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"content": "\u003cp>Every 10 minutes, someone's name is added to a waiting list -- a waiting list for a new kidney, heart, lung or other organ. And every day, about 18 people die waiting.\u003c/p>\n\u003cp>Starting today, San Francisco's Link TV is screening a remarkable documentary, \"The Power of Two.\" Twin sisters with fatal cystic fibrosis each received a double lung transplant. In the clip below, they travel to the National Donor Memorial in Richmond, VA.\"In a way it was like a pilgrimage to a Mecca,\" says Ana, one of the twins. \"Because this is the place where our country pays tribute to all the people who have said 'yes' to organ donation.\"\u003c/p>\n\u003cp>\u003ciframe width=\"560\" height=\"315\" src=\"http://www.youtube.com/embed/h0FNzKZpE-I?list=PLVkJQKghDX6fN1ttpp08vt-rUia39Hjgc\" frameborder=\"0\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>You can watch the complete documentary \u003ca href=\"http://www.linktv.org/poweroftwo?sitebnr\" target=\"_blank\">online at LinkTV\u003c/a>. \u003c/p>\n\u003cp>And, if you're not already, you can \u003ca href=\"http://donatelife.net/register-now/\" target=\"_blank\">sign up to be an organ donor\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>By Julie Rovner, \u003ca href=\"http://www.npr.org/blogs/health/2013/05/22/183903991/Boomer-Housemates-Have-More-Fun\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_12895\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12895\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/goldengirls_01-a6aea59e62f67d0b27c946f3e4fd27bf9061a677-s3-300x224.jpg\" alt='Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)' width=\"300\" height=\"224\">\u003cfigcaption class=\"wp-caption-text\">Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are \u003ca href=\"http://www.geron.org/About%20Us/press-room/Archived%20Press%20Releases/80-2012-press-releases/1329-single-baby-boomers-facing-increased-challenges-as-they-age\">disproportionately women\u003c/a>. As this vast generation rushes into retirement, there's a growing concern among experts on aging: Who will take care of all these people when they're too old to care for themselves?\u003c/p>\n\u003cp>It's a question many of the experts take personally. \"\u003cem>That\u003c/em> is what scares me,\" says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. \"Because I am one of those people,\" she says, \"and I do think about it.\"\u003c/p>\n\u003cp>\"Oh, I've got wonderful nieces and nephews,\" Rix says, noting that's what a lot of her boomer peers claim, too. \"Well, in fact, they've got their families. They've got their in-laws. They've got their parents. And I don't think it's reasonable to expect much out of them.\"\u003c/p>\n\u003cp>Kathleen Kelly, who runs the \u003ca href=\"http://www.caregiver.org/caregiver/jsp/home.jsp\">Family Caregiver Alliance and the National Center on Caregiving in San Francisco\u003c/a>, says she's seeing the same sort of concern in her social circle. \"I'm in my 50s, and my friends are all talking about, 'Could we all move in together? Could we buy an apartment building and all live together?' There are all sorts of permutations of this conversation,\" Kelly says. \"But it really is something that people are thinking about, particularly women.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And, because boomers are boomers, some are doing more than just thinking about it. Already, there's a small but apparently growing movement of boomer women forming group houses with their single peers.\u003c!--more-->\u003c/p>\n\u003cp>One of those homes belongs to Bonnie Moore. She's a pert, 60-something divorcee who lives in a well-kept, five-bedroom house in Bowie, Md., a cozy suburb of Washington, D.C.\u003c/p>\n\u003cp>In order to stay in her house after her divorce, Moore needed financial help. But she wanted to do more than just add boarders who would help pay the bills, she says. The home she's organized instead is \"a little bit like family, a little bit like roommates, a little bit like a sorority house,\" she says from the sofa of her softly lit living room. \"It just evolves.\"\u003c/p>\n\u003cp>Moore, an attorney, isn't actually childless. She has a grown son who lives in Utah and has been urging Moore to move there to be closer to him and his family. \"He's just sort of saying, 'Well, Mom you're old now; we have to take care of you,' \" Moore says. \"And I'm saying, 'I'm not old. I've got 20 years out there in my yard, thank you very much,' \" she says with a laugh.\u003c/p>\n\u003cp>Moore has been careful about selecting as housemates women who get along, but who also have a sense of independence. \"All of us, we have our own separate lives,\" she says. \"We do our own separate things, but we'll meet up in the kitchen and chitchat. And then we'll all go our different ways, which makes it nice. None of us are joined at the hip, and yet we all live together and do our own thing and live in the same house.\"\u003c/p>\n\u003cp>Lorene Solivan is one of Moore's three current roommates — \"the youngest,\" Solivan says proudly, having just turned 60.\u003c/p>\n\u003cp>Solivan, an event manager for a food company, had been living in an apartment in Northern Virginia. But she was having financial troubles of her own and was looking to downsize.\u003c/p>\n\u003cp>\"And then I saw the ad on Craigslist: GOLDEN GIRLS HOUSE. I said, 'Oh, that looks like fun,' \" she says.\u003c/p>\n\u003cp>Solivan, who does much of the group's cooking, says it's been a nice transition for her. To live with a built-in social group of people your own age is \"a big plus,\" she says, \"whether you're 20, 40, or 60 — whatever the case may be.\"\u003c/p>\n\u003cp>That's why Bonnie Moore is trying to take her concept and expand it. She already has a \u003ca href=\"http://www.goldengirlsnetwork.org/\">website\u003c/a> and is working on a guide to help other single boomer women set up houses like hers. \"I think it'll be fun,\" she says. \"And I'd like to be part of various seminars and workshops for women [about] the whole idea of living communally and learning to get along in this kind of environment.\"\u003c/p>\n\u003cp>Still, there are a lot of obstacles. One big one is that most boomers don't realize they might need help getting or paying for long-term care if their health falters.\u003c/p>\n\u003cp>\"I call it the 70-70-70 conundrum,\" says Bruce Chernof, president and CEO of \u003ca href=\"http://thescanfoundation.org/\">The SCAN Foundation\u003c/a>, which focuses on long-term health care issues. \"Seventy percent of people over the age of 65 will need some form of long-term care supports as they age,\" he says. But when you look at polling, \"roughly 70 percent of Americans don't actually think they're likely to need it, and roughly 70 percent think Medicare will probably cover it when they get there.\"\u003c/p>\n\u003cp>The problem, of course, he adds, is that \"those last two 70 percents are not true.\"\u003c/p>\n\u003cp>Then there's the numbers problem. \"We know that ... about a third of baby boomers are single,\" says Kathleen Kelly. \"But we also know that there's a large percentage of those that are in their 50s and 60s [who] are getting divorced, and so we're going to have more single individuals in the future. We just haven't seen this before.\"\u003c/p>\n\u003cp>At the same time, most boomers have had fewer children than previous generations did, and many boomers have no children.\u003c/p>\n\u003cp>\"So there's less adult children to take the place of the caregiving cohort that currently is providing ... caregiving to their parents,\" she says. And today, family caregiving provides an estimated $450 billion a year worth of unpaid care.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Sara Rix of AARP says a big problem for single boomer women is that they're not financially prepared to hire the caregivers they might need if they don't have family members to volunteer the time. \"[These single women] are still likely to be concentrated in what we've traditionally called the 'pink collar' jobs,\" she says, which are \"the lower wage, low benefit occupations. So when they reach old age, they often reach old age without pension coverage.\"\u003c/p>\n\u003cp>Most of these women will have Social Security, Rix says — assuming that they are eligible, and that the rules don't change between now and when they retire. But for many older women, that will be all, or nearly all the money they have to live on, she says, \"and it's not going to pay for a lot of care — formal care. So it's a frightening future for a lot of women.\"\u003c/p>\n\u003cp>There are things women can do to make that future a little less frightening, says Kelly. Some suggestions are pretty obvious, like maintaining a healthy, active lifestyle.\u003c/p>\n\u003cp>But another bit of advice may be less intuitive, Kelly says, \"and that is to invest in social relationships and networks.\" She doesn't mean the sort of social networks people create on the Internet, but rather, \"a community of individuals [living with or near you, so] that you may be able to share tasks and responsibilities as you grow older.\"\u003c/p>\n\u003cp>That brings us back to Bonnie Moore, who says that deciding to form a group house was about more than just financial necessity. \"I think women naturally are more community oriented,\" Moore says. \"It's just part of the woman's nature.\"\u003c/p>\n\u003cp>And besides, she adds, \"to come home and have someone say, 'Hi, how was your day?' ... That's really nice sometimes.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So if you're a boomer and you liked that group house you shared in college or just after, good for you. The United States is one of the few developed nations that has no organized public policy for providing long-term care — so group living may be in your future as well as your past.\u003c/p>\n\n",
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"excerpt": "Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are disproportionately women. As this vast generation rushes into retirement, there's a growing concern among experts on aging: Who will take care of all these people when they're too old to care for themselves?\r\n\r\nIt's a question many of the experts take personally. \"That is what scares me,\" says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. \"Because I am one of those people,\" she says, \"and I do think about it.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Julie Rovner, \u003ca href=\"http://www.npr.org/blogs/health/2013/05/22/183903991/Boomer-Housemates-Have-More-Fun\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_12895\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12895\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/goldengirls_01-a6aea59e62f67d0b27c946f3e4fd27bf9061a677-s3-300x224.jpg\" alt='Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)' width=\"300\" height=\"224\">\u003cfigcaption class=\"wp-caption-text\">Lorene Solivan moved into the \"Golden Girls\" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are \u003ca href=\"http://www.geron.org/About%20Us/press-room/Archived%20Press%20Releases/80-2012-press-releases/1329-single-baby-boomers-facing-increased-challenges-as-they-age\">disproportionately women\u003c/a>. As this vast generation rushes into retirement, there's a growing concern among experts on aging: Who will take care of all these people when they're too old to care for themselves?\u003c/p>\n\u003cp>It's a question many of the experts take personally. \"\u003cem>That\u003c/em> is what scares me,\" says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. \"Because I am one of those people,\" she says, \"and I do think about it.\"\u003c/p>\n\u003cp>\"Oh, I've got wonderful nieces and nephews,\" Rix says, noting that's what a lot of her boomer peers claim, too. \"Well, in fact, they've got their families. They've got their in-laws. They've got their parents. And I don't think it's reasonable to expect much out of them.\"\u003c/p>\n\u003cp>Kathleen Kelly, who runs the \u003ca href=\"http://www.caregiver.org/caregiver/jsp/home.jsp\">Family Caregiver Alliance and the National Center on Caregiving in San Francisco\u003c/a>, says she's seeing the same sort of concern in her social circle. \"I'm in my 50s, and my friends are all talking about, 'Could we all move in together? Could we buy an apartment building and all live together?' There are all sorts of permutations of this conversation,\" Kelly says. \"But it really is something that people are thinking about, particularly women.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And, because boomers are boomers, some are doing more than just thinking about it. Already, there's a small but apparently growing movement of boomer women forming group houses with their single peers.\u003c!--more-->\u003c/p>\n\u003cp>One of those homes belongs to Bonnie Moore. She's a pert, 60-something divorcee who lives in a well-kept, five-bedroom house in Bowie, Md., a cozy suburb of Washington, D.C.\u003c/p>\n\u003cp>In order to stay in her house after her divorce, Moore needed financial help. But she wanted to do more than just add boarders who would help pay the bills, she says. The home she's organized instead is \"a little bit like family, a little bit like roommates, a little bit like a sorority house,\" she says from the sofa of her softly lit living room. \"It just evolves.\"\u003c/p>\n\u003cp>Moore, an attorney, isn't actually childless. She has a grown son who lives in Utah and has been urging Moore to move there to be closer to him and his family. \"He's just sort of saying, 'Well, Mom you're old now; we have to take care of you,' \" Moore says. \"And I'm saying, 'I'm not old. I've got 20 years out there in my yard, thank you very much,' \" she says with a laugh.\u003c/p>\n\u003cp>Moore has been careful about selecting as housemates women who get along, but who also have a sense of independence. \"All of us, we have our own separate lives,\" she says. \"We do our own separate things, but we'll meet up in the kitchen and chitchat. And then we'll all go our different ways, which makes it nice. None of us are joined at the hip, and yet we all live together and do our own thing and live in the same house.\"\u003c/p>\n\u003cp>Lorene Solivan is one of Moore's three current roommates — \"the youngest,\" Solivan says proudly, having just turned 60.\u003c/p>\n\u003cp>Solivan, an event manager for a food company, had been living in an apartment in Northern Virginia. But she was having financial troubles of her own and was looking to downsize.\u003c/p>\n\u003cp>\"And then I saw the ad on Craigslist: GOLDEN GIRLS HOUSE. I said, 'Oh, that looks like fun,' \" she says.\u003c/p>\n\u003cp>Solivan, who does much of the group's cooking, says it's been a nice transition for her. To live with a built-in social group of people your own age is \"a big plus,\" she says, \"whether you're 20, 40, or 60 — whatever the case may be.\"\u003c/p>\n\u003cp>That's why Bonnie Moore is trying to take her concept and expand it. She already has a \u003ca href=\"http://www.goldengirlsnetwork.org/\">website\u003c/a> and is working on a guide to help other single boomer women set up houses like hers. \"I think it'll be fun,\" she says. \"And I'd like to be part of various seminars and workshops for women [about] the whole idea of living communally and learning to get along in this kind of environment.\"\u003c/p>\n\u003cp>Still, there are a lot of obstacles. One big one is that most boomers don't realize they might need help getting or paying for long-term care if their health falters.\u003c/p>\n\u003cp>\"I call it the 70-70-70 conundrum,\" says Bruce Chernof, president and CEO of \u003ca href=\"http://thescanfoundation.org/\">The SCAN Foundation\u003c/a>, which focuses on long-term health care issues. \"Seventy percent of people over the age of 65 will need some form of long-term care supports as they age,\" he says. But when you look at polling, \"roughly 70 percent of Americans don't actually think they're likely to need it, and roughly 70 percent think Medicare will probably cover it when they get there.\"\u003c/p>\n\u003cp>The problem, of course, he adds, is that \"those last two 70 percents are not true.\"\u003c/p>\n\u003cp>Then there's the numbers problem. \"We know that ... about a third of baby boomers are single,\" says Kathleen Kelly. \"But we also know that there's a large percentage of those that are in their 50s and 60s [who] are getting divorced, and so we're going to have more single individuals in the future. We just haven't seen this before.\"\u003c/p>\n\u003cp>At the same time, most boomers have had fewer children than previous generations did, and many boomers have no children.\u003c/p>\n\u003cp>\"So there's less adult children to take the place of the caregiving cohort that currently is providing ... caregiving to their parents,\" she says. And today, family caregiving provides an estimated $450 billion a year worth of unpaid care.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Sara Rix of AARP says a big problem for single boomer women is that they're not financially prepared to hire the caregivers they might need if they don't have family members to volunteer the time. \"[These single women] are still likely to be concentrated in what we've traditionally called the 'pink collar' jobs,\" she says, which are \"the lower wage, low benefit occupations. So when they reach old age, they often reach old age without pension coverage.\"\u003c/p>\n\u003cp>Most of these women will have Social Security, Rix says — assuming that they are eligible, and that the rules don't change between now and when they retire. But for many older women, that will be all, or nearly all the money they have to live on, she says, \"and it's not going to pay for a lot of care — formal care. So it's a frightening future for a lot of women.\"\u003c/p>\n\u003cp>There are things women can do to make that future a little less frightening, says Kelly. Some suggestions are pretty obvious, like maintaining a healthy, active lifestyle.\u003c/p>\n\u003cp>But another bit of advice may be less intuitive, Kelly says, \"and that is to invest in social relationships and networks.\" She doesn't mean the sort of social networks people create on the Internet, but rather, \"a community of individuals [living with or near you, so] that you may be able to share tasks and responsibilities as you grow older.\"\u003c/p>\n\u003cp>That brings us back to Bonnie Moore, who says that deciding to form a group house was about more than just financial necessity. \"I think women naturally are more community oriented,\" Moore says. \"It's just part of the woman's nature.\"\u003c/p>\n\u003cp>And besides, she adds, \"to come home and have someone say, 'Hi, how was your day?' ... That's really nice sometimes.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So if you're a boomer and you liked that group house you shared in college or just after, good for you. The United States is one of the few developed nations that has no organized public policy for providing long-term care — so group living may be in your future as well as your past.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Where You Live Affects What Kind of Surgery You'll Have: Look It Up",
"title": "Where You Live Affects What Kind of Surgery You'll Have: Look It Up",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_12878\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-12878\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/surgeon-hands-620x413.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"413\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Where you live matters. And in health care, it matters in all sorts of ways you might not think of immediately. If you're having elective surgery, one of the major factors determining what kind of treatment you will receive depends on where you live, according to new research released Tuesday.\u003c/p>\n\u003cp>In health policy, \"elective\" does not necessarily mean cosmetic surgery. Treatments for early stage cancers are considered \"elective\" because there are a range of options. The California Healthcare Foundation (CHCF) has been following this issue in its \"\u003ca href=\"http://www.chcf.org/publications/2011/09/medical-variation-rates-california#region=hsa&c=6/37.41928/-123.39017&procedure=epci\" target=\"_blank\">All Over the Map\u003c/a>\" project. Previously, the foundation has examined variation in heart procedures, joint replacement and c-sections. Tuesday the foundation added a detailed look at geographic variation in treatments for three more conditions: breast cancer, prostate cancer, and back and neck pain.\u003c/p>\n\u003cp>PIcking out eyebrow-raising numbers was no problem:\u003c/p>\n\u003cul>\n\u003cli>Men in Indio (Riverside County) receive brachytherapy, known commonly as radiation seeds, to treat prostate cancer at almost five times the statewide average.\u003c/li>\n\u003cli>Women in Healdsburg (Sonoma County) receive lumpectomy without radiation for early stage breast cancer at 270 percent of the statewide average.\u003c/li>\n\u003cli>People in Brawley (Imperial County) are nearly three times as likely to receive cervical fusion, where two vertebrae in the neck are fused together, for neck problems compared to statewide.\u003c/li>\n\u003c/ul>\n\u003cp>\u003ca href=\"http://www.chcf.org/publications/2013/05/medical-variation-map#6/36.985/-119.443&procedure=lura_123®ion=hsa\" target=\"_blank\">\u003cimg class=\"alignright size-full wp-image-12855\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/CHCF_AllOverTheMap_Banner2_200513_R1Single.jpg\" alt=\"CHCF_AllOverTheMap_Banner2_200513_R1Single\" width=\"289\" height=\"399\">\u003c/a>Low rates are easy to find, too. To name just one: women in Lancaster, northeast of Los Angeles, with early stage breast cancer receive lumpectomy with radiation at just 26 percent of the statewide average.\u003c/p>\n\u003cp>The question is why. Maribeth Shannon with the foundation says the variation is \"just puzzling to us.\" She stressed that the statewide average is not necessarily the \"right\" rate, but the state average is an estimate that's easy to use as a benchmark.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In its analysis, the foundation accounted and adjusted for a host of patient characteristics that might skew the numbers. Still, the broad variation is there. Shannon pointed out that it would be \"unusual\" that patients would differ so significantly in what treatments they wanted, simply according to where they lived.\u003c/p>\n\u003cp>\"It's much more likely,\" Shannon said, \"that physicians practicing in that area tend to rely on that course of treatment over others. ... It does seem to be more the physician preference than the patient preference.\"\u003c!--more-->\u003c/p>\n\u003cp>Professor Renee Hsia at UC San Francisco was not involved in the study. She agreed that physician preference matters, counter to what patients might think.\u003c/p>\n\u003cp>\"A lot of patients out there think you go to one doctor and they will prescribe the same treatment,\" no matter where you live, Hsia said, \"because you go to medical school and there's one answer.\" Tuesday's release shows there's \"a lot of variability.\"\u003c/p>\n\u003cp>\"The way your peers practice ... in your group or in your hospital affects the way you practice also,\" Hsia said. \"I wouldn't say it's peer pressure, but it's adapting to your current environment.\"\u003c/p>\n\u003cp>\u003cstrong>Patients should be \"good consumers\"\u003c/strong>\u003c/p>\n\u003cp>Jeff Belkora, a UCSF professor of health policy says that physician preference for certain treatments needs to be \"trumped\" by what individual patients need. He called for patients to be good consumers and challenge their physicians. \"We want to work with our physicians,\" Belkora said. \"We want to trust them. At the same time ... any given doctor is different than any given patient, so we need to make them understand what we want and what we need.\"\u003c/p>\n\u003cp>If you're thinking that's a tall order in the face of a challenging diagnosis, patients should remember that they likely have more time to weigh options than they might think. Belkora says patients need to make their diagnosis and treatment decisions into a \"project.\"\u003c/p>\n\u003cp>Elizabeth Becker of Piedmont did exactly that. She was diagnosed with DCIS, a very early stage non-invasive breast cancer, a year ago. She spent weeks researching her treatment options. The more she found out about the specific biology of her specific type of cancer, the closer she came to a decision. While DCIS is unlikely to recur as invasive cancer, in Becker's case, if the cancer recurred, it was likely to be aggressive. Becker ultimately chose a mastectomy.\u003c/p>\n\u003cp>\"I felt powerful,\" she said, referring to the process of deciding as well as the options and choices she had. She also credited her doctor who held open-ended conversations with her. Becker said another doctor she had seen seemed to want to \"teach me about breast cancer and then tell me my (treatment) option.\" She was unimpressed.\u003c/p>\n\u003cp>Belkora says there are resources available for people facing treatment decisions. The first stop is research at reputable sites such as the American Cancer Society or the National Cancer Institute for those with a cancer diagnosis, he says.\u003c/p>\n\u003cp>The Informed Medical Decisions Foundation has \u003ca href=\"http://informedmedicaldecisions.org/shared-decision-making-in-practice/decision-aids/\" target=\"_blank\">decision aids\u003c/a> for a wide variety of conditions, from cancers to back pain to heart disease. Health libraries at medical centers can also be a good resource.\u003c/p>\n\u003cp>But it's easy to imagine that handling this \"project\" and doing all this research is a tall order for anyone staring down a diagnosis, let alone the most vulnerable among us, people who are low income, with little education, people who have limited English skills.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While Shannon said the foundation's goal is in part to encourage patients to be more proactive, she also said the greater transparency could be an effective way to let \"physicians know that they seem to be outliers,\" she said. \"that they seem to be prescribing a particular course of treatment much more often or less often than their peers across the state do.\"\u003c/p>\n\n",
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"excerpt": "Where you live matters. And in health care, it matters in all sorts of ways you might not think of immediately. If you're having elective surgery, one of the major factors determining what kind of treatment you will receive depends on where you live, according to new research released Tuesday.\r\n\r\nIn health policy, \"elective\" does not necessarily mean cosmetic surgery. Treatments for early stage cancers are considered \"elective\" because there are a range of options. The California Healthcare Foundation (CHCF) has been following this issue in its \"All Over the Map\" project. Previously, the foundation has examined variation in heart procedures, joint replacement and c-sections. Tuesday the foundation added a detailed look at geographic variation in treatments for three more conditions: breast cancer, prostate cancer, and back and neck pain.",
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"description": "Where you live matters. And in health care, it matters in all sorts of ways you might not think of immediately. If you're having elective surgery, one of the major factors determining what kind of treatment you will receive depends on where you live, according to new research released Tuesday.\r\n\r\nIn health policy, "elective" does not necessarily mean cosmetic surgery. Treatments for early stage cancers are considered "elective" because there are a range of options. The California Healthcare Foundation (CHCF) has been following this issue in its "All Over the Map" project. Previously, the foundation has examined variation in heart procedures, joint replacement and c-sections. Tuesday the foundation added a detailed look at geographic variation in treatments for three more conditions: breast cancer, prostate cancer, and back and neck pain.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12878\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-12878\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/surgeon-hands-620x413.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"413\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Where you live matters. And in health care, it matters in all sorts of ways you might not think of immediately. If you're having elective surgery, one of the major factors determining what kind of treatment you will receive depends on where you live, according to new research released Tuesday.\u003c/p>\n\u003cp>In health policy, \"elective\" does not necessarily mean cosmetic surgery. Treatments for early stage cancers are considered \"elective\" because there are a range of options. The California Healthcare Foundation (CHCF) has been following this issue in its \"\u003ca href=\"http://www.chcf.org/publications/2011/09/medical-variation-rates-california#region=hsa&c=6/37.41928/-123.39017&procedure=epci\" target=\"_blank\">All Over the Map\u003c/a>\" project. Previously, the foundation has examined variation in heart procedures, joint replacement and c-sections. Tuesday the foundation added a detailed look at geographic variation in treatments for three more conditions: breast cancer, prostate cancer, and back and neck pain.\u003c/p>\n\u003cp>PIcking out eyebrow-raising numbers was no problem:\u003c/p>\n\u003cul>\n\u003cli>Men in Indio (Riverside County) receive brachytherapy, known commonly as radiation seeds, to treat prostate cancer at almost five times the statewide average.\u003c/li>\n\u003cli>Women in Healdsburg (Sonoma County) receive lumpectomy without radiation for early stage breast cancer at 270 percent of the statewide average.\u003c/li>\n\u003cli>People in Brawley (Imperial County) are nearly three times as likely to receive cervical fusion, where two vertebrae in the neck are fused together, for neck problems compared to statewide.\u003c/li>\n\u003c/ul>\n\u003cp>\u003ca href=\"http://www.chcf.org/publications/2013/05/medical-variation-map#6/36.985/-119.443&procedure=lura_123®ion=hsa\" target=\"_blank\">\u003cimg class=\"alignright size-full wp-image-12855\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/CHCF_AllOverTheMap_Banner2_200513_R1Single.jpg\" alt=\"CHCF_AllOverTheMap_Banner2_200513_R1Single\" width=\"289\" height=\"399\">\u003c/a>Low rates are easy to find, too. To name just one: women in Lancaster, northeast of Los Angeles, with early stage breast cancer receive lumpectomy with radiation at just 26 percent of the statewide average.\u003c/p>\n\u003cp>The question is why. Maribeth Shannon with the foundation says the variation is \"just puzzling to us.\" She stressed that the statewide average is not necessarily the \"right\" rate, but the state average is an estimate that's easy to use as a benchmark.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In its analysis, the foundation accounted and adjusted for a host of patient characteristics that might skew the numbers. Still, the broad variation is there. Shannon pointed out that it would be \"unusual\" that patients would differ so significantly in what treatments they wanted, simply according to where they lived.\u003c/p>\n\u003cp>\"It's much more likely,\" Shannon said, \"that physicians practicing in that area tend to rely on that course of treatment over others. ... It does seem to be more the physician preference than the patient preference.\"\u003c!--more-->\u003c/p>\n\u003cp>Professor Renee Hsia at UC San Francisco was not involved in the study. She agreed that physician preference matters, counter to what patients might think.\u003c/p>\n\u003cp>\"A lot of patients out there think you go to one doctor and they will prescribe the same treatment,\" no matter where you live, Hsia said, \"because you go to medical school and there's one answer.\" Tuesday's release shows there's \"a lot of variability.\"\u003c/p>\n\u003cp>\"The way your peers practice ... in your group or in your hospital affects the way you practice also,\" Hsia said. \"I wouldn't say it's peer pressure, but it's adapting to your current environment.\"\u003c/p>\n\u003cp>\u003cstrong>Patients should be \"good consumers\"\u003c/strong>\u003c/p>\n\u003cp>Jeff Belkora, a UCSF professor of health policy says that physician preference for certain treatments needs to be \"trumped\" by what individual patients need. He called for patients to be good consumers and challenge their physicians. \"We want to work with our physicians,\" Belkora said. \"We want to trust them. At the same time ... any given doctor is different than any given patient, so we need to make them understand what we want and what we need.\"\u003c/p>\n\u003cp>If you're thinking that's a tall order in the face of a challenging diagnosis, patients should remember that they likely have more time to weigh options than they might think. Belkora says patients need to make their diagnosis and treatment decisions into a \"project.\"\u003c/p>\n\u003cp>Elizabeth Becker of Piedmont did exactly that. She was diagnosed with DCIS, a very early stage non-invasive breast cancer, a year ago. She spent weeks researching her treatment options. The more she found out about the specific biology of her specific type of cancer, the closer she came to a decision. While DCIS is unlikely to recur as invasive cancer, in Becker's case, if the cancer recurred, it was likely to be aggressive. Becker ultimately chose a mastectomy.\u003c/p>\n\u003cp>\"I felt powerful,\" she said, referring to the process of deciding as well as the options and choices she had. She also credited her doctor who held open-ended conversations with her. Becker said another doctor she had seen seemed to want to \"teach me about breast cancer and then tell me my (treatment) option.\" She was unimpressed.\u003c/p>\n\u003cp>Belkora says there are resources available for people facing treatment decisions. The first stop is research at reputable sites such as the American Cancer Society or the National Cancer Institute for those with a cancer diagnosis, he says.\u003c/p>\n\u003cp>The Informed Medical Decisions Foundation has \u003ca href=\"http://informedmedicaldecisions.org/shared-decision-making-in-practice/decision-aids/\" target=\"_blank\">decision aids\u003c/a> for a wide variety of conditions, from cancers to back pain to heart disease. Health libraries at medical centers can also be a good resource.\u003c/p>\n\u003cp>But it's easy to imagine that handling this \"project\" and doing all this research is a tall order for anyone staring down a diagnosis, let alone the most vulnerable among us, people who are low income, with little education, people who have limited English skills.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While Shannon said the foundation's goal is in part to encourage patients to be more proactive, she also said the greater transparency could be an effective way to let \"physicians know that they seem to be outliers,\" she said. \"that they seem to be prescribing a particular course of treatment much more often or less often than their peers across the state do.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Easy to Do, Inexpensive; Music Calms Some ICU Patients",
"title": "Easy to Do, Inexpensive; Music Calms Some ICU Patients",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>By Leslie Harris O'Hanlon\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12826\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-12826 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AA004801-620x452.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">(Ryan McVay/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The adage stems from the 18th century: music has charms to sooth the savage breast. It's probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Patients in the music group received 38 percent fewer doses of sedatives.\u003c/aside>\n\u003cp>Researchers at Ohio State University looked at ICU patients on mechanical ventilators for respiratory failure. Those who listened to the music of their choice not only had greater reduction in anxiety but also used fewer sedation drugs and lower doses compared to patients who did not have access to music -- they received usual ICU care. Mechanical ventilation, or ventilatory support, is when a patient is connected to a machine, called a ventilator, to help him or her breath.\u003c/p>\n\u003cp>Researchers call this \"patient-directed music\" because patients could select their own music and put headphones on whenever they wanted.\u003c/p>\n\u003cp>The \"intervention empowered patients to use music to manage their own anxiety whenever they felt they needed the use of music to help them relax or when they desired some quiet time,” said lead author Professor Linda L. Chlan at Ohio State. “Music does not induce adverse side effects, which are sometimes evident with sedative agents administered to these patients.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The clinical trial included 373 patients on ventilators. Researchers looked at 12 intensive care units in the Minneapolis-St. Paul area; the study went on for nearly five years. Patients were put into three groups: those who picked their own musical selections with the help of a music therapist, those who used noise-canceling headphones and those who received usual care.\u003c/p>\n\u003cp>Researchers measured anxiety daily by asking patients the question: “How are you feeling today?” The amount and frequency of sedative drugs were also measured. Patients in the music group listened to music for an average of 80 minutes per day.\u003c/p>\n\u003cp>Analysis showed that patients in the music group had an anxiety score that was 19.5 points lower than patients in the usual care group. Also, patients in the music group received fewer doses of sedatives -- 38 percent fewer doses.\u003c/p>\n\u003cp>Researchers published comments that patients or family members made to nurses. For example:\u003c/p>\n\u003cul>\n\u003cli>\"Patient looks very peaceful and states she like the music.\"\u003c/li>\n\u003cli>\"After putting headphones on, patient appears less anxious.\"\u003c/li>\n\u003cli>\"Evening was quieter. Patient put headphones on which seemed to help a lot.\"\u003c/li>\n\u003c/ul>\n\u003cp>Not surprisingly, people on ventilators in an ICU are often under a great deal of stress. Potent sedatives are usually given to these patients to help them feel less anxious, the study authors wrote. But those drugs can have harsh side effects, including weakness, delirium and a lowering a blood pressure. That lower blood pressure can prevent the heart, brain and other parts of the body from getting enough blood.\u003c/p>\n\u003cp>“Mechanically ventilated patients have little control over (drug) interventions to relieve anxiety,\" Chlan wrote in an email. \"Dosing and frequency of sedative and analgesic medications are controlled by intensive care unit (ICU) clinicians. ... Interventions are needed that reduce anxiety, actively involve patients, and minimize the use of sedative medications.”\u003c/p>\n\u003cp>This isn’t the first study to highlight how music can help alleviate stress. A large scale review of 400 research papers\u003ca href=\"http://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(13)00049-1\" target=\"_blank\"> published in Trends in Cognitive Sciences\u003c/a> found that music can improve the function of the body's immune system and reduce levels of stress. Further, listening to music was more successful than prescription drugs in decreasing a person's anxiety before undergoing surgery. In a 2012 paper \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22071366\" target=\"_blank\">published in The Journal of Pain\u003c/a>, researchers from the University of Utah Pain Research Center found that listening to music could lessen pain by distracting people’s attention away from the pain. Also, according to the American Cancer Society, there is evidence that when used with conventional treatment, music therapy can help to reduce pain and relieve chemotherapy-induced nausea and vomiting in cancer patients. Music therapy, which can include making or listening to music or writing songs, may also relieve stress and provide an overall sense of well-being.\u003c/p>\n\u003cp>The current JAMA study had some limitations, said Dr. Elie Azoulay with the Sorbonne in Paris who wrote an accompanying editorial in JAMA. Azoulay says the effects of listening to music were only studied short term, and the use of sedatives was not standardized across all ICUs in the study. Azoulay added that conducting in-depth interviews with patients after they were discharged could help researchers better understand the impact music had on those patients’ anxiety levels.\u003c/p>\n\u003cp>Still, the ability of music to help patients in distress is an area worth exploring further, he said, especially since it’s low cost and easy to incorporate.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Patient's anxiety can be reduced and by a means that can be accessible for all ICUs all over the world,” he said.\u003c/p>\n\n",
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"excerpt": "The adage stems from the 18th century: music has charms to sooth the savage beast. It's probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Leslie Harris O'Hanlon\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12826\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-12826 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AA004801-620x452.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">(Ryan McVay/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The adage stems from the 18th century: music has charms to sooth the savage breast. It's probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Patients in the music group received 38 percent fewer doses of sedatives.\u003c/aside>\n\u003cp>Researchers at Ohio State University looked at ICU patients on mechanical ventilators for respiratory failure. Those who listened to the music of their choice not only had greater reduction in anxiety but also used fewer sedation drugs and lower doses compared to patients who did not have access to music -- they received usual ICU care. Mechanical ventilation, or ventilatory support, is when a patient is connected to a machine, called a ventilator, to help him or her breath.\u003c/p>\n\u003cp>Researchers call this \"patient-directed music\" because patients could select their own music and put headphones on whenever they wanted.\u003c/p>\n\u003cp>The \"intervention empowered patients to use music to manage their own anxiety whenever they felt they needed the use of music to help them relax or when they desired some quiet time,” said lead author Professor Linda L. Chlan at Ohio State. “Music does not induce adverse side effects, which are sometimes evident with sedative agents administered to these patients.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The clinical trial included 373 patients on ventilators. Researchers looked at 12 intensive care units in the Minneapolis-St. Paul area; the study went on for nearly five years. Patients were put into three groups: those who picked their own musical selections with the help of a music therapist, those who used noise-canceling headphones and those who received usual care.\u003c/p>\n\u003cp>Researchers measured anxiety daily by asking patients the question: “How are you feeling today?” The amount and frequency of sedative drugs were also measured. Patients in the music group listened to music for an average of 80 minutes per day.\u003c/p>\n\u003cp>Analysis showed that patients in the music group had an anxiety score that was 19.5 points lower than patients in the usual care group. Also, patients in the music group received fewer doses of sedatives -- 38 percent fewer doses.\u003c/p>\n\u003cp>Researchers published comments that patients or family members made to nurses. For example:\u003c/p>\n\u003cul>\n\u003cli>\"Patient looks very peaceful and states she like the music.\"\u003c/li>\n\u003cli>\"After putting headphones on, patient appears less anxious.\"\u003c/li>\n\u003cli>\"Evening was quieter. Patient put headphones on which seemed to help a lot.\"\u003c/li>\n\u003c/ul>\n\u003cp>Not surprisingly, people on ventilators in an ICU are often under a great deal of stress. Potent sedatives are usually given to these patients to help them feel less anxious, the study authors wrote. But those drugs can have harsh side effects, including weakness, delirium and a lowering a blood pressure. That lower blood pressure can prevent the heart, brain and other parts of the body from getting enough blood.\u003c/p>\n\u003cp>“Mechanically ventilated patients have little control over (drug) interventions to relieve anxiety,\" Chlan wrote in an email. \"Dosing and frequency of sedative and analgesic medications are controlled by intensive care unit (ICU) clinicians. ... Interventions are needed that reduce anxiety, actively involve patients, and minimize the use of sedative medications.”\u003c/p>\n\u003cp>This isn’t the first study to highlight how music can help alleviate stress. A large scale review of 400 research papers\u003ca href=\"http://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(13)00049-1\" target=\"_blank\"> published in Trends in Cognitive Sciences\u003c/a> found that music can improve the function of the body's immune system and reduce levels of stress. Further, listening to music was more successful than prescription drugs in decreasing a person's anxiety before undergoing surgery. In a 2012 paper \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22071366\" target=\"_blank\">published in The Journal of Pain\u003c/a>, researchers from the University of Utah Pain Research Center found that listening to music could lessen pain by distracting people’s attention away from the pain. Also, according to the American Cancer Society, there is evidence that when used with conventional treatment, music therapy can help to reduce pain and relieve chemotherapy-induced nausea and vomiting in cancer patients. Music therapy, which can include making or listening to music or writing songs, may also relieve stress and provide an overall sense of well-being.\u003c/p>\n\u003cp>The current JAMA study had some limitations, said Dr. Elie Azoulay with the Sorbonne in Paris who wrote an accompanying editorial in JAMA. Azoulay says the effects of listening to music were only studied short term, and the use of sedatives was not standardized across all ICUs in the study. Azoulay added that conducting in-depth interviews with patients after they were discharged could help researchers better understand the impact music had on those patients’ anxiety levels.\u003c/p>\n\u003cp>Still, the ability of music to help patients in distress is an area worth exploring further, he said, especially since it’s low cost and easy to incorporate.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Patient's anxiety can be reduced and by a means that can be accessible for all ICUs all over the world,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "What's a BRCA Gene Anyway?",
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"content": "\u003cfigure id=\"attachment_12777\" class=\"wp-caption aligncenter\" style=\"max-width: 432px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4839882457/\">\u003cimg class=\"size-full wp-image-12777\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg\" alt=\"(Gage Skidmore/Flickr)\" width=\"432\" height=\"386\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg 432w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-400x357.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-320x286.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The first thing you need to know about the BRCA gene is that you have it.\u003c/p>\n\u003cp>Don't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We all have two copies of the BRCA genes. Men, too.\u003c/aside>\n\u003cp>The problem is what happens when they don't function normally. We'll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.\u003c/p>\n\u003cp>For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are \"like sentences,\" Nussbaum said. \"They are made up of words.\" When they're spelled right, all is well.\u003c/p>\n\u003cp>But \"you can have all kinds of misspellings,\" Nussbaum said. \"Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If you've ever texted or sent an email or written anything on a computer, you know that there are misspellings that don't change the meaning of what you're trying to say. Nussbaum used the example of \"gray\" and \"grey\". The change in spelling does not change the meaning.\u003c/p>\n\u003cp>With the BRCA genes, there are \"thousands\" of ways the gene can be misspelled, Nussbaum said. But just like gray/grey doesn't matter, neither do many of those BRCA misspellings or what Angelina Jolie correctly called a mutation.\u003c/p>\n\u003cp>Then there are the ones that do matter. Sadly, they matter way too much. On Tuesday Angelina Jolie said \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0\" target=\"_blank\">she had a mutation\u003c/a> that gave her an 87 percent risk of developing breast cancer, which is why she decided to undergo a preventive double mastectomy.\u003c/p>\n\u003cp>In general, women who have inherited the harmful mutations have about\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> 60 percent risk\u003c/a> of developing breast cancer over their lifetimes, according to the National Cancer Institute. They are also at much higher risk of ovarian cancer. And men who inherit the gene have a dramatically increased risk of male breast cancer as well as pancreatic and prostate cancers.\u003c/p>\n\u003cp>Still, only about 10 percent of all breast cancers are associated with these mutations. Or, to put it the opposite way, roughly 90 percent of all breast cancers are not related to BRCA mutations. They just happen, for reasons doctors and scientists cannot fully explain.\u003c/p>\n\u003cp>I just googled \"Angelina Jolie\" and \"mastectomy\" and got 736 million results. It's probably safe to say countless women are thinking about BRCA testing right now. But before you run to a lab, Nussbaum said they start with an \"accurate and complete\" family history, including on the father's side. Remember that you get one copy of all your genes, including the BRCA1 and 2 genes, from your dad.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While \"thousands\" of mutations cause harm and \"thousands\" more have no effect at all, Nussbaum then pointed to a third category, \"variance of uncertain significance,\" he said. Doctors see the mutation, but cannot determine if it damages the gene's function or not. \"So there is no such thing as 'the BRCA1 mutation.' There are thousands. Some are deleterious. Some are not. Some we don't know.\"\u003c/p>\n\n",
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"excerpt": "The first thing you need to know about the BRCA gene is that you have it.\r\n\r\nDon't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12777\" class=\"wp-caption aligncenter\" style=\"max-width: 432px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4839882457/\">\u003cimg class=\"size-full wp-image-12777\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg\" alt=\"(Gage Skidmore/Flickr)\" width=\"432\" height=\"386\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg 432w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-400x357.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-320x286.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The first thing you need to know about the BRCA gene is that you have it.\u003c/p>\n\u003cp>Don't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We all have two copies of the BRCA genes. Men, too.\u003c/aside>\n\u003cp>The problem is what happens when they don't function normally. We'll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.\u003c/p>\n\u003cp>For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are \"like sentences,\" Nussbaum said. \"They are made up of words.\" When they're spelled right, all is well.\u003c/p>\n\u003cp>But \"you can have all kinds of misspellings,\" Nussbaum said. \"Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you've ever texted or sent an email or written anything on a computer, you know that there are misspellings that don't change the meaning of what you're trying to say. Nussbaum used the example of \"gray\" and \"grey\". The change in spelling does not change the meaning.\u003c/p>\n\u003cp>With the BRCA genes, there are \"thousands\" of ways the gene can be misspelled, Nussbaum said. But just like gray/grey doesn't matter, neither do many of those BRCA misspellings or what Angelina Jolie correctly called a mutation.\u003c/p>\n\u003cp>Then there are the ones that do matter. Sadly, they matter way too much. On Tuesday Angelina Jolie said \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0\" target=\"_blank\">she had a mutation\u003c/a> that gave her an 87 percent risk of developing breast cancer, which is why she decided to undergo a preventive double mastectomy.\u003c/p>\n\u003cp>In general, women who have inherited the harmful mutations have about\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> 60 percent risk\u003c/a> of developing breast cancer over their lifetimes, according to the National Cancer Institute. They are also at much higher risk of ovarian cancer. And men who inherit the gene have a dramatically increased risk of male breast cancer as well as pancreatic and prostate cancers.\u003c/p>\n\u003cp>Still, only about 10 percent of all breast cancers are associated with these mutations. Or, to put it the opposite way, roughly 90 percent of all breast cancers are not related to BRCA mutations. They just happen, for reasons doctors and scientists cannot fully explain.\u003c/p>\n\u003cp>I just googled \"Angelina Jolie\" and \"mastectomy\" and got 736 million results. It's probably safe to say countless women are thinking about BRCA testing right now. But before you run to a lab, Nussbaum said they start with an \"accurate and complete\" family history, including on the father's side. Remember that you get one copy of all your genes, including the BRCA1 and 2 genes, from your dad.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While \"thousands\" of mutations cause harm and \"thousands\" more have no effect at all, Nussbaum then pointed to a third category, \"variance of uncertain significance,\" he said. Doctors see the mutation, but cannot determine if it damages the gene's function or not. \"So there is no such thing as 'the BRCA1 mutation.' There are thousands. Some are deleterious. Some are not. Some we don't know.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours ",
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"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_12715\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/foreignoffice/7296732418/\">\u003cimg class=\"size-large wp-image-12715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/angelinajolie_foreignandcommonwealthoffice-620x603.jpg\" alt=\"(Foreign and Commonwealth Office/Flickr)\" width=\"620\" height=\"603\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Foreign and Commonwealth Office/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, \"\u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">My Medical Choice\u003c/a>.\"\u003c/p>\n\u003cp>But the key here is a\u003cem> specific\u003c/em> BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that \"the risk is different in the case of each woman.\"\u003c/p>\n\u003cp>About \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">10 percent\u003c/a> of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, \u003ca href=\"http://acspressroom.wordpress.com/2013/05/14/jolie/\" target=\"_blank\">explains in more detail\u003c/a> what individual women should consider, in a response to Jolie's piece:\u003c/p>\n\u003cblockquote>\u003cp>This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.\u003c!--more-->\u003c/p>\n\u003cp>Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.\u003c/p>\n\u003cp>A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.\u003c/p>\n\u003cp>Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer.\u003c/p>\n\u003cp>Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that 'only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.' Nonetheless, after careful consideration, this might be the right choice for some women.\u003c/p>\u003c/blockquote>\n\u003cp>For some women, yes. But, while mutations in the BRCA genes are fairly rare, the majority of women opting for preventive mastectomy are not at elevated risk, as \u003ca href=\"http://www.npr.org/blogs/health/2013/05/14/183892507/angelina-jolie-and-the-rise-of-preventive-mastectomies\" target=\"_blank\">NPR's Shots blog notes\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"We found that women who have cancer in one breast overestimate their risk of cancer in the other breast by sixfold,\" says \u003ca href=\"http://www.surg.umn.edu/Faculty_Alpha/tuttle_todd_m/home.html\">Todd Tuttle\u003c/a>, chief of surgical oncology at the University of Minnesota. \"It's very exaggerated.\" ...\u003c/p>\n\u003cp>Increased awareness of breast cancer due to the ubiquitous pink ribbon campaigns could be fueling the rise in prophylactic mastectomies, some people say. \"Women have this exaggerated perceived risk of getting breast cancer,\" Tuttle told Shots. \"They see breast cancer everywhere.\"\u003c/p>\n\u003cp>There has not been an increase in prophylactic mastectomy in Europe, Tuttle notes, though women there have access to the same surgery and reconstruction. \"I wonder if part of the difference is this hyperawareness of breast cancer.\"\u003c/p>\u003c/blockquote>\n\u003cp>Berkeley-based journalist Peggy Orenstein \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">took on the hyperawareness\u003c/a> of breast cancer in another New York Times venue, its Sunday magazine. Orenstein was first diagnosed with breast cancer 16 years ago. She had a lumpectomy plus radiation, then suffered a recurrence last year. Her only option was mastectomy, which she had on the affected breast. Yet she opted against preventive mastectomy on the other side. \u003ca href=\"http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0\" target=\"_blank\">From her article\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>My first instinct this round was to have my other breast removed as well — I never wanted to go through this again. My oncologist argued against it. The tamoxifen would lower my risk of future disease to that of an average woman, he said. Would an average woman cut off her breasts? I could have preventive surgery if I wanted to, he added, but it would be a psychological decision, not a medical one.\u003c/p>\n\u003cp>I weighed the options as my hospital date approached. Average risk, after all, is not zero. Could I live with that? Part of me still wanted to extinguish all threat. I have a 9-year-old daughter; I would do anything — I need to do \u003cem>everything\u003c/em> — to keep from dying. Yet, if death was the issue, the greatest danger wasn’t my other breast. It is that, despite treatment and a good prognosis, the cancer I’ve already had has metastasized. Preventive mastectomy wouldn’t change that; nor would it entirely eliminate the possibility of new disease, because there’s always some tissue left behind.\u003c/p>\n\u003cp>What did doing “everything” mean, anyway? There are days when I skip sunscreen. I don’t exercise as much as I should. I haven’t given up aged Gouda despite my latest cholesterol count; I don’t get enough calcium. And, oh, yeah, my house is six blocks from a fault line. Is living with a certain amount of breast-cancer risk really so different? I decided to take my doctor’s advice, to do only what had to be done.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, at Breast Cancer Action, spokeswoman Angela Wall points out that Jolie had access to \"all the information she needs.\" But in the interest of stating the obvious, that is not the case for every woman.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The genetic test for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/12/breast-cancer-gene-mutations-at-heart-of-supreme-court-case/\" target=\"_blank\">BRCA mutations\u003c/a> is held tightly by Myriad Genetics, so tightly that \u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\">a case questioning whether human genes are patentabl\u003c/a>e has made it the U.S. Supreme Court. Wall says that laboratories across the country could offer a comparable test for a fraction of the cost -- potentially opening up the test to more women -- but Myriad will not license it, making its $3,000 test a monopoly.\u003c/p>\n\u003cp>While Wall is supportive of Jolie's decision (\"This is an impossible decision and women do not make this choice lightly\"), she says the answer to breast cancer is not prophylactic mastectomy, it's prevention.\u003c/p>\n\u003cp>\"It we want to get really serious about preventing breast cancer,\" she practically fumed over the phone, \"we need to do a lot more than celebrating a woman who has preventive mastectomy. ... What about all the other risk factors? The environmental risk factors?\" She advocates that what is needed are strong regulations to limit or ban known toxins that cause breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://health.clevelandclinic.org/2012/10/breast-cancer-do-your-genes-put-you-at-risk/?utm_campaign=cc+tweets&utm_medium=social&utm_source=twitter&utm_content=130514+breast+cancer+genes&dynid=twitter-_-cc+tweets-_-social-_-social-_-130514+breast+cancer+genes\" target=\"_blank\">Breast Cancer -- Do Your Genes Put You At Risk? \u003c/a>(Cleveland Clinic)\u003c/p>\n\n",
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"excerpt": "Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times op-ed piece.\r\n\r\nBut the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolile is very careful to walk through all her personal decisions stemming from her unusually high risk but qualifies that \"the risk is different in the case of each woman.\"",
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"description": "Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times op-ed piece.\r\n\r\nBut the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolile is very careful to walk through all her personal decisions stemming from her unusually high risk but qualifies that "the risk is different in the case of each woman."",
"title": "Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12715\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/foreignoffice/7296732418/\">\u003cimg class=\"size-large wp-image-12715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/angelinajolie_foreignandcommonwealthoffice-620x603.jpg\" alt=\"(Foreign and Commonwealth Office/Flickr)\" width=\"620\" height=\"603\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Foreign and Commonwealth Office/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, \"\u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">My Medical Choice\u003c/a>.\"\u003c/p>\n\u003cp>But the key here is a\u003cem> specific\u003c/em> BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that \"the risk is different in the case of each woman.\"\u003c/p>\n\u003cp>About \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">10 percent\u003c/a> of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, \u003ca href=\"http://acspressroom.wordpress.com/2013/05/14/jolie/\" target=\"_blank\">explains in more detail\u003c/a> what individual women should consider, in a response to Jolie's piece:\u003c/p>\n\u003cblockquote>\u003cp>This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.\u003c!--more-->\u003c/p>\n\u003cp>Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.\u003c/p>\n\u003cp>A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.\u003c/p>\n\u003cp>Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer.\u003c/p>\n\u003cp>Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that 'only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.' Nonetheless, after careful consideration, this might be the right choice for some women.\u003c/p>\u003c/blockquote>\n\u003cp>For some women, yes. But, while mutations in the BRCA genes are fairly rare, the majority of women opting for preventive mastectomy are not at elevated risk, as \u003ca href=\"http://www.npr.org/blogs/health/2013/05/14/183892507/angelina-jolie-and-the-rise-of-preventive-mastectomies\" target=\"_blank\">NPR's Shots blog notes\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"We found that women who have cancer in one breast overestimate their risk of cancer in the other breast by sixfold,\" says \u003ca href=\"http://www.surg.umn.edu/Faculty_Alpha/tuttle_todd_m/home.html\">Todd Tuttle\u003c/a>, chief of surgical oncology at the University of Minnesota. \"It's very exaggerated.\" ...\u003c/p>\n\u003cp>Increased awareness of breast cancer due to the ubiquitous pink ribbon campaigns could be fueling the rise in prophylactic mastectomies, some people say. \"Women have this exaggerated perceived risk of getting breast cancer,\" Tuttle told Shots. \"They see breast cancer everywhere.\"\u003c/p>\n\u003cp>There has not been an increase in prophylactic mastectomy in Europe, Tuttle notes, though women there have access to the same surgery and reconstruction. \"I wonder if part of the difference is this hyperawareness of breast cancer.\"\u003c/p>\u003c/blockquote>\n\u003cp>Berkeley-based journalist Peggy Orenstein \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">took on the hyperawareness\u003c/a> of breast cancer in another New York Times venue, its Sunday magazine. Orenstein was first diagnosed with breast cancer 16 years ago. She had a lumpectomy plus radiation, then suffered a recurrence last year. Her only option was mastectomy, which she had on the affected breast. Yet she opted against preventive mastectomy on the other side. \u003ca href=\"http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0\" target=\"_blank\">From her article\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>My first instinct this round was to have my other breast removed as well — I never wanted to go through this again. My oncologist argued against it. The tamoxifen would lower my risk of future disease to that of an average woman, he said. Would an average woman cut off her breasts? I could have preventive surgery if I wanted to, he added, but it would be a psychological decision, not a medical one.\u003c/p>\n\u003cp>I weighed the options as my hospital date approached. Average risk, after all, is not zero. Could I live with that? Part of me still wanted to extinguish all threat. I have a 9-year-old daughter; I would do anything — I need to do \u003cem>everything\u003c/em> — to keep from dying. Yet, if death was the issue, the greatest danger wasn’t my other breast. It is that, despite treatment and a good prognosis, the cancer I’ve already had has metastasized. Preventive mastectomy wouldn’t change that; nor would it entirely eliminate the possibility of new disease, because there’s always some tissue left behind.\u003c/p>\n\u003cp>What did doing “everything” mean, anyway? There are days when I skip sunscreen. I don’t exercise as much as I should. I haven’t given up aged Gouda despite my latest cholesterol count; I don’t get enough calcium. And, oh, yeah, my house is six blocks from a fault line. Is living with a certain amount of breast-cancer risk really so different? I decided to take my doctor’s advice, to do only what had to be done.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, at Breast Cancer Action, spokeswoman Angela Wall points out that Jolie had access to \"all the information she needs.\" But in the interest of stating the obvious, that is not the case for every woman.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The genetic test for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/12/breast-cancer-gene-mutations-at-heart-of-supreme-court-case/\" target=\"_blank\">BRCA mutations\u003c/a> is held tightly by Myriad Genetics, so tightly that \u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\">a case questioning whether human genes are patentabl\u003c/a>e has made it the U.S. Supreme Court. Wall says that laboratories across the country could offer a comparable test for a fraction of the cost -- potentially opening up the test to more women -- but Myriad will not license it, making its $3,000 test a monopoly.\u003c/p>\n\u003cp>While Wall is supportive of Jolie's decision (\"This is an impossible decision and women do not make this choice lightly\"), she says the answer to breast cancer is not prophylactic mastectomy, it's prevention.\u003c/p>\n\u003cp>\"It we want to get really serious about preventing breast cancer,\" she practically fumed over the phone, \"we need to do a lot more than celebrating a woman who has preventive mastectomy. ... What about all the other risk factors? The environmental risk factors?\" She advocates that what is needed are strong regulations to limit or ban known toxins that cause breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://health.clevelandclinic.org/2012/10/breast-cancer-do-your-genes-put-you-at-risk/?utm_campaign=cc+tweets&utm_medium=social&utm_source=twitter&utm_content=130514+breast+cancer+genes&dynid=twitter-_-cc+tweets-_-social-_-social-_-130514+breast+cancer+genes\" target=\"_blank\">Breast Cancer -- Do Your Genes Put You At Risk? \u003c/a>(Cleveland Clinic)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mark Bittman Talks Up Part-Time Veganism (and Delivers 3 Easy Recipes)",
"title": "Mark Bittman Talks Up Part-Time Veganism (and Delivers 3 Easy Recipes)",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_12663\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/10/mark-bittman-talks-up-part-time-veganism-and-delivers-3-easy-recipes/assortment-of-fresh-vegetables-and-fruit/\" rel=\"attachment wp-att-12663\">\u003cimg class=\"size-medium wp-image-12663\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/Bittman-Vegan-Before-6-300x200.jpg\" alt=\"(Getty Images)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>It all started with a prescription from his doctor, but not for a drug.\u003c/p>\n\u003cp>\"You should probably become a vegan,\" New York Times food writer Mark Bittman says his doctor told him. That was six years ago. Then 57, Bittman says he was 40 pounds overweight, and his cholesterol and blood sugar which had always been normal, had moved into the \"danger zone.\"\u003c/p>\n\u003cp>Bittman had built his career around food, and being a vegan didn't appeal to him, as he recounted this week on\u003ca href=\"http://www.kqed.org/a/forum/R201305090900\" target=\"_blank\"> KQED's Forum\u003c/a>. \"I wanted ... something do-able, something I could stick with,\" he said.\u003c/p>\n\u003cp>He hatched the idea of being vegan until dinner -- \"you're only postponing gratitude\" until then.\u003c/p>\n\u003cp>It seems to have worked. Today, he's 35 pounds lighter and he says his blood sugar and cholesterol are back in the normal range.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now he has recounted his experience in a new book, \"\u003ca href=\"http://www.amazon.com/VB6-Before-Weight-Restore-Health/dp/0385344740\" target=\"_blank\">VB6: Eat Vegan Before 6:00 to Restore Your Health and Lose Weight ... for Good.\u003c/a>\"\u003c!--more-->\u003c/p>\n\u003cp>His approach shatters the idea of a diet as being something you go on and then at some point go off. \"It's not a diet of 'lose 21 pounds in 21 days,'\" he says. \"It's a plan for how you're going to eat, not for a month, but from now on.\"\u003c/p>\n\u003cp>Specifically, Bittman eats very few animal products before 6pm -- one allowance he makes is for cream in his coffee. He also avoids highly processed foods such as white rice, white pasta, all junk food and alcohol. For breakfast, often it's oatmeal, fot lunch, rice and beans, or a salad, or both. He snacks on nuts and fruit.\u003c/p>\n\u003cp>After 6PM, he reverts to his \"wicked ways,\" at least in theory. Bittman found that once he started losing weight, he felt better, which was powerful incentive to keep eating a more healthy diet. Today, even after 6PM, he eats fewer animal products than he used to.\u003c/p>\n\u003cp>He embraced a vegan diet (even if part-time) because the \"writing has been on the wall for a long time that a plant-based diet is the way to go.\"\u003c/p>\n\u003cp>On Forum, he argued strongly against processed foods. \"As far as a daily diet goes,\" he said, \"the reason that plants are better than processed foods is that they're real, they have one ingredient ... we know what's in them.\"\u003c/p>\n\u003cp>Animal products, he pointed out, are full of nutrients, but we eat \"way too much of them,\" around 600 pounds per person annually in the U.S.\u003c/p>\n\u003cp>Not only are all those animal products bad for your health, it's \"not sustainable environmentally,\" he added.\u003c/p>\n\u003cp>His approach is alluring, since he's allowing freedom from rules. \"I like to punctuate my day with a nice meal and a glass or three or wine,\" he joked. \"And I like to stop thinking about rules ... when I'm done working. Dinner does that for me.\" He pointed out that plenty of research shows that eating your big meal in the middle of the day is likely better for you, but that \"doesn't work for me.\"\u003c/p>\n\u003cp>By now you might be wondering how you would actually put this into action. On Forum, he easily listed three dishes, each endlessly variable, that even a basic cook could whip up:\u003c/p>\n\u003col>\n\u003cli>\u003cstrong>Rice and beans\u003c/strong>: He described a recent meal of brown rice, chick peas, chopped kale and stir-frying it with jalapeno and cilantro. \"It was really fantastic. That was a great lunch,\" he enthused. (Note that he specified whole grain rice.)\u003c/li>\n\u003cli>\u003cstrong>Chopped salad\u003c/strong>. Just take things out of your fridge, \"start chopping them up, put them in a bowl, you're in business.\"\u003c/li>\n\u003cli>\u003cstrong>Stir fry\u003c/strong>. \"Instead of having center-of-the-plate meat, you're having two ounces of meat per person -- or even less -- a much more moderate amount, mixed with vegetables in a style most people like.\"\u003c/li>\n\u003c/ol>\n\u003cp>A caller asked where to begin if you're cooking for a family. He advised starting with breakfast, getting rid of \"everything that is not a whole-grain alternative.\" He recommended smoothies with fruit and soy milk or almond milk, oatmeal with \"stuff in it, whatever reasonable thing you want,\" or a fruit salad.\u003c/p>\n\u003cp>But even with his suggestions, he said \"everybody's got to ... tinker with this a bit.\"\u003c/p>\n\u003cp>\"It's just a strategy, but it's not the only strategy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mark Bittman on Forum:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201305090900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201305090900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12663\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/10/mark-bittman-talks-up-part-time-veganism-and-delivers-3-easy-recipes/assortment-of-fresh-vegetables-and-fruit/\" rel=\"attachment wp-att-12663\">\u003cimg class=\"size-medium wp-image-12663\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/Bittman-Vegan-Before-6-300x200.jpg\" alt=\"(Getty Images)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>It all started with a prescription from his doctor, but not for a drug.\u003c/p>\n\u003cp>\"You should probably become a vegan,\" New York Times food writer Mark Bittman says his doctor told him. That was six years ago. Then 57, Bittman says he was 40 pounds overweight, and his cholesterol and blood sugar which had always been normal, had moved into the \"danger zone.\"\u003c/p>\n\u003cp>Bittman had built his career around food, and being a vegan didn't appeal to him, as he recounted this week on\u003ca href=\"http://www.kqed.org/a/forum/R201305090900\" target=\"_blank\"> KQED's Forum\u003c/a>. \"I wanted ... something do-able, something I could stick with,\" he said.\u003c/p>\n\u003cp>He hatched the idea of being vegan until dinner -- \"you're only postponing gratitude\" until then.\u003c/p>\n\u003cp>It seems to have worked. Today, he's 35 pounds lighter and he says his blood sugar and cholesterol are back in the normal range.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now he has recounted his experience in a new book, \"\u003ca href=\"http://www.amazon.com/VB6-Before-Weight-Restore-Health/dp/0385344740\" target=\"_blank\">VB6: Eat Vegan Before 6:00 to Restore Your Health and Lose Weight ... for Good.\u003c/a>\"\u003c!--more-->\u003c/p>\n\u003cp>His approach shatters the idea of a diet as being something you go on and then at some point go off. \"It's not a diet of 'lose 21 pounds in 21 days,'\" he says. \"It's a plan for how you're going to eat, not for a month, but from now on.\"\u003c/p>\n\u003cp>Specifically, Bittman eats very few animal products before 6pm -- one allowance he makes is for cream in his coffee. He also avoids highly processed foods such as white rice, white pasta, all junk food and alcohol. For breakfast, often it's oatmeal, fot lunch, rice and beans, or a salad, or both. He snacks on nuts and fruit.\u003c/p>\n\u003cp>After 6PM, he reverts to his \"wicked ways,\" at least in theory. Bittman found that once he started losing weight, he felt better, which was powerful incentive to keep eating a more healthy diet. Today, even after 6PM, he eats fewer animal products than he used to.\u003c/p>\n\u003cp>He embraced a vegan diet (even if part-time) because the \"writing has been on the wall for a long time that a plant-based diet is the way to go.\"\u003c/p>\n\u003cp>On Forum, he argued strongly against processed foods. \"As far as a daily diet goes,\" he said, \"the reason that plants are better than processed foods is that they're real, they have one ingredient ... we know what's in them.\"\u003c/p>\n\u003cp>Animal products, he pointed out, are full of nutrients, but we eat \"way too much of them,\" around 600 pounds per person annually in the U.S.\u003c/p>\n\u003cp>Not only are all those animal products bad for your health, it's \"not sustainable environmentally,\" he added.\u003c/p>\n\u003cp>His approach is alluring, since he's allowing freedom from rules. \"I like to punctuate my day with a nice meal and a glass or three or wine,\" he joked. \"And I like to stop thinking about rules ... when I'm done working. Dinner does that for me.\" He pointed out that plenty of research shows that eating your big meal in the middle of the day is likely better for you, but that \"doesn't work for me.\"\u003c/p>\n\u003cp>By now you might be wondering how you would actually put this into action. On Forum, he easily listed three dishes, each endlessly variable, that even a basic cook could whip up:\u003c/p>\n\u003col>\n\u003cli>\u003cstrong>Rice and beans\u003c/strong>: He described a recent meal of brown rice, chick peas, chopped kale and stir-frying it with jalapeno and cilantro. \"It was really fantastic. That was a great lunch,\" he enthused. (Note that he specified whole grain rice.)\u003c/li>\n\u003cli>\u003cstrong>Chopped salad\u003c/strong>. Just take things out of your fridge, \"start chopping them up, put them in a bowl, you're in business.\"\u003c/li>\n\u003cli>\u003cstrong>Stir fry\u003c/strong>. \"Instead of having center-of-the-plate meat, you're having two ounces of meat per person -- or even less -- a much more moderate amount, mixed with vegetables in a style most people like.\"\u003c/li>\n\u003c/ol>\n\u003cp>A caller asked where to begin if you're cooking for a family. He advised starting with breakfast, getting rid of \"everything that is not a whole-grain alternative.\" He recommended smoothies with fruit and soy milk or almond milk, oatmeal with \"stuff in it, whatever reasonable thing you want,\" or a fruit salad.\u003c/p>\n\u003cp>But even with his suggestions, he said \"everybody's got to ... tinker with this a bit.\"\u003c/p>\n\u003cp>\"It's just a strategy, but it's not the only strategy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mark Bittman on Forum:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201305090900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201305090900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Editor's Note: In a world where random violence seems to be a constant threat, it can feel like we're on our own, unprotected and unsupported. As part of our occasional series \"\u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story\u003c/a>,\" Sheila Jumping Bull of Oakland describes how she found strength and solace from a spiritual ceremony called \"Wiping of the Tears.\"\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Sheila Jumping Bull\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12218\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/19/native-american-woman-finds-strength-in-spiritual-ceremony/shielajumping-bull_shukakalantari/\" rel=\"attachment wp-att-12218\">\u003cimg class=\"size-medium wp-image-12218\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/ShielaJumping-Bull_ShukaKalantari-300x225.jpg\" alt=\"Shiela Jumping-Bull records her commentary in a KQED studio as part of the "What's Your Story?" series.\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shiela Jumping-Bull records her commentary in a KQED studio as part of the \"What's Your Story?\" series. (Shuka Kalantari/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Two years ago I was shot in my leg while waiting for the bus. I was in the wrong place at the wrong time. After being shot, I was told that I would never walk again, or that if I did, I'd have to walk with a cane. Being that I had to stay in bed for three months straight, not being able to walk or hold my own baby or do anything for myself, I became depressed. I didn't want anything to do with life. Mentally, I was not here. I couldn't believe what was going on. I was angry, confused and hurt.\u003c/p>\n\u003cp>We have a medicine man that comes to our Native community, once a month. He does ceremonies, sweat lodges, talking circles. He did a ceremony called Wiping of the Tears. I didn't want to participate in this ceremony, but a lot of people from the Native American community told me that I should because it would help me.\u003c/p>\n\u003caside class=\"pullquote alignright\">As I prayed and as these songs were being sung, I could feel my spirit coming back.\u003c/aside>\n\u003cp>A Wiping of the Tears ceremony is where you call upon your ancestors and those who have passed before you to come and help heal you -- and take away your pain. As the medicine man sings these songs, these sacred songs, these ceremonial songs, you pray, and you ask for their guidance, their strength, their love, and their help.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It helped me in my mental state because I was going through a really hard time, and I felt lost. As I prayed and as these songs were being sung, I could feel my spirit coming back, I could feel my mentality coming back, I could feel myself being Sheila again -- and not some victim.\u003c/p>\n\u003cp>When I think about it, the Wiping of the Tears ceremony really brought me back to reality. It helped me to start building my life over again and to build my courage and strength up to start trying to help others. I feel like I am me again.\u003c/p>\n\u003cp>I feel determined to let the Native American Community know more about mental health, and that it's okay to be diagnosed with a mental health issue or to be on medication. It does not mean you are crazy.\u003c/p>\n\u003cp>Thanks to the ceremony -- and the strength I got from the ancestors -- I am ready to get my life back and get back to my life.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Jumping Bull's Story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201304190850b.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201304190850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "Two years ago I was shot in my leg while waiting for the bus. I was in the wrong place at the wrong time. After being shot, I was told that I would never walk again, or that if I did, I'd have to walk with a cane. Being that I had to stay in bed for three months straight, not being able to walk or hold my own baby or do anything for myself, I became depressed. I didn't want anything to do with life. Mentally, I was not here. I couldn't believe what was going on. I was angry, confused and hurt.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's Note: In a world where random violence seems to be a constant threat, it can feel like we're on our own, unprotected and unsupported. As part of our occasional series \"\u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story\u003c/a>,\" Sheila Jumping Bull of Oakland describes how she found strength and solace from a spiritual ceremony called \"Wiping of the Tears.\"\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Sheila Jumping Bull\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12218\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/19/native-american-woman-finds-strength-in-spiritual-ceremony/shielajumping-bull_shukakalantari/\" rel=\"attachment wp-att-12218\">\u003cimg class=\"size-medium wp-image-12218\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/ShielaJumping-Bull_ShukaKalantari-300x225.jpg\" alt=\"Shiela Jumping-Bull records her commentary in a KQED studio as part of the "What's Your Story?" series.\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shiela Jumping-Bull records her commentary in a KQED studio as part of the \"What's Your Story?\" series. (Shuka Kalantari/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Two years ago I was shot in my leg while waiting for the bus. I was in the wrong place at the wrong time. After being shot, I was told that I would never walk again, or that if I did, I'd have to walk with a cane. Being that I had to stay in bed for three months straight, not being able to walk or hold my own baby or do anything for myself, I became depressed. I didn't want anything to do with life. Mentally, I was not here. I couldn't believe what was going on. I was angry, confused and hurt.\u003c/p>\n\u003cp>We have a medicine man that comes to our Native community, once a month. He does ceremonies, sweat lodges, talking circles. He did a ceremony called Wiping of the Tears. I didn't want to participate in this ceremony, but a lot of people from the Native American community told me that I should because it would help me.\u003c/p>\n\u003caside class=\"pullquote alignright\">As I prayed and as these songs were being sung, I could feel my spirit coming back.\u003c/aside>\n\u003cp>A Wiping of the Tears ceremony is where you call upon your ancestors and those who have passed before you to come and help heal you -- and take away your pain. As the medicine man sings these songs, these sacred songs, these ceremonial songs, you pray, and you ask for their guidance, their strength, their love, and their help.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It helped me in my mental state because I was going through a really hard time, and I felt lost. As I prayed and as these songs were being sung, I could feel my spirit coming back, I could feel my mentality coming back, I could feel myself being Sheila again -- and not some victim.\u003c/p>\n\u003cp>When I think about it, the Wiping of the Tears ceremony really brought me back to reality. It helped me to start building my life over again and to build my courage and strength up to start trying to help others. I feel like I am me again.\u003c/p>\n\u003cp>I feel determined to let the Native American Community know more about mental health, and that it's okay to be diagnosed with a mental health issue or to be on medication. It does not mean you are crazy.\u003c/p>\n\u003cp>Thanks to the ceremony -- and the strength I got from the ancestors -- I am ready to get my life back and get back to my life.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Jumping Bull's Story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201304190850b.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201304190850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>You've heard of group therapy for mental health issues, how about physical conditions?\u003c/strong>\u003c/p>\n\u003cp>By Michelle Andrews, \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/031913-Michelle-Andrews-on-group-patient-appointments.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11535\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/21/sometimes-three-isnt-a-crowd-group-appointments-with-doctors/paper-people-khn/\" rel=\"attachment wp-att-11535\">\u003cimg class=\"size-full wp-image-11535\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/paper-people-KHN.jpg\" alt=\"(Courtesy: Kaiser Health News)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>When visiting the doctor, there may be strength in numbers.\u003c/p>\n\u003cp>A growing number of doctors have begun holding group appointments -- seeing up to a dozen patients with similar medical concerns all at once. Advocates of the approach say such visits allow doctors to treat more patients, spend more time with them (even if not one-on-one), increase appointment availability and improve health outcomes.\u003c/p>\n\u003cp>Some of the most successful shared appointments bring together patients with the same chronic condition, such as diabetes or heart disease. For example, in a diabetes group visit, a doctor might ask everyone to remove their shoes so he can examine their feet for sores or signs of infection, among other things. A typical session lasts up to two hours. In addition to answering questions and examining patients, the doctor often leads a discussion, often assisted by a nurse.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We tell people, 'You don't have to say anything,' But give them 10 minutes, and they're talking about their sex lives.\"\u003c/aside>\n\u003cp>Insurance typically covers a group appointment just as it would an individual appointment -- no change in the co-pay amount. Insurers generally focus on the level of care provided rather than where it's provided or how many people are in the room, says Edward Noffsinger, who consults about group visits. (His website is even called \u003ca href=\"http://www.groupvisits.com\" target=\"_blank\">groupvisits.com\u003c/a>.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some patients say there are advantages to the group setting. \"Patients like the diversity of issues discussed,\" Noffsinger says. \"And they like getting 2 hours with their doctor.\"\u003c!--more-->\u003c/p>\n\u003cp>Patients sign an agreement promising not to disclose what they discuss at the meeting. Although some patients are initially hesitant about the approach, doctors say their shyness generally evaporates quickly.\u003c/p>\n\u003cp>\"We tell people, 'You don't have to say anything,' \" says Edward Shahady, with the Florida Academy of Family Physicians Foundation in Jacksonville. \"But give them 10 minutes, and they're talking about their sex lives.\" Shahady trains medical residents and doctors to conduct group visits with diabetes patients.\u003c/p>\n\u003cp>Though group appointments may allow doctors to increase the number of patients they see and thereby boost their income, many doctors are uncomfortable with the concept, experts say, because they're used to taking a more authoritative approach with patients rather than facilitating a discussion with them.\u003c/p>\n\u003cp>According to the American Academy of Family Physicians, 12.7 percent of family physicians conducted group visits in 2010, up from 5.7 percent in 2005.\u003c/p>\n\u003cp>Doctors say patients may learn more from each other than they do from physicians. \"Patients really want to hear what others patients are experiencing, \" Shahady says.\u003c/p>\n\u003cp>Jake Padilla of Westminster, Colo., participated in his first group visit more than a decade ago, shortly after he had heart bypass surgery.\u003c/p>\n\u003cp>Padilla, now 67, continued to attend group appointments geared to primary-care patients' concerns for years after that at the Kaiser Permanente outpatient clinic near his home. He usually went once a month or so, and the members of the group constantly changed.\u003c/p>\n\u003cp>One woman who attended the group was 102 years old, he remembers. Fellow patients wanted to know how she managed to live that long. One of her secrets, she said, was deep breathing. Padilla has since used that advice when his blood pressure gets out of control.\u003c/p>\n\u003cp>But group visits aren't for everyone. Padilla's wife, Tedi, went to one meeting with him and never went back.\u003c/p>\n\u003cp>\"She said she didn't have time to sit there and listen to all those patients,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced by Kaiser Health News with support from \u003ca href=\"http://www.thescanfoundation.org/\">The SCAN Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "When visiting the doctor, there may be strength in numbers.\r\n\r\nA growing number of doctors have begun holding group appointments -- seeing up to a dozen patients with similar medical concerns all at once. Advocates of the approach say such visits allow doctors to treat more patients, spend more time with them (even if not one-on-one), increase appointment availability and improve health outcomes.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>You've heard of group therapy for mental health issues, how about physical conditions?\u003c/strong>\u003c/p>\n\u003cp>By Michelle Andrews, \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/031913-Michelle-Andrews-on-group-patient-appointments.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11535\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/21/sometimes-three-isnt-a-crowd-group-appointments-with-doctors/paper-people-khn/\" rel=\"attachment wp-att-11535\">\u003cimg class=\"size-full wp-image-11535\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/paper-people-KHN.jpg\" alt=\"(Courtesy: Kaiser Health News)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>When visiting the doctor, there may be strength in numbers.\u003c/p>\n\u003cp>A growing number of doctors have begun holding group appointments -- seeing up to a dozen patients with similar medical concerns all at once. Advocates of the approach say such visits allow doctors to treat more patients, spend more time with them (even if not one-on-one), increase appointment availability and improve health outcomes.\u003c/p>\n\u003cp>Some of the most successful shared appointments bring together patients with the same chronic condition, such as diabetes or heart disease. For example, in a diabetes group visit, a doctor might ask everyone to remove their shoes so he can examine their feet for sores or signs of infection, among other things. A typical session lasts up to two hours. In addition to answering questions and examining patients, the doctor often leads a discussion, often assisted by a nurse.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We tell people, 'You don't have to say anything,' But give them 10 minutes, and they're talking about their sex lives.\"\u003c/aside>\n\u003cp>Insurance typically covers a group appointment just as it would an individual appointment -- no change in the co-pay amount. Insurers generally focus on the level of care provided rather than where it's provided or how many people are in the room, says Edward Noffsinger, who consults about group visits. (His website is even called \u003ca href=\"http://www.groupvisits.com\" target=\"_blank\">groupvisits.com\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some patients say there are advantages to the group setting. \"Patients like the diversity of issues discussed,\" Noffsinger says. \"And they like getting 2 hours with their doctor.\"\u003c!--more-->\u003c/p>\n\u003cp>Patients sign an agreement promising not to disclose what they discuss at the meeting. Although some patients are initially hesitant about the approach, doctors say their shyness generally evaporates quickly.\u003c/p>\n\u003cp>\"We tell people, 'You don't have to say anything,' \" says Edward Shahady, with the Florida Academy of Family Physicians Foundation in Jacksonville. \"But give them 10 minutes, and they're talking about their sex lives.\" Shahady trains medical residents and doctors to conduct group visits with diabetes patients.\u003c/p>\n\u003cp>Though group appointments may allow doctors to increase the number of patients they see and thereby boost their income, many doctors are uncomfortable with the concept, experts say, because they're used to taking a more authoritative approach with patients rather than facilitating a discussion with them.\u003c/p>\n\u003cp>According to the American Academy of Family Physicians, 12.7 percent of family physicians conducted group visits in 2010, up from 5.7 percent in 2005.\u003c/p>\n\u003cp>Doctors say patients may learn more from each other than they do from physicians. \"Patients really want to hear what others patients are experiencing, \" Shahady says.\u003c/p>\n\u003cp>Jake Padilla of Westminster, Colo., participated in his first group visit more than a decade ago, shortly after he had heart bypass surgery.\u003c/p>\n\u003cp>Padilla, now 67, continued to attend group appointments geared to primary-care patients' concerns for years after that at the Kaiser Permanente outpatient clinic near his home. He usually went once a month or so, and the members of the group constantly changed.\u003c/p>\n\u003cp>One woman who attended the group was 102 years old, he remembers. Fellow patients wanted to know how she managed to live that long. One of her secrets, she said, was deep breathing. Padilla has since used that advice when his blood pressure gets out of control.\u003c/p>\n\u003cp>But group visits aren't for everyone. Padilla's wife, Tedi, went to one meeting with him and never went back.\u003c/p>\n\u003cp>\"She said she didn't have time to sit there and listen to all those patients,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced by Kaiser Health News with support from \u003ca href=\"http://www.thescanfoundation.org/\">The SCAN Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mammograms: Which Women? How Often?",
"title": "Mammograms: Which Women? How Often?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations almost four years ago from the U.S. Preventive Services Task Force that mammograms are \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">not routinely recommended\u003c/a> for them. Instead, the decision is an \"individual one\" that a woman can make, presumably in conversation with her doctor.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1669103\" target=\"_blank\">a new study\u003c/a> has a tailored recommendation. For women in their 40s with \"extremely dense breasts,\" annual screening will reduce their risk of being diagnosed with advanced stage breast cancer.\u003c/p>\n\u003cp>\"There is this sub-group that is higher risk and has more aggressive tumors,\" said lead researcher Karla Kerlikowske, an epidemiologist and biostatistician at UCSF. \"Annual mammography is probably better for that group.\"\u003c/p>\n\u003cp>To date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too, like breast density. About 12 to 15 percent of women in their 40s have \"extremely dense breasts.\" Radiologists categorize breast density on a scale of 1 to 4, and a score of 4 is \"extremely dense.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But women with dense breasts are also at higher risk of false positives and may need to go through additional imaging and unnecessary biopsies. How much? The researchers report that women with extremely dense breasts have a 65.5 percent likelihood of a false positive over a ten year period. Still, \"annual screening has added benefit to detect breast cancer at an earlier stage\" than screening every other year, the researchers write.\u003c/p>\n\u003cp>(As an aside: if you're a woman in your 40s with doctor-diagnosed \"extremely dense breasts,\" then your risk of breast cancer matches that of an average-risk woman in her 50s, according to the analysis.)\u003c/p>\n\u003cp>In the study, published in this week's JAMA Internal Medicine, researchers looked at nearly one million women -- more than 11,000 women with breast cancer and more than 900,000 without breast cancer, all of whom had mammograms.\u003c/p>\n\u003cp>Researchers also looked at women who used hormone therapy after menopause. Hormone therapy has been shown to increase a woman's risk of breast cancer. For women ages 50-74, even for women with dense breasts or hormone therapy use, annual screening made no difference.\u003c/p>\n\u003cp>\"They could be screened every two years and have the same benefit as being screened every year and fewer harms from mammography,\" Kerlikowske said.\u003c/p>\n\u003cp>Those harms can be common. If you're a woman in the 50-74 group, with less dense breasts (a \"2\" scored by a radiologist), and do not take hormone therapy, your risk of a false positive after ten years of annual mammography is 49.8 percent. The likelihood of a false positive falls to 30.7 percent if a woman is having a mammogram every other year.\u003c/p>\n\u003cp>In a \u003ca href=\"http://annfammed.org/content/11/2/106.full\" target=\"_blank\">separate study\u003c/a> this week, researchers found that these false positives lead to \"long-term psychosocial harm\" for many women.\u003c/p>\n\u003cp>It's unlikely that recommendations will be changed based on this study. The American Cancer Society offers\u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> different recommendations\u003c/a> than the U.S. Preventive Services Task Force. The ACS continues to recommend an annual mammogram for women beginning at age 40. The group's chief medical officer, Dr. Otis Brawley says he doesn't \"see us changing right now.\"\u003c/p>\n\u003cp>But he also said he could foresee a time of targeted recommendations for women-- not just for having mammograms more frequently, but less frequently, too.\u003c/p>\n\u003cp>\"I think we are moving toward a period of time,\" Brawley said, \"where we will identify through a bunch of questions that involve family history, age, density of breast tissue ... whether one is menopausal or not menopausal, and we're going to have a group of women who will be in their 50s, and we will tell them you ought to have a mammogram every three years.\"\u003c/p>\n\u003cp>He added there could be a group that needs mammograms annually and a very targeted group that might need to be screened even more frequently.\u003c/p>\n\u003cp>\u003cstrong>New law takes effect April 1st\u003c/strong>\u003c/p>\n\u003cp>The study comes just as\u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_1501-1550/sb_1538_bill_20120922_chaptered.pdf\" target=\"_blank\"> a new law\u003c/a> is scheduled to take effect in California. Starting April 1st, radiologists will be required to notify women if they have heterogeneously dense or extremely dense breast tissue (category 3 or 4). Radiologists already send women a report after their mammogram; they would add this information to that letter.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The law passed with overwhelming support in the California legislature, but Brawley says aside from extremely dense breasts, that breast density is a subjective measure. UCSF's Kerlikowske says she thinks the \"law is ahead of the science,\" because there's no data showing that other kinds of screening tests, such as ultrasound or MRI, have any benefit for these women.\u003c/p>\n\n",
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"excerpt": "As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations four years ago from the US Preventive Services Task Force that mammograms are not routinely recommended for them. Instead, the decision is an \"individual one\" that a woman can make, presumably in conversation with her doctor.\r\n\r\nTo date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too. In particular, women with dense breasts are at higher risk for cancer. Now a new study, led by researchers at UCSF have looked specifically at breast density and how what doctors call the \"screening interval\" of mammograms might affect their risk of being diagnosed with advanced breast cancer.",
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"description": "As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations four years ago from the US Preventive Services Task Force that mammograms are not routinely recommended for them. Instead, the decision is an "individual one" that a woman can make, presumably in conversation with her doctor.\r\n\r\nTo date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too. In particular, women with dense breasts are at higher risk for cancer. Now a new study, led by researchers at UCSF have looked specifically at breast density and how what doctors call the "screening interval" of mammograms might affect their risk of being diagnosed with advanced breast cancer.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>As everybody knows by now, how frequently a woman should have a mammogram is a topic of hot debate in the U.S. In particular, women in their 40s have been troubled by recommendations almost four years ago from the U.S. Preventive Services Task Force that mammograms are \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">not routinely recommended\u003c/a> for them. Instead, the decision is an \"individual one\" that a woman can make, presumably in conversation with her doctor.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1669103\" target=\"_blank\">a new study\u003c/a> has a tailored recommendation. For women in their 40s with \"extremely dense breasts,\" annual screening will reduce their risk of being diagnosed with advanced stage breast cancer.\u003c/p>\n\u003cp>\"There is this sub-group that is higher risk and has more aggressive tumors,\" said lead researcher Karla Kerlikowske, an epidemiologist and biostatistician at UCSF. \"Annual mammography is probably better for that group.\"\u003c/p>\n\u003cp>To date, most recommendations have relied on one risk factor: age. A woman's risk of breast cancer increases as she gets older. But there are other risk factors, too, like breast density. About 12 to 15 percent of women in their 40s have \"extremely dense breasts.\" Radiologists categorize breast density on a scale of 1 to 4, and a score of 4 is \"extremely dense.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But women with dense breasts are also at higher risk of false positives and may need to go through additional imaging and unnecessary biopsies. How much? The researchers report that women with extremely dense breasts have a 65.5 percent likelihood of a false positive over a ten year period. Still, \"annual screening has added benefit to detect breast cancer at an earlier stage\" than screening every other year, the researchers write.\u003c/p>\n\u003cp>(As an aside: if you're a woman in your 40s with doctor-diagnosed \"extremely dense breasts,\" then your risk of breast cancer matches that of an average-risk woman in her 50s, according to the analysis.)\u003c/p>\n\u003cp>In the study, published in this week's JAMA Internal Medicine, researchers looked at nearly one million women -- more than 11,000 women with breast cancer and more than 900,000 without breast cancer, all of whom had mammograms.\u003c/p>\n\u003cp>Researchers also looked at women who used hormone therapy after menopause. Hormone therapy has been shown to increase a woman's risk of breast cancer. For women ages 50-74, even for women with dense breasts or hormone therapy use, annual screening made no difference.\u003c/p>\n\u003cp>\"They could be screened every two years and have the same benefit as being screened every year and fewer harms from mammography,\" Kerlikowske said.\u003c/p>\n\u003cp>Those harms can be common. If you're a woman in the 50-74 group, with less dense breasts (a \"2\" scored by a radiologist), and do not take hormone therapy, your risk of a false positive after ten years of annual mammography is 49.8 percent. The likelihood of a false positive falls to 30.7 percent if a woman is having a mammogram every other year.\u003c/p>\n\u003cp>In a \u003ca href=\"http://annfammed.org/content/11/2/106.full\" target=\"_blank\">separate study\u003c/a> this week, researchers found that these false positives lead to \"long-term psychosocial harm\" for many women.\u003c/p>\n\u003cp>It's unlikely that recommendations will be changed based on this study. The American Cancer Society offers\u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> different recommendations\u003c/a> than the U.S. Preventive Services Task Force. The ACS continues to recommend an annual mammogram for women beginning at age 40. The group's chief medical officer, Dr. Otis Brawley says he doesn't \"see us changing right now.\"\u003c/p>\n\u003cp>But he also said he could foresee a time of targeted recommendations for women-- not just for having mammograms more frequently, but less frequently, too.\u003c/p>\n\u003cp>\"I think we are moving toward a period of time,\" Brawley said, \"where we will identify through a bunch of questions that involve family history, age, density of breast tissue ... whether one is menopausal or not menopausal, and we're going to have a group of women who will be in their 50s, and we will tell them you ought to have a mammogram every three years.\"\u003c/p>\n\u003cp>He added there could be a group that needs mammograms annually and a very targeted group that might need to be screened even more frequently.\u003c/p>\n\u003cp>\u003cstrong>New law takes effect April 1st\u003c/strong>\u003c/p>\n\u003cp>The study comes just as\u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_1501-1550/sb_1538_bill_20120922_chaptered.pdf\" target=\"_blank\"> a new law\u003c/a> is scheduled to take effect in California. Starting April 1st, radiologists will be required to notify women if they have heterogeneously dense or extremely dense breast tissue (category 3 or 4). Radiologists already send women a report after their mammogram; they would add this information to that letter.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The law passed with overwhelming support in the California legislature, but Brawley says aside from extremely dense breasts, that breast density is a subjective measure. UCSF's Kerlikowske says she thinks the \"law is ahead of the science,\" because there's no data showing that other kinds of screening tests, such as ultrasound or MRI, have any benefit for these women.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_11271\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/11/the-doctor-will-see-you-now-virtually/screen-shot-2013-02-01-at-2-51-53-pm/\" rel=\"attachment wp-att-11271\">\u003cimg class=\"size-medium wp-image-11271\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-02-01-at-2.51.53-PM-300x177.png\" alt=\"A demonstration of CareSimple's virtual house call.\" width=\"300\" height=\"177\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A demonstration of CareSimple's virtual house call.\u003c/figcaption>\u003c/figure>\n\u003cp>Remember the really old days of house calls? A kindly doctor with a black bag would come to your house and treat your (often minor) complaint?\u003c/p>\n\u003cp>Frankly, I don't remember those days either. But I have heard of the house call, and now Carena, a Seattle-based company, is expanding into California with a 21st century house call -- a virtual house call.\u003c/p>\n\u003cp>It works like this: like everything these days, you first create an account. When you need care, you log on and request a visit. Within 30 minutes, Carena says, a doctor or nurse practitioner will contact you by phone or email (your choice). If it's email, you will get a link to a secure \"virtual exam room.\" (The man in the photo above is Dr. Ben Green, in a virtual exam room.)\u003c/p>\n\u003cp>From there you are diagnosed. If you need a prescription, CareSimple says its doctors are licensed in California and can phone in a prescription to your pharmacy. The service is $25/month with a $5 per visit fee. Or you can pay for a single visit, without the membership. That's $85.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Carena's CEO Ralph Derrickson says this kind of service is driven by several factors, not the least of which is technological advancement which permits secure video conferencing. But Derrickson also points out that the prevalence of high-deductible health plans, sometimes $5,000, makes a service like CareSimple appealing financially.\u003c/p>\n\u003cp>\"The way health care is getting paid for is changing,\" Derrickson says. \"The reality is that what used to be a $25 co-pay, in 2013 is becoming a $250 encounter. … We’re less expensive and done on your terms.”\u003c/p>\n\u003cp>And a visit to the ER can easily run over $1,000, which Derrickson says CareSimple can help clients avoid. If not, and a CareSimple doctor or nurse needs to refer you to the ER, then there's no charge for the CareSimple visit.\u003c/p>\n\u003cp>Dr. Sophia Chang is skeptical. She's with the California HealthCare Foundation and a practicing internist at San Francisco General Hospital. She wondered if this was a higher cost version of the nurse advice line and fretted about continuity of care, something which is already a challenge in American medicine.\u003c/p>\n\u003cp>\"It’s great to be able to answer primary style medical questions quickly at the convenience of the consumer,\" Chang says. \"The problem is that when it may be something that requires more than simple triage. There’s no mechnamism to link this to any testing. It’s all phone interaction or video interaction.\"\u003c/p>\n\u003cp>Derrickson and Green say the company's statistics show that more than 80 percent of the time, they are able to resolve a visit with advice or prescription.\u003c/p>\n\u003cp>Green says the company has been in business for several years in Washington state, and they've learned well what they can and cannot manage. \"We’ve developed skills, we’ve developed clinical protocols,\" he says. \"Our providers are a local group that we train independently here, and we focus on all the conditions that we are safely and effectively going to manage.\"\u003c/p>\n\u003cp>He specifies sinus infections, urinary tract infections, stomach viruses, flu and rashes, as common conditions CareSimple doctors can safely manage.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They say all the doctors with the service are board certified, and their patient satisfaction rates in Washington have been greater than 95 percent.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_11271\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/11/the-doctor-will-see-you-now-virtually/screen-shot-2013-02-01-at-2-51-53-pm/\" rel=\"attachment wp-att-11271\">\u003cimg class=\"size-medium wp-image-11271\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-02-01-at-2.51.53-PM-300x177.png\" alt=\"A demonstration of CareSimple's virtual house call.\" width=\"300\" height=\"177\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A demonstration of CareSimple's virtual house call.\u003c/figcaption>\u003c/figure>\n\u003cp>Remember the really old days of house calls? A kindly doctor with a black bag would come to your house and treat your (often minor) complaint?\u003c/p>\n\u003cp>Frankly, I don't remember those days either. But I have heard of the house call, and now Carena, a Seattle-based company, is expanding into California with a 21st century house call -- a virtual house call.\u003c/p>\n\u003cp>It works like this: like everything these days, you first create an account. When you need care, you log on and request a visit. Within 30 minutes, Carena says, a doctor or nurse practitioner will contact you by phone or email (your choice). If it's email, you will get a link to a secure \"virtual exam room.\" (The man in the photo above is Dr. Ben Green, in a virtual exam room.)\u003c/p>\n\u003cp>From there you are diagnosed. If you need a prescription, CareSimple says its doctors are licensed in California and can phone in a prescription to your pharmacy. The service is $25/month with a $5 per visit fee. Or you can pay for a single visit, without the membership. That's $85.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Carena's CEO Ralph Derrickson says this kind of service is driven by several factors, not the least of which is technological advancement which permits secure video conferencing. But Derrickson also points out that the prevalence of high-deductible health plans, sometimes $5,000, makes a service like CareSimple appealing financially.\u003c/p>\n\u003cp>\"The way health care is getting paid for is changing,\" Derrickson says. \"The reality is that what used to be a $25 co-pay, in 2013 is becoming a $250 encounter. … We’re less expensive and done on your terms.”\u003c/p>\n\u003cp>And a visit to the ER can easily run over $1,000, which Derrickson says CareSimple can help clients avoid. If not, and a CareSimple doctor or nurse needs to refer you to the ER, then there's no charge for the CareSimple visit.\u003c/p>\n\u003cp>Dr. Sophia Chang is skeptical. She's with the California HealthCare Foundation and a practicing internist at San Francisco General Hospital. She wondered if this was a higher cost version of the nurse advice line and fretted about continuity of care, something which is already a challenge in American medicine.\u003c/p>\n\u003cp>\"It’s great to be able to answer primary style medical questions quickly at the convenience of the consumer,\" Chang says. \"The problem is that when it may be something that requires more than simple triage. There’s no mechnamism to link this to any testing. It’s all phone interaction or video interaction.\"\u003c/p>\n\u003cp>Derrickson and Green say the company's statistics show that more than 80 percent of the time, they are able to resolve a visit with advice or prescription.\u003c/p>\n\u003cp>Green says the company has been in business for several years in Washington state, and they've learned well what they can and cannot manage. \"We’ve developed skills, we’ve developed clinical protocols,\" he says. \"Our providers are a local group that we train independently here, and we focus on all the conditions that we are safely and effectively going to manage.\"\u003c/p>\n\u003cp>He specifies sinus infections, urinary tract infections, stomach viruses, flu and rashes, as common conditions CareSimple doctors can safely manage.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They say all the doctors with the service are board certified, and their patient satisfaction rates in Washington have been greater than 95 percent.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Wounded Veterans Find Comfort, Hope in Cooking Class",
"title": "Wounded Veterans Find Comfort, Hope in Cooking Class",
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"content": "\u003cp>\u003cstrong>By Mina Kim\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_11242\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4123_photo_kronmark_fish/\" rel=\"attachment wp-att-11242\">\u003cimg class=\"size-medium wp-image-11242\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4123_photo_Kronmark_fish-300x225.jpg\" alt=\"Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day "boot camp" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day \"boot camp\" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>In a stainless-steel teaching kitchen deep within the old stone walls of the elite Culinary Institute of America in Napa Valley, acclaimed chef Lars Kronmark pulls a piece of fat from the cavity of a raw, whole chicken.\u003c/p>\n\u003cp>“A big chunk of fat like that, it doesn’t really hurt to leave it in there,” Kronmark said. “But in the end of the day, that’s still going to be too much fat.”\u003c/p>\n\u003cp>It looks like a standard cooking class. But this is an unusual class for an unusual group of students. It’s a healthy cooking “boot camp” designed for wounded veterans of the Iraq and Afghanistan wars with a goal of helping veterans connect with each other and learn to eat healthier.\u003c/p>\n\u003cp>Six military veterans and their spouses dressed in white chef’s coats and hats watch Kronmark closely. His healthy cooking techniques are welcome tips to the group of 12, including veteran James McQuoid, who lives with post-traumatic stress disorder.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I’m of the larger variety,” McQuoid said. “A couple years ago, I didn’t care about my health. I was very reclusive and what not, but through therapy and stuff I’ve come to realize — I’ve got a younger child — I want to be around a bit longer, and I’m really not helping myself at all.”\u003c/p>\n\u003cfigure id=\"attachment_11245\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4121_photo_dinner-served/\" rel=\"attachment wp-att-11245\">\u003cimg class=\"size-medium wp-image-11245\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4121_photo_dinner-served-300x225.jpg\" alt=\"A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Federal officials estimate more than 70 percent of the veterans receiving care in the VA are overweight or obese. McQuoid’s doctor recommended he get more omega-3 fatty acids by eating fish instead of fatty meats.\u003c/p>\n\u003cp>“But I didn’t know how to cook fish,” McQuoid said. “After being here though, I can cook fish!”\u003c/p>\n\u003cp>The four-day boot camp is a program of the Wounded Warrior Project, a nonprofit that serves injured veterans transitioning to civilian life. The camp’s days begin with lectures on subjects like the physiology of taste and end with vets and their partners preparing dishes for dinner. Today’s menu includes roast chicken with lemon and rosemary, Baja fish tacos, and pork loin cooked in a pomegranate glaze.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Invisible Wounds\u003c/strong>\u003c/p>\n\u003cp>Yet, the program is playing a much bigger role than helping veterans eat better. Julia Valentour, health and wellness coordinator at the Wounded Warrior Project’s San Diego office, said there’s a waiting list for the classes that often helps veterans break through the isolation they feel when they return from war.\u003c/p>\n\u003cp>“I don’t think people realize what [veterans] go through and how much they sacrifice for us,” Valentour said. “You’re not hearing about the war on TV everyday, so you tend to forget that it’s still going on.”\u003c/p>\n\u003cp>At one cooking station a young man in a wheelchair with prosthetic legs, quietly peels sweet potatoes. Another veteran purses his lips in concentration as he chops cilantro using only one hand. But for many of the veterans, their wounds are not visible.\u003c/p>\n\u003cp>Tiffany Rush-Green who flew in from Phoenix for the class with her husband Yancy Green, a Marine, said this is the first time she’s seen her husband smile in a long time.\u003c/p>\n\u003cp>“Finally we can do something together, and take our time and just be a team so we can find that common ground,” Rush-Green said. “I am not a veteran, so a lot of times I can’t relate to him on certain issues, but cooking I think we’re going to be able to relate to each other on.”\u003c/p>\n\u003cp>Yancy Green said his wife is happy because she won’t have to do all the cooking anymore.\u003c/p>\n\u003cp>“I have no more excuses after this week,” he said.\u003c/p>\n\u003cp>For Renee Hampton and her husband — who asked not to give his name because he’s on active duty — being here is a dream come true. Hampton said her husband learned to cook when he was five and always wanted to be a chef, but chemicals used in the war robbed him of his ability to smell and taste. Still, it hasn’t dampened his experience in the class.\u003c/p>\n\u003cp>“I absolutely love this,” he said. “Besides, all my life, I’ve always wanted one of these [chef] jackets, and now I get one.”\u003c/p>\n\u003cp>For Culinary Institute chef Kronmark, the service members humble him in ways he hasn’t felt before.\u003c/p>\n\u003cp>“Makes you remember how lucky you are,” Kronmark said. “It’s really amazing.”\u003c/p>\n\u003cp>The next class is scheduled for May, and will be for spouses or caregivers of veterans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Mina Kim\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_11242\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4123_photo_kronmark_fish/\" rel=\"attachment wp-att-11242\">\u003cimg class=\"size-medium wp-image-11242\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4123_photo_Kronmark_fish-300x225.jpg\" alt=\"Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day "boot camp" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chef Lars Kronmark teaches veterans how to remove the skin of a fish; part of a four-day \"boot camp\" at Napa's Culinary Institute of America where injured veterans and their spouses learn healthy cooking tips. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>In a stainless-steel teaching kitchen deep within the old stone walls of the elite Culinary Institute of America in Napa Valley, acclaimed chef Lars Kronmark pulls a piece of fat from the cavity of a raw, whole chicken.\u003c/p>\n\u003cp>“A big chunk of fat like that, it doesn’t really hurt to leave it in there,” Kronmark said. “But in the end of the day, that’s still going to be too much fat.”\u003c/p>\n\u003cp>It looks like a standard cooking class. But this is an unusual class for an unusual group of students. It’s a healthy cooking “boot camp” designed for wounded veterans of the Iraq and Afghanistan wars with a goal of helping veterans connect with each other and learn to eat healthier.\u003c/p>\n\u003cp>Six military veterans and their spouses dressed in white chef’s coats and hats watch Kronmark closely. His healthy cooking techniques are welcome tips to the group of 12, including veteran James McQuoid, who lives with post-traumatic stress disorder.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I’m of the larger variety,” McQuoid said. “A couple years ago, I didn’t care about my health. I was very reclusive and what not, but through therapy and stuff I’ve come to realize — I’ve got a younger child — I want to be around a bit longer, and I’m really not helping myself at all.”\u003c/p>\n\u003cfigure id=\"attachment_11245\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/08/wounded-veterans-find-comfort-hope-in-cooking-class/rs4121_photo_dinner-served/\" rel=\"attachment wp-att-11245\">\u003cimg class=\"size-medium wp-image-11245\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/RS4121_photo_dinner-served-300x225.jpg\" alt=\"A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A healthy dinner is served at Napa's Culinary Institute of America healthy-cooking boot camp for injured veterans. (Mina Kim/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Federal officials estimate more than 70 percent of the veterans receiving care in the VA are overweight or obese. McQuoid’s doctor recommended he get more omega-3 fatty acids by eating fish instead of fatty meats.\u003c/p>\n\u003cp>“But I didn’t know how to cook fish,” McQuoid said. “After being here though, I can cook fish!”\u003c/p>\n\u003cp>The four-day boot camp is a program of the Wounded Warrior Project, a nonprofit that serves injured veterans transitioning to civilian life. The camp’s days begin with lectures on subjects like the physiology of taste and end with vets and their partners preparing dishes for dinner. Today’s menu includes roast chicken with lemon and rosemary, Baja fish tacos, and pork loin cooked in a pomegranate glaze.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Invisible Wounds\u003c/strong>\u003c/p>\n\u003cp>Yet, the program is playing a much bigger role than helping veterans eat better. Julia Valentour, health and wellness coordinator at the Wounded Warrior Project’s San Diego office, said there’s a waiting list for the classes that often helps veterans break through the isolation they feel when they return from war.\u003c/p>\n\u003cp>“I don’t think people realize what [veterans] go through and how much they sacrifice for us,” Valentour said. “You’re not hearing about the war on TV everyday, so you tend to forget that it’s still going on.”\u003c/p>\n\u003cp>At one cooking station a young man in a wheelchair with prosthetic legs, quietly peels sweet potatoes. Another veteran purses his lips in concentration as he chops cilantro using only one hand. But for many of the veterans, their wounds are not visible.\u003c/p>\n\u003cp>Tiffany Rush-Green who flew in from Phoenix for the class with her husband Yancy Green, a Marine, said this is the first time she’s seen her husband smile in a long time.\u003c/p>\n\u003cp>“Finally we can do something together, and take our time and just be a team so we can find that common ground,” Rush-Green said. “I am not a veteran, so a lot of times I can’t relate to him on certain issues, but cooking I think we’re going to be able to relate to each other on.”\u003c/p>\n\u003cp>Yancy Green said his wife is happy because she won’t have to do all the cooking anymore.\u003c/p>\n\u003cp>“I have no more excuses after this week,” he said.\u003c/p>\n\u003cp>For Renee Hampton and her husband — who asked not to give his name because he’s on active duty — being here is a dream come true. Hampton said her husband learned to cook when he was five and always wanted to be a chef, but chemicals used in the war robbed him of his ability to smell and taste. Still, it hasn’t dampened his experience in the class.\u003c/p>\n\u003cp>“I absolutely love this,” he said. “Besides, all my life, I’ve always wanted one of these [chef] jackets, and now I get one.”\u003c/p>\n\u003cp>For Culinary Institute chef Kronmark, the service members humble him in ways he hasn’t felt before.\u003c/p>\n\u003cp>“Makes you remember how lucky you are,” Kronmark said. “It’s really amazing.”\u003c/p>\n\u003cp>The next class is scheduled for May, and will be for spouses or caregivers of veterans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201303081630c.xml\">\u003c/embed>\u003c/object>\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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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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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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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "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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},
"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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"order": 16
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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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"snap-judgment": {
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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