme, then all [the usual systems] get disrupted,\" says Huda Akil, co-director of the Molecular and Behavioral Neuroscience Institute at the University of Michigan. \"And eventually, you do it long enough and it starts impacting other systems ... immune responses; it can affect the heart; it affects brain cells. It depends how long we're talking about.\"\u003c/p>\n\u003cp>In our poll, many Americans responding said that to cope with excessive stress they end up eating more or sleeping more. Yet others said they end up sleeping less and eating less. Sometimes these reactions can help reduce stress, research shows — but other times not.\u003c/p>\n\u003cp>David Linden, a professor of neuroscience at Johns Hopkins University School of Medicine and author of The Compass of Pleasure, has been thinking about the source of all this stress.\u003c/p>\n\u003cp>\"I think a lot of people imagine that our modern lifestyle — with constantly chirping cellphones and email and all these demands — has led to more stress,\" Linden says. \"And the truth is, it really doesn't seem to be that way.\"\u003c/p>\n\u003cp>Think how stressful it must have been for our forebears, who lived in constant worry that their children would die of infectious diseases (still a \u003ca href=\"http://www.npr.org/blogs/health/2014/03/30/262730420/ending-polio-paves-the-way-for-india-to-stop-a-childhood-killer\" target=\"_blank\">constant threat\u003c/a> in some parts of the world).\u003c/p>\n\u003cp>\"It's not like stress is mounting up in our modern age — it's just [that] the flavor of it is changing,\" Linden says.\u003c/p>\n\u003cp>And that flavor isn't changing as much as you might think. Our poll finds that over the past year, the major causes of stress in Americans are still those age-old troubles: illness, disease and the death of a loved one.\u003c/p>\n\u003cp>Now, 14 percent of the people we polled said they didn't feel stressed at all. But that doesn't mean a few people have found a secret Eden right here on Earth.\u003c/p>\n\u003cp>Huda Akil says some people are simply more tolerant of stress than others. She sees this clearly in \u003ca href=\"http://www.experts.umich.edu/pubDetail.asp?n=Huda+Akil&u_id=2801&oe_id=1&o_id=44&id=84890908540\" target=\"_blank\">her animal studies\u003c/a>.\u003c/p>\n\u003cp>\"Some animals like risky situations, actually go seek them, and other animals cower away from them,\" Akil says. \"And it's clearly genetic. We can breed for it. And it shows up very, very early in life. And it is in humans what we define often as temperament.\"\u003c/p>\n\u003cp>That temperament is shaped by both biology and our experiences as young children. It can have a lifelong impact on how we perceive stress and cope with it. The good news is this mix of psychology and biochemistry is malleable.\u003c/p>\n\u003cp>\"A lot of stress can be very disruptive,\" Akil says. \"But a little bit of stress is kind of like working your muscles, your emotional muscles. And you build them up and you learn how to cope. So this is not something that's irretrievably wired to be bad or good. It can be retuned and fine-tuned, and it's never too late.\"\u003c/p>\n\u003cp>Stress is, at root, a mechanism for adapting to changing circumstances. So when a challenging situation inevitably appears, the trick is to get the stress reaction to work to your advantage.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"nsxXRDWxbTc1tHTIy1oRJaUmANvLBH9i\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20121\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/480197193crop.jpg\">\u003cimg class=\"size-large wp-image-20121\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/480197193crop-640x428.jpg\" alt=\"A stress system gone awry can quite literally make people sick. (Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A stress system gone awry can quite literally make people sick. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Richard Harris,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/07/09/325216030/like-all-animals-we-need-stress-just-not-too-much\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ask somebody about stress, and you're likely to hear an outpouring about all the bad things that cause it — and the bad things that result. But if you ask a biologist, you'll hear that stress can be good.\u003c/p>\n\u003cp>In fact, it's essential.\u003c/p>\n\u003caside class=\"pullquote alignleft\">But people who responded to NPR's poll talked mostly about the downside of stress.\u003c/aside>\n\u003cp>For example, the adrenal glands of all animals have evolved to pump out \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/\" target=\"_blank\">stress hormones\u003c/a> in unexpected situations — the hormones spur action and increase fuel to the brain, helping the animal react to danger appropriately. Those hormones also flow to memory centers in the brain, to help the critter remember those notable moments and places.\u003c/p>\n\u003cp>\"If it turns out to be dangerous and if the animal actually turns out to survive danger, then it will be aware of this as a potentially dangerous place,\" explains Bruce McEwen, head of the neuroendocrinology laboratory at The Rockefeller University. \"In that sense, stress is good.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>People also experience this good kind of stress. It's your body's reaction as you get pumped up to speak in public, for example, or compete in an athletic event.\u003c/p>\n\u003cp>\"We do something that takes a little bit of a risk and has a good outcome, we feel exhilarated — that's good stress,\" McEwen says.\u003c/p>\n\u003cp>Of course, that's not what most people were thinking of when pollsters called them earlier this year. \u003ca href=\"http://www.npr.org/blogs/health/2014/07/07/327322187/stressed-out-americans-tell-us-about-stress-in-their-lives\" target=\"_blank\">NPR conducted a poll\u003c/a> that focused on stress in America, with the Robert Wood Johnson Foundation and the Harvard School of Public Health.\u003c/p>\n\u003cp>Those responding talked mostly about the downside of stress — the sort that comes from tension at work or family friction. The biological mechanisms that help us in the short run, it turns out, aren't so useful when the stress grinds on for weeks or months.\u003c/p>\n\u003cp>McEwen, who wrote The End of Stress As We Know It, says often people find ways to tolerate that stress. But it can also be overwhelming, \"and then, we have something that's been called toxic stress,\" he says.\u003c/p>\n\u003cp>The stress system gone awry can literally make you sick.\u003c/p>\n\u003cp>\"When stress is sustained or repeating or extreme, then all [the usual systems] get disrupted,\" says Huda Akil, co-director of the Molecular and Behavioral Neuroscience Institute at the University of Michigan. \"And eventually, you do it long enough and it starts impacting other systems ... immune responses; it can affect the heart; it affects brain cells. It depends how long we're talking about.\"\u003c/p>\n\u003cp>In our poll, many Americans responding said that to cope with excessive stress they end up eating more or sleeping more. Yet others said they end up sleeping less and eating less. Sometimes these reactions can help reduce stress, research shows — but other times not.\u003c/p>\n\u003cp>David Linden, a professor of neuroscience at Johns Hopkins University School of Medicine and author of The Compass of Pleasure, has been thinking about the source of all this stress.\u003c/p>\n\u003cp>\"I think a lot of people imagine that our modern lifestyle — with constantly chirping cellphones and email and all these demands — has led to more stress,\" Linden says. \"And the truth is, it really doesn't seem to be that way.\"\u003c/p>\n\u003cp>Think how stressful it must have been for our forebears, who lived in constant worry that their children would die of infectious diseases (still a \u003ca href=\"http://www.npr.org/blogs/health/2014/03/30/262730420/ending-polio-paves-the-way-for-india-to-stop-a-childhood-killer\" target=\"_blank\">constant threat\u003c/a> in some parts of the world).\u003c/p>\n\u003cp>\"It's not like stress is mounting up in our modern age — it's just [that] the flavor of it is changing,\" Linden says.\u003c/p>\n\u003cp>And that flavor isn't changing as much as you might think. Our poll finds that over the past year, the major causes of stress in Americans are still those age-old troubles: illness, disease and the death of a loved one.\u003c/p>\n\u003cp>Now, 14 percent of the people we polled said they didn't feel stressed at all. But that doesn't mean a few people have found a secret Eden right here on Earth.\u003c/p>\n\u003cp>Huda Akil says some people are simply more tolerant of stress than others. She sees this clearly in \u003ca href=\"http://www.experts.umich.edu/pubDetail.asp?n=Huda+Akil&u_id=2801&oe_id=1&o_id=44&id=84890908540\" target=\"_blank\">her animal studies\u003c/a>.\u003c/p>\n\u003cp>\"Some animals like risky situations, actually go seek them, and other animals cower away from them,\" Akil says. \"And it's clearly genetic. We can breed for it. And it shows up very, very early in life. And it is in humans what we define often as temperament.\"\u003c/p>\n\u003cp>That temperament is shaped by both biology and our experiences as young children. It can have a lifelong impact on how we perceive stress and cope with it. The good news is this mix of psychology and biochemistry is malleable.\u003c/p>\n\u003cp>\"A lot of stress can be very disruptive,\" Akil says. \"But a little bit of stress is kind of like working your muscles, your emotional muscles. And you build them up and you learn how to cope. So this is not something that's irretrievably wired to be bad or good. It can be retuned and fine-tuned, and it's never too late.\"\u003c/p>\n\u003cp>Stress is, at root, a mechanism for adapting to changing circumstances. So when a challenging situation inevitably appears, the trick is to get the stress reaction to work to your advantage.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"nsxXRDWxbTc1tHTIy1oRJaUmANvLBH9i\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "With DARPA Support, Lawrence Lab Seeks to Develop Brain Implant to Treat Memory Loss",
"headTitle": "With DARPA Support, Lawrence Lab Seeks to Develop Brain Implant to Treat Memory Loss | KQED",
"content": "\u003cfigure id=\"attachment_19144\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-1-1024x877.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-19144\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-1-1024x877.png\" alt=\"Researchers at Lawrence Livermore National Lab will develop an implantable device that will use electrical signals to communicate with individual neurons in the brain. UCLA scientists will use the device to study and repair memory function in brain trauma patients. (Courtesy of LLNL)\" width=\"640\" height=\"549\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers at Lawrence Livermore National Lab will develop an implantable device that will use electrical signals to communicate with individual neurons in the brain. (Courtesy of LLNL)\u003c/figcaption>\u003c/figure>\n\u003cp>Misplace your car keys? Forget to buy milk at the store? Temporary lapses in memory can be such a nuisance. But for those coping with a memory-impairing disease or traumatic brain injury, this kind of memory loss can become debilitating.\u003c/p>\n\u003cp>“Anyone who has witnessed the effects of memory loss in another person knows its toll and how few options are available to treat it,” says Justin Sanchez, program manager at the Defense Advanced Research Projects Agency, better known as DARPA.\u003c/p>\n\u003cp>On Tuesday DARPA announced a new multi-million dollar effort to develop and test a new generation of therapeutic brain implants that will help service members, veterans and civilians recover from memory loss caused by brain trauma or disease.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘This project, although it sounds a little bit Buck Rogers, is actually not far off from what’s happening already.’\u003ccite>— Robert Fisher, Stanford\u003c/cite>\u003c/aside>\n\u003cp>Here’s the tricky thing about treating memory loss: Scientists still don’t completely understand how the brain goes about capturing, storing and retrieving memories. Sure, they know that regions such as the hippocampus are important for the process. But developing precise medical interventions will require a much deeper understanding of how memory works.\u003c/p>\n\u003cp>How deep? Try single neuron deep.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Through the DARPA-funded project, researchers at the Lawrence Livermore National Laboratory and UCLA are developing an implantable brain device that will be able to eavesdrop on single neurons as they communicate with their neighbors. As the researchers decipher this cryptic neural language, they will use finely tuned electrical signals to join the conversation and help restore memory function. They are slated to begin clinical trials in the final year of the four-year project.\u003c/p>\n\u003cp>“This project, although it sounds a little bit Buck Rogers, is actually not far off from what’s happening already,” says Robert Fisher, professor of neurology and director of the Stanford Epilepsy Center. He’s tested similar brain implants for epilepsy patients, but is not involved in this project.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘You need to interface with neurons on their level.’\u003ccite>— Satinderpall Pannu, LLNL\u003c/cite>\u003c/aside>\n\u003cp>Parkinson’s patients are already receiving neural pacemakers. And similar therapies are being studied to treat a number of conditions, not only epilepsy, but also depression and obsessive-compulsive disorder.\u003c/p>\n\u003cp>But while existing deep brain stimulation techniques target large groups of neurons, the new research will require technologies that can communicate with single neurons.\u003c/p>\n\u003cp>“You need to interface with neurons on their level,” says Satinderpall Pannu, director of the Lawrence Livermore National Laboratory’s Center for Bioengineering. Current deep brain stimulation devices have electrodes that are a hundred times bigger than individual neurons. To talk to single neurons, the electrodes need to be as small as the neurons themselves — smaller than the width of a single hair.\u003c/p>\n\u003cfigure id=\"attachment_19145\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-2-1024x682.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-19145\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-2-1024x682.jpeg\" alt=\"Lawrence Livermore engineers Angela Tooker and Vanessa Tolosa load silicon wafers into a metal deposition chamber during the development of the neural device. (Courtesy of LLNL)\" width=\"600\" height=\"400\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lawrence Livermore engineers Angela Tooker and Vanessa Tolosa load silicon wafers into a metal deposition chamber during the development of the neural device. (Courtesy of LLNL)\u003c/figcaption>\u003c/figure>\n\u003cp>Pannu and his colleagues will create the incredibly small device that the UCLA scientists need for their research and clinical trials. Pannu says the technology will be very similar to what he is \u003ca href=\"http://www.technologyreview.com/news/527561/military-funds-brain-computer-interfaces-to-control-feelings/\" target=\"_blank\" rel=\"noopener\">currently developing with UCSF scientists\u003c/a> to treat a variety of psychoneurological diseases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Both the UCLA and UCSF projects are funded by DARPA and support President Obama’s BRAIN initiative.\u003c/p>\n\n",
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"excerpt": "Misplace your car keys? Forget to buy milk at the store? For those coping with a memory-impairing disease or injury, memory loss can be debilitating. New therapeutic brain implants could help patients overcome memory deficits.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19144\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-1-1024x877.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-19144\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-1-1024x877.png\" alt=\"Researchers at Lawrence Livermore National Lab will develop an implantable device that will use electrical signals to communicate with individual neurons in the brain. UCLA scientists will use the device to study and repair memory function in brain trauma patients. (Courtesy of LLNL)\" width=\"640\" height=\"549\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers at Lawrence Livermore National Lab will develop an implantable device that will use electrical signals to communicate with individual neurons in the brain. (Courtesy of LLNL)\u003c/figcaption>\u003c/figure>\n\u003cp>Misplace your car keys? Forget to buy milk at the store? Temporary lapses in memory can be such a nuisance. But for those coping with a memory-impairing disease or traumatic brain injury, this kind of memory loss can become debilitating.\u003c/p>\n\u003cp>“Anyone who has witnessed the effects of memory loss in another person knows its toll and how few options are available to treat it,” says Justin Sanchez, program manager at the Defense Advanced Research Projects Agency, better known as DARPA.\u003c/p>\n\u003cp>On Tuesday DARPA announced a new multi-million dollar effort to develop and test a new generation of therapeutic brain implants that will help service members, veterans and civilians recover from memory loss caused by brain trauma or disease.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘This project, although it sounds a little bit Buck Rogers, is actually not far off from what’s happening already.’\u003ccite>— Robert Fisher, Stanford\u003c/cite>\u003c/aside>\n\u003cp>Here’s the tricky thing about treating memory loss: Scientists still don’t completely understand how the brain goes about capturing, storing and retrieving memories. Sure, they know that regions such as the hippocampus are important for the process. But developing precise medical interventions will require a much deeper understanding of how memory works.\u003c/p>\n\u003cp>How deep? Try single neuron deep.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Through the DARPA-funded project, researchers at the Lawrence Livermore National Laboratory and UCLA are developing an implantable brain device that will be able to eavesdrop on single neurons as they communicate with their neighbors. As the researchers decipher this cryptic neural language, they will use finely tuned electrical signals to join the conversation and help restore memory function. They are slated to begin clinical trials in the final year of the four-year project.\u003c/p>\n\u003cp>“This project, although it sounds a little bit Buck Rogers, is actually not far off from what’s happening already,” says Robert Fisher, professor of neurology and director of the Stanford Epilepsy Center. He’s tested similar brain implants for epilepsy patients, but is not involved in this project.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘You need to interface with neurons on their level.’\u003ccite>— Satinderpall Pannu, LLNL\u003c/cite>\u003c/aside>\n\u003cp>Parkinson’s patients are already receiving neural pacemakers. And similar therapies are being studied to treat a number of conditions, not only epilepsy, but also depression and obsessive-compulsive disorder.\u003c/p>\n\u003cp>But while existing deep brain stimulation techniques target large groups of neurons, the new research will require technologies that can communicate with single neurons.\u003c/p>\n\u003cp>“You need to interface with neurons on their level,” says Satinderpall Pannu, director of the Lawrence Livermore National Laboratory’s Center for Bioengineering. Current deep brain stimulation devices have electrodes that are a hundred times bigger than individual neurons. To talk to single neurons, the electrodes need to be as small as the neurons themselves — smaller than the width of a single hair.\u003c/p>\n\u003cfigure id=\"attachment_19145\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-2-1024x682.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-19145\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/RAM-2-1024x682.jpeg\" alt=\"Lawrence Livermore engineers Angela Tooker and Vanessa Tolosa load silicon wafers into a metal deposition chamber during the development of the neural device. (Courtesy of LLNL)\" width=\"600\" height=\"400\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lawrence Livermore engineers Angela Tooker and Vanessa Tolosa load silicon wafers into a metal deposition chamber during the development of the neural device. (Courtesy of LLNL)\u003c/figcaption>\u003c/figure>\n\u003cp>Pannu and his colleagues will create the incredibly small device that the UCLA scientists need for their research and clinical trials. Pannu says the technology will be very similar to what he is \u003ca href=\"http://www.technologyreview.com/news/527561/military-funds-brain-computer-interfaces-to-control-feelings/\" target=\"_blank\" rel=\"noopener\">currently developing with UCSF scientists\u003c/a> to treat a variety of psychoneurological diseases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Both the UCLA and UCSF projects are funded by DARPA and support President Obama’s BRAIN initiative.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Everything You Know about Cholesterol Is Probably Wrong",
"headTitle": "Everything You Know about Cholesterol Is Probably Wrong | KQED",
"content": "\u003cfigure id=\"attachment_19133\" class=\"wp-caption alignleft\" style=\"max-width: 635px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/KQED_sweets.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-19133\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/KQED_sweets.jpg\" alt=\"Recent research suggests that cutting down on sugar does more to protect the heart than avoiding saturated fats. (Alex/Flickr)\" width=\"635\" height=\"357\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Recent research suggests that cutting down on sugar does more to protect the heart than avoiding saturated fats. (Alex/\u003ca href=\"https://www.flickr.com/photos/ajagendorf25/5557425274\">Flickr\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Most of us know that too much cholesterol promotes heart disease. And many know that cholesterol comes in good and bad forms. “Bad” (low-density lipoprotein, or LDL) cholesterol clogs the arteries that pump blood to the heart and feed the brain, raising the risk of heart attack and stroke. “Good” (high-density lipoprotein, or HDL) cholesterol removes excess cholesterol and fat from the bloodstream, keeping arteries healthy.\u003c/p>\n\u003cp>But a little knowledge can be a dangerous thing: this good versus bad scenario offers a simplistic view of cholesterol’s role in heart disease.\u003c/p>\n\u003cp>Doctors assess cardiac health with routine blood tests that estimate LDL and HDL cholesterol levels along with total cholesterol and triglycerides. But cholesterol is just one component of the lipoprotein particles (spherical balls made of proteins and other lipids) that transport the water-phobic molecules through the blood. Most blood tests reflect how much cholesterol the particles carry but don’t provide any information about the particles themselves.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It turns the cholesterol story upside down.”\u003c/aside>\n\u003cp>“But it all starts with the particle,” says Ronald Krauss, senior scientist and director of Atherosclerosis Research at Children’s Hospital Oakland Research Institute. “The LDL particles go into the artery wall and carry the cholesterol with them. So we see the cholesterol in the plaque but it’s the particle concentration and the number of particles that really determine the process.”\u003c/p>\n\u003cp>Smaller LDL particles carry less cholesterol than larger LDL particles, yet it’s the smaller particles that are most strongly associated with heart disease risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That’s because smaller particles are more likely to glom on to artery walls and do so more often because they circulate in the blood longer. Once they get stuck, they undergo chemical changes that make them more toxic to arteries.\u003c/p>\n\u003cp>So if you have mostly small LDL particles, your cholesterol levels could be normal, but you may still be at risk for heart disease, Krauss says. “It turns the cholesterol story upside down.”\u003c/p>\n\u003cp>\u003cstrong>New methods for evaluating risk\u003c/strong>\u003c/p>\n\u003cp>That’s why more researchers are turning to methods that can measure the size and density of lipoprotein particles to better understand how heart disease develops. In a new \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24852168\">study, published in the Journal of Lipid Research\u003c/a> last month, researchers at the University of Pittsburgh used a method (called nuclear magnetic resonance spectroscopy) designed to measure the characteristics of lipoprotein particles as a first step to understanding how menopause may facilitate cardiovascular disease in women.\u003c/p>\n\u003cp>Risk of heart disease increases with age as decades of inactivity and unhealthy eating habits promote plaque formation inside artery walls, ultimately blocking blood flow and causing a heart attack. Estrogen has a beneficial effect on arteries, which helps explain why women have a lower risk of heart disease than men—until they stop menstruating.\u003c/p>\n\u003cfigure id=\"attachment_19154\" class=\"wp-caption alignleft\" style=\"max-width: 350px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/Blausen_CoronaryArteryDisease-216x162.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-19154\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/Blausen_CoronaryArteryDisease-216x162.png\" alt=\"Athlerosclerosis, the formation of yellowish plaque made mostly of cholesterol inside artery walls. blocks blood flow and can lead to cardiac arrest. (Blausen/Wikipedia)\" width=\"350\" height=\"263\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Athlerosclerosis, the buildup of cholesterol-laden yellowish plaque inside artery walls, restricts blood flow and can lead to cardiac arrest. (Blausen/Wikipedia)\u003c/figcaption>\u003c/figure>\n\u003cp>Why that edge disappears around menopause isn’t entirely clear. Lower estrogen levels may alter cholesterol abundance or metabolism, as suggested by studies linking menopause to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/16810536\">higher levels of total cholesterol\u003c/a>, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/12027776\">LDL cholesterol \u003c/a>and triglycerides. In the new study, the researchers found an association between lower levels of estrogen and “low quality” cholesterol carriers, including the smaller LDL particles associated with increased risk.\u003c/p>\n\u003cp>The study was small—it examined just 120 women of the 3,302 women enrolled in an ongoing study of menopausal change (the \u003ca href=\"http://www.swanstudy.org/\">Study of Women’s Health Across the Nation\u003c/a>). But it lends support to the notion that as women approach midlife, their falling estrogen levels may help drive a shift from high-quality lipoproteins, which can clear excess cholesterol from the bloodstream, to lower-quality molecules that can’t.\u003c/p>\n\u003cp>That doesn’t mean boosting estrogen is a good idea. The \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf05/ht/htpostmenrs.htm\">U.S. Preventive Services Task Force\u003c/a> recommends against using hormone replacement therapy to reduce cardiac risk. Instead, women over 45 should get their cholesterol levels checked every five years. Routine blood tests will spot signs of trouble in most people, Krauss says, though more physicians are using the specialized tests for both women and men with diabetes, obesity or a family history of early heart disease to better assess their health status.\u003c/p>\n\u003cp>\u003cstrong>Reducing risk\u003c/strong>\u003c/p>\n\u003cp>Every year about \u003ca href=\"http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm\">600,000 people will die of heart disease\u003c/a>, the leading cause of death in the United States since 1921, when it surpassed pneumonia and flu.\u003c/p>\n\u003cp>These numbers are particularly troubling because heart disease is largely preventable. And though people can reduce their risk—primarily by exercising, losing weight and not smoking—many don’t. \u003ca href=\"http://my.clevelandclinic.org/Documents/About-Cleveland-Clinic/newsroom/love-your-heart-results.pdf\">Cleveland Clinic researchers\u003c/a> reported in February that a third of adults wouldn’t change their exercise or eating habits and just half of respondents said they’d stop smoking, despite a two- to fourfold increased risk.\u003c/p>\n\u003cp>Though logic suggests that raising good cholesterol through drugs or supplements could help those not inclined to change bad habits, the\u003ca href=\"http://journals.lww.com/co-cardiology/Abstract/2013/07000/Recent_clinical_trials_evaluating_benefit_of_drug.3.aspx\"> evidence suggests otherwise\u003c/a>. There’s no doubt that HDL has protective features, Krauss says, but there’s no guarantee that raising HDL levels will reduce your risk of heart disease. The evidence that small LDL particles promote heart disease, however, is “rock solid.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The best way to thwart those LDL particles, Krauss says, is \u003ca href=\"http://annals.org/article.aspx?articleid=1846638&resultClick=3\">not by avoiding saturated fats\u003c/a>, as we’ve long assumed. Saturated fats don’t affect the LDL particles, but sugar and carbohydrates do. “Taking away eggs and milk has virtually no effect on the bad guys,” says Krauss. “But you can make a really big improvement if you cut the sugar out.”\u003c/p>\n\n",
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"excerpt": "Most of us have heard about good cholesterol and bad cholesterol. But it's not the cholesterol that causes harm, it's the particles that carry it. And routine blood tests don't measure them.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19133\" class=\"wp-caption alignleft\" style=\"max-width: 635px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/KQED_sweets.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-19133\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/KQED_sweets.jpg\" alt=\"Recent research suggests that cutting down on sugar does more to protect the heart than avoiding saturated fats. (Alex/Flickr)\" width=\"635\" height=\"357\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Recent research suggests that cutting down on sugar does more to protect the heart than avoiding saturated fats. (Alex/\u003ca href=\"https://www.flickr.com/photos/ajagendorf25/5557425274\">Flickr\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Most of us know that too much cholesterol promotes heart disease. And many know that cholesterol comes in good and bad forms. “Bad” (low-density lipoprotein, or LDL) cholesterol clogs the arteries that pump blood to the heart and feed the brain, raising the risk of heart attack and stroke. “Good” (high-density lipoprotein, or HDL) cholesterol removes excess cholesterol and fat from the bloodstream, keeping arteries healthy.\u003c/p>\n\u003cp>But a little knowledge can be a dangerous thing: this good versus bad scenario offers a simplistic view of cholesterol’s role in heart disease.\u003c/p>\n\u003cp>Doctors assess cardiac health with routine blood tests that estimate LDL and HDL cholesterol levels along with total cholesterol and triglycerides. But cholesterol is just one component of the lipoprotein particles (spherical balls made of proteins and other lipids) that transport the water-phobic molecules through the blood. Most blood tests reflect how much cholesterol the particles carry but don’t provide any information about the particles themselves.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It turns the cholesterol story upside down.”\u003c/aside>\n\u003cp>“But it all starts with the particle,” says Ronald Krauss, senior scientist and director of Atherosclerosis Research at Children’s Hospital Oakland Research Institute. “The LDL particles go into the artery wall and carry the cholesterol with them. So we see the cholesterol in the plaque but it’s the particle concentration and the number of particles that really determine the process.”\u003c/p>\n\u003cp>Smaller LDL particles carry less cholesterol than larger LDL particles, yet it’s the smaller particles that are most strongly associated with heart disease risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That’s because smaller particles are more likely to glom on to artery walls and do so more often because they circulate in the blood longer. Once they get stuck, they undergo chemical changes that make them more toxic to arteries.\u003c/p>\n\u003cp>So if you have mostly small LDL particles, your cholesterol levels could be normal, but you may still be at risk for heart disease, Krauss says. “It turns the cholesterol story upside down.”\u003c/p>\n\u003cp>\u003cstrong>New methods for evaluating risk\u003c/strong>\u003c/p>\n\u003cp>That’s why more researchers are turning to methods that can measure the size and density of lipoprotein particles to better understand how heart disease develops. In a new \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24852168\">study, published in the Journal of Lipid Research\u003c/a> last month, researchers at the University of Pittsburgh used a method (called nuclear magnetic resonance spectroscopy) designed to measure the characteristics of lipoprotein particles as a first step to understanding how menopause may facilitate cardiovascular disease in women.\u003c/p>\n\u003cp>Risk of heart disease increases with age as decades of inactivity and unhealthy eating habits promote plaque formation inside artery walls, ultimately blocking blood flow and causing a heart attack. Estrogen has a beneficial effect on arteries, which helps explain why women have a lower risk of heart disease than men—until they stop menstruating.\u003c/p>\n\u003cfigure id=\"attachment_19154\" class=\"wp-caption alignleft\" style=\"max-width: 350px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/Blausen_CoronaryArteryDisease-216x162.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-19154\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/07/Blausen_CoronaryArteryDisease-216x162.png\" alt=\"Athlerosclerosis, the formation of yellowish plaque made mostly of cholesterol inside artery walls. blocks blood flow and can lead to cardiac arrest. (Blausen/Wikipedia)\" width=\"350\" height=\"263\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Athlerosclerosis, the buildup of cholesterol-laden yellowish plaque inside artery walls, restricts blood flow and can lead to cardiac arrest. (Blausen/Wikipedia)\u003c/figcaption>\u003c/figure>\n\u003cp>Why that edge disappears around menopause isn’t entirely clear. Lower estrogen levels may alter cholesterol abundance or metabolism, as suggested by studies linking menopause to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/16810536\">higher levels of total cholesterol\u003c/a>, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/12027776\">LDL cholesterol \u003c/a>and triglycerides. In the new study, the researchers found an association between lower levels of estrogen and “low quality” cholesterol carriers, including the smaller LDL particles associated with increased risk.\u003c/p>\n\u003cp>The study was small—it examined just 120 women of the 3,302 women enrolled in an ongoing study of menopausal change (the \u003ca href=\"http://www.swanstudy.org/\">Study of Women’s Health Across the Nation\u003c/a>). But it lends support to the notion that as women approach midlife, their falling estrogen levels may help drive a shift from high-quality lipoproteins, which can clear excess cholesterol from the bloodstream, to lower-quality molecules that can’t.\u003c/p>\n\u003cp>That doesn’t mean boosting estrogen is a good idea. The \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf05/ht/htpostmenrs.htm\">U.S. Preventive Services Task Force\u003c/a> recommends against using hormone replacement therapy to reduce cardiac risk. Instead, women over 45 should get their cholesterol levels checked every five years. Routine blood tests will spot signs of trouble in most people, Krauss says, though more physicians are using the specialized tests for both women and men with diabetes, obesity or a family history of early heart disease to better assess their health status.\u003c/p>\n\u003cp>\u003cstrong>Reducing risk\u003c/strong>\u003c/p>\n\u003cp>Every year about \u003ca href=\"http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm\">600,000 people will die of heart disease\u003c/a>, the leading cause of death in the United States since 1921, when it surpassed pneumonia and flu.\u003c/p>\n\u003cp>These numbers are particularly troubling because heart disease is largely preventable. And though people can reduce their risk—primarily by exercising, losing weight and not smoking—many don’t. \u003ca href=\"http://my.clevelandclinic.org/Documents/About-Cleveland-Clinic/newsroom/love-your-heart-results.pdf\">Cleveland Clinic researchers\u003c/a> reported in February that a third of adults wouldn’t change their exercise or eating habits and just half of respondents said they’d stop smoking, despite a two- to fourfold increased risk.\u003c/p>\n\u003cp>Though logic suggests that raising good cholesterol through drugs or supplements could help those not inclined to change bad habits, the\u003ca href=\"http://journals.lww.com/co-cardiology/Abstract/2013/07000/Recent_clinical_trials_evaluating_benefit_of_drug.3.aspx\"> evidence suggests otherwise\u003c/a>. There’s no doubt that HDL has protective features, Krauss says, but there’s no guarantee that raising HDL levels will reduce your risk of heart disease. The evidence that small LDL particles promote heart disease, however, is “rock solid.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The best way to thwart those LDL particles, Krauss says, is \u003ca href=\"http://annals.org/article.aspx?articleid=1846638&resultClick=3\">not by avoiding saturated fats\u003c/a>, as we’ve long assumed. Saturated fats don’t affect the LDL particles, but sugar and carbohydrates do. “Taking away eggs and milk has virtually no effect on the bad guys,” says Krauss. “But you can make a really big improvement if you cut the sugar out.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feds Say Autism Therapy Now Covered As Children's Medicaid Benefit",
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"content": "\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/7/cms-guidance-says-autism-therapy-covered-as-medicaid-benefit-for-kids\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>CMS officials \u003ca style=\"color: #6d1618\" href=\"http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf\" target=\"_blank\">released federal guidance\u003c/a> for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"ABA therapy must be covered (by Medi-Cal). It's very, very clear.\" \u003c/aside>\n\u003cp>\"It's a good day. It's such a good day,\" said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. \"Whenever you get a decision that we've been seeking for years, that is a good day.\"\u003c/p>\n\u003cp>Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid -- and therefore it also must be covered under Medi-Cal, California's version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame.\u003c!--more-->\u003c/p>\n\u003cp>\"ABA therapy must be covered under EPSDT. It's very, very clear,\" Jacobson said. \"Any coverable benefit must be provided under the age of 21. If it's coverable in any way, then you have to provide it.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On top of that, CMS' new guidance says state officials don't need to file a State Plan Amendment to start coverage of autism therapy. \"It doesn't have to be in your state plan, it says it right there,\" Jacobson said.\u003c/p>\n\u003cp>State officials were a little more careful.\u003c/p>\n\u003cp>According to Norman Williams, deputy director of public affairs for the Department of Health Care Services, the health policy experts at DHCS need a bit more time to fully review the guidance.\u003c/p>\n\u003cp>Kornack acknowledged that \"lawyers are still dissecting the guidance and [that] there's some leeway here about how states will implement this.\"\u003c/p>\n\u003cp>\"But whether they implement is no longer a question,\" she said.\u003c/p>\n\u003cp>State officials previously have said they were awaiting federal guidance on the question of ABA therapy coverage -- and Kornack, for one, can't wait to hear the official word from the state.\u003c/p>\n\u003cp>\"I don't think we could ask for better clarification than what we just got,\" she said. \"There's some latitude for states in terms of how to augment the waiver, there will be complexities. But there's no latitude about whether they provide services. The question about whether they provide it is done.\"\u003c/p>\n\u003cp>Jacobson said now it's just a matter of the time of implementation till Medi-Cal children can access ABA therapy services.\u003c/p>\n\u003cp>\"When I look at as clarification of existing requirements, I don't know how much you could delay it,\" she said. \"They have to make it available and accessible, and make families aware that it's available and accessible. I'd say, if families already have medical necessity established, they should try to pursue coverage right away.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"BWwh2OirqqsTtzUNMv2viXsdoF50551A\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/7/cms-guidance-says-autism-therapy-covered-as-medicaid-benefit-for-kids\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>CMS officials \u003ca style=\"color: #6d1618\" href=\"http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf\" target=\"_blank\">released federal guidance\u003c/a> for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"ABA therapy must be covered (by Medi-Cal). It's very, very clear.\" \u003c/aside>\n\u003cp>\"It's a good day. It's such a good day,\" said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. \"Whenever you get a decision that we've been seeking for years, that is a good day.\"\u003c/p>\n\u003cp>Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid -- and therefore it also must be covered under Medi-Cal, California's version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame.\u003c!--more-->\u003c/p>\n\u003cp>\"ABA therapy must be covered under EPSDT. It's very, very clear,\" Jacobson said. \"Any coverable benefit must be provided under the age of 21. If it's coverable in any way, then you have to provide it.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On top of that, CMS' new guidance says state officials don't need to file a State Plan Amendment to start coverage of autism therapy. \"It doesn't have to be in your state plan, it says it right there,\" Jacobson said.\u003c/p>\n\u003cp>State officials were a little more careful.\u003c/p>\n\u003cp>According to Norman Williams, deputy director of public affairs for the Department of Health Care Services, the health policy experts at DHCS need a bit more time to fully review the guidance.\u003c/p>\n\u003cp>Kornack acknowledged that \"lawyers are still dissecting the guidance and [that] there's some leeway here about how states will implement this.\"\u003c/p>\n\u003cp>\"But whether they implement is no longer a question,\" she said.\u003c/p>\n\u003cp>State officials previously have said they were awaiting federal guidance on the question of ABA therapy coverage -- and Kornack, for one, can't wait to hear the official word from the state.\u003c/p>\n\u003cp>\"I don't think we could ask for better clarification than what we just got,\" she said. \"There's some latitude for states in terms of how to augment the waiver, there will be complexities. But there's no latitude about whether they provide services. The question about whether they provide it is done.\"\u003c/p>\n\u003cp>Jacobson said now it's just a matter of the time of implementation till Medi-Cal children can access ABA therapy services.\u003c/p>\n\u003cp>\"When I look at as clarification of existing requirements, I don't know how much you could delay it,\" she said. \"They have to make it available and accessible, and make families aware that it's available and accessible. I'd say, if families already have medical necessity established, they should try to pursue coverage right away.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"BWwh2OirqqsTtzUNMv2viXsdoF50551A\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20071\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/153764421.jpg\">\u003cimg class=\"size-large wp-image-20071\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/153764421-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>New research from Stanford shows that physical activity -- or lack thereof -- may be a bigger driver of the obesity epidemic than diet is.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The rate of Americans reporting inactivity has skyrocketed.\u003c/aside>\n\u003cp>The researchers looked at national survey results of people's health habits -- including diet and exercise -- from 1988 to 2010. The stunner was the increase in people who reported no leisure-time physical activity.\u003c/p>\n\u003cp>In 1988, 19 percent of women were inactive. By 2010, that number had jumped to 52 percent.\u003c!--more-->\u003c/p>\n\u003cp>For men, the rate nearly quadrupled, going from 11 to 43 percent in the same time period.\u003c/p>\n\u003cp>But what didn't change was the number of calories people consumed. In other words, people were eating about the same but exercising significantly less.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dr. Uri Ladabaum, a gastroenterologist at Stanford University Medical Center, led the study. He said that the research can only suggest an association between inactivity and increasing obesity, but that people should not decide diet is irrelevant to obesity.\u003c/p>\n\u003cp>\"We would not want to suggest in any way that caloric intake is not important,\" Ladabaum said. \"But it raises the question of how much of the change in obesity prevalence might be related to physical activity.\"\u003c/p>\n\u003cp>The researchers analyzed results from the\u003ca href=\"http://www.cdc.gov/nchs/nhanes.htm\" target=\"_blank\"> National Health and Nutrition Examination Survey\u003c/a>, conducted by the Centers for Disease Control. Participants reported their activity over the last month and their diet over the last 24 hours. Ladabaum said the team did not find a difference in total caloric count or breakdown by protein, carbohydrate and fat, over the 22-year study period.\u003c/p>\n\u003cp>The prevalence of obesity increased from 1988-2010, from 25 to 35 percent of women and from 20 to 35 percent of men.\u003c/p>\n\u003cp>The data included survey results from more than 17,000 participants between 1988-1994 and about 5,000 people each year from 1995 through 2010.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was published in the \u003ca href=\"http://www.amjmed.com/article/S0002-9343(14)00191-0/abstract\" target=\"_blank\">American Journal of Medicine\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20071\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/153764421.jpg\">\u003cimg class=\"size-large wp-image-20071\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/153764421-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>New research from Stanford shows that physical activity -- or lack thereof -- may be a bigger driver of the obesity epidemic than diet is.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The rate of Americans reporting inactivity has skyrocketed.\u003c/aside>\n\u003cp>The researchers looked at national survey results of people's health habits -- including diet and exercise -- from 1988 to 2010. The stunner was the increase in people who reported no leisure-time physical activity.\u003c/p>\n\u003cp>In 1988, 19 percent of women were inactive. By 2010, that number had jumped to 52 percent.\u003c!--more-->\u003c/p>\n\u003cp>For men, the rate nearly quadrupled, going from 11 to 43 percent in the same time period.\u003c/p>\n\u003cp>But what didn't change was the number of calories people consumed. In other words, people were eating about the same but exercising significantly less.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Uri Ladabaum, a gastroenterologist at Stanford University Medical Center, led the study. He said that the research can only suggest an association between inactivity and increasing obesity, but that people should not decide diet is irrelevant to obesity.\u003c/p>\n\u003cp>\"We would not want to suggest in any way that caloric intake is not important,\" Ladabaum said. \"But it raises the question of how much of the change in obesity prevalence might be related to physical activity.\"\u003c/p>\n\u003cp>The researchers analyzed results from the\u003ca href=\"http://www.cdc.gov/nchs/nhanes.htm\" target=\"_blank\"> National Health and Nutrition Examination Survey\u003c/a>, conducted by the Centers for Disease Control. Participants reported their activity over the last month and their diet over the last 24 hours. Ladabaum said the team did not find a difference in total caloric count or breakdown by protein, carbohydrate and fat, over the 22-year study period.\u003c/p>\n\u003cp>The prevalence of obesity increased from 1988-2010, from 25 to 35 percent of women and from 20 to 35 percent of men.\u003c/p>\n\u003cp>The data included survey results from more than 17,000 participants between 1988-1994 and about 5,000 people each year from 1995 through 2010.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was published in the \u003ca href=\"http://www.amjmed.com/article/S0002-9343(14)00191-0/abstract\" target=\"_blank\">American Journal of Medicine\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Judge Rules Berkeley Must Change Soda Tax Language",
"title": "Judge Rules Berkeley Must Change Soda Tax Language",
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"content": "\u003cfigure id=\"attachment_17715\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update September 2, 6:05 p.m.:\u003c/strong> A judge ruled Tuesday that Berkeley officials must change the soda tax measure language because it is currently misleading.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Soda tax advocates say this change \"doesn't concern us at all.\" \u003c/aside>\n\u003cp>Alameda County Superior Court Judge Evelio Grillo said the city's statement that the tax would only be imposed on \"high-calorie, sugary drinks\" is \"a form of advocacy and therefore not impartial.\"\u003c/p>\n\u003cp>Grillo ordered the city to change the summary to say that the tax would apply to \"sugar-sweetened beverages,\" which he said is more neutral and less likely to create prejudice for or against Measure D.\u003c/p>\n\u003cp>Anthony Johnson and Leon Cain \u003ca href=\"http://www.berkeleyside.com/2014/08/15/lawsuit-filed-over-berkeley-soda-tax-ballot-language/\" target=\"_blank\">filed the lawsuit in August\u003c/a>. Cain has previously attended Berkeley council meetings on behalf of the No Berkeley Beverage Tax campaign.\u003c!--more-->\u003c/p>\n\u003cp>Tax opponents had also argued that ballot language that says the tax would be paid by distributors, not by consumers, is misleading because they believe distributors would pass on the extra cost to consumers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Grillo ruled against tax opponents on that issue, saying they failed to provide clear and convincing evidence based on the ballot statement that the tax won't be paid by consumers is misleading or partial.\u003c/p>\n\u003cp>The judge said tax opponents \"only speculate that it is like that such cost will be passed down to consumers, but it is unknown at this point whether or not any of the tax will eventually be passed down to consumers.\"\u003c/p>\n\u003cp>Grillo said the city correctly pointed out that distributors and retailers could choose to absorb the cost of the tax in order to better compete with other businesses.\u003c/p>\n\u003cp>Berkeley school board member Joshua Daniels, who is co-chair of the campaign in favor of Measure D, said Grillo's order that the ballot language be changed is only a \"relatively minor\" development and \"doesn't concern us at all\" because \"everyone knows that the measure is focused on preventing diabetes,\" and he thinks it will still be approved.\u003c/p>\n\u003cp>Daniels said that overall Grillo's ruling is \"a victory\" for Measure D supporters.\u003c/p>\n\u003cp>Grillo's ruling came one day before the deadline on Wednesday for the Alameda County Registrar of Voters Office to send ballot arguments to the printer so that voters can receive them well in advance of the election on Nov. 4.\u003c/p>\n\u003cp>\u003cstrong>Original Post July 2, 2014 \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>By Charles Siler\u003c/strong>, \u003ca href=\"http://www.berkeleyside.com/2014/07/02/berkeley-puts-sugar-tax-on-november-ballot-could-be-first-in-country-to-take-on-big-soda/\" target=\"_blank\">Berkeleyside\u003c/a>\u003c/p>\n\u003cp>Berkeley City Council voted unanimously Tuesday night to include a proposal that would tax distributors of sugar-sweetened beverages on the November ballot.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Voters will decide on penny-per-ounce tax on soda and other sugar-sweetened beverages.\u003c/aside>\n\u003cp>The measure, which proposes a one-cent-per-ounce charge at the distributor level, would be the first such tax passed in the country. Richmond tried to pass a similar tax in 2012, but it was voted down after a $2.7 million campaign by the soda industry.\u003c/p>\n\u003cp>Supporters of the tax point to studies linking sugary drinks to childhood obesity and diabetes. Members of community organization Berkeley vs. Big Soda gathered on the steps of city hall before the Tuesday night meeting to voice their support of the tax.\u003c/p>\n\u003cp>“We want to support our kids. We don’t want our kids to be sick with diabetes,” said Dr. Vicki Alexander, co-chair of the Berkeley Healthy Child Foundation, at the council meeting. “We know that we can change that trend.”\u003c/p>\n\u003cp>Opponents of the tax said the measure would prove ineffective.\u003c/p>\n\u003cp>“I agree that diabetes and childhood obesity are big issues. I just don’t necessarily agree that taxation on sweetened beverages or soda is the best way to deal with that,” said Jennifer Skidmore of J&J Vending. “Statistics show that purchasing of sweetened beverages is already on the decline, without taxation.”\u003c/p>\n\u003cp>Supporters also say the tax is a social justice issue, pointing to the higher rates of obesity in black and Latino communities.\u003c/p>\n\u003cp>“Research shows diabetes rates in Latino, African-American communities have reached epidemic proportions,” said Xavier Morales, executive director of the Latino Coalition for a Healthy California. “That’s not an exaggeration.”\u003c/p>\n\u003cp>“Big Soda will claim that we are attacking a product that is beloved by low-income folks,” said Councilmember Laurie Capitelli, “but those are the people who are coming to us and asking us to put this on the ballot.”\u003c/p>\n\u003cp>Ted Mundorff, CEO and president of Landmark Theaters, which owns both the Shattuck Cinemas and the California Theater, said revenue from the tax would not be earmarked for any healthy initiatives.\u003c/p>\n\u003cp>“If we could solve obesity and diabetes with a one-cent tax I’d say bring it on, let’s do two cents,” Mundorff said. “But the reality is that this cent is going into the general fund, and it is not earmarked to do anything, except to hurt business.”\u003c/p>\n\u003cp>Because the measure proposes a general tax, as opposed to a special tax, revenue from the tax would go into the general fund and cannot be reserved for any special purpose. With a special tax, the money could be designated for anti-obesity initiatives, such as nutrition programs in schools — but a special tax requires a two-thirds majority vote, while a general tax requires only 50 percent plus one.\u003c/p>\n\u003cp>The sugar tax on San Francisco’s November ballot is a special tax, and so will require a two-thirds majority to pass, unlike the Berkeley proposal. The San Francisco measure also proposes a tax of two cents per ounce, rather than Berkeley’s one.\u003c/p>\n\u003cp>Berkeley’s November ballot will read: “Shall an ordinance imposing a 1¢ per ounce general tax on the distribution of high-calorie, sugary drinks (e.g., sodas, energy drinks, presweetened teas) and sweeteners used to sweeten such drinks, but exempting: (1) sweeteners (e.g., sugar, honey,syrups) typically used by consumers and distributed to grocery stores; (2) drinks and sweeteners distributed to very small retailers; (3) diet drinks, milk products, 100% juice, baby formula, alcohol, or drinks taken for medical reasons, be adopted?” Councilmember Linda Maio proposed the new, slightly different language at the Tuesday meeting.\u003c/p>\n\u003cp>Supporters of the tax acknowledged that in the coming months, the soda industry will likely campaign heavily against the tax measure in Berkeley and in San Francisco.\u003c/p>\n\u003cp>“I don’t think even if they spent a million dollars they could confuse the people of Berkeley. So I’m not really worried about how much money they spend,” said Councilmember Kriss Worthington. “The people of Berkeley are too smart to be confused.”\u003c/p>\n\u003cp>“There’s going to be a lot of opposition, there’s going to be lot of lies,” said Mayor Tom Bates. “They’re going to be sending people door to door with distortions, with misinformation, and it’s going to be tough. So we all need to work. This is the beginning, this is not the end.”\u003c/p>\n\u003cp>\u003cem style=\"color: #4d4d4d\">KQED News Associate \u003ca style=\"color: #336699\" href=\"http://www.berkeleyside.com/\" target=\"_blank\">Berkeleyside\u003c/a> is an independently owned news website based in Berkeley, Calif. \u003ca style=\"color: #336699\" href=\"http://berkeleyside.us2.list-manage.com/subscribe?u=4851428a10883a05193b1dd6c&id=aad4b5ee64\" target=\"_blank\">Click here\u003c/a> if you would you like to receive the latest Berkeley news in your inbox once a day for free with Berkeleyside’s Daily Briefing email.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17715\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update September 2, 6:05 p.m.:\u003c/strong> A judge ruled Tuesday that Berkeley officials must change the soda tax measure language because it is currently misleading.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Soda tax advocates say this change \"doesn't concern us at all.\" \u003c/aside>\n\u003cp>Alameda County Superior Court Judge Evelio Grillo said the city's statement that the tax would only be imposed on \"high-calorie, sugary drinks\" is \"a form of advocacy and therefore not impartial.\"\u003c/p>\n\u003cp>Grillo ordered the city to change the summary to say that the tax would apply to \"sugar-sweetened beverages,\" which he said is more neutral and less likely to create prejudice for or against Measure D.\u003c/p>\n\u003cp>Anthony Johnson and Leon Cain \u003ca href=\"http://www.berkeleyside.com/2014/08/15/lawsuit-filed-over-berkeley-soda-tax-ballot-language/\" target=\"_blank\">filed the lawsuit in August\u003c/a>. Cain has previously attended Berkeley council meetings on behalf of the No Berkeley Beverage Tax campaign.\u003c!--more-->\u003c/p>\n\u003cp>Tax opponents had also argued that ballot language that says the tax would be paid by distributors, not by consumers, is misleading because they believe distributors would pass on the extra cost to consumers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Grillo ruled against tax opponents on that issue, saying they failed to provide clear and convincing evidence based on the ballot statement that the tax won't be paid by consumers is misleading or partial.\u003c/p>\n\u003cp>The judge said tax opponents \"only speculate that it is like that such cost will be passed down to consumers, but it is unknown at this point whether or not any of the tax will eventually be passed down to consumers.\"\u003c/p>\n\u003cp>Grillo said the city correctly pointed out that distributors and retailers could choose to absorb the cost of the tax in order to better compete with other businesses.\u003c/p>\n\u003cp>Berkeley school board member Joshua Daniels, who is co-chair of the campaign in favor of Measure D, said Grillo's order that the ballot language be changed is only a \"relatively minor\" development and \"doesn't concern us at all\" because \"everyone knows that the measure is focused on preventing diabetes,\" and he thinks it will still be approved.\u003c/p>\n\u003cp>Daniels said that overall Grillo's ruling is \"a victory\" for Measure D supporters.\u003c/p>\n\u003cp>Grillo's ruling came one day before the deadline on Wednesday for the Alameda County Registrar of Voters Office to send ballot arguments to the printer so that voters can receive them well in advance of the election on Nov. 4.\u003c/p>\n\u003cp>\u003cstrong>Original Post July 2, 2014 \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>By Charles Siler\u003c/strong>, \u003ca href=\"http://www.berkeleyside.com/2014/07/02/berkeley-puts-sugar-tax-on-november-ballot-could-be-first-in-country-to-take-on-big-soda/\" target=\"_blank\">Berkeleyside\u003c/a>\u003c/p>\n\u003cp>Berkeley City Council voted unanimously Tuesday night to include a proposal that would tax distributors of sugar-sweetened beverages on the November ballot.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Voters will decide on penny-per-ounce tax on soda and other sugar-sweetened beverages.\u003c/aside>\n\u003cp>The measure, which proposes a one-cent-per-ounce charge at the distributor level, would be the first such tax passed in the country. Richmond tried to pass a similar tax in 2012, but it was voted down after a $2.7 million campaign by the soda industry.\u003c/p>\n\u003cp>Supporters of the tax point to studies linking sugary drinks to childhood obesity and diabetes. Members of community organization Berkeley vs. Big Soda gathered on the steps of city hall before the Tuesday night meeting to voice their support of the tax.\u003c/p>\n\u003cp>“We want to support our kids. We don’t want our kids to be sick with diabetes,” said Dr. Vicki Alexander, co-chair of the Berkeley Healthy Child Foundation, at the council meeting. “We know that we can change that trend.”\u003c/p>\n\u003cp>Opponents of the tax said the measure would prove ineffective.\u003c/p>\n\u003cp>“I agree that diabetes and childhood obesity are big issues. I just don’t necessarily agree that taxation on sweetened beverages or soda is the best way to deal with that,” said Jennifer Skidmore of J&J Vending. “Statistics show that purchasing of sweetened beverages is already on the decline, without taxation.”\u003c/p>\n\u003cp>Supporters also say the tax is a social justice issue, pointing to the higher rates of obesity in black and Latino communities.\u003c/p>\n\u003cp>“Research shows diabetes rates in Latino, African-American communities have reached epidemic proportions,” said Xavier Morales, executive director of the Latino Coalition for a Healthy California. “That’s not an exaggeration.”\u003c/p>\n\u003cp>“Big Soda will claim that we are attacking a product that is beloved by low-income folks,” said Councilmember Laurie Capitelli, “but those are the people who are coming to us and asking us to put this on the ballot.”\u003c/p>\n\u003cp>Ted Mundorff, CEO and president of Landmark Theaters, which owns both the Shattuck Cinemas and the California Theater, said revenue from the tax would not be earmarked for any healthy initiatives.\u003c/p>\n\u003cp>“If we could solve obesity and diabetes with a one-cent tax I’d say bring it on, let’s do two cents,” Mundorff said. “But the reality is that this cent is going into the general fund, and it is not earmarked to do anything, except to hurt business.”\u003c/p>\n\u003cp>Because the measure proposes a general tax, as opposed to a special tax, revenue from the tax would go into the general fund and cannot be reserved for any special purpose. With a special tax, the money could be designated for anti-obesity initiatives, such as nutrition programs in schools — but a special tax requires a two-thirds majority vote, while a general tax requires only 50 percent plus one.\u003c/p>\n\u003cp>The sugar tax on San Francisco’s November ballot is a special tax, and so will require a two-thirds majority to pass, unlike the Berkeley proposal. The San Francisco measure also proposes a tax of two cents per ounce, rather than Berkeley’s one.\u003c/p>\n\u003cp>Berkeley’s November ballot will read: “Shall an ordinance imposing a 1¢ per ounce general tax on the distribution of high-calorie, sugary drinks (e.g., sodas, energy drinks, presweetened teas) and sweeteners used to sweeten such drinks, but exempting: (1) sweeteners (e.g., sugar, honey,syrups) typically used by consumers and distributed to grocery stores; (2) drinks and sweeteners distributed to very small retailers; (3) diet drinks, milk products, 100% juice, baby formula, alcohol, or drinks taken for medical reasons, be adopted?” Councilmember Linda Maio proposed the new, slightly different language at the Tuesday meeting.\u003c/p>\n\u003cp>Supporters of the tax acknowledged that in the coming months, the soda industry will likely campaign heavily against the tax measure in Berkeley and in San Francisco.\u003c/p>\n\u003cp>“I don’t think even if they spent a million dollars they could confuse the people of Berkeley. So I’m not really worried about how much money they spend,” said Councilmember Kriss Worthington. “The people of Berkeley are too smart to be confused.”\u003c/p>\n\u003cp>“There’s going to be a lot of opposition, there’s going to be lot of lies,” said Mayor Tom Bates. “They’re going to be sending people door to door with distortions, with misinformation, and it’s going to be tough. So we all need to work. This is the beginning, this is not the end.”\u003c/p>\n\u003cp>\u003cem style=\"color: #4d4d4d\">KQED News Associate \u003ca style=\"color: #336699\" href=\"http://www.berkeleyside.com/\" target=\"_blank\">Berkeleyside\u003c/a> is an independently owned news website based in Berkeley, Calif. \u003ca style=\"color: #336699\" href=\"http://berkeleyside.us2.list-manage.com/subscribe?u=4851428a10883a05193b1dd6c&id=aad4b5ee64\" target=\"_blank\">Click here\u003c/a> if you would you like to receive the latest Berkeley news in your inbox once a day for free with Berkeleyside’s Daily Briefing email.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Digital Mammograms: Pricey And Perhaps No Better for Older Women",
"title": "Digital Mammograms: Pricey And Perhaps No Better for Older Women",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19962\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS10502_86541005-hpf.jpg\">\u003cimg class=\"size-full wp-image-19962\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS10502_86541005-hpf.jpg\" alt=\"In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/07/RS10502_86541005-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/07/RS10502_86541005-hpf-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/07/RS10502_86541005-hpf-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kara Manke,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/07/02/327320236/costlier-digital-mammograms-may-not-be-better-for-older-women\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Medicare spending on breast cancer screening for women age 65 and older has jumped nearly 50 percent in recent years. But the rise in price was not associated with an improvement in the early detection of breast cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"We did not see a change in the detection of early or late stage tumors.\" \u003c/aside>\n\u003cp>Researchers at the Yale School of Medicine found that Medicare spending on breast cancer screening rose from $666 million in the years 2001-2002 to $962 million in the years 2008-2009.\u003c/p>\n\u003cp>So why the big increases in costs?\u003c/p>\n\u003cp>\"The way that we screen for breast cancer has changed dramatically,\" explains Yale's Dr. Cary Gross, an internist and a co-author of the study. The study was \u003ca href=\"https://secure.oxfordjournals.org/licensing/index.html?doi=10.1093/jnci/dju159\" target=\"_blank\">published this week\u003c/a> in the Journal of The National Cancer Institute.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the past decade, many hospitals and clinics have switched to using digital mammography machines, which, like digital cameras, provide clearer, more detailed images that are easier to store, share and enhance than their film-based counterparts. They have also adopted computer-aided detection, which can help radiologists spot tumors they might otherwise miss.\u003c/p>\n\u003cp>But buying new machines and training people to use them can be expensive. To offset the costs, Medicare reimburses doctors and hospitals around 50 percent more for digital mammograms than for film mammograms.\u003c/p>\n\u003cp>According to the Yale review of the data, the use of digital mammograms and of computer-aided detection increased nationally from around two percent to 30 percent between 2000 and 2010. As a result, the cost per screening mammogram rose from $75 to $101 during this period.\u003c/p>\n\u003cp>They estimated that for each Medicare recipient, the average cost of all screening-related tests, including follow-up biopsies, MRIs, and ultrasounds, increased from $76 to $112 during the time period. Almost all of that increase in cost came from digital mammography and computer-aided detection.\u003c/p>\n\u003caside class=\"pullquote alignright\">How much did you pay for a mammogram? \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Join KQED's PriceCheck and share what you paid!\u003c/a>\u003c/aside>\n\u003cp>But switching to the more expensive technology didn't seem to help doctors spot cancer.\u003c/p>\n\u003cp>\"The purpose of a screening test is hopefully to catch malignancy at an earlier stage when it is more treatable. But we did not see a change in the detection of early or late stage tumors,\" says Dr. Brigid Killelea, a breast surgeon at Yale and lead author on the study.\u003c/p>\n\u003cp>This study adds to the mixed report card on digital mammography since the technology first came into general use in the mid-2000s. Studies show that it\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/detection/mammograms\" target=\"_blank\"> can be more accurate\u003c/a> at detecting cancer in younger women because it allows doctors to more easily identify tumors in denser breast tissue. But it is about as accurate as film scans for older women.\u003c/p>\n\u003cp>Radiologists argue that digital screening offers many benefits for patients, even if it doesn't always find more tumors.\u003c/p>\n\u003cp>\"I think digital is better all around,\" says Dr. Daniel Kopans, a professor of radiology at Harvard Medical School, speaking on behalf of the American College of Radiology.\u003c/p>\n\u003cp>With digital mammography, he explains, technologists can see the images right away and can easily adjust the contrast. Patients don't have to wait for film to be developed, or submit to additional scanning if the images were overexposed or underexposed. Doctors can easily store and share images, allowing them to better track changes over time or seek the opinion of a colleague.\u003c/p>\n\u003cp>Kopans also points out that the Medicare reimbursement levels may not match the true costs of digital technology.\u003c/p>\n\u003cp>\"I would urge that we look at what the real costs are rather than just saying that we shouldn't spend the money,\" he says.\u003c/p>\n\u003cp>Unfortunately, women who are concerned about their breast health — and their tax dollars — rarely have a choice of which method to choose. As of July 2014, \u003ca href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">95 percent of mammography\u003c/a> machines in the United States were digital.\u003c/p>\n\u003cp>\"At this point I don't think anyone would look at this study and say they should dig the old film machines out of the closet,\" says Gross. Digital machines are more accurate for a subset of the population, he says, and now that they are so widespread it would be impractical for breast imaging centers to buy new film-based machines for their older patients.\u003c/p>\n\u003cp>But he says the study underscores the importance of fully discussing the efficacy, cost and insurance coverage of future technologies — such as 3-D mammograms, which are just starting to be introduced — before they go into common use.\u003c/p>\n\u003cp>\"I view this as a cautionary tale,\" Gross says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19962\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS10502_86541005-hpf.jpg\">\u003cimg class=\"size-full wp-image-19962\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS10502_86541005-hpf.jpg\" alt=\"In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/07/RS10502_86541005-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/07/RS10502_86541005-hpf-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/07/RS10502_86541005-hpf-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kara Manke,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/07/02/327320236/costlier-digital-mammograms-may-not-be-better-for-older-women\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Medicare spending on breast cancer screening for women age 65 and older has jumped nearly 50 percent in recent years. But the rise in price was not associated with an improvement in the early detection of breast cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"We did not see a change in the detection of early or late stage tumors.\" \u003c/aside>\n\u003cp>Researchers at the Yale School of Medicine found that Medicare spending on breast cancer screening rose from $666 million in the years 2001-2002 to $962 million in the years 2008-2009.\u003c/p>\n\u003cp>So why the big increases in costs?\u003c/p>\n\u003cp>\"The way that we screen for breast cancer has changed dramatically,\" explains Yale's Dr. Cary Gross, an internist and a co-author of the study. The study was \u003ca href=\"https://secure.oxfordjournals.org/licensing/index.html?doi=10.1093/jnci/dju159\" target=\"_blank\">published this week\u003c/a> in the Journal of The National Cancer Institute.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the past decade, many hospitals and clinics have switched to using digital mammography machines, which, like digital cameras, provide clearer, more detailed images that are easier to store, share and enhance than their film-based counterparts. They have also adopted computer-aided detection, which can help radiologists spot tumors they might otherwise miss.\u003c/p>\n\u003cp>But buying new machines and training people to use them can be expensive. To offset the costs, Medicare reimburses doctors and hospitals around 50 percent more for digital mammograms than for film mammograms.\u003c/p>\n\u003cp>According to the Yale review of the data, the use of digital mammograms and of computer-aided detection increased nationally from around two percent to 30 percent between 2000 and 2010. As a result, the cost per screening mammogram rose from $75 to $101 during this period.\u003c/p>\n\u003cp>They estimated that for each Medicare recipient, the average cost of all screening-related tests, including follow-up biopsies, MRIs, and ultrasounds, increased from $76 to $112 during the time period. Almost all of that increase in cost came from digital mammography and computer-aided detection.\u003c/p>\n\u003caside class=\"pullquote alignright\">How much did you pay for a mammogram? \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Join KQED's PriceCheck and share what you paid!\u003c/a>\u003c/aside>\n\u003cp>But switching to the more expensive technology didn't seem to help doctors spot cancer.\u003c/p>\n\u003cp>\"The purpose of a screening test is hopefully to catch malignancy at an earlier stage when it is more treatable. But we did not see a change in the detection of early or late stage tumors,\" says Dr. Brigid Killelea, a breast surgeon at Yale and lead author on the study.\u003c/p>\n\u003cp>This study adds to the mixed report card on digital mammography since the technology first came into general use in the mid-2000s. Studies show that it\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/detection/mammograms\" target=\"_blank\"> can be more accurate\u003c/a> at detecting cancer in younger women because it allows doctors to more easily identify tumors in denser breast tissue. But it is about as accurate as film scans for older women.\u003c/p>\n\u003cp>Radiologists argue that digital screening offers many benefits for patients, even if it doesn't always find more tumors.\u003c/p>\n\u003cp>\"I think digital is better all around,\" says Dr. Daniel Kopans, a professor of radiology at Harvard Medical School, speaking on behalf of the American College of Radiology.\u003c/p>\n\u003cp>With digital mammography, he explains, technologists can see the images right away and can easily adjust the contrast. Patients don't have to wait for film to be developed, or submit to additional scanning if the images were overexposed or underexposed. Doctors can easily store and share images, allowing them to better track changes over time or seek the opinion of a colleague.\u003c/p>\n\u003cp>Kopans also points out that the Medicare reimbursement levels may not match the true costs of digital technology.\u003c/p>\n\u003cp>\"I would urge that we look at what the real costs are rather than just saying that we shouldn't spend the money,\" he says.\u003c/p>\n\u003cp>Unfortunately, women who are concerned about their breast health — and their tax dollars — rarely have a choice of which method to choose. As of July 2014, \u003ca href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">95 percent of mammography\u003c/a> machines in the United States were digital.\u003c/p>\n\u003cp>\"At this point I don't think anyone would look at this study and say they should dig the old film machines out of the closet,\" says Gross. Digital machines are more accurate for a subset of the population, he says, and now that they are so widespread it would be impractical for breast imaging centers to buy new film-based machines for their older patients.\u003c/p>\n\u003cp>But he says the study underscores the importance of fully discussing the efficacy, cost and insurance coverage of future technologies — such as 3-D mammograms, which are just starting to be introduced — before they go into common use.\u003c/p>\n\u003cp>\"I view this as a cautionary tale,\" Gross says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Guidelines Say Many Women Can Skip Pelvic Exam",
"title": "New Guidelines Say Many Women Can Skip Pelvic Exam",
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"content": "\u003cfigure id=\"attachment_9590\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233.jpg\">\u003cimg class=\"size-full wp-image-9590\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233.jpg\" alt=\"(Maigh/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If this picture makes you shudder, you'll want to understand the new guideline. (Maigh/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.\u003c/p>\n\u003cp>Routine pelvic exams don't benefit women who have no symptoms of disease and who aren't pregnant, and they can cause harm, the American College of Physicians said Monday as it recommended that doctors quit using them as a screening tool.\u003c/p>\n\u003cp>It's part of a growing movement to evaluate whether many longtime medical practices are done more out of habit than necessity, and the guideline is sure to be controversial.\u003c/p>\n\u003cp>Scientific evidence \"just doesn't support the benefit of having a pelvic exam every year,\" said guideline coauthor Dr. Linda Humphrey of the Portland Veterans Affairs Medical Center and Oregon Health & Science University.\u003c!--more-->\u003c/p>\n\u003cp>\"There will be women who are relieved, and there are women who really want to go in and talk with their doctor about it and will choose to continue this,\" she added.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The recommendations aren't binding to doctors — or insurers.\u003c/p>\n\u003cp>Indeed, a different doctors' group, the American College of Obstetricians and Gynecologists, still recommends yearly pelvic exams even as it acknowledges a lack of evidence supporting, or refuting, them.\u003c/p>\n\u003cp>Pelvic exams have long been considered part of a \"well-woman visit,\" and some 62 million were performed in the United States in 2010, the latest available data.\u003c/p>\n\u003cp>Here's what put the test under the microscope: Pap smears that check for cervical cancer used to be done yearly but now are recommended only every three to five years. So if women weren't going through that test every year, did they still need the pelvic exam that traditionally accompanied it?\u003c/p>\n\u003cp>During a pelvic exam, a doctor feels for abnormalities in the ovaries, uterus and other pelvic organs. But two years ago, scientists at the Centers for Disease Control and Prevention reported that the internal exams weren't a good screening tool for ovarian cancer and shouldn't be required before a woman was prescribed birth control pills.\u003c/p>\n\u003cp>The American College of Physicians, specialists in internal medicine, took a broader look.\u003c/p>\n\u003cp>Pelvic exams are appropriate for women with symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction, the ACP said. And women should get their Pap smears on schedule — but a Pap doesn't require the extra step of a manual pelvic exam, it said.\u003c/p>\n\u003cp>For symptom-free women, years of medical studies show routine pelvic exams aren't useful to screen for ovarian or other gynecologic cancers, they don't reduce deaths, and there are other ways, such as urine tests, to detect such problems as sexually transmitted infections, the doctors' group reported in the journal Annals of Internal Medicine.\u003c/p>\n\u003cp>Moreover, pelvic exams can cause harm — from unnecessary and expensive extra testing when the exam sparks a false alarm, to the anxiety, embarrassment and discomfort that many women report, especially survivors of sexual abuse, the guidelines said.\u003c/p>\n\u003cp>No one knows how many women postpone a doctor's visit for fear of a pelvic exam, Humphrey said.\u003c/p>\n\u003cp>Dr. Ranit Mishori, a family physician and associate professor at Georgetown University School of Medicine, said the new guideline \"gets rid of an unnecessary practice\" that takes up valuable time that could be put to better use.\u003c/p>\n\u003cp>\"Many women will be happy to hear that, and I think also, frankly, many physicians will be happy to hear it. Many of us have stopped doing them for a long time,\" said Mishori, who wasn't involved with the recommendations.\u003c/p>\n\u003cp>Despite its continued recommendation for annual pelvic exams, the American College of Obstetricians and Gynecologists \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/18/et-tu-pelvic-exams/\" target=\"_blank\">said in 2012\u003c/a> that patients should decide together with their providers whether to have them.\u003c/p>\n\u003cp>Sometimes that exam lets the doctor spot, say, problems around the uterus that might lead to questions about incontinence that the supposedly asymptomatic patient was too embarrassed to bring up, said ACOG vice president Dr. Barbara Levy.\u003c/p>\n\u003cp>\"Women have an expectation that they're going to have an exam\" if they choose a gynecologist, Levy said.\u003c/p>\n\u003cp>An editorial published alongside the guidelines Monday cautioned that pelvic exams also look for noncancerous uterine and ovarian growths, and the scientific review didn't address whether that's beneficial.\u003c/p>\n\u003cp>Still, editorial coauthors Drs. George Sawaya and Vanessa Jacoby of the University of California, San Francisco, said that whether the new guideline changes doctors' practice or not, it could lead to better evaluation of what \"has become more of a ritual than an evidence-based practice.\"\u003c/p>\n\u003cp>\"Clinicians who continue to offer the examination should at least be cognizant of the uncertainty of benefit and the potential to cause harm through a positive test result and the cascade of events that follow,\" they wrote.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9590\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233.jpg\">\u003cimg class=\"size-full wp-image-9590\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233.jpg\" alt=\"(Maigh/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/12/PelvicExamStirrups_Maigh_Flickr-e1404162693233-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If this picture makes you shudder, you'll want to understand the new guideline. (Maigh/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.\u003c/p>\n\u003cp>Routine pelvic exams don't benefit women who have no symptoms of disease and who aren't pregnant, and they can cause harm, the American College of Physicians said Monday as it recommended that doctors quit using them as a screening tool.\u003c/p>\n\u003cp>It's part of a growing movement to evaluate whether many longtime medical practices are done more out of habit than necessity, and the guideline is sure to be controversial.\u003c/p>\n\u003cp>Scientific evidence \"just doesn't support the benefit of having a pelvic exam every year,\" said guideline coauthor Dr. Linda Humphrey of the Portland Veterans Affairs Medical Center and Oregon Health & Science University.\u003c!--more-->\u003c/p>\n\u003cp>\"There will be women who are relieved, and there are women who really want to go in and talk with their doctor about it and will choose to continue this,\" she added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The recommendations aren't binding to doctors — or insurers.\u003c/p>\n\u003cp>Indeed, a different doctors' group, the American College of Obstetricians and Gynecologists, still recommends yearly pelvic exams even as it acknowledges a lack of evidence supporting, or refuting, them.\u003c/p>\n\u003cp>Pelvic exams have long been considered part of a \"well-woman visit,\" and some 62 million were performed in the United States in 2010, the latest available data.\u003c/p>\n\u003cp>Here's what put the test under the microscope: Pap smears that check for cervical cancer used to be done yearly but now are recommended only every three to five years. So if women weren't going through that test every year, did they still need the pelvic exam that traditionally accompanied it?\u003c/p>\n\u003cp>During a pelvic exam, a doctor feels for abnormalities in the ovaries, uterus and other pelvic organs. But two years ago, scientists at the Centers for Disease Control and Prevention reported that the internal exams weren't a good screening tool for ovarian cancer and shouldn't be required before a woman was prescribed birth control pills.\u003c/p>\n\u003cp>The American College of Physicians, specialists in internal medicine, took a broader look.\u003c/p>\n\u003cp>Pelvic exams are appropriate for women with symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction, the ACP said. And women should get their Pap smears on schedule — but a Pap doesn't require the extra step of a manual pelvic exam, it said.\u003c/p>\n\u003cp>For symptom-free women, years of medical studies show routine pelvic exams aren't useful to screen for ovarian or other gynecologic cancers, they don't reduce deaths, and there are other ways, such as urine tests, to detect such problems as sexually transmitted infections, the doctors' group reported in the journal Annals of Internal Medicine.\u003c/p>\n\u003cp>Moreover, pelvic exams can cause harm — from unnecessary and expensive extra testing when the exam sparks a false alarm, to the anxiety, embarrassment and discomfort that many women report, especially survivors of sexual abuse, the guidelines said.\u003c/p>\n\u003cp>No one knows how many women postpone a doctor's visit for fear of a pelvic exam, Humphrey said.\u003c/p>\n\u003cp>Dr. Ranit Mishori, a family physician and associate professor at Georgetown University School of Medicine, said the new guideline \"gets rid of an unnecessary practice\" that takes up valuable time that could be put to better use.\u003c/p>\n\u003cp>\"Many women will be happy to hear that, and I think also, frankly, many physicians will be happy to hear it. Many of us have stopped doing them for a long time,\" said Mishori, who wasn't involved with the recommendations.\u003c/p>\n\u003cp>Despite its continued recommendation for annual pelvic exams, the American College of Obstetricians and Gynecologists \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/18/et-tu-pelvic-exams/\" target=\"_blank\">said in 2012\u003c/a> that patients should decide together with their providers whether to have them.\u003c/p>\n\u003cp>Sometimes that exam lets the doctor spot, say, problems around the uterus that might lead to questions about incontinence that the supposedly asymptomatic patient was too embarrassed to bring up, said ACOG vice president Dr. Barbara Levy.\u003c/p>\n\u003cp>\"Women have an expectation that they're going to have an exam\" if they choose a gynecologist, Levy said.\u003c/p>\n\u003cp>An editorial published alongside the guidelines Monday cautioned that pelvic exams also look for noncancerous uterine and ovarian growths, and the scientific review didn't address whether that's beneficial.\u003c/p>\n\u003cp>Still, editorial coauthors Drs. George Sawaya and Vanessa Jacoby of the University of California, San Francisco, said that whether the new guideline changes doctors' practice or not, it could lead to better evaluation of what \"has become more of a ritual than an evidence-based practice.\"\u003c/p>\n\u003cp>\"Clinicians who continue to offer the examination should at least be cognizant of the uncertainty of benefit and the potential to cause harm through a positive test result and the cascade of events that follow,\" they wrote.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "You Can Transform Your Genetic Ancestry Data Into Health Info, But Your Results May Vary",
"headTitle": "You Can Transform Your Genetic Ancestry Data Into Health Info, But Your Results May Vary | KQED",
"content": "\u003cfigure id=\"attachment_18733\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/MyEthnicityData23andMe.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-18733\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/MyEthnicityData23andMe.jpg\" alt=\"Promethease can convert ancestry data like this into health data.\" width=\"640\" height=\"341\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Promethease can convert ancestry data like this into health data.\u003c/figcaption>\u003c/figure>\n\u003cp>DNA ancestry tests like those offered by \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a> or \u003ca href=\"http://home.ancestry.com/\">ancestry.com\u003c/a> are a lot of fun and in some cases can be incredibly useful. For example, if you’re adopted, you can find out things about your past you had no way of finding out before. You can also find long lost relatives or confirm relationships you weren’t sure about. (Click \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/dna-testing-first-cousins\">here \u003c/a>for a great example of a person confirming that someone he thought was a first cousin really was.) And of course, it is just plain fun to find out your family history.\u003c/p>\n\u003cp>But this isn’t enough for everyone. After finding a seemingly endless supply of fifth cousins, you may now want to get more out of your DNA test. You may want to learn a bit about what your DNA can say about your current and future health and maybe even about your earwax and why your pee smells funny whenever you eat asparagus.\u003c/p>\n\u003cp>If this were 2012 or even most of 2013, you’d have no trouble at all finding out about this stuff. You would have seen all this information and more from a \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a> test.\u003c/p>\n\u003cp>This all changed in November of 2013 when the Federal Drug Administration (FDA)\u003ca href=\"http://ww2.kqed.org/science/2013/12/09/consumer-genetic-testing-company-23andme-faces-its-own-test-from-the-fda/\"> forced 23andMe to stop giving out these types of results\u003c/a>. Now it may seem like that until the FDA and 23andMe work out their differences, there simply isn’t any way to get a hold of the kind of data you used to be able to get. But there actually is with an online resource called \u003ca href=\"http://www.snpedia.com/index.php/Promethease\">Promethease\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Promethease to the Rescue (?)\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For just $5, Promethease can turn ancestry/family DNA data from companies like \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>, \u003ca href=\"https://www.familytreedna.com/\">FamilyTreeDNA\u003c/a>, and/or \u003ca href=\"http://home.ancestry.com/\">ancestry.com\u003c/a> into DNA health data. The link \u003ca href=\"http://www.snpedia.com/index.php/Promethease\">here \u003c/a>has step-by-step instructions about how to get your raw data from each of these companies and how to use Promethease to learn about your disease risks, which medicines may give you trouble and even which bits of DNA contributed to those blue eyes.\u003c/p>\n\u003cp>One nice feature is that after 45 days, all the online traces of your report disappear a la \u003ca href=\"http://www.snapchat.com/\">Snapchat\u003c/a>. In other words, there is no record of your health data floating around the internet for bad folks to somehow use against you. (You can download a hard copy to your computer and should within the 45 days.)\u003c/p>\n\u003cp>Sounds like a perfect way to convert your ancestry data into health data! Except, of course, that you need to be careful about the data you get and what you do about it.\u003c/p>\n\u003cp>Remember, genetic tests in general can only tell you what scientists know about the DNA these tests look at. They obviously can’t tell you anything about the DNA the test doesn’t cover nor things hidden in the DNA that scientists haven’t figured out yet. Your results will be constrained both by what we don’t yet know and by the DNA the companies happen to test.\u003c/p>\n\u003cp>Now none of this says anything about Promethease at all. They do a great job at providing the most up-to-date information based on the literature that is available for various DNA differences that result in increased disease risk, eye color prediction and so on. It is just that the picture you will get will be incomplete. And different based on the test results you use.\u003c/p>\n\u003cp>This may all sound pretty abstract but this stuff matters. To show you how, I’ll use my Alzheimer’s risk as an example.\u003c/p>\n\u003cp>As you’ll see, my original results from 23andMe are different from the Promethease results I get from the same 23andMe data. And the results from my ancestry.com data are different from both of these.\u003c/p>\n\u003cp>\u003cstrong>Increased and Decreased Risk for Alzheimer’s\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_18731\" class=\"wp-caption alignright\" style=\"max-width: 236px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/BarryAlz23andMeOfficialSmall.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-18731\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/BarryAlz23andMeOfficialSmall.jpg\" alt=\"My reported lowered risk is almost entirely due to my having two copies of APOE2.\" width=\"236\" height=\"239\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">My reported lowered risk is almost entirely due to my having two copies of APOE2.\u003c/figcaption>\u003c/figure>\n\u003cp>I got my 23andMe test before the FDA (temporarily) halted them from giving out health data. As you can see at the right, my risk for Alzheimer’s is, according to the test, much lower than average.\u003c/p>\n\u003cp>This decreased risk is almost completely determined by my having two copies of the APOE2 version of the APOE gene. Now of course there are many other genes that will affect this number either positively or negatively. But APOE is the most important gene scientists have identified so far.\u003c/p>\n\u003cp>When I send my 23andMe data through Promethease, I do not get my results distilled this way. I see a much longer list that includes many findings that 23andMe probably correctly chose not to include because the results are too new, not significant enough, not done with enough participants or any other number of potential problems. This makes the report harder to interpret as I don’t know which results are the most important (although the report does give me some idea).\u003c/p>\n\u003cp>What this means is that I see lots of reports based on different parts of my DNA. A quick look suggests a wash—the different bits of DNA I have that contribute to my Alzheimer’s risk seem to all cancel out. With more digging I would be able to glean the fact that my APOE2 is the key part of my test results and that I have a lowered risk based on the DNA they tested and by what we know about Alzheimer’s and genes right now. But it would take a lot of time and not necessarily be easy (especially if I weren’t already a scientist).\u003c/p>\n\u003cp>My Alzheimer’s risk is very different when I look at my ancestry.com results because they happen not to include the APOE2 marker. Because of this, I end up looking like I am at a higher risk for Alzheimer’s because of all of those other, less significant markers.\u003c/p>\n\u003cp>If I were just to use my ancestry.com results, I would come to a completely different conclusion about my chances for getting Alzheimer’s.This result would matter a whole lot more if instead of two copies of APOE2, I had two copies of APOE4. Then I would be at a significantly higher risk for Alzheimer’s but this would be invisible to my ancestry.com results.\u003c/p>\n\u003cp>None of this says anything bad about ancestry.com. They presumably chose the DNA they wanted to focus on based on what would give them the best results for ancestry and there is no reason to think they chose poorly. It is just they did not happen to choose the specific bit of DNA that indicated I had a lowered risk for Alzheimer’s.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This all points to the bigger problem with trying to predict disease risk for complicated diseases with an incomplete understanding of our genome. Even if we sequenced every last A, T, C, and G, we still might not get an accurate read on our risks for having a heart attack or ending up with diabetes.\u003c/p>\n\n",
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"excerpt": "An online service called Promethease allows you to convert your genetic ancestry data into health data. If you do, keep in mind that you may miss key health data because your ancestry test might not have been designed to find important health markers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18733\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/MyEthnicityData23andMe.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-18733\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/MyEthnicityData23andMe.jpg\" alt=\"Promethease can convert ancestry data like this into health data.\" width=\"640\" height=\"341\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Promethease can convert ancestry data like this into health data.\u003c/figcaption>\u003c/figure>\n\u003cp>DNA ancestry tests like those offered by \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a> or \u003ca href=\"http://home.ancestry.com/\">ancestry.com\u003c/a> are a lot of fun and in some cases can be incredibly useful. For example, if you’re adopted, you can find out things about your past you had no way of finding out before. You can also find long lost relatives or confirm relationships you weren’t sure about. (Click \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/dna-testing-first-cousins\">here \u003c/a>for a great example of a person confirming that someone he thought was a first cousin really was.) And of course, it is just plain fun to find out your family history.\u003c/p>\n\u003cp>But this isn’t enough for everyone. After finding a seemingly endless supply of fifth cousins, you may now want to get more out of your DNA test. You may want to learn a bit about what your DNA can say about your current and future health and maybe even about your earwax and why your pee smells funny whenever you eat asparagus.\u003c/p>\n\u003cp>If this were 2012 or even most of 2013, you’d have no trouble at all finding out about this stuff. You would have seen all this information and more from a \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a> test.\u003c/p>\n\u003cp>This all changed in November of 2013 when the Federal Drug Administration (FDA)\u003ca href=\"http://ww2.kqed.org/science/2013/12/09/consumer-genetic-testing-company-23andme-faces-its-own-test-from-the-fda/\"> forced 23andMe to stop giving out these types of results\u003c/a>. Now it may seem like that until the FDA and 23andMe work out their differences, there simply isn’t any way to get a hold of the kind of data you used to be able to get. But there actually is with an online resource called \u003ca href=\"http://www.snpedia.com/index.php/Promethease\">Promethease\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Promethease to the Rescue (?)\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For just $5, Promethease can turn ancestry/family DNA data from companies like \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>, \u003ca href=\"https://www.familytreedna.com/\">FamilyTreeDNA\u003c/a>, and/or \u003ca href=\"http://home.ancestry.com/\">ancestry.com\u003c/a> into DNA health data. The link \u003ca href=\"http://www.snpedia.com/index.php/Promethease\">here \u003c/a>has step-by-step instructions about how to get your raw data from each of these companies and how to use Promethease to learn about your disease risks, which medicines may give you trouble and even which bits of DNA contributed to those blue eyes.\u003c/p>\n\u003cp>One nice feature is that after 45 days, all the online traces of your report disappear a la \u003ca href=\"http://www.snapchat.com/\">Snapchat\u003c/a>. In other words, there is no record of your health data floating around the internet for bad folks to somehow use against you. (You can download a hard copy to your computer and should within the 45 days.)\u003c/p>\n\u003cp>Sounds like a perfect way to convert your ancestry data into health data! Except, of course, that you need to be careful about the data you get and what you do about it.\u003c/p>\n\u003cp>Remember, genetic tests in general can only tell you what scientists know about the DNA these tests look at. They obviously can’t tell you anything about the DNA the test doesn’t cover nor things hidden in the DNA that scientists haven’t figured out yet. Your results will be constrained both by what we don’t yet know and by the DNA the companies happen to test.\u003c/p>\n\u003cp>Now none of this says anything about Promethease at all. They do a great job at providing the most up-to-date information based on the literature that is available for various DNA differences that result in increased disease risk, eye color prediction and so on. It is just that the picture you will get will be incomplete. And different based on the test results you use.\u003c/p>\n\u003cp>This may all sound pretty abstract but this stuff matters. To show you how, I’ll use my Alzheimer’s risk as an example.\u003c/p>\n\u003cp>As you’ll see, my original results from 23andMe are different from the Promethease results I get from the same 23andMe data. And the results from my ancestry.com data are different from both of these.\u003c/p>\n\u003cp>\u003cstrong>Increased and Decreased Risk for Alzheimer’s\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_18731\" class=\"wp-caption alignright\" style=\"max-width: 236px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/BarryAlz23andMeOfficialSmall.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-18731\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/06/BarryAlz23andMeOfficialSmall.jpg\" alt=\"My reported lowered risk is almost entirely due to my having two copies of APOE2.\" width=\"236\" height=\"239\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">My reported lowered risk is almost entirely due to my having two copies of APOE2.\u003c/figcaption>\u003c/figure>\n\u003cp>I got my 23andMe test before the FDA (temporarily) halted them from giving out health data. As you can see at the right, my risk for Alzheimer’s is, according to the test, much lower than average.\u003c/p>\n\u003cp>This decreased risk is almost completely determined by my having two copies of the APOE2 version of the APOE gene. Now of course there are many other genes that will affect this number either positively or negatively. But APOE is the most important gene scientists have identified so far.\u003c/p>\n\u003cp>When I send my 23andMe data through Promethease, I do not get my results distilled this way. I see a much longer list that includes many findings that 23andMe probably correctly chose not to include because the results are too new, not significant enough, not done with enough participants or any other number of potential problems. This makes the report harder to interpret as I don’t know which results are the most important (although the report does give me some idea).\u003c/p>\n\u003cp>What this means is that I see lots of reports based on different parts of my DNA. A quick look suggests a wash—the different bits of DNA I have that contribute to my Alzheimer’s risk seem to all cancel out. With more digging I would be able to glean the fact that my APOE2 is the key part of my test results and that I have a lowered risk based on the DNA they tested and by what we know about Alzheimer’s and genes right now. But it would take a lot of time and not necessarily be easy (especially if I weren’t already a scientist).\u003c/p>\n\u003cp>My Alzheimer’s risk is very different when I look at my ancestry.com results because they happen not to include the APOE2 marker. Because of this, I end up looking like I am at a higher risk for Alzheimer’s because of all of those other, less significant markers.\u003c/p>\n\u003cp>If I were just to use my ancestry.com results, I would come to a completely different conclusion about my chances for getting Alzheimer’s.This result would matter a whole lot more if instead of two copies of APOE2, I had two copies of APOE4. Then I would be at a significantly higher risk for Alzheimer’s but this would be invisible to my ancestry.com results.\u003c/p>\n\u003cp>None of this says anything bad about ancestry.com. They presumably chose the DNA they wanted to focus on based on what would give them the best results for ancestry and there is no reason to think they chose poorly. It is just they did not happen to choose the specific bit of DNA that indicated I had a lowered risk for Alzheimer’s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This all points to the bigger problem with trying to predict disease risk for complicated diseases with an incomplete understanding of our genome. Even if we sequenced every last A, T, C, and G, we still might not get an accurate read on our risks for having a heart attack or ending up with diabetes.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19806\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/178753234.jpg\">\u003cimg class=\"size-large wp-image-19806\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/178753234-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>As a woman who had not just her last child, but also her first child after age 33, I enthusiastically clicked on the NPR story in my Facebook feed this morning.\u003c/p>\n\u003cp>NPR reports that older moms -- women who had their last child after age 33 -- have twice the odds of \"exceptional longevity\" as women who had their last child before age 29. This \"exceptional longevity\" is defined as living to age 95. The research is according to a study published this week in the journal Menopause.\u003c/p>\n\u003cp>I got over the fact that \"older moms\" are women who had their last child after 33, which seems kind of young to me.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/blogs/health/2014/06/28/326163561/older-moms-take-heart-you-may-be-more-likely-to-live-longer\" target=\"_blank\">NPR explains\u003c/a> why there may be a connection between bearing children later and longevity:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>\"We think that a woman's ability to have children at a later age is evidence that her reproductive system is aging more slowly, and that the rest of her system is also aging more slowly,\" says Thomas Perls, a geriatrician at Boston Medical Center. He's an author of the paper and a principal investigator of the\u003ca href=\"https://dsgweb.wustl.edu/llfs/\" target=\"_blank\"> Long Life Family Study\u003c/a>, an international effort to figure out the secrets of a long and healthy life.\u003c/p>\n\u003cp>That might bring some comfort to older moms who have been told that they won't be able to keep up with their teenagers.\u003c/p>\n\u003cp>Other research also has shown that women who \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/19414513\" target=\"_blank\">give birth later in life\u003c/a> are more likely to make it to 95 or 100 years. The theory is that certain genetic variations that allow women to bear children later are also related to longevity.\u003c/p>\n\u003cp>\"Variants allowing a woman to have children over a longer period of time would increase the chances she can pass the genes on to children and subsequent generations,\" says Perls. \"It's essentially winning the evolutionary game.\"\u003c/p>\u003c/blockquote>\n\u003cp>NPR correctly points out that this \"age of last child\" is not perfect marker for how old a woman's reproductive system is. A woman might reasonably have decided not to have more children, even though her body was capable of going on.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So the next step is to see if there's an association between longevity and the age of menopause, which would be a better marker of the longevity of a woman's reproductive ability.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The researchers corrected for several variables, they say, including education and tobacco use. In addition, none of the women in the study used fertility treatments. Researchers said having children at an older age after using those treatments is not likely to be associated with longer life.\u003c/p>\n\n",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"science-friday": {
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