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"content": "\u003cp>New \u003ca href=\"http://www.news.wisc.edu/22356\">research\u003c/a> from the University of Wisconsin suggests that deforestation is promoting the spread of a disease called Nipah virus in Bangladesh. The virus has no cure, no vaccine -- and a mortality rate of more than 70 percent.\u003c/p>\n\u003cp>After Nipah virus first appeared in Malaysia in 1998, epidemiologists traced it back to Indian flying foxes -- giant fruit bats that are widespread in South Asia. In \u003ca href=\"http://blogs.discovermagazine.com/bodyhorrors/2013/04/30/climatic-ori-nipah-virus/#.U3Y4gcYhsnA\">Malaysia\u003c/a> the bats infected domesticated pigs, which in turn infected their farmers. But the latest outbreaks have been in Bangladesh, where pigs are rare. A 2006 \u003ca href=\"http://wwwnc.cdc.gov/eid/article/12/12/pdfs/06-0732.pdf\">study\u003c/a> by the CDC and other groups concluded that the Bangladesh outbreaks were caused by drinking contaminated date palm sap, a sugary syrup humans and bats both love.\u003c/p>\n\u003cfigure id=\"attachment_70513\" class=\"wp-caption alignleft\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_5914.jpg\">\u003cimg class=\"wp-image-70513 size-large\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_5914-270x360.jpg\" alt=\"Sap collectors slice into date palm trees with machetes, then hang clay pots to catch the sweet syrup that drips out. Bats drinking from the pot can contaminate the sap with Nipah virus. Photo courtesy of Micah Hahn.\" width=\"270\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sap collectors slice into date palm trees with machetes, then hang clay pots to catch the sweet syrup that drips out. Bats drinking from the pots can contaminate the sap with Nipah virus. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\u003cp>Date palm sap is collected from tree trunks, like maple syrup: collectors tap the trees with machetes and let the syrup run into clay pots overnight. During the night, when the bats are out foraging, they find these pots, drink from them, and sometimes leave behind the Nipah virus in their saliva, urine, or feces. Cooking or fermenting the sap could destroy the virus, but in Bangladesh the sap is commonly sold raw at street markets, a practice the government \u003ca href=\"http://www.nytimes.com/2011/03/22/health/22global.html?_r=0\">banned\u003c/a> after a 2011 outbreak that killed 21 children.\u003c/p>\n\u003cp>That law isn't enforced, though, especially in rural areas, and the sale of raw sap continues. The Institute of Epidemiology, Disease Control, and Research in Dhaka, the capital of Bangladesh, \u003ca href=\"http://www.iedcr.org/index.php?option=com_content&view=article&id=106\">reported\u003c/a> 18 more cases before February 11 of this year. Patients usually show up with a fever, headache, and neurological symptoms like confusion and seizures. There isn’t much doctors can do beyond keeping them comfortable and helping them breathe once the disease spreads to their lungs.\u003c/p>\n\u003cp>Understanding which villages are most vulnerable to Nipah would facilitate more targeted prevention efforts, but the virus' geographic distribution was puzzling. Outbreaks seemed to be clustered around a strip of territory in central and northwestern Bangladesh that’s come to be called the “\u003ca href=\"http://www.icddrb.org/media-centre/news/1996-dealing-with-nipah-virus-how-low-cost-methods-may-save-lives-in-bangladesh\">Nipah belt\u003c/a>.” Population density is higher in the Nipah belt than outside it, and forest density is lower, but the bat population -- presumably the source of the outbreaks -- is the same. And even within the Nipah belt, some villages escaped the virus entirely when similar ones, with the same number of bats, had outbreaks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That was the mystery that intrigued Micah Hahn, then a graduate student at the \u003ca href=\"http://www.nelson.wisc.edu\">Nelson Institute for Environmental Studies\u003c/a> at UW-Madison. “Why here, but not there? How does the environment help determine who gets Nipah virus and who does not?”\u003c/p>\n\u003cp>To answer that question, Dr. Hahn and her colleagues combined high-tech remote-sensing techniques with low-tech door-to-door surveys. They also hung infrared cameras to monitor bats feeding at night. All this data enabled them to create a high-resolution map that compared the geographic distribution and density of people, bats, and trees.\u003c/p>\n\u003cfigure id=\"attachment_70516\" class=\"wp-caption alignleft\" style=\"max-width: 650px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_1099-e1400185366313.jpg\">\u003cimg class=\"wp-image-70516\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_1099-e1400185366313-541x360.jpg\" alt=\"Bat roosts. Photo courtesy of Micah Hahn.\" width=\"650\" height=\"432\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During the day, fruit bats roost in colonies of hundreds. But surprisingly, just having a bat colony nearby doesn't necessarily increase the chance that Nipah virus will spill over to humans. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\u003cp>That led to the discovery of a surprising culprit: deforestation. The United Nations’ Food and Agriculture Organization estimates that Bangladesh has lost nearly three-quarters of its forest in the last 30 years as its population has expanded. In the Nipah belt, as Hahn explains in this \u003ca href=\"https://www.youtube.com/watch?v=VCnL3aoNEAA\">video\u003c/a> from the Nelson Institute, what remains are small, uneven patches of forest instead of large swaths of jungle. The places where the forest is most fragmented are the places most vulnerable to Nipah virus.\u003c/p>\n\u003cp>For every 10 percent reduction in tree cover at the sites in the Nipah belt where the bats were roosting, Hahn found that a nearby village was \u003cstrong>twice\u003c/strong> as likely to have an outbreak. Why? Even though there were the same number of bats in these fragmented forests as in thicker ones, Hahn observed that they “tended to settle in several small roosts scattered throughout the villages, rather than in one large roosting colony.” In areas where the human population density is high, like in the Nipah belt, Hahn speculates that this dispersion increases the likelihood that the bats will find human food sources. When bats and humans start sharing food, disease transmission becomes much more likely.\u003c/p>\n\u003cfigure id=\"attachment_70520\" class=\"wp-caption alignnone\" style=\"max-width: 650px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IGP5159.jpg\">\u003cimg class=\"wp-image-70520\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IGP5159-537x360.jpg\" alt=\"Date palm sap is collected in clay pots like these. Covering the pots with fabric to keep the bats out can prevent contaminationDate palm sap pots. Photo courtesy of Micah Hahn. \" width=\"650\" height=\"435\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Date palm sap is collected in clay pots like these. Covering the pots with fabric to keep bats out can prevent contamination. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\u003cp>But Hahn is quick to point out that the bats themselves aren’t the problem. In fact, since bats help regenerate forest by strewing seeds all over their territory, they could be part of the solution. “This is not just about having bats,” she said. It’s a combination of bat behavior and human behavior that sparked the emergence of Nipah virus in Bangladesh. “The disease risk is a result of humans changing the landscape in ways that create opportunities for human/wildlife interactions,” Hahn said\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Nipah virus isn’t the only disease whose spread is influenced by the way humans manage the landscape. In Uganda, replacing natural swamps with cropland increased the risk of malaria. Yellow fever, leishmaniasis, and Hantavirus have also been shown to behave differently when the landscape changes. Hahn’s research will help target Nipah prevention and surveillance efforts to the most vulnerable villages, but it’s also evidence that the consequences of reshaping our environment could be more complicated than we expected.\u003c/p>\n\u003cfigure id=\"attachment_70514\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_0199-e1400184212923.jpg\">\u003cimg class=\"wp-image-70514\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_0199-e1400184212923-551x360.jpg\" alt=\"When the forest is broken up into small patches with lots of holes in the canopy, bat and humans start to find food in the same areas. Photo courtesy of Micah Hahn.\" width=\"650\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When the forest is broken up into small patches and interspersed with human settlements, like it is in the Nipah belt, humans and bats can start sharing food sources. Bat-borne diseases are the result. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>New \u003ca href=\"http://www.news.wisc.edu/22356\">research\u003c/a> from the University of Wisconsin suggests that deforestation is promoting the spread of a disease called Nipah virus in Bangladesh. The virus has no cure, no vaccine -- and a mortality rate of more than 70 percent.\u003c/p>\n\u003cp>After Nipah virus first appeared in Malaysia in 1998, epidemiologists traced it back to Indian flying foxes -- giant fruit bats that are widespread in South Asia. In \u003ca href=\"http://blogs.discovermagazine.com/bodyhorrors/2013/04/30/climatic-ori-nipah-virus/#.U3Y4gcYhsnA\">Malaysia\u003c/a> the bats infected domesticated pigs, which in turn infected their farmers. But the latest outbreaks have been in Bangladesh, where pigs are rare. A 2006 \u003ca href=\"http://wwwnc.cdc.gov/eid/article/12/12/pdfs/06-0732.pdf\">study\u003c/a> by the CDC and other groups concluded that the Bangladesh outbreaks were caused by drinking contaminated date palm sap, a sugary syrup humans and bats both love.\u003c/p>\n\u003cfigure id=\"attachment_70513\" class=\"wp-caption alignleft\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_5914.jpg\">\u003cimg class=\"wp-image-70513 size-large\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_5914-270x360.jpg\" alt=\"Sap collectors slice into date palm trees with machetes, then hang clay pots to catch the sweet syrup that drips out. Bats drinking from the pot can contaminate the sap with Nipah virus. Photo courtesy of Micah Hahn.\" width=\"270\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sap collectors slice into date palm trees with machetes, then hang clay pots to catch the sweet syrup that drips out. Bats drinking from the pots can contaminate the sap with Nipah virus. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\u003cp>Date palm sap is collected from tree trunks, like maple syrup: collectors tap the trees with machetes and let the syrup run into clay pots overnight. During the night, when the bats are out foraging, they find these pots, drink from them, and sometimes leave behind the Nipah virus in their saliva, urine, or feces. Cooking or fermenting the sap could destroy the virus, but in Bangladesh the sap is commonly sold raw at street markets, a practice the government \u003ca href=\"http://www.nytimes.com/2011/03/22/health/22global.html?_r=0\">banned\u003c/a> after a 2011 outbreak that killed 21 children.\u003c/p>\n\u003cp>That law isn't enforced, though, especially in rural areas, and the sale of raw sap continues. The Institute of Epidemiology, Disease Control, and Research in Dhaka, the capital of Bangladesh, \u003ca href=\"http://www.iedcr.org/index.php?option=com_content&view=article&id=106\">reported\u003c/a> 18 more cases before February 11 of this year. Patients usually show up with a fever, headache, and neurological symptoms like confusion and seizures. There isn’t much doctors can do beyond keeping them comfortable and helping them breathe once the disease spreads to their lungs.\u003c/p>\n\u003cp>Understanding which villages are most vulnerable to Nipah would facilitate more targeted prevention efforts, but the virus' geographic distribution was puzzling. Outbreaks seemed to be clustered around a strip of territory in central and northwestern Bangladesh that’s come to be called the “\u003ca href=\"http://www.icddrb.org/media-centre/news/1996-dealing-with-nipah-virus-how-low-cost-methods-may-save-lives-in-bangladesh\">Nipah belt\u003c/a>.” Population density is higher in the Nipah belt than outside it, and forest density is lower, but the bat population -- presumably the source of the outbreaks -- is the same. And even within the Nipah belt, some villages escaped the virus entirely when similar ones, with the same number of bats, had outbreaks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That was the mystery that intrigued Micah Hahn, then a graduate student at the \u003ca href=\"http://www.nelson.wisc.edu\">Nelson Institute for Environmental Studies\u003c/a> at UW-Madison. “Why here, but not there? How does the environment help determine who gets Nipah virus and who does not?”\u003c/p>\n\u003cp>To answer that question, Dr. Hahn and her colleagues combined high-tech remote-sensing techniques with low-tech door-to-door surveys. They also hung infrared cameras to monitor bats feeding at night. All this data enabled them to create a high-resolution map that compared the geographic distribution and density of people, bats, and trees.\u003c/p>\n\u003cfigure id=\"attachment_70516\" class=\"wp-caption alignleft\" style=\"max-width: 650px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_1099-e1400185366313.jpg\">\u003cimg class=\"wp-image-70516\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_1099-e1400185366313-541x360.jpg\" alt=\"Bat roosts. Photo courtesy of Micah Hahn.\" width=\"650\" height=\"432\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During the day, fruit bats roost in colonies of hundreds. But surprisingly, just having a bat colony nearby doesn't necessarily increase the chance that Nipah virus will spill over to humans. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\u003cp>That led to the discovery of a surprising culprit: deforestation. The United Nations’ Food and Agriculture Organization estimates that Bangladesh has lost nearly three-quarters of its forest in the last 30 years as its population has expanded. In the Nipah belt, as Hahn explains in this \u003ca href=\"https://www.youtube.com/watch?v=VCnL3aoNEAA\">video\u003c/a> from the Nelson Institute, what remains are small, uneven patches of forest instead of large swaths of jungle. The places where the forest is most fragmented are the places most vulnerable to Nipah virus.\u003c/p>\n\u003cp>For every 10 percent reduction in tree cover at the sites in the Nipah belt where the bats were roosting, Hahn found that a nearby village was \u003cstrong>twice\u003c/strong> as likely to have an outbreak. Why? Even though there were the same number of bats in these fragmented forests as in thicker ones, Hahn observed that they “tended to settle in several small roosts scattered throughout the villages, rather than in one large roosting colony.” In areas where the human population density is high, like in the Nipah belt, Hahn speculates that this dispersion increases the likelihood that the bats will find human food sources. When bats and humans start sharing food, disease transmission becomes much more likely.\u003c/p>\n\u003cfigure id=\"attachment_70520\" class=\"wp-caption alignnone\" style=\"max-width: 650px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IGP5159.jpg\">\u003cimg class=\"wp-image-70520\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IGP5159-537x360.jpg\" alt=\"Date palm sap is collected in clay pots like these. Covering the pots with fabric to keep the bats out can prevent contaminationDate palm sap pots. Photo courtesy of Micah Hahn. \" width=\"650\" height=\"435\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Date palm sap is collected in clay pots like these. Covering the pots with fabric to keep bats out can prevent contamination. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\u003cp>But Hahn is quick to point out that the bats themselves aren’t the problem. In fact, since bats help regenerate forest by strewing seeds all over their territory, they could be part of the solution. “This is not just about having bats,” she said. It’s a combination of bat behavior and human behavior that sparked the emergence of Nipah virus in Bangladesh. “The disease risk is a result of humans changing the landscape in ways that create opportunities for human/wildlife interactions,” Hahn said\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Nipah virus isn’t the only disease whose spread is influenced by the way humans manage the landscape. In Uganda, replacing natural swamps with cropland increased the risk of malaria. Yellow fever, leishmaniasis, and Hantavirus have also been shown to behave differently when the landscape changes. Hahn’s research will help target Nipah prevention and surveillance efforts to the most vulnerable villages, but it’s also evidence that the consequences of reshaping our environment could be more complicated than we expected.\u003c/p>\n\u003cfigure id=\"attachment_70514\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_0199-e1400184212923.jpg\">\u003cimg class=\"wp-image-70514\" src=\"http://ww2.kqed.org/quest/wp-content/uploads/sites/39/2014/01/IMG_0199-e1400184212923-551x360.jpg\" alt=\"When the forest is broken up into small patches with lots of holes in the canopy, bat and humans start to find food in the same areas. Photo courtesy of Micah Hahn.\" width=\"650\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When the forest is broken up into small patches and interspersed with human settlements, like it is in the Nipah belt, humans and bats can start sharing food sources. Bat-borne diseases are the result. Photo courtesy of Micah Hahn.\u003c/figcaption>\u003c/figure>\n\n\u003c/div>\u003c/p>",
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"title": "Veterans of Long-Past Wars Find Hope in PTSD Diagnosis",
"headTitle": "Veterans of Long-Past Wars Find Hope in PTSD Diagnosis | KQED",
"content": "\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2014/05/20140526science.mp3\u003c/p>\n\u003c/div>\n\u003cp>\u003cem>This story originally aired on\u003c/em> \u003ca href=\"http://www.californiareport.org/archive/R201307260850/a?__utma=111150238.900526782.1397169073.1400791631.1400871590.12&__utmb=111150238.4.8.1400877197319&__utmc=111150238&__utmx=-&__utmz=111150238.1400871543.12.4.utmcsr=google%7Cutmccn=%28organic%29%7Cutmcmd=organic%7Cutmctr=%28not%20provided%29&__utmv=-&__utmk=40508258\">The California Report\u003c/a>\u003cem> as part of the \u003ca href=\"http://www.kqed.org/news/bayarea/lifeafterwar/?__utma=34673459.900526782.1397169073.1400791631.1400871590.12&__utmb=34673459.0.10.1400871593&__utmc=34673459&__utmx=-&__utmz=34673459.1400871543.12.4.utmcsr=google%7Cutmccn=%28organic%29%7Cutmcmd=organic%7Cutmctr=%28not%20provided%29&__utmv=-&__utmk=81495701\">“Life After War”\u003c/a> series.\u003c/em>\u003c/p>\n\u003cp>As a soldier in Japan, Donald Foster, an 86-year-old veteran of World War II, worked in a Japanese orphanage. He said it made him feel patriotic — at first.\u003c/p>\n\u003cp>“But when you see these little tykes dropping dead from aplastic anemia, and the burns on adults wandering around dazed before they died of radiation sickness, rather than make me more patriotic, I just felt — I just threw up,” Foster said.\u003c/p>\n\u003cfigure id=\"attachment_17734\" class=\"wp-caption alignright\" style=\"max-width: 335px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-17734\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/RS5810_Don-Foster-poses-with-a-photo-of-himself-from-WW-2.-scr.jpg\" alt=\"Don Foster poses with a photo of himself from World War II. (Scott Shafer/KQED)\" width=\"335\" height=\"447\">\u003cfigcaption class=\"wp-caption-text\">Don Foster poses with a photo of himself from World War II. (Scott Shafer/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>After he returned home, he married, had several children and began an impressive career. His work with the United Nations and World Bank took him to dozens of nations. He retired about five years ago.\u003c/p>\n\u003cp>All that globe-trotting helped mask his struggles with depression and anger, issues he never linked back to his military service. But two years ago, after a massive earthquake in Japan triggered a tsunami, the scenes of devastation brought back a flood of memories.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He had an urgent, almost desperate, need to find out what happened to the kids he saw on television.\u003c/p>\n\u003cp>That incident led him to Grass Valley psychologist Page Brown, who works with veterans. She said PTSD symptoms are very often triggered by scenes of war, violence or devastation.\u003c/p>\n\u003cp>Foster was diagnosed with PTSD about two years ago. He said he didn’t expect to learn that his symptoms were related to his military experience. Brown said that’s not an unusual reaction of older vets.\u003c/p>\n\u003cp>“It’s more common than not that they’re surprised that there’s a relationship,” Brown said. “They think they’re fine, and that the rest of the world is stupid.”\u003c/p>\n\u003cp>PTSD symptoms in older vets can also be triggered by life changes, like the loss of a spouse or retirement, Brown said.\u003c/p>\n\u003cp>Another one of her patients, Dan Renfro, served with the Marines in Vietnam between 1965 and 1967. Unlike Foster, he did see combat. Lots of it.\u003c/p>\n\u003cp>“I was shot down in three different disabled helicopters,” Renfro said. “The last was the worst. It took a couple days to get out.”\u003c/p>\n\u003cp>His transition to civilian life was a long slide into misery: divorce, drinking and the inability to hold a job.\u003c/p>\n\u003cp>He often gets bored, or fired, not uncommon symptoms for people with PTSD. Renfro said he has had 45 jobs since he got out of the Marines.\u003c/p>\n\u003cp>Renfro eventually remarried, quit drinking and managed to bring a semblance of order to his life. But in 1993, a horrible tragedy sent him into a downward spiral. His 19-year-old stepson was murdered, shot in the head after leaving a party near Sacramento.\u003c/p>\n\u003cp>[contextly_sidebar id=”fda8578fba39a56b43d27daeb3d1b14f”]\u003c/p>\n\u003cp>“The anger’s still there. It’s right here, all the time,” he said.\u003c/p>\n\u003cp>A few years ago, Renfro was diagnosed with PTSD and began getting help.\u003c/p>\n\u003cp>“PTSD sounds a lot better than idiot or A-hole,” Renfro said of his diagnosis.\u003c/p>\n\u003cp>Renfro is hardly alone. At the VA office in San Francisco, social worker Keith Armstrong heads up the PTSD program. His clients are mostly Vietnam-era vets now, but he has a few from World War II.\u003c/p>\n\u003cp>No matter how old the veteran is, a PTSD diagnosis can help bring new insights into mental health problems, Armstrong said.\u003c/p>\n\u003cp>“The pieces get put together in your mind about how to understand all of these erratic behaviors,” Armstrong said. “You find yourself irritable, you may be sleeping badly or that you get startled at loud noises, whether they be dump trucks or whatever — that I think for a number of people there’s relief.”\u003c/p>\n\u003cp>Fran, Foster’s wife of 64 years, said she agrees that a PTSD diagnosis is definitely better late than never.\u003c/p>\n\u003cp>“I and other family members would get really exasperated because you think, ‘Well, just control yourself, you know? What are you mad about?’” she said. “When you understand it probably wasn’t at all easy, that would explain it.”\u003c/p>\n\u003cp>Today, the VA is much more focused on PTSD, but the agency is overwhelmed with all the returning vets affected by it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Still, there’s hope that treating veterans’ symptoms before decades have passed will help mitigate the kind of suffering in silence that many veterans of earlier wars endured.\u003c/p>\n\n",
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"excerpt": "More than a quarter-million veterans of the wars in Iraq and Afghanistan have been treated for post-traumatic stress disorder, but younger vets aren't the only ones dealing with it. Even today, veterans from conflicts as far back as World War II struggle with symptoms.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/div>\n\u003cp>\u003cem>This story originally aired on\u003c/em> \u003ca href=\"http://www.californiareport.org/archive/R201307260850/a?__utma=111150238.900526782.1397169073.1400791631.1400871590.12&__utmb=111150238.4.8.1400877197319&__utmc=111150238&__utmx=-&__utmz=111150238.1400871543.12.4.utmcsr=google%7Cutmccn=%28organic%29%7Cutmcmd=organic%7Cutmctr=%28not%20provided%29&__utmv=-&__utmk=40508258\">The California Report\u003c/a>\u003cem> as part of the \u003ca href=\"http://www.kqed.org/news/bayarea/lifeafterwar/?__utma=34673459.900526782.1397169073.1400791631.1400871590.12&__utmb=34673459.0.10.1400871593&__utmc=34673459&__utmx=-&__utmz=34673459.1400871543.12.4.utmcsr=google%7Cutmccn=%28organic%29%7Cutmcmd=organic%7Cutmctr=%28not%20provided%29&__utmv=-&__utmk=81495701\">“Life After War”\u003c/a> series.\u003c/em>\u003c/p>\n\u003cp>As a soldier in Japan, Donald Foster, an 86-year-old veteran of World War II, worked in a Japanese orphanage. He said it made him feel patriotic — at first.\u003c/p>\n\u003cp>“But when you see these little tykes dropping dead from aplastic anemia, and the burns on adults wandering around dazed before they died of radiation sickness, rather than make me more patriotic, I just felt — I just threw up,” Foster said.\u003c/p>\n\u003cfigure id=\"attachment_17734\" class=\"wp-caption alignright\" style=\"max-width: 335px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-17734\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/RS5810_Don-Foster-poses-with-a-photo-of-himself-from-WW-2.-scr.jpg\" alt=\"Don Foster poses with a photo of himself from World War II. (Scott Shafer/KQED)\" width=\"335\" height=\"447\">\u003cfigcaption class=\"wp-caption-text\">Don Foster poses with a photo of himself from World War II. (Scott Shafer/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>After he returned home, he married, had several children and began an impressive career. His work with the United Nations and World Bank took him to dozens of nations. He retired about five years ago.\u003c/p>\n\u003cp>All that globe-trotting helped mask his struggles with depression and anger, issues he never linked back to his military service. But two years ago, after a massive earthquake in Japan triggered a tsunami, the scenes of devastation brought back a flood of memories.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He had an urgent, almost desperate, need to find out what happened to the kids he saw on television.\u003c/p>\n\u003cp>That incident led him to Grass Valley psychologist Page Brown, who works with veterans. She said PTSD symptoms are very often triggered by scenes of war, violence or devastation.\u003c/p>\n\u003cp>Foster was diagnosed with PTSD about two years ago. He said he didn’t expect to learn that his symptoms were related to his military experience. Brown said that’s not an unusual reaction of older vets.\u003c/p>\n\u003cp>“It’s more common than not that they’re surprised that there’s a relationship,” Brown said. “They think they’re fine, and that the rest of the world is stupid.”\u003c/p>\n\u003cp>PTSD symptoms in older vets can also be triggered by life changes, like the loss of a spouse or retirement, Brown said.\u003c/p>\n\u003cp>Another one of her patients, Dan Renfro, served with the Marines in Vietnam between 1965 and 1967. Unlike Foster, he did see combat. Lots of it.\u003c/p>\n\u003cp>“I was shot down in three different disabled helicopters,” Renfro said. “The last was the worst. It took a couple days to get out.”\u003c/p>\n\u003cp>His transition to civilian life was a long slide into misery: divorce, drinking and the inability to hold a job.\u003c/p>\n\u003cp>He often gets bored, or fired, not uncommon symptoms for people with PTSD. Renfro said he has had 45 jobs since he got out of the Marines.\u003c/p>\n\u003cp>Renfro eventually remarried, quit drinking and managed to bring a semblance of order to his life. But in 1993, a horrible tragedy sent him into a downward spiral. His 19-year-old stepson was murdered, shot in the head after leaving a party near Sacramento.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“The anger’s still there. It’s right here, all the time,” he said.\u003c/p>\n\u003cp>A few years ago, Renfro was diagnosed with PTSD and began getting help.\u003c/p>\n\u003cp>“PTSD sounds a lot better than idiot or A-hole,” Renfro said of his diagnosis.\u003c/p>\n\u003cp>Renfro is hardly alone. At the VA office in San Francisco, social worker Keith Armstrong heads up the PTSD program. His clients are mostly Vietnam-era vets now, but he has a few from World War II.\u003c/p>\n\u003cp>No matter how old the veteran is, a PTSD diagnosis can help bring new insights into mental health problems, Armstrong said.\u003c/p>\n\u003cp>“The pieces get put together in your mind about how to understand all of these erratic behaviors,” Armstrong said. “You find yourself irritable, you may be sleeping badly or that you get startled at loud noises, whether they be dump trucks or whatever — that I think for a number of people there’s relief.”\u003c/p>\n\u003cp>Fran, Foster’s wife of 64 years, said she agrees that a PTSD diagnosis is definitely better late than never.\u003c/p>\n\u003cp>“I and other family members would get really exasperated because you think, ‘Well, just control yourself, you know? What are you mad about?’” she said. “When you understand it probably wasn’t at all easy, that would explain it.”\u003c/p>\n\u003cp>Today, the VA is much more focused on PTSD, but the agency is overwhelmed with all the returning vets affected by it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Still, there’s hope that treating veterans’ symptoms before decades have passed will help mitigate the kind of suffering in silence that many veterans of earlier wars endured.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Key Drivers of the Rise in Double Mastectomies: Anxiety and MRIs",
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"content": "\u003cfigure id=\"attachment_19209\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005.jpg\">\u003cimg class=\"size-large wp-image-19209\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #111111\">\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/05/21/314586804/anxiety-and-mris-may-be-driving-the-rise-in-double-mastectomies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp style=\"color: #111111\">The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don't face a higher risk of getting cancer in the other breast.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003cspan style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.\u003c/span>\u003c/aside>\n\u003cp style=\"color: #111111\">That has cancer doctors troubled, because for those women having the other breast removed doesn't reduce their risk of getting breast cancer again or increase their odds of survival. And they don't know why women are making this choice.\u003c/p>\n\u003cp style=\"color: #111111\">Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.\u003c/p>\n\u003cp style=\"color: #111111\">Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn't show more cancer.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"color: #111111\">\"Usually there's something on the image that can't be fully explained,\" says \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://www.med.umich.edu/cansort/bio_hawley.html\">Sarah Hawley\u003c/a>, an associate professor at the University of Michigan and lead author of the \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=1873911\">study\u003c/a>, which was published Wednesday in\u003cem> JAMA Surgery\u003c/em>. \"The thing that shows up on the MRI may well be nothing, but it's really difficult to know that you saw something unusual and then not worry about it.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley and her colleagues looked at 1,447 women who were diagnosed with breast cancer in one breast from 2005 to 2007 or from 2009 to 2010. In all, 19 percent of the women seriously considered having a double mastectomy, and almost 8 percent of them decided to have that surgery.\u003c/p>\n\u003cp style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again.\u003c/p>\n\u003cp style=\"color: #111111\">Women with more education were more likely to choose double mastectomy, the study found, as were women who had had genetic testing, even if the results came back showing they had no increased risk.\u003c/p>\n\u003cp style=\"color: #111111\">That surprised Hawley; she thought women who got good news on a genetic test would be less likely to then have a prophylactic mastectomy. She doesn't know if simply having a genetic test is enough to get women thinking seriously about double mastectomy, or if they're making the decision before they get the results back.\u003c/p>\n\u003cp style=\"color: #111111\">Hawley studies how patients make decisions about cancer treatment and says this study raises a big question: Are women not understanding the risk information that doctors communicate, or do they understand and decide to go ahead with the surgery anyway?\u003c/p>\n\u003cp style=\"color: #111111\">\"I think the answer is both are going on,\" Hawley says. \"Women are hearing the message but not completely understanding. Risk information is difficult to convey and understand, especially when you're getting a cancer diagnosis. And even when women understand, they are choosing to go ahead.\"\u003c/p>\n\u003cp style=\"color: #111111\">Most women won't lower their risk of cancer by getting a double mastectomy because their risk of getting breast cancer again was already very low. And removing the noncancerous breast doesn't affect the survival rate from the existing cancer.\u003c/p>\n\u003cp style=\"color: #111111\">For women who don't have a family history of breast cancer or the BRCA genetic mutations, other cancer treatments, including lumpectomy and single mastectomy, can improve a woman's chances just as much as double mastectomy, Hawley says.\u003c/p>\n\u003cp style=\"color: #111111\">\"Not feeling like double mastectomy is the only thing you can do to 'do everything possible' would be a good thing to get out there,\" she adds. \"it seems like there's pressure to consider it now, and if you don't do it you're not doing everything possible.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley is testing a decision tool aimed to help women weigh their choices for breast cancer treatment and hopes that it will help reduce the anxiety that comes with a cancer diagnosis and the difficult decisions that follow.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FnFrgdHm3CmxNVXNNmsSOH7vmlTadUe4\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19209\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005.jpg\">\u003cimg class=\"size-large wp-image-19209\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #111111\">\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/05/21/314586804/anxiety-and-mris-may-be-driving-the-rise-in-double-mastectomies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp style=\"color: #111111\">The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don't face a higher risk of getting cancer in the other breast.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003cspan style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.\u003c/span>\u003c/aside>\n\u003cp style=\"color: #111111\">That has cancer doctors troubled, because for those women having the other breast removed doesn't reduce their risk of getting breast cancer again or increase their odds of survival. And they don't know why women are making this choice.\u003c/p>\n\u003cp style=\"color: #111111\">Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.\u003c/p>\n\u003cp style=\"color: #111111\">Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn't show more cancer.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp style=\"color: #111111\">\"Usually there's something on the image that can't be fully explained,\" says \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://www.med.umich.edu/cansort/bio_hawley.html\">Sarah Hawley\u003c/a>, an associate professor at the University of Michigan and lead author of the \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=1873911\">study\u003c/a>, which was published Wednesday in\u003cem> JAMA Surgery\u003c/em>. \"The thing that shows up on the MRI may well be nothing, but it's really difficult to know that you saw something unusual and then not worry about it.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley and her colleagues looked at 1,447 women who were diagnosed with breast cancer in one breast from 2005 to 2007 or from 2009 to 2010. In all, 19 percent of the women seriously considered having a double mastectomy, and almost 8 percent of them decided to have that surgery.\u003c/p>\n\u003cp style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again.\u003c/p>\n\u003cp style=\"color: #111111\">Women with more education were more likely to choose double mastectomy, the study found, as were women who had had genetic testing, even if the results came back showing they had no increased risk.\u003c/p>\n\u003cp style=\"color: #111111\">That surprised Hawley; she thought women who got good news on a genetic test would be less likely to then have a prophylactic mastectomy. She doesn't know if simply having a genetic test is enough to get women thinking seriously about double mastectomy, or if they're making the decision before they get the results back.\u003c/p>\n\u003cp style=\"color: #111111\">Hawley studies how patients make decisions about cancer treatment and says this study raises a big question: Are women not understanding the risk information that doctors communicate, or do they understand and decide to go ahead with the surgery anyway?\u003c/p>\n\u003cp style=\"color: #111111\">\"I think the answer is both are going on,\" Hawley says. \"Women are hearing the message but not completely understanding. Risk information is difficult to convey and understand, especially when you're getting a cancer diagnosis. And even when women understand, they are choosing to go ahead.\"\u003c/p>\n\u003cp style=\"color: #111111\">Most women won't lower their risk of cancer by getting a double mastectomy because their risk of getting breast cancer again was already very low. And removing the noncancerous breast doesn't affect the survival rate from the existing cancer.\u003c/p>\n\u003cp style=\"color: #111111\">For women who don't have a family history of breast cancer or the BRCA genetic mutations, other cancer treatments, including lumpectomy and single mastectomy, can improve a woman's chances just as much as double mastectomy, Hawley says.\u003c/p>\n\u003cp style=\"color: #111111\">\"Not feeling like double mastectomy is the only thing you can do to 'do everything possible' would be a good thing to get out there,\" she adds. \"it seems like there's pressure to consider it now, and if you don't do it you're not doing everything possible.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley is testing a decision tool aimed to help women weigh their choices for breast cancer treatment and hopes that it will help reduce the anxiety that comes with a cancer diagnosis and the difficult decisions that follow.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FnFrgdHm3CmxNVXNNmsSOH7vmlTadUe4\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Emotional Symptoms Can Linger After Kids' Concussions",
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"content": "\u003cfigure id=\"attachment_19079\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/paul-w-locke/3849016443/in/photolist-6S8dut-9LRutM-8YmHem-aqg2sC-2ywFK8-dN2e9b-7GBePg-aDSwEo-csMBNC-9hE4j9-9wpRd5-c13yB3-deUPez-8nBLgJ-cfnnEJ-8kzYzM-7Mq3bq-dY7ZM-aowdxy-aaxMY2-au3E95-3dYZDg-aoxi41-7MoDtw-38GR1K-sGdyV-ayHQqr-NPBY2-co2oo5-4Q2oj6-cDEo3G-8GhAtS-3eic6B-bCdCg3-9uFCg3-6HStro-24erFm-atZDXa-7Uoh4A-egGgUo-9cqkMP-atZVS2-aE8cc9-2kFZqA-atZF1T-dd77vL-3GrytX-avLrhK-ftbWhj-9Latke\">\u003cimg class=\"size-large wp-image-19079\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/3849016443_b0c6b90277_b-640x426.jpg\" alt=\"Emotional symptoms such as frustration, and sleep difficulty can start more than a week after the initial injury and may be a sign of more serious concussion. (Paul-W/Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While headaches and fatigue are the most common concussion symptoms, nearly one in five patients may also suffer emotional symptoms. (Paul-W/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>That big hit your child took on the football field was over a week ago. He says his headaches are gone -- but he’s just not himself. He can’t sleep and he just snapped back at you when you asked him how he was doing. You wonder if this is just normal teenager behavior or a sign of the concussion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Frustration, irritability, and sleep difficulty a week or more after injury may signal a more serious concussion.\u003c/aside>\n\u003cp>Concussions are diagnosed by physical symptoms like headaches, dizziness, difficulty thinking clearly, or fatigue after a head injury. But those physical symptoms may evolve into emotional symptoms during the days and weeks after an injury according to \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/05/07/peds.2014-0158.abstract\" target=\"_blank\">a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Yes, headaches and fatigue were the most common symptoms immediately following a concussion, according to researchers at Harvard Medical School. But emotional symptoms such as frustration, irritability, restlessness, and sleep difficulty were seen in up to 17 percent of patients a week or more after injury and may be a marker of a more serious concussion.\u003c!--more-->\u003c/p>\n\u003cp>The study followed 235 patients, ages 11-22 years old, at their initial visit to the emergency department for a concussion and then for 12 weeks following their concussion.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“For individuals who have a prolonged recovery [greater than 14 days], emotional or behavioral symptoms tend to occur later and may reflect different pathophysiology,” said Dr. Christopher Giza in an email. He's a pediatric neurologist at UCLA's David Geffen School of Medicine.\u003c/p>\n\u003cp>Dr. Michael Collins, a neuropsychologist and executive director of the University of Pittsburgh Sports Medicine Concussion Program, also believes that concussions with emotional symptoms may represent a unique subset of patients who have concussion. In particular, he believes that this kind of concussion is the result of injury to the nervous system that assists in balance and coordination. the vestibular system.\u003c/p>\n\u003cp>Dr. Collins says that some of the research suggests that there are unusual processes in the system the helps with balance and coordination -- what doctors call the vestibular system -- \"that may provoke emotional changes following concussions.\" He said that preliminary research suggests that rehabilitation for the vestibular system may help people recover from these unusual symptoms.\u003c/p>\n\u003cp>This \"vestibular rehabilitation\" involves graduated exercises focused on coordination and balance. Although vestibular rehabilitation is promising, more research must be done. Today, the mainstay treatment for concussions remains a short period -- days to weeks -- of \"cognitive rest,\" in effect resting the brain.\u003c/p>\n\u003cp>This kind of rest involves often involves time away from school or work, and other social activities. Although shown to be beneficial, kids must be closely monitored as the components of cognitive rest may also contribute to the development of emotional symptoms later on in recovery.\u003c/p>\n\u003cp>“Cognitive rest is an important component of recovery,\" said Dr. Matthew Eisenberg lead researcher in the study. He's an emergency medicine physician at Boston Children’s Hospital. \"Much like an athlete would avoid jumping on a sprained ankle, there does seem to be a period after which the cost-benefit ratio changes. It is difficult to say when this switch occurs.”\u003c/p>\n\u003cp>The difficulty that many patients with concussions suffer is that unlike ankle injuries there is no cast or crutches to remind others of the injury, which can provoke pressure to return to “normal” in the classroom and athletic field. This social pressure may also contribute to emotional symptoms that develop during recovery.\u003c/p>\n\u003cp>Parents, coaches, and others taking care of patients should have patience during their child’s recovery and keep in mind that all concussions are different and requires close monitoring immediately after the injury, as well as later during recovery.\u003c/p>\n\u003cp>“The biggest takeaway is that while your child may be showing some signs of improvement from the physical symptoms of concussion, it is important to watch out for the late-arriving emotional symptoms,” said Dr. Eisenberg, “The child who is isolating him/herself, exhibiting personality changes, altered sleep behavior, or depressed mood may be experiencing very severe post-concussive symptoms even as his or her headache have resolved.”\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"98QLXKoIsFuO0vSQit7GAMy5ZUuvSEsM\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19079\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/paul-w-locke/3849016443/in/photolist-6S8dut-9LRutM-8YmHem-aqg2sC-2ywFK8-dN2e9b-7GBePg-aDSwEo-csMBNC-9hE4j9-9wpRd5-c13yB3-deUPez-8nBLgJ-cfnnEJ-8kzYzM-7Mq3bq-dY7ZM-aowdxy-aaxMY2-au3E95-3dYZDg-aoxi41-7MoDtw-38GR1K-sGdyV-ayHQqr-NPBY2-co2oo5-4Q2oj6-cDEo3G-8GhAtS-3eic6B-bCdCg3-9uFCg3-6HStro-24erFm-atZDXa-7Uoh4A-egGgUo-9cqkMP-atZVS2-aE8cc9-2kFZqA-atZF1T-dd77vL-3GrytX-avLrhK-ftbWhj-9Latke\">\u003cimg class=\"size-large wp-image-19079\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/3849016443_b0c6b90277_b-640x426.jpg\" alt=\"Emotional symptoms such as frustration, and sleep difficulty can start more than a week after the initial injury and may be a sign of more serious concussion. (Paul-W/Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While headaches and fatigue are the most common concussion symptoms, nearly one in five patients may also suffer emotional symptoms. (Paul-W/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>That big hit your child took on the football field was over a week ago. He says his headaches are gone -- but he’s just not himself. He can’t sleep and he just snapped back at you when you asked him how he was doing. You wonder if this is just normal teenager behavior or a sign of the concussion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Frustration, irritability, and sleep difficulty a week or more after injury may signal a more serious concussion.\u003c/aside>\n\u003cp>Concussions are diagnosed by physical symptoms like headaches, dizziness, difficulty thinking clearly, or fatigue after a head injury. But those physical symptoms may evolve into emotional symptoms during the days and weeks after an injury according to \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/05/07/peds.2014-0158.abstract\" target=\"_blank\">a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Yes, headaches and fatigue were the most common symptoms immediately following a concussion, according to researchers at Harvard Medical School. But emotional symptoms such as frustration, irritability, restlessness, and sleep difficulty were seen in up to 17 percent of patients a week or more after injury and may be a marker of a more serious concussion.\u003c!--more-->\u003c/p>\n\u003cp>The study followed 235 patients, ages 11-22 years old, at their initial visit to the emergency department for a concussion and then for 12 weeks following their concussion.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“For individuals who have a prolonged recovery [greater than 14 days], emotional or behavioral symptoms tend to occur later and may reflect different pathophysiology,” said Dr. Christopher Giza in an email. He's a pediatric neurologist at UCLA's David Geffen School of Medicine.\u003c/p>\n\u003cp>Dr. Michael Collins, a neuropsychologist and executive director of the University of Pittsburgh Sports Medicine Concussion Program, also believes that concussions with emotional symptoms may represent a unique subset of patients who have concussion. In particular, he believes that this kind of concussion is the result of injury to the nervous system that assists in balance and coordination. the vestibular system.\u003c/p>\n\u003cp>Dr. Collins says that some of the research suggests that there are unusual processes in the system the helps with balance and coordination -- what doctors call the vestibular system -- \"that may provoke emotional changes following concussions.\" He said that preliminary research suggests that rehabilitation for the vestibular system may help people recover from these unusual symptoms.\u003c/p>\n\u003cp>This \"vestibular rehabilitation\" involves graduated exercises focused on coordination and balance. Although vestibular rehabilitation is promising, more research must be done. Today, the mainstay treatment for concussions remains a short period -- days to weeks -- of \"cognitive rest,\" in effect resting the brain.\u003c/p>\n\u003cp>This kind of rest involves often involves time away from school or work, and other social activities. Although shown to be beneficial, kids must be closely monitored as the components of cognitive rest may also contribute to the development of emotional symptoms later on in recovery.\u003c/p>\n\u003cp>“Cognitive rest is an important component of recovery,\" said Dr. Matthew Eisenberg lead researcher in the study. He's an emergency medicine physician at Boston Children’s Hospital. \"Much like an athlete would avoid jumping on a sprained ankle, there does seem to be a period after which the cost-benefit ratio changes. It is difficult to say when this switch occurs.”\u003c/p>\n\u003cp>The difficulty that many patients with concussions suffer is that unlike ankle injuries there is no cast or crutches to remind others of the injury, which can provoke pressure to return to “normal” in the classroom and athletic field. This social pressure may also contribute to emotional symptoms that develop during recovery.\u003c/p>\n\u003cp>Parents, coaches, and others taking care of patients should have patience during their child’s recovery and keep in mind that all concussions are different and requires close monitoring immediately after the injury, as well as later during recovery.\u003c/p>\n\u003cp>“The biggest takeaway is that while your child may be showing some signs of improvement from the physical symptoms of concussion, it is important to watch out for the late-arriving emotional symptoms,” said Dr. Eisenberg, “The child who is isolating him/herself, exhibiting personality changes, altered sleep behavior, or depressed mood may be experiencing very severe post-concussive symptoms even as his or her headache have resolved.”\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"98QLXKoIsFuO0vSQit7GAMy5ZUuvSEsM\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong> \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_19084\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-e1400005363707.jpg\">\u003cimg class=\"size-large wp-image-19084\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-640x428.jpg\" alt=\"UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Chris Richard\u003c/strong>\u003c/p>\n\u003cp>A new UCLA psychology study has found evidence that being overweight may make people tired and then become more sedentary, not the other way around.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The rats on the junk food diet rested nearly twice as long as the lean rats. \u003c/aside>\n\u003cp> Researchers got the proof from testing rats, whose physiology is similar to that of human beings.\u003c/p>\n\u003cp>A team led by psychology professor Aaron Blaisdell of \u003ca href=\"http://www.bri.ucla.edu/\">UCLA's Brain Research Institute\u003c/a> put one group of 16 rats on the standard lab diet, largely ground corn, wheat, soybean and fish meal. A second group got a highly processed and refined diet, with casein as the main protein source, soybean oil, sugar and a little starch: a rat’s version of junk food.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It may be no surprise that after three months, the junk food eaters got fat.\u003c!--more-->\u003c/p>\n\u003cp>But what did strike the researchers is that as the rats gained weight, they lost energy. And they didn’t regain their verve when they started getting healthier food.\u003c/p>\n\u003cp>The study started with a long period of differentiating the animals’ diets and monitoring their weight. After six months, Blaisdell’s team started setting giving them tasks to perform.\u003c/p>\n\u003cp>Each rat was placed in a box with a lever that opened a little compartment. At first, the animals had to learn to press the lever to open the compartment and get a drink of sugar water, Blaisdell said. When all the rats had mastered that trick, the researchers made it harder, requiring three presses to open the compartment. Next, researchers demanded progressively more: three presses for the first treat, six for the second, nine for the third and so on.\u003c/p>\n\u003cp>“At a certain point, you’re going to say, ‘It isn’t worth it. I give up.’ And the question was, when would the rats give up?” Blaisdell said.\u003c/p>\n\u003cp>Even though all the rats had had their rations cut and were demonstrably hungry when the half-hour long testing sessions began, the fat animals showed little heart for getting the compartment open. The rats on the junk food diet rested nearly twice as long as the lean rats\u003cstrong> before r\u003c/strong>esuming their attempts to get at the sugar water, Blaisdell said.\u003c/p>\n\u003cp>An Australian study had noted that when rats lived on the kinds of foods typically served in cafeterias, the parts of their brains that control appetite degraded, but they started to recover when the animals got healthier food over a period of nine days.\u003c/p>\n\u003cp>Blaisdell thought the something similar would happen with his test subjects when he switched their diets around. But it didn’t.\u003c/p>\n\u003cp>Even on the healthier diets, the fat rats continued to have trouble sticking to their tasks, and they didn’t lose weight. Likewise, placing the lean rats on the junk food diet for nine days didn't increase their weight noticeably or impair their determination to get at the sugar treats.\u003c/p>\n\u003cp>This suggests that a long-running junk food diet causes the most physical and mental harm, not just the occasional binge, Blaisdell said. And the findings suggest that diet-induced obesity is a cause, not an effect, of lethargy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"8DIq8xzgzJUQuXz3BqsiZOrMfoyqqqA3\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong> \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_19084\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-e1400005363707.jpg\">\u003cimg class=\"size-large wp-image-19084\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-640x428.jpg\" alt=\"UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Chris Richard\u003c/strong>\u003c/p>\n\u003cp>A new UCLA psychology study has found evidence that being overweight may make people tired and then become more sedentary, not the other way around.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The rats on the junk food diet rested nearly twice as long as the lean rats. \u003c/aside>\n\u003cp> Researchers got the proof from testing rats, whose physiology is similar to that of human beings.\u003c/p>\n\u003cp>A team led by psychology professor Aaron Blaisdell of \u003ca href=\"http://www.bri.ucla.edu/\">UCLA's Brain Research Institute\u003c/a> put one group of 16 rats on the standard lab diet, largely ground corn, wheat, soybean and fish meal. A second group got a highly processed and refined diet, with casein as the main protein source, soybean oil, sugar and a little starch: a rat’s version of junk food.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It may be no surprise that after three months, the junk food eaters got fat.\u003c!--more-->\u003c/p>\n\u003cp>But what did strike the researchers is that as the rats gained weight, they lost energy. And they didn’t regain their verve when they started getting healthier food.\u003c/p>\n\u003cp>The study started with a long period of differentiating the animals’ diets and monitoring their weight. After six months, Blaisdell’s team started setting giving them tasks to perform.\u003c/p>\n\u003cp>Each rat was placed in a box with a lever that opened a little compartment. At first, the animals had to learn to press the lever to open the compartment and get a drink of sugar water, Blaisdell said. When all the rats had mastered that trick, the researchers made it harder, requiring three presses to open the compartment. Next, researchers demanded progressively more: three presses for the first treat, six for the second, nine for the third and so on.\u003c/p>\n\u003cp>“At a certain point, you’re going to say, ‘It isn’t worth it. I give up.’ And the question was, when would the rats give up?” Blaisdell said.\u003c/p>\n\u003cp>Even though all the rats had had their rations cut and were demonstrably hungry when the half-hour long testing sessions began, the fat animals showed little heart for getting the compartment open. The rats on the junk food diet rested nearly twice as long as the lean rats\u003cstrong> before r\u003c/strong>esuming their attempts to get at the sugar water, Blaisdell said.\u003c/p>\n\u003cp>An Australian study had noted that when rats lived on the kinds of foods typically served in cafeterias, the parts of their brains that control appetite degraded, but they started to recover when the animals got healthier food over a period of nine days.\u003c/p>\n\u003cp>Blaisdell thought the something similar would happen with his test subjects when he switched their diets around. But it didn’t.\u003c/p>\n\u003cp>Even on the healthier diets, the fat rats continued to have trouble sticking to their tasks, and they didn’t lose weight. Likewise, placing the lean rats on the junk food diet for nine days didn't increase their weight noticeably or impair their determination to get at the sugar treats.\u003c/p>\n\u003cp>This suggests that a long-running junk food diet causes the most physical and mental harm, not just the occasional binge, Blaisdell said. And the findings suggest that diet-induced obesity is a cause, not an effect, of lethargy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"8DIq8xzgzJUQuXz3BqsiZOrMfoyqqqA3\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "An Unusual Stanford Art Exhibit Draws Upon Disease for Inspiration",
"headTitle": "An Unusual Stanford Art Exhibit Draws Upon Disease for Inspiration | KQED",
"content": "\u003cfigure id=\"attachment_17243\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" rel=\"attachment wp-att-17243\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17243\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" alt=\"Three views of Rodin's hand\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From left to right: A computer scan of Rodin’s sculpture “Left Hand of Eustache de St. Pierre.” Inner anatomy. Exterior scan and inner anatomy combined for an augmented reality view. (Sarah Hegmann/Stanford School of Medicine)\u003c/figcaption>\u003c/figure>\n\u003cp>Art often idealizes the human body, sidelining messy reality. Imagine entering a museum only to recognize on display a disease or disability that you’ve struggled with.\u003c/p>\n\u003cp>This experience is now available to sufferers of \u003ca title=\"NIH - Apert Syndrome\" href=\"http://ghr.nlm.nih.gov/condition/apert-syndrome\">Apert syndrome\u003c/a>, \u003ca title=\"NIH - Dupuytren's contracture\" href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001233.htm\">Dupuytren’s contracture\u003c/a> and a variety of other maladies at “Inside Rodin’s Hands: Art, Technology, and Surgery.” This unusual exhibit, running April 9 – August 3 at Stanford’s \u003ca title=\"Cantor Arts Center\" href=\"https://museum.stanford.edu/index.html\">Cantor Arts Center\u003c/a>, is a collaboration between one of the world’s largest Rodin collections and preeminent medical schools.\u003c/p>\n\u003cp>\u003cb>Intentional or incidental?\u003c/b>\u003c/p>\n\u003cp>Auguste Rodin was famous for departing from traditional mythological figures to create more realistic forms. He may well have been inspired by human injuries and imperfections; for example, his sculpture “Large Clenched Left Hand\u003ci>” \u003c/i>appears to have Charcot-Marie-Tooth—a genetic disorder that damages the nervous system, killing muscle tissue and deforming extremities.\u003c/p>\n\u003cfigure id=\"attachment_17251\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" rel=\"attachment wp-att-17251\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17251 size-full\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" alt=\"CMT hand and Sculpture that looks like it\" width=\"300\" height=\"251\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Left: hand deformity caused by Charcot-Marie-Tooth disease. Right: Large Clenched Left Hand by August Rodin.\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s striking for somebody like me who sees people with CMT quite often, and quite often the older people have that distinctive hand posture. It’s remarkable to see it cast in bronze,” says Rick Alber, a San Francisco resident who became involved with the \u003ca title=\"CMTA - SF Peninsula/South Bay Support Group\" href=\"http://www.cmtausa.org/index.php?option=com_community&view=groups&task=viewgroup&groupid=29&Itemid=15\">local CMT support group\u003c/a> when his daughter was diagnosed with the disease.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ci>“\u003c/i>Large Clenched Left Hand\u003ci>” \u003c/i>may or may not be actually modeled on the hand of someone with CMT. \u003ca title=\"James Chang - Stanford\" href=\"https://med.stanford.edu/profiles/james-chang\">Dr. James Chang\u003c/a>, the Stanford hand surgeon whose thought experiments inspired the exhibit, points out that the diagnoses are “pure conjecture.”\u003c/p>\n\u003cp>But it’s worth noting that Jean-Martin Charcot, one of the three doctors who first identified CMT, was in Rodin’s social circle. According to Bernard Barryte, curator of the Cantor’s Rodin collection, “Given their association, it is possible that Rodin saw a victim of [CMT] in connection with Charcot. However, it is just as likely that Rodin independently saw someone with this disease, found the configuration of the hand fascinating and expressive and modeled it.”\u003c/p>\n\u003cp>\u003cb>Busted Nerves and Their Consequences\u003c/b>\u003c/p>\n\u003cp>CMT causes the nerves farthest from the brain and spine to deteriorate, first in the feet and legs and later in the hands. The nerves lose their ability to transmit signals and activate muscles, and as anyone who’s worn a cast knows, unused muscles atrophy. In CMT, this creates deformities such as the claw shape recognizable in Rodin’s sculpture. Over time, says Alber, “Your hands and feet become tingly, numb, and weakened. The bottoms of your feet get cuts and blisters and things you can’t feel.”\u003c/p>\n\u003cfigure id=\"attachment_17258\" class=\"wp-caption alignleft\" style=\"max-width: 210px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" rel=\"attachment wp-att-17258\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17258 size-medium\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" alt=\"Plate 6 from Engravings of the Bones, Muscles, and Tendons\" width=\"210\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lots of muscles mean lots of things can go wrong. Plate 6 from John Bell’s Engravings of the Bones, Muscles, and Tendons (London, 1810), on display at the “Inside Rodin’s Hands” exhibit.\u003c/figcaption>\u003c/figure>\n\u003cp>Symptoms of CMT aren’t usually obvious until adulthood, and like all genetic diseases it tends to run in families. But one of CMT’s hallmarks is unpredictability, in part because it can be caused by many different genetic mutations. Says Alber, “One person might be a bit clumsy. Another person is in a wheelchair at age 12.” His daughter didn’t inherent a diseased gene from either parent—her body invented it from scratch with what’s called a \u003ci>de novo\u003c/i> mutation. And although she was diagnosed in early childhood, the disease’s progression has so far been slow. Now 23, she works at a Jamba Juice in San Francisco.\u003c/p>\n\u003cp>CMT can’t be cured like an infectious disease, because every cell in the body has the same mutated gene. One real but distant possibility is \u003ca title=\"Nature - Charcot-Marie-Tooth Gene Therapy\" href=\"http://www.nature.com/mt/journal/v22/n3/full/mt2013250a.html\">gene therapy\u003c/a>, in which functional copies of the affected gene could be delivered directly to the damaged nerves and muscles. In theory, the body could then use these genes to build the missing proteins and repair the damage. Meanwhile, treatment options are limited: physical therapy, orthopedic braces, sometimes surgery.\u003c/p>\n\u003cp>\u003cstrong>Bronze Patients\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_17263\" class=\"wp-caption alignright\" style=\"max-width: 216px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" rel=\"attachment wp-att-17263\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17263\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" alt=\"Rodin's hand sculptures with iPads \" width=\"216\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodin’s hand sculptures with iPads offering views of their inner anatomy. (Danna Staaf/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>For years, Rodin’s art has been aiding Stanford doctors and medical students to think in three dimensions as they learn to identify and treat the underlying medical conditions. The sculptures inspired Dr. Chang to create an undergraduate class titled “Surgical Anatomy of the Hand: From Rodin to Reconstruction” in which students diagnose a sculpture and develop a treatment plan. Samuel Cohen Tanugi, who took Dr. Chang’s class in 2010, described “Large Clenched Left Hand” as a result of damage to two nerves in particular, the ulnar nerve and the median nerve. He wrote, “Reconstruction would require complex nerve and tendon transfers to rebalance the hand into a more normal posture.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Chang will give a free public lecture about the exhibit on May 29th at 6:30 p.m. in the Cantor auditorium. Admission to the \u003ca title=\"Stanford - Rodin's Hands\" href=\"https://museum.stanford.edu/news_room/Rodins-hands.html\">exhibit\u003c/a> itself, as to the rest of the Cantor Center and sculpture garden, is also free.\u003c/p>\n\n",
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"excerpt": "Imagine entering an art museum, only to recognize a disease you've struggled with. A variety of maladies are featured in the exhibit “Inside Rodin’s Hands: Art, Technology, and Surgery at Stanford’s Cantor Arts Center.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17243\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" rel=\"attachment wp-att-17243\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17243\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" alt=\"Three views of Rodin's hand\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From left to right: A computer scan of Rodin’s sculpture “Left Hand of Eustache de St. Pierre.” Inner anatomy. Exterior scan and inner anatomy combined for an augmented reality view. (Sarah Hegmann/Stanford School of Medicine)\u003c/figcaption>\u003c/figure>\n\u003cp>Art often idealizes the human body, sidelining messy reality. Imagine entering a museum only to recognize on display a disease or disability that you’ve struggled with.\u003c/p>\n\u003cp>This experience is now available to sufferers of \u003ca title=\"NIH - Apert Syndrome\" href=\"http://ghr.nlm.nih.gov/condition/apert-syndrome\">Apert syndrome\u003c/a>, \u003ca title=\"NIH - Dupuytren's contracture\" href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001233.htm\">Dupuytren’s contracture\u003c/a> and a variety of other maladies at “Inside Rodin’s Hands: Art, Technology, and Surgery.” This unusual exhibit, running April 9 – August 3 at Stanford’s \u003ca title=\"Cantor Arts Center\" href=\"https://museum.stanford.edu/index.html\">Cantor Arts Center\u003c/a>, is a collaboration between one of the world’s largest Rodin collections and preeminent medical schools.\u003c/p>\n\u003cp>\u003cb>Intentional or incidental?\u003c/b>\u003c/p>\n\u003cp>Auguste Rodin was famous for departing from traditional mythological figures to create more realistic forms. He may well have been inspired by human injuries and imperfections; for example, his sculpture “Large Clenched Left Hand\u003ci>” \u003c/i>appears to have Charcot-Marie-Tooth—a genetic disorder that damages the nervous system, killing muscle tissue and deforming extremities.\u003c/p>\n\u003cfigure id=\"attachment_17251\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" rel=\"attachment wp-att-17251\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17251 size-full\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" alt=\"CMT hand and Sculpture that looks like it\" width=\"300\" height=\"251\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Left: hand deformity caused by Charcot-Marie-Tooth disease. Right: Large Clenched Left Hand by August Rodin.\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s striking for somebody like me who sees people with CMT quite often, and quite often the older people have that distinctive hand posture. It’s remarkable to see it cast in bronze,” says Rick Alber, a San Francisco resident who became involved with the \u003ca title=\"CMTA - SF Peninsula/South Bay Support Group\" href=\"http://www.cmtausa.org/index.php?option=com_community&view=groups&task=viewgroup&groupid=29&Itemid=15\">local CMT support group\u003c/a> when his daughter was diagnosed with the disease.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>“\u003c/i>Large Clenched Left Hand\u003ci>” \u003c/i>may or may not be actually modeled on the hand of someone with CMT. \u003ca title=\"James Chang - Stanford\" href=\"https://med.stanford.edu/profiles/james-chang\">Dr. James Chang\u003c/a>, the Stanford hand surgeon whose thought experiments inspired the exhibit, points out that the diagnoses are “pure conjecture.”\u003c/p>\n\u003cp>But it’s worth noting that Jean-Martin Charcot, one of the three doctors who first identified CMT, was in Rodin’s social circle. According to Bernard Barryte, curator of the Cantor’s Rodin collection, “Given their association, it is possible that Rodin saw a victim of [CMT] in connection with Charcot. However, it is just as likely that Rodin independently saw someone with this disease, found the configuration of the hand fascinating and expressive and modeled it.”\u003c/p>\n\u003cp>\u003cb>Busted Nerves and Their Consequences\u003c/b>\u003c/p>\n\u003cp>CMT causes the nerves farthest from the brain and spine to deteriorate, first in the feet and legs and later in the hands. The nerves lose their ability to transmit signals and activate muscles, and as anyone who’s worn a cast knows, unused muscles atrophy. In CMT, this creates deformities such as the claw shape recognizable in Rodin’s sculpture. Over time, says Alber, “Your hands and feet become tingly, numb, and weakened. The bottoms of your feet get cuts and blisters and things you can’t feel.”\u003c/p>\n\u003cfigure id=\"attachment_17258\" class=\"wp-caption alignleft\" style=\"max-width: 210px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" rel=\"attachment wp-att-17258\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17258 size-medium\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" alt=\"Plate 6 from Engravings of the Bones, Muscles, and Tendons\" width=\"210\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lots of muscles mean lots of things can go wrong. Plate 6 from John Bell’s Engravings of the Bones, Muscles, and Tendons (London, 1810), on display at the “Inside Rodin’s Hands” exhibit.\u003c/figcaption>\u003c/figure>\n\u003cp>Symptoms of CMT aren’t usually obvious until adulthood, and like all genetic diseases it tends to run in families. But one of CMT’s hallmarks is unpredictability, in part because it can be caused by many different genetic mutations. Says Alber, “One person might be a bit clumsy. Another person is in a wheelchair at age 12.” His daughter didn’t inherent a diseased gene from either parent—her body invented it from scratch with what’s called a \u003ci>de novo\u003c/i> mutation. And although she was diagnosed in early childhood, the disease’s progression has so far been slow. Now 23, she works at a Jamba Juice in San Francisco.\u003c/p>\n\u003cp>CMT can’t be cured like an infectious disease, because every cell in the body has the same mutated gene. One real but distant possibility is \u003ca title=\"Nature - Charcot-Marie-Tooth Gene Therapy\" href=\"http://www.nature.com/mt/journal/v22/n3/full/mt2013250a.html\">gene therapy\u003c/a>, in which functional copies of the affected gene could be delivered directly to the damaged nerves and muscles. In theory, the body could then use these genes to build the missing proteins and repair the damage. Meanwhile, treatment options are limited: physical therapy, orthopedic braces, sometimes surgery.\u003c/p>\n\u003cp>\u003cstrong>Bronze Patients\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_17263\" class=\"wp-caption alignright\" style=\"max-width: 216px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" rel=\"attachment wp-att-17263\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17263\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" alt=\"Rodin's hand sculptures with iPads \" width=\"216\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodin’s hand sculptures with iPads offering views of their inner anatomy. (Danna Staaf/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>For years, Rodin’s art has been aiding Stanford doctors and medical students to think in three dimensions as they learn to identify and treat the underlying medical conditions. The sculptures inspired Dr. Chang to create an undergraduate class titled “Surgical Anatomy of the Hand: From Rodin to Reconstruction” in which students diagnose a sculpture and develop a treatment plan. Samuel Cohen Tanugi, who took Dr. Chang’s class in 2010, described “Large Clenched Left Hand” as a result of damage to two nerves in particular, the ulnar nerve and the median nerve. He wrote, “Reconstruction would require complex nerve and tendon transfers to rebalance the hand into a more normal posture.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Chang will give a free public lecture about the exhibit on May 29th at 6:30 p.m. in the Cantor auditorium. Admission to the \u003ca title=\"Stanford - Rodin's Hands\" href=\"https://museum.stanford.edu/news_room/Rodins-hands.html\">exhibit\u003c/a> itself, as to the rest of the Cantor Center and sculpture garden, is also free.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19022\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818.jpg\">\u003cimg class=\"size-large wp-image-19022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818-640x433.jpg\" alt=\"So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The researchers hope their findings will help doctors and patients understand what \"normal\" bleeding is during perimenopause. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Jennifer Huber\u003c/strong>\u003c/p>\n\u003cp>I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.\u003c/p>\n\u003caside class=\"pullquote alignleft\">More than three-fourths of women in the study reported periods lasting at least 10 days.\u003c/aside>\n\u003cp>As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.\u003c/p>\n\u003cp>In \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12768/abstract%20\" target=\"_blank\">the study\u003c/a>, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.\u003c!--more-->\u003c/p>\n\u003cp>Researchers found the following rates reported at least three times during the 10-year study period:\u003c/p>\n\u003cul>\n\u003cli>78 percent of women: periods lasted at least 10 days\u003c/li>\n\u003cli>67 percent: spotting lasted six or more days\u003c/li>\n\u003cli>35 percent: heavy bleeding lasted three or more days\u003c/li>\n\u003c/ul>\n\u003cp>The report was recently published in \u003cem>BJOG: An International Journal of Obstetrics and Gynaeocology.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause),\" the authors noted.\u003c/p>\n\u003cp>The researchers used data from the \u003ca href=\"http://www.swanstudy.org/about.asp\" target=\"_blank\">Study of Women’s Health Across the Nation\u003c/a> (SWAN), a study of middle-aged women living in the U.S.\u003c/p>\n\u003cp>The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.\u003c/p>\n\u003cp>\u003cstrong>First Major Multi-Racial Study of Its Kind\u003c/strong>\u003c/p>\n\u003cp>This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.\u003c/p>\n\u003cp>Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.\u003c/p>\n\u003cp>The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.\u003c/p>\n\u003cp>“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in \u003ca href=\"http://ns.umich.edu/new/releases/22121-prolonged-and-heavy-bleeding-during-menopause-is-common%20\" target=\"_blank\">a statement\u003c/a>. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”\u003c/p>\n\u003cp>The study was funded by the National Institutes of Health and other federal government health agencies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"HvsaE1friuAlqV5hibJLYCWI5Kne58E1\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19022\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818.jpg\">\u003cimg class=\"size-large wp-image-19022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818-640x433.jpg\" alt=\"So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The researchers hope their findings will help doctors and patients understand what \"normal\" bleeding is during perimenopause. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Jennifer Huber\u003c/strong>\u003c/p>\n\u003cp>I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.\u003c/p>\n\u003caside class=\"pullquote alignleft\">More than three-fourths of women in the study reported periods lasting at least 10 days.\u003c/aside>\n\u003cp>As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.\u003c/p>\n\u003cp>In \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12768/abstract%20\" target=\"_blank\">the study\u003c/a>, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.\u003c!--more-->\u003c/p>\n\u003cp>Researchers found the following rates reported at least three times during the 10-year study period:\u003c/p>\n\u003cul>\n\u003cli>78 percent of women: periods lasted at least 10 days\u003c/li>\n\u003cli>67 percent: spotting lasted six or more days\u003c/li>\n\u003cli>35 percent: heavy bleeding lasted three or more days\u003c/li>\n\u003c/ul>\n\u003cp>The report was recently published in \u003cem>BJOG: An International Journal of Obstetrics and Gynaeocology.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause),\" the authors noted.\u003c/p>\n\u003cp>The researchers used data from the \u003ca href=\"http://www.swanstudy.org/about.asp\" target=\"_blank\">Study of Women’s Health Across the Nation\u003c/a> (SWAN), a study of middle-aged women living in the U.S.\u003c/p>\n\u003cp>The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.\u003c/p>\n\u003cp>\u003cstrong>First Major Multi-Racial Study of Its Kind\u003c/strong>\u003c/p>\n\u003cp>This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.\u003c/p>\n\u003cp>Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.\u003c/p>\n\u003cp>The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.\u003c/p>\n\u003cp>“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in \u003ca href=\"http://ns.umich.edu/new/releases/22121-prolonged-and-heavy-bleeding-during-menopause-is-common%20\" target=\"_blank\">a statement\u003c/a>. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”\u003c/p>\n\u003cp>The study was funded by the National Institutes of Health and other federal government health agencies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"HvsaE1friuAlqV5hibJLYCWI5Kne58E1\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2014/05/20140505science.mp3\u003c/p>\n\u003c/div>\n\u003cfigure id=\"attachment_17201\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17201\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/DNA-2.jpg\" alt=\"A magnified strand of DNA. (Credit: Tomasz Wyszomirski)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">A magnified strand of DNA. (Tomasz Wyszomirski)\u003c/figcaption>\u003c/figure>\n\u003cp>Consumers who want to find out about their genetic health risks without going to the doctor and paying a hefty price may have to wait. For a while, personal genetic tests were becoming more affordable and informative. But the industry took a blow last year when the government cracked down on Mountain View company \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>.\u003c/p>\n\u003cp>That was the last consumer gene testing company still offering health information after two years of federal efforts to regulate the industry. Unlike other companies, many of which folded or sold, 23andMe is working with regulators to come back to the consumer genetic health market.\u003c/p>\n\u003cp>\u003cstrong>A Passion for Consumer Genetics\u003c/strong>\u003c/p>\n\u003cp>On a recent Thursday evening at the \u003ca href=\"http://www.calacademy.org/\">California Academy of Sciences\u003c/a> in San Francisco, the star of the show was not the giant T-Rex skeleton in the lobby but a small-framed, energetic Silicon Valley entrepreneur speaking about personal genetics.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘One of the main things people think about when they think of their genetic information, is that they want the health interpretation.’\u003c/aside>\n\u003cp>“I want to ask this audience, how many people have ever had a genetic test?” said \u003ca href=\"https://www.23andme.com/about/board/\">Anne Wojcicki\u003c/a>, CEO of 23andMe.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Of about 150 people in the audience, some 30 people raised their hands.\u003c/p>\n\u003cp>“So my goal is in the next ten years that every single one of you would raise your hand,” Wojcicki said.\u003c/p>\n\u003cp>Wojcicki said since 2007, more than half a million customers have sent in a saliva sample and gotten information that included their risks for developing cardiac disease and breast cancer, as well genetic traits such as how fast they metabolize caffeine. But last November the FDA ordered 23andMe to stop sales of its $99 tests.\u003c/p>\n\u003cp>\u003cstrong>FDA to 23andMe: Stop Selling Gene Tests\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.fda.gov/newsevents/testimony/ucm219925.htm\">The FDA said\u003c/a>, in a very public letter, that the company’s test kit was a medical device that needed to be regulated and that 23andMe failed to prove it was interpreting health results accurately.\u003c/p>\n\u003cfigure id=\"attachment_17192\" class=\"wp-caption alignleft\" style=\"max-width: 252px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17192\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/Wojcicki-216x162.jpg\" alt=\"23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\" width=\"252\" height=\"189\">\u003cfigcaption class=\"wp-caption-text\">23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Wojcicki said the ruling has hit her company hard. “As a result, we have had to stop offering our healthcare service, and it’s had a significant impact because it’s one of the main things people think about when they think of their genetic information, is that they want the health interpretation.”\u003c/p>\n\u003cp>So now, 23andMe is working with the FDA in an effort to once again be able to offer health information. Meanwhile, the company can still provide ancestry information, which is already a crowded field.\u003c/p>\n\u003cp>Hank Greely directs the \u003ca href=\"https://www.law.stanford.edu/organizations/programs-and-centers/center-for-law-and-the-biosciences\">Center for Law and the Biosciences\u003c/a> at Stanford. He said dwindling sales will impact the company’s efforts to build a sizable research database—and that’s important to its business strategy.\u003c/p>\n\u003cp>“For those customers who agree to it by signing a somewhat opaque consent form,” Greely said, “they can sell that information to pharma and bio, but without lots of new customers coming in that service becomes less attractive to pharma and biotech.”\u003c/p>\n\u003cp>Some have criticized 23andme for considering selling anonymized data. But Wojcicki is unapologetic.\u003c/p>\n\u003cp>“23andMe partners with those companies because those are the people who are making therapies,” she said. “And if we want to get better therapies for breast cancer, and you want to get better therapies for asthma and migraines and all kinds of the other conditions that impact our lives, we have to work with pharma companies.”\u003cbr>\n\u003cstrong>\u003cbr>\nBig Data May Lead to Medical Breakthroughs\u003c/strong>\u003c/p>\n\u003cp>And here’s where consumer genetics isn’t just about the consumer. All that genetic information, or big data, can be used to run studies in search of medical breakthroughs. That means any company that wants to stay at the forefront has to keep up with the changing science.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘We know that the world has been quite focused on getting the so-called thousand-dollar genome.’\u003c/aside>\n\u003cp>In your human genome you have an entire set of 23 human chromosomes, made up of, among other things, DNA building blocks called base pairs. The human genome is composed of 3 billion base pairs.\u003c/p>\n\u003cp>Right now consumer gene tests take tiny snips of less than a million base pairs to look at one person’s unique genetic blueprint. Each of these unique variations is called a snp (yep, pronounced “snip”), for “single nucleotide polymorphism.”\u003c/p>\n\u003cp>\u003cstrong>The Future Lies in Sequencing the Whole Genome\u003c/strong>\u003c/p>\n\u003cp>But a snp is just a fraction of the entire genome. Scientists say the key to the future of genetics lies in sequencing the whole genome.\u003c/p>\n\u003cp>“We know that the world has been quite focused on getting the so-called thousand-dollar genome,” said Vance Vanier, vice president of reproductive and genetic health at San Diego-based \u003ca href=\"http://www.illumina.com/\">Illumina\u003c/a>. The company has just unveiled a system it claims can sequence a human genome for $1,000. That’s a big drop from the nearly $3 billion dollar price tag to sequence the first genome in 2003.\u003c/p>\n\u003cp>“I think the story of the next five years is to see that affordability spread more and more to broader segments of society and to clinical laboratories specifically,” said Vanier, who was CEO of an early consumer gene testing company called Navigenics.\u003c/p>\n\u003cp>And while he believes genetic testing will continue to be done primarily through medical professionals, he said he still sees a place for consumer gene tests. After all, Vanier said, there was a time home pregnancy tests had to be done in a doctor’s office. Now people can even buy over-the-counter HIV tests.\u003c/p>\n\u003cp>“I think the pattern you see,” Vanier said, “is as information gets better understood and as there are more social safeguards around it to protect from a misuse of it, then there is increasing comfort of how it can evolve into the consumer market.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>And so the debate continues between those that believe accessing your DNA has become a basic right and those who believe gene tests are better left to a doctor.\u003cbr>\n\u003cem>\u003cbr>\nSince this story published, 23andMe officials confirm they \u003ca href=\"http://www.reuters.com/article/2014/05/06/23andme-genetictesting-idUSL2N0NS0Y820140506?feedType=RSS\">are considering selling their gene tests in markets outside the U.S.\u003c/a> after facing hurdles with the FDA.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/div>\n\u003cfigure id=\"attachment_17201\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17201\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/DNA-2.jpg\" alt=\"A magnified strand of DNA. (Credit: Tomasz Wyszomirski)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">A magnified strand of DNA. (Tomasz Wyszomirski)\u003c/figcaption>\u003c/figure>\n\u003cp>Consumers who want to find out about their genetic health risks without going to the doctor and paying a hefty price may have to wait. For a while, personal genetic tests were becoming more affordable and informative. But the industry took a blow last year when the government cracked down on Mountain View company \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>.\u003c/p>\n\u003cp>That was the last consumer gene testing company still offering health information after two years of federal efforts to regulate the industry. Unlike other companies, many of which folded or sold, 23andMe is working with regulators to come back to the consumer genetic health market.\u003c/p>\n\u003cp>\u003cstrong>A Passion for Consumer Genetics\u003c/strong>\u003c/p>\n\u003cp>On a recent Thursday evening at the \u003ca href=\"http://www.calacademy.org/\">California Academy of Sciences\u003c/a> in San Francisco, the star of the show was not the giant T-Rex skeleton in the lobby but a small-framed, energetic Silicon Valley entrepreneur speaking about personal genetics.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘One of the main things people think about when they think of their genetic information, is that they want the health interpretation.’\u003c/aside>\n\u003cp>“I want to ask this audience, how many people have ever had a genetic test?” said \u003ca href=\"https://www.23andme.com/about/board/\">Anne Wojcicki\u003c/a>, CEO of 23andMe.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of about 150 people in the audience, some 30 people raised their hands.\u003c/p>\n\u003cp>“So my goal is in the next ten years that every single one of you would raise your hand,” Wojcicki said.\u003c/p>\n\u003cp>Wojcicki said since 2007, more than half a million customers have sent in a saliva sample and gotten information that included their risks for developing cardiac disease and breast cancer, as well genetic traits such as how fast they metabolize caffeine. But last November the FDA ordered 23andMe to stop sales of its $99 tests.\u003c/p>\n\u003cp>\u003cstrong>FDA to 23andMe: Stop Selling Gene Tests\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.fda.gov/newsevents/testimony/ucm219925.htm\">The FDA said\u003c/a>, in a very public letter, that the company’s test kit was a medical device that needed to be regulated and that 23andMe failed to prove it was interpreting health results accurately.\u003c/p>\n\u003cfigure id=\"attachment_17192\" class=\"wp-caption alignleft\" style=\"max-width: 252px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17192\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/Wojcicki-216x162.jpg\" alt=\"23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\" width=\"252\" height=\"189\">\u003cfigcaption class=\"wp-caption-text\">23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Wojcicki said the ruling has hit her company hard. “As a result, we have had to stop offering our healthcare service, and it’s had a significant impact because it’s one of the main things people think about when they think of their genetic information, is that they want the health interpretation.”\u003c/p>\n\u003cp>So now, 23andMe is working with the FDA in an effort to once again be able to offer health information. Meanwhile, the company can still provide ancestry information, which is already a crowded field.\u003c/p>\n\u003cp>Hank Greely directs the \u003ca href=\"https://www.law.stanford.edu/organizations/programs-and-centers/center-for-law-and-the-biosciences\">Center for Law and the Biosciences\u003c/a> at Stanford. He said dwindling sales will impact the company’s efforts to build a sizable research database—and that’s important to its business strategy.\u003c/p>\n\u003cp>“For those customers who agree to it by signing a somewhat opaque consent form,” Greely said, “they can sell that information to pharma and bio, but without lots of new customers coming in that service becomes less attractive to pharma and biotech.”\u003c/p>\n\u003cp>Some have criticized 23andme for considering selling anonymized data. But Wojcicki is unapologetic.\u003c/p>\n\u003cp>“23andMe partners with those companies because those are the people who are making therapies,” she said. “And if we want to get better therapies for breast cancer, and you want to get better therapies for asthma and migraines and all kinds of the other conditions that impact our lives, we have to work with pharma companies.”\u003cbr>\n\u003cstrong>\u003cbr>\nBig Data May Lead to Medical Breakthroughs\u003c/strong>\u003c/p>\n\u003cp>And here’s where consumer genetics isn’t just about the consumer. All that genetic information, or big data, can be used to run studies in search of medical breakthroughs. That means any company that wants to stay at the forefront has to keep up with the changing science.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘We know that the world has been quite focused on getting the so-called thousand-dollar genome.’\u003c/aside>\n\u003cp>In your human genome you have an entire set of 23 human chromosomes, made up of, among other things, DNA building blocks called base pairs. The human genome is composed of 3 billion base pairs.\u003c/p>\n\u003cp>Right now consumer gene tests take tiny snips of less than a million base pairs to look at one person’s unique genetic blueprint. Each of these unique variations is called a snp (yep, pronounced “snip”), for “single nucleotide polymorphism.”\u003c/p>\n\u003cp>\u003cstrong>The Future Lies in Sequencing the Whole Genome\u003c/strong>\u003c/p>\n\u003cp>But a snp is just a fraction of the entire genome. Scientists say the key to the future of genetics lies in sequencing the whole genome.\u003c/p>\n\u003cp>“We know that the world has been quite focused on getting the so-called thousand-dollar genome,” said Vance Vanier, vice president of reproductive and genetic health at San Diego-based \u003ca href=\"http://www.illumina.com/\">Illumina\u003c/a>. The company has just unveiled a system it claims can sequence a human genome for $1,000. That’s a big drop from the nearly $3 billion dollar price tag to sequence the first genome in 2003.\u003c/p>\n\u003cp>“I think the story of the next five years is to see that affordability spread more and more to broader segments of society and to clinical laboratories specifically,” said Vanier, who was CEO of an early consumer gene testing company called Navigenics.\u003c/p>\n\u003cp>And while he believes genetic testing will continue to be done primarily through medical professionals, he said he still sees a place for consumer gene tests. After all, Vanier said, there was a time home pregnancy tests had to be done in a doctor’s office. Now people can even buy over-the-counter HIV tests.\u003c/p>\n\u003cp>“I think the pattern you see,” Vanier said, “is as information gets better understood and as there are more social safeguards around it to protect from a misuse of it, then there is increasing comfort of how it can evolve into the consumer market.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And so the debate continues between those that believe accessing your DNA has become a basic right and those who believe gene tests are better left to a doctor.\u003cbr>\n\u003cem>\u003cbr>\nSince this story published, 23andMe officials confirm they \u003ca href=\"http://www.reuters.com/article/2014/05/06/23andme-genetictesting-idUSL2N0NS0Y820140506?feedType=RSS\">are considering selling their gene tests in markets outside the U.S.\u003c/a> after facing hurdles with the FDA.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Silicon Valley Health-Tech Wrestles with the FDA",
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"content": "\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"CNmeBBlBPPwQslZMYMxjOTuOuvmvqRlu\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California Legislature To Consider Antibiotic Ban in Animals",
"title": "California Legislature To Consider Antibiotic Ban in Animals",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Scientists Have Engineered a Version of Bird Flu That Can Spread Between Mammals",
"headTitle": "Scientists Have Engineered a Version of Bird Flu That Can Spread Between Mammals | KQED",
"content": "\u003cfigure id=\"attachment_16622\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" rel=\"attachment wp-att-16622\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16622\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" alt=\"Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu's genetic material can change that so you can catch it from another person. (Wikimedia Commons/M M (Padmanaba01))\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu’s genetic material can change that so you can catch it from another person. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Chicken_market_in_Xining,_Qinghai_province,_China.jpg\" class=\"nofancybox\">M M Padmanaba01\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Back in 2003, four people got sick and died from the\u003ca href=\"http://en.wikipedia.org/wiki/Global_spread_of_H5N1#Human_and_bird_cases\"> H5N1 strain of bird flu\u003c/a> in China. And that wasn’t the last time either. Every few years, new cases reappear and around \u003ca href=\"http://www.who.int/mediacentre/factsheets/avian_influenza/en/\">60% of the infected people die\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, even when it isn’t infecting people, the bird flu continues to percolate in all sorts of domestic and wild birds, spreading and evolving. Millions of birds have died from the disease and millions more have been slaughtered, with the \u003ca href=\"http://www.japantimes.co.jp/news/2014/04/14/national/112000-chickens-culled-at-kumamoto-farms-in-bid-to-curb-bird-flu-outbreak/#.U01y1vldVIF\">latest outbreak being in Japan\u003c/a> where they’ve just killed 112,000 chickens.\u003c/p>\n\u003cp>Ever since it first appeared, scientists have worried that the bird flu would turn into a \u003ca href=\"http://en.wikipedia.org/wiki/Pandemic\">pandemic \u003c/a>similar to the Spanish Flu that killed somewhere between 50 and 100 million people at the end of World War I. For now, the fact that it only spreads from birds to people has kept this deadly disease in check. But as a\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24725402\"> new study\u003c/a> in the leading journal \u003ca href=\"http://www.cell.com/\">Cell \u003c/a>shows, this protection may not last forever.\u003c/p>\n\u003cp>In this study, the authors find that it takes just five small changes in the virus’ genetic material to make it able to spread from one ferret to another. While the changes may not be the same ones to make a virus able to spread between people, odds are that a similarly small set of changes will be all that is required.\u003c/p>\n\u003cfigure id=\"attachment_16625\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" rel=\"attachment wp-att-16625\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16625\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" alt=\"Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/Viki)\" width=\"300\" height=\"253\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Fretts_301004_selbstfotografiert,_GNU-FDL.jpg\" class=\"nofancybox\">Viki\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A search of all the viruses sequenced to date showed that a few of the necessary mutations are already out there in the wild. This means that while the odds are low that one virus would get all five changes, they are not zero. One day, a virus may appear in nature with all five changes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Luckily for us (and the ferrets), when this virus does mutate so it can spread from ferret to ferret, it becomes much less deadly. Doses that easily wiped out a ferret now have little or no effect. This is pretty common in the viral world—there is a tradeoff between deadliness and the ability to spread.\u003c/p>\n\u003cp>Of course, there is no guarantee that the virus will be less deadly if it mutates to spread from person to person. And it may not have to be to still kill a lot of people.\u003c/p>\n\u003cp>As I said, right now the virus is killing around 60% of the people it infects. The Spanish flu only needed to kill 10% of the people it infected to wipe out somewhere between 3 and 6% of the world’s population. So even if a version of the bird flu evolved to both spread between people and be six times less deadly, it could still be devastating.\u003c/p>\n\u003cp>Research like this is critical for monitoring the virus out in the wild. By identifying the changes that can cause the virus to be able to spread from person to person, we can keep a close watch on things and quarantine people if a virus ever does stumble on the right set of mutations. But research like this is also \u003ca href=\"http://www.npr.org/blogs/health/2013/02/22/172582712/to-keep-deadly-bird-flu-in-the-lab-feds-set-rules-for-scientists\">controversial\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Escaped and Engineered Viruses\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16628\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" rel=\"attachment wp-att-16628\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16628\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" alt=\"We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/Zuzanna K. Filutowska)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Laboratorium-biologia-molekularna.jpg\" class=\"nofancybox\">Zuzanna K. Filutowska\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A big worry with this type of research is that a virus might escape the lab and spread out into the wild. There are a huge number of safeguards in place to keep the virus from escaping but nothing is 100%. There is a small chance it could get out. (It is important to note that there has not been a single smallpox outbreak despite almost 40 years of research.)\u003c/p>\n\u003cp>The second concern is that the wrong sorts of people may be able to use this freely available information to make an artificial virus to use as a weapon. This isn’t very likely either but is definitely possible. The researchers created a virus that could spread between ferrets on a machine in a lab which means other people might be able to do this as well. This capability has really only become feasible in the last few years.\u003c/p>\n\u003cp>It is important to keep in mind that the viruses that have been made so far may pose little risk to people or even ferrets. But if they did get out, it might only be a matter of time before they build up the mutations they need to spread between people and then we may be in real trouble. These escaped or engineered viruses would have a head start which makes them more likely to stumble on the set of mutations that makes them lethal and highly infectious.\u003c/p>\n\u003cp>The government decided back in 2012 that this sort of research was OK if done with the right safeguards in place. They argued that the benefits of being able to nip a pandemic in the bud outweighed the risk of the research causing a pandemic on its own. So far this has turned out to be true.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.youtube.com/watch?v=90oP2ez8l4k\">Lengthy discussion on the controversy of this research (YouTube) \u003c/a>\u003c/p>\n\n",
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"excerpt": "Scientists were able to engineer a version of the bird flu that can spread between mammals, the first step towards turning this virus into a pandemic. This research is controversial as it has created something that is potentially dangerous.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16622\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" rel=\"attachment wp-att-16622\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16622\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" alt=\"Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu's genetic material can change that so you can catch it from another person. (Wikimedia Commons/M M (Padmanaba01))\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu’s genetic material can change that so you can catch it from another person. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Chicken_market_in_Xining,_Qinghai_province,_China.jpg\" class=\"nofancybox\">M M Padmanaba01\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Back in 2003, four people got sick and died from the\u003ca href=\"http://en.wikipedia.org/wiki/Global_spread_of_H5N1#Human_and_bird_cases\"> H5N1 strain of bird flu\u003c/a> in China. And that wasn’t the last time either. Every few years, new cases reappear and around \u003ca href=\"http://www.who.int/mediacentre/factsheets/avian_influenza/en/\">60% of the infected people die\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, even when it isn’t infecting people, the bird flu continues to percolate in all sorts of domestic and wild birds, spreading and evolving. Millions of birds have died from the disease and millions more have been slaughtered, with the \u003ca href=\"http://www.japantimes.co.jp/news/2014/04/14/national/112000-chickens-culled-at-kumamoto-farms-in-bid-to-curb-bird-flu-outbreak/#.U01y1vldVIF\">latest outbreak being in Japan\u003c/a> where they’ve just killed 112,000 chickens.\u003c/p>\n\u003cp>Ever since it first appeared, scientists have worried that the bird flu would turn into a \u003ca href=\"http://en.wikipedia.org/wiki/Pandemic\">pandemic \u003c/a>similar to the Spanish Flu that killed somewhere between 50 and 100 million people at the end of World War I. For now, the fact that it only spreads from birds to people has kept this deadly disease in check. But as a\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24725402\"> new study\u003c/a> in the leading journal \u003ca href=\"http://www.cell.com/\">Cell \u003c/a>shows, this protection may not last forever.\u003c/p>\n\u003cp>In this study, the authors find that it takes just five small changes in the virus’ genetic material to make it able to spread from one ferret to another. While the changes may not be the same ones to make a virus able to spread between people, odds are that a similarly small set of changes will be all that is required.\u003c/p>\n\u003cfigure id=\"attachment_16625\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" rel=\"attachment wp-att-16625\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16625\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" alt=\"Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/Viki)\" width=\"300\" height=\"253\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Fretts_301004_selbstfotografiert,_GNU-FDL.jpg\" class=\"nofancybox\">Viki\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A search of all the viruses sequenced to date showed that a few of the necessary mutations are already out there in the wild. This means that while the odds are low that one virus would get all five changes, they are not zero. One day, a virus may appear in nature with all five changes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Luckily for us (and the ferrets), when this virus does mutate so it can spread from ferret to ferret, it becomes much less deadly. Doses that easily wiped out a ferret now have little or no effect. This is pretty common in the viral world—there is a tradeoff between deadliness and the ability to spread.\u003c/p>\n\u003cp>Of course, there is no guarantee that the virus will be less deadly if it mutates to spread from person to person. And it may not have to be to still kill a lot of people.\u003c/p>\n\u003cp>As I said, right now the virus is killing around 60% of the people it infects. The Spanish flu only needed to kill 10% of the people it infected to wipe out somewhere between 3 and 6% of the world’s population. So even if a version of the bird flu evolved to both spread between people and be six times less deadly, it could still be devastating.\u003c/p>\n\u003cp>Research like this is critical for monitoring the virus out in the wild. By identifying the changes that can cause the virus to be able to spread from person to person, we can keep a close watch on things and quarantine people if a virus ever does stumble on the right set of mutations. But research like this is also \u003ca href=\"http://www.npr.org/blogs/health/2013/02/22/172582712/to-keep-deadly-bird-flu-in-the-lab-feds-set-rules-for-scientists\">controversial\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Escaped and Engineered Viruses\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16628\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" rel=\"attachment wp-att-16628\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16628\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" alt=\"We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/Zuzanna K. Filutowska)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Laboratorium-biologia-molekularna.jpg\" class=\"nofancybox\">Zuzanna K. Filutowska\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A big worry with this type of research is that a virus might escape the lab and spread out into the wild. There are a huge number of safeguards in place to keep the virus from escaping but nothing is 100%. There is a small chance it could get out. (It is important to note that there has not been a single smallpox outbreak despite almost 40 years of research.)\u003c/p>\n\u003cp>The second concern is that the wrong sorts of people may be able to use this freely available information to make an artificial virus to use as a weapon. This isn’t very likely either but is definitely possible. The researchers created a virus that could spread between ferrets on a machine in a lab which means other people might be able to do this as well. This capability has really only become feasible in the last few years.\u003c/p>\n\u003cp>It is important to keep in mind that the viruses that have been made so far may pose little risk to people or even ferrets. But if they did get out, it might only be a matter of time before they build up the mutations they need to spread between people and then we may be in real trouble. These escaped or engineered viruses would have a head start which makes them more likely to stumble on the set of mutations that makes them lethal and highly infectious.\u003c/p>\n\u003cp>The government decided back in 2012 that this sort of research was OK if done with the right safeguards in place. They argued that the benefits of being able to nip a pandemic in the bud outweighed the risk of the research causing a pandemic on its own. So far this has turned out to be true.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.youtube.com/watch?v=90oP2ez8l4k\">Lengthy discussion on the controversy of this research (YouTube) \u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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},
"radiolab": {
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"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": {
"id": "science-friday",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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