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"content": "\u003cp>\u003cstrong>By Mina Kim, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_9388\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Scale_EricaFeliciano_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9388\" title=\"(Erica Feliciano/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Scale_EricaFeliciano_Flickr-300x286.jpg\" alt=\"(Erica Feliciano/Flickr)\" width=\"300\" height=\"286\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Erica Feliciano/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Researchers at the Palo Alto Medical Foundation Research Institute and Stanford University School of Medicine say they have found a cheaper and more practical way to help people lose weight. They're hoping the findings will help reduce the incidence of Type 2 diabetes.\u003c/p>\n\u003cp>Researchers have known for a while, that one-on-one coaching is an effective way to help people lose weight and lower their risk for Type 2 diabetes. But that method can be hard to implement in a doctor's office said Stanford Professor of Medicine Randall Stafford, a researcher who worked on the study.\u003c/p>\n\u003cp>“Lack of time of the doctor, the difficulties in hiring the appropriate staff,” Stafford said. “And then the fact that the type of services are quite expensive.”\u003c/p>\n\u003cp>Stafford and others found two, less intensive programs -- group coaching or take-home DVDs -- led to an average 10 to 15 pounds of weight-loss over a 15-month period. Stafford said that's enough to have a health impact.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“As little as 5 percent loss of body weight can have some major effects in terms of some of the metabolic consequences of obesity,” Stafford said. “Things like hypertension, cholesterol and even diabetes.”\u003c/p>\n\u003cp>Stafford said the approaches could extend the reach and lower the cost of lifestyle intervention programs.\u003c/p>\n\u003cp>There is one caveat. Most of the study volunteers were whites and Asian Americans who were from a single clinic in Silicon Valley. Stafford said he plans to repeat the study with a low-income, Latino population in Santa Cruz.\u003c/p>\n\u003cp>The study was published Monday, in the \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1485081\" target=\"_blank\">Archives of Internal Medicine\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to include Palo Alto Medical Foundation Research Institute as one of the institutions involved in the study.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cfigure id=\"attachment_8324\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/OrganicProduce_SielJu_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8324\" title=\"Organic produce. (Siel Ju: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/OrganicProduce_SielJu_Flickr-300x202.jpg\" alt=\"Organic produce. (Siel Ju: Flickr)\" width=\"300\" height=\"202\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Organic produce. (Siel Ju: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>As Amy Standen reported this morning for KQED, researchers at Stanford University have combed through hundreds of scientific papers, comparing organically-grown produce to conventional. In one important respect, they found very little difference.\u003c/p>\n\u003cp>\u003ca title=\"http://annals.org/article.aspx?articleid=1355685\" href=\"http://annals.org/article.aspx?articleid=1355685\" target=\"_blank\">The study\u003c/a>, published Monday in the Annals of Internal Medicine, didn't ask whether organic fruits and vegetables are better for the environment, or create a safer workplace for farm workers.\u003c/p>\n\u003cp>It didn't ask whether organic foods taste better, or whether trace amounts of pesticides can affect human health over time.\u003c/p>\n\u003cp>Rather, said physician \u003ca title=\"http://healthpolicy.stanford.edu/people/Dena_M_Bravata\" href=\"http://healthpolicy.stanford.edu/people/Dena_M_Bravata\" target=\"_blank\">Dena Bravata\u003c/a>, the study's co-author, the question was:\u003c/p>\n\u003cp>\"What is the evidence that organic and conventional foods differ in either their nutritional benefit or their safety?\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The answer? There isn't much evidence of that at all. Bravata says when it comes to healthfulness, \"there is, in general, not a robust evidence base for the difference between organic and conventional foods.\"\u003c/p>\n\u003cp>Over at NPR, \u003ca title=\"http://www.npr.org/blogs/thesalt/2012/09/04/160395259/why-organic-food-may-not-be-healthier-for-you\" href=\"http://www.npr.org/blogs/thesalt/2012/09/04/160395259/why-organic-food-may-not-be-healthier-for-you\" target=\"_blank\">the Salt blog\u003c/a> added this context:\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>When it comes to their nutritional quality, vegetables vary enormously, and that's true whether they are organic or conventional. One carrot in the grocery store, for instance, may have two or three times more beta carotene (which gives us vitamin A) than its neighbor. That's due to all kinds of things: differences in the genetic makeup of different varieties, the ripeness of the produce when it was picked, even the weather.\u003c/p>\n\u003cp>So there really are vegetables that are more nutritious than others, but the dividing line between them isn't whether or not they are organic. \"You can't use organic as your sole criteria for judging nutritional quality,\" says Smith-Spangler.\u003c/p>\n\u003cp>Of course, people may have other reasons for buying organic food. It's a different style of agriculture. Organic farmers often control pests by growing a greater variety of crops. They increase the fertility of their fields through nitrogen-fixing plants, or by adding compost instead of applying synthetic fertilizer.\u003c/p>\n\u003cp>That can bring environmental benefits, such as more diverse insect life in the field or less fertilizer runoff into neighboring streams. But such methods also cost money. That's part of what you are buying when you buy organic.\u003c/p>\n\u003cp>So if you really want to find the most nutritious vegetables, and the organic label won't take you there, what will?\u003c/p>\n\u003cp>At the moment, unfortunately, there isn't a good guide. But a lot of scientists are working on it.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>In the meantime, Standen reports, children who ate organic produce had less pesticide in their urine than kids who ate conventional produce. But in both groups, pesticide levels were below federal limits.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The answer? There isn't much evidence of that at all. Bravata says when it comes to healthfulness, \"there is, in general, not a robust evidence base for the difference between organic and conventional foods.\"\u003c/p>\n\u003cp>Over at NPR, \u003ca title=\"http://www.npr.org/blogs/thesalt/2012/09/04/160395259/why-organic-food-may-not-be-healthier-for-you\" href=\"http://www.npr.org/blogs/thesalt/2012/09/04/160395259/why-organic-food-may-not-be-healthier-for-you\" target=\"_blank\">the Salt blog\u003c/a> added this context:\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>When it comes to their nutritional quality, vegetables vary enormously, and that's true whether they are organic or conventional. One carrot in the grocery store, for instance, may have two or three times more beta carotene (which gives us vitamin A) than its neighbor. That's due to all kinds of things: differences in the genetic makeup of different varieties, the ripeness of the produce when it was picked, even the weather.\u003c/p>\n\u003cp>So there really are vegetables that are more nutritious than others, but the dividing line between them isn't whether or not they are organic. \"You can't use organic as your sole criteria for judging nutritional quality,\" says Smith-Spangler.\u003c/p>\n\u003cp>Of course, people may have other reasons for buying organic food. It's a different style of agriculture. Organic farmers often control pests by growing a greater variety of crops. They increase the fertility of their fields through nitrogen-fixing plants, or by adding compost instead of applying synthetic fertilizer.\u003c/p>\n\u003cp>That can bring environmental benefits, such as more diverse insect life in the field or less fertilizer runoff into neighboring streams. But such methods also cost money. That's part of what you are buying when you buy organic.\u003c/p>\n\u003cp>So if you really want to find the most nutritious vegetables, and the organic label won't take you there, what will?\u003c/p>\n\u003cp>At the moment, unfortunately, there isn't a good guide. But a lot of scientists are working on it.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>In the meantime, Standen reports, children who ate organic produce had less pesticide in their urine than kids who ate conventional produce. But in both groups, pesticide levels were below federal limits.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Hispanic children have had a lower rate of autism than other children -- although their cases tend to be more severe. Researchers had wondered -- is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?\u003c/p>\n\u003cp>I think you can guess the answer. But proving it is generally better than guessing.\u003c/p>\n\u003cp>In one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the \u003ca title=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" href=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" target=\"_blank\">UC Davis MIND Institute\u003c/a> wrote that Hispanic children \"displayed more similarities than differences compared to non-Hispanics.\" In the case of autism, they found that rates of autism were actually roughly the same between Hispanic and non-Hispanic children.\u003c/p>\n\u003cp>The study's lead author, Virginia Chaidez, Ph.D. said the research filled in a piece of \"large puzzle\" and added \"autism is a spectrum and it's very similar across the board. So we're pretty confident in promoting outreach and trying to encourage the Hispanic community to learn the signs very early in life.\"\u003c!--more-->\u003c/p>\n\u003cp>Chaidez's paper \u003cem>\u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" target=\"_blank\">Autism spectrum disorders in Hispanics and non-Hispanics\u003c/a>, \u003c/em>was published in the journal \u003cem>Autism. \u003c/em>Research was funded by government grants and the MIND Institute.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>MIND Institute researchers have been following more than 1,000 children since 2003 as part of the larger CHARGE study (Childhood Autism Risks from Genetics and the Environment). CHARGE children fall into three groups: children with autism, children with developmental delay, but not autism and children enrolled from the general population. While autism is much more about deficits in social interaction and communicating, developmental delay has to do with children who lag in meeting physical or intellectual milestones.\u003c/p>\n\u003cp>In addition to looking at rates of autism in Hispanic and non-Hispanic children, researchers also looked at comparisons in developmental delay and found some surprises. First, in both Hispanic and non-Hispanic children, nearly one in five children in the developmental delay group actually met the criteria for autism. If parents don't get the correct diagnosis, it's much less likely their children can get the correct treatment.\u003c/p>\n\u003cp>In addition, 16.5 percent of Hispanic children enrolled from the general population -- \"typically developing\" -- met criteria for either developmental delay or mixed development, compared with just 2.8 percent of non-Hispanic participants. That's more than a five-fold difference. In the published study, researchers explored many possibilities for this disparity.\u003c/p>\n\u003cp>One explanation is that children who speak two languages at home tend to test lower at young ages. (This is expected in bilingual or multilingual children -- they generally catch up later.) \"Test bias\" may have then accounted for some of the difference. On the other hand, researchers wrote that \"milder forms of developmental disabilities are more likely to go undetected in Hispanics.\" Finally, Hispanics may have cultural differences in expectations for child behavior and parenting practices, so diagnosis and treatment may not be sought out.\u003c/p>\n\u003cp>When Maribel Hernandez of Sacramento noticed something seemed not quite right with her young son, some family members told her not to worry and that he would be fine. Instead, she went to her pediatrician. Her son was diagnosed with autism. After her second son was born, he, too, was diagnosed with the disorder. Hernandez is bilingual and encourages parents -- in both English and Spanish -- to seek out diagnosis and treatment. \"They need to ask,\" she told me, \"they need to go and ask for help. If they don't have a chance to go and review what he's supposed to be doing at six months, 12 months, 18 months, if they don't have that chance, then they can't compare with the peers.\"\u003c/p>\n\u003cp>Chaidez also encourages parents to be aware of\u003ca title=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" href=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" target=\"_blank\"> developmental milestones\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Hispanic children have had a lower rate of autism than other children -- although their cases tend to be more severe. Researchers wondered -- is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?\r\n\r\nI think you can guess the answer. But proving it is generally better than guessing.\r\n\r\nIn one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the UC Davis MIND Institute wrote that Hispanic children \"displayed more similarities than differences compared to non-Hispanics.\" In the case of autism, they found that rates of autism were about the same between Hispanic and non-Hispanic children.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hispanic children have had a lower rate of autism than other children -- although their cases tend to be more severe. Researchers had wondered -- is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?\u003c/p>\n\u003cp>I think you can guess the answer. But proving it is generally better than guessing.\u003c/p>\n\u003cp>In one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the \u003ca title=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" href=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" target=\"_blank\">UC Davis MIND Institute\u003c/a> wrote that Hispanic children \"displayed more similarities than differences compared to non-Hispanics.\" In the case of autism, they found that rates of autism were actually roughly the same between Hispanic and non-Hispanic children.\u003c/p>\n\u003cp>The study's lead author, Virginia Chaidez, Ph.D. said the research filled in a piece of \"large puzzle\" and added \"autism is a spectrum and it's very similar across the board. So we're pretty confident in promoting outreach and trying to encourage the Hispanic community to learn the signs very early in life.\"\u003c!--more-->\u003c/p>\n\u003cp>Chaidez's paper \u003cem>\u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" target=\"_blank\">Autism spectrum disorders in Hispanics and non-Hispanics\u003c/a>, \u003c/em>was published in the journal \u003cem>Autism. \u003c/em>Research was funded by government grants and the MIND Institute.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>MIND Institute researchers have been following more than 1,000 children since 2003 as part of the larger CHARGE study (Childhood Autism Risks from Genetics and the Environment). CHARGE children fall into three groups: children with autism, children with developmental delay, but not autism and children enrolled from the general population. While autism is much more about deficits in social interaction and communicating, developmental delay has to do with children who lag in meeting physical or intellectual milestones.\u003c/p>\n\u003cp>In addition to looking at rates of autism in Hispanic and non-Hispanic children, researchers also looked at comparisons in developmental delay and found some surprises. First, in both Hispanic and non-Hispanic children, nearly one in five children in the developmental delay group actually met the criteria for autism. If parents don't get the correct diagnosis, it's much less likely their children can get the correct treatment.\u003c/p>\n\u003cp>In addition, 16.5 percent of Hispanic children enrolled from the general population -- \"typically developing\" -- met criteria for either developmental delay or mixed development, compared with just 2.8 percent of non-Hispanic participants. That's more than a five-fold difference. In the published study, researchers explored many possibilities for this disparity.\u003c/p>\n\u003cp>One explanation is that children who speak two languages at home tend to test lower at young ages. (This is expected in bilingual or multilingual children -- they generally catch up later.) \"Test bias\" may have then accounted for some of the difference. On the other hand, researchers wrote that \"milder forms of developmental disabilities are more likely to go undetected in Hispanics.\" Finally, Hispanics may have cultural differences in expectations for child behavior and parenting practices, so diagnosis and treatment may not be sought out.\u003c/p>\n\u003cp>When Maribel Hernandez of Sacramento noticed something seemed not quite right with her young son, some family members told her not to worry and that he would be fine. Instead, she went to her pediatrician. Her son was diagnosed with autism. After her second son was born, he, too, was diagnosed with the disorder. Hernandez is bilingual and encourages parents -- in both English and Spanish -- to seek out diagnosis and treatment. \"They need to ask,\" she told me, \"they need to go and ask for help. If they don't have a chance to go and review what he's supposed to be doing at six months, 12 months, 18 months, if they don't have that chance, then they can't compare with the peers.\"\u003c/p>\n\u003cp>Chaidez also encourages parents to be aware of\u003ca title=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" href=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" target=\"_blank\"> developmental milestones\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hantavirus Investigation at Yosemite Continues",
"title": "Hantavirus Investigation at Yosemite Continues",
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"content": "\u003cp>By \u003cstrong>Lauren Sommer\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8278\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8278\" title=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr-300x225.jpg\" alt=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>State public health officials are warning 1,700 people who stayed in \u003ca title=\"http://www.nps.gov/yose/index.htm\" href=\"http://www.nps.gov/yose/index.htm\" target=\"_blank\">Yosemite National Park\u003c/a>'s Curry Village tent cabins since mid-June about \u003ca title=\"http://www.cdc.gov/hantavirus/\" href=\"http://www.cdc.gov/hantavirus/\" target=\"_blank\">hantavirus\u003c/a>. Three people who stayed in the tent cabins this summer have contracted the illness and two people have died. There may be a fourth case as well.\u003c/p>\n\u003cp>A group of the tent cabins are closed as public health officials investigate the cases. The state health department had previously warned the park about the risk.\u003c/p>\n\u003cp>Hantavirus is a serious illness which causes flu-like symptoms. It can progress rapidly and has a 38 percent mortality rate, according to the Centers for Disease Control. There is no known treatment, although prompt admission to the ICU and oxygen therapy can be helpful.\u003c/p>\n\u003cp>The virus is spread through mouse droppings, says Vicki Kramer, Ph.D., Chief of the Vector-Borne Disease Section of the California Department of Public Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If rodents do invade an area, it’s important not to sweep, not to vacuum because that causes the virus to become airborne,\" she said.\u003c/p>\n\u003cp>Hantavirus is rare. There have been only 60 cases in the last two decades in California. Kramer’s department has been working with the park since two previous hantavirus cases in 2000 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>Two years ago, it was recommended park staff be trained in cleaning standards -- which Kramer says the park did. Health officials also recommended putting up warning signs in the tent cabins. But the park didn't follow that recommendation.\u003c/p>\n\u003cp>\"We certainly want to put signs up in places,\" said Yosemite National Park spokesman Scott Gediman. \"But we’ve learned over the years that to sit there and have a sign everywhere listing every potential danger is both impractical and something we have to balance.\"\u003c/p>\n\u003cp>Gediman says there are signs up now. Tent cabins are being inspected and retrofitted to prevent mice from getting in.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" href=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" target=\"_blank\">Los Angeles Times\u003c/a> reports that officials are testing deer mice across the park in an effort to learn what is causing the outbreak. Park ranger Jana McCabe told the \u003cem>Times\u003c/em> they are \"pretty confident that it's not a cleanliness issue.\"\u003c/p>\n\u003cp>McCabe continues:\u003c/p>\n\u003cblockquote>\u003cp>\"We've reviewed the cases; we've reviewed the cleaning methods,\" she said. \"It makes you start wondering, what has changed? What is going on in the environment? That's really the question.\"\u003c/p>\n\u003cp>After confirming the first two infections earlier this month, Yosemite officials began catching deer mice and disinfecting the Curry Village cabins. They also contacted health authorities.\u003c/p>\n\u003cp>... The California Department of Public Health said Tuesday afternoon that it had recommended a closure of affected cabins \"due to the level of mouse activity and presence of the hantavirus.\" Gediman said the closure was part of the cleaning and repair process already underway.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>More:\u003c/strong>\u003cbr>\n\u003cem>California Watch: \u003c/em>\u003ca title=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" href=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" target=\"_blank\">Scientists Calls to Warn Yosemite Visitors Went Unheeded\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Lauren Sommer's report:\u003c/em>\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/R201208300850b.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/R201208300850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "State public health officials are warning 1,700 people who stayed in Yosemite National Park's Curry Village tent cabins since mid-June about hantavirus. Three people who stayed in the tent cabins this summer have contracted the illness and two people have died. There may be a fourth case as well.\r\n\r\nA group of the tent cabins are closed as public health officials investigate the cases. The state health department had previously warned the park about the risk.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003cstrong>Lauren Sommer\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8278\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8278\" title=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/CurryVillage_Yosemite_JunSeita_Flickr-300x225.jpg\" alt=\"Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Curry Village tent cabins at Yosemite National Park. (Jun Seita: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>State public health officials are warning 1,700 people who stayed in \u003ca title=\"http://www.nps.gov/yose/index.htm\" href=\"http://www.nps.gov/yose/index.htm\" target=\"_blank\">Yosemite National Park\u003c/a>'s Curry Village tent cabins since mid-June about \u003ca title=\"http://www.cdc.gov/hantavirus/\" href=\"http://www.cdc.gov/hantavirus/\" target=\"_blank\">hantavirus\u003c/a>. Three people who stayed in the tent cabins this summer have contracted the illness and two people have died. There may be a fourth case as well.\u003c/p>\n\u003cp>A group of the tent cabins are closed as public health officials investigate the cases. The state health department had previously warned the park about the risk.\u003c/p>\n\u003cp>Hantavirus is a serious illness which causes flu-like symptoms. It can progress rapidly and has a 38 percent mortality rate, according to the Centers for Disease Control. There is no known treatment, although prompt admission to the ICU and oxygen therapy can be helpful.\u003c/p>\n\u003cp>The virus is spread through mouse droppings, says Vicki Kramer, Ph.D., Chief of the Vector-Borne Disease Section of the California Department of Public Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If rodents do invade an area, it’s important not to sweep, not to vacuum because that causes the virus to become airborne,\" she said.\u003c/p>\n\u003cp>Hantavirus is rare. There have been only 60 cases in the last two decades in California. Kramer’s department has been working with the park since two previous hantavirus cases in 2000 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>Two years ago, it was recommended park staff be trained in cleaning standards -- which Kramer says the park did. Health officials also recommended putting up warning signs in the tent cabins. But the park didn't follow that recommendation.\u003c/p>\n\u003cp>\"We certainly want to put signs up in places,\" said Yosemite National Park spokesman Scott Gediman. \"But we’ve learned over the years that to sit there and have a sign everywhere listing every potential danger is both impractical and something we have to balance.\"\u003c/p>\n\u003cp>Gediman says there are signs up now. Tent cabins are being inspected and retrofitted to prevent mice from getting in.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" href=\"http://www.latimes.com/news/local/la-me-yosemite-20120829,0,304568.story\" target=\"_blank\">Los Angeles Times\u003c/a> reports that officials are testing deer mice across the park in an effort to learn what is causing the outbreak. Park ranger Jana McCabe told the \u003cem>Times\u003c/em> they are \"pretty confident that it's not a cleanliness issue.\"\u003c/p>\n\u003cp>McCabe continues:\u003c/p>\n\u003cblockquote>\u003cp>\"We've reviewed the cases; we've reviewed the cleaning methods,\" she said. \"It makes you start wondering, what has changed? What is going on in the environment? That's really the question.\"\u003c/p>\n\u003cp>After confirming the first two infections earlier this month, Yosemite officials began catching deer mice and disinfecting the Curry Village cabins. They also contacted health authorities.\u003c/p>\n\u003cp>... The California Department of Public Health said Tuesday afternoon that it had recommended a closure of affected cabins \"due to the level of mouse activity and presence of the hantavirus.\" Gediman said the closure was part of the cleaning and repair process already underway.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>More:\u003c/strong>\u003cbr>\n\u003cem>California Watch: \u003c/em>\u003ca title=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" href=\"http://californiawatch.org/dailyreport/calif-scientists-calls-warn-yosemite-visitors-virus-went-unheeded-17784\" target=\"_blank\">Scientists Calls to Warn Yosemite Visitors Went Unheeded\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Lauren Sommer's report:\u003c/em>\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/R201208300850b.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/R201208300850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_8104\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MedicalTextbooks_Pmccormi_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8104\" title=\"(Pmccormi: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MedicalTextbooks_Pmccormi_Flickr-300x225.jpg\" alt=\"(Pmccormi: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Pmccormi: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Eve Harris\u003c/strong>\u003c/p>\n\u003cp>How do you know your doctor is right? Ideally you and your doctor have a relationship based on trust. That is, you believe she knows the best options to recommend to you. \u003cem>You\u003c/em> may think your doctor is right, but -- how does \u003cem>your doctor \u003c/em>know she's right? We'd like to think physicians are relying on the latest evidence of medical practice. But not all physicians do that.\u003c/p>\n\u003cp>I recently joined in a robust, four-day discussion designed to address this issue at the \u003ca title=\"http://www.cochrane.org/news/tags/authors/14th-rocky-mountain-workshop-how-practice-evidence-based-health-care-steamboat-spr\" href=\"http://www.cochrane.org/news/tags/authors/14th-rocky-mountain-workshop-how-practice-evidence-based-health-care-steamboat-spr\" target=\"_blank\">14th Rocky Mountain Workshop on How to Practice Evidence-Based Health Care\u003c/a>. Doctors, policy makers and yes, journalists gathered to explore what many patients might have thought they were already getting: evidence-based health care, also called evidence based medicine.\u003c/p>\n\u003cp>In evidence based medicine, a hierarchy of evidence\u003cem> \u003c/em>guides decisions about patient care. But at the same time, evidence based medicine recognizes that \u003cem>evidence alone is not sufficient\u003c/em>. That's because treatment options come with risks, and different patients will react differently to different risks. It's not a simple matter of \"Drug X\" or \"Treatment Y\" has a five percent higher likelihood of success. If \"Treatment Y\" involves a risk or side effect a patient finds unacceptable, then this patient's preference is part of the decision process.\u003c/p>\n\u003cp>Decision makers \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/8963526\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/8963526\" target=\"_blank\">must always acknowledge these trade offs\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>The emphasis on patients’ considerations makes evidence based medicine a patient-centered practice, ideal for the coming age of healthcare reform. It’s imperative that both providers and patients learn to properly evaluate their sources of medical information. Even tougher -- old habits die hard, as we all know. Earlier this year in the \u003ca title=\"http://jama.jamanetwork.com/article.aspx?articleid=1104821\" href=\"http://jama.jamanetwork.com/article.aspx?articleid=1104821\" target=\"_blank\">Journal of the American Medical Association\u003c/a>, Stanford professor \u003ca href=\"http://med.stanford.edu/profiles/John_Ioannidis/\">John Ioannidis\u003c/a> (and others) wrote of just how hard it is to reverse established medical practice:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>\u003c/em>Ideally, good medical practices are replaced by better ones, based on robust comparative trials in which new interventions outperform older ones and establish new standards of care. Often, however … what was thought to be beneficial was not. In these cases, it becomes apparent that clinicians, encouraged by professional societies and guidelines, have been using medications, procedures, or preventive measures in vain.\u003c/p>\u003c/blockquote>\n\u003cp>Factors beyond science -- including bias -- can alter the outcome of a study. They can even affect what research is conducted and published. Ioannidis is well known for exposing ways this happens and why it is harmful to patients and physicians.\u003c/p>\n\u003cp>One take-away from the workshop I particularly endorse came from the U.S. Preventive Services Task Force chair \u003ca href=\"http://www.uspreventiveservicestaskforce.org/tflongbios.htm\">Virginia Moyer\u003c/a>: researchers should stop designing research around outcomes that don't matter to patients! One example we discussed was bone density. What patients care about is preventing fractures. But studies looked at bone density, believing bone density was linked to fractures. Turns out it's not. In this case, studies that look at fractures are what's needed.\u003c/p>\n\u003cp>But overall it appears that patient perspectives and values are increasingly part of research design. The Patient Centered Outcomes Research Institute (PCORI) is funding innovative new studies. In a recent article, PCORI explains \"\u003ca href=\"http://www.pcori.org/blog/why-methods-matter/\" target=\"_blank\">Why Methods Matter\u003c/a>.\" Today, patients have more treatment options than ever, and changes in the way we receive our healthcare today – shorter hospital stays, for example -- may affect outcomes. So although difficult, it’s crucial for patients and providers to understand and use the most relevant information when making decisions.\u003c/p>\n\u003cp>Doctors and patients are making progress in defining and trying out new ways of communicating about treatment decisions. Achieving the best outcomes via this newer, more participatory practice of medicine requires attention not only to the evidence provided by high quality studies but also clinical judgment and the bottom line: patient values.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Eve Harris is a Bay Area writer. Check out her health blog, \u003ca href=\"http://eve-harris.blogspot.com/\">A Healthy Piece of My Mind\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8104\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MedicalTextbooks_Pmccormi_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8104\" title=\"(Pmccormi: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MedicalTextbooks_Pmccormi_Flickr-300x225.jpg\" alt=\"(Pmccormi: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Pmccormi: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Eve Harris\u003c/strong>\u003c/p>\n\u003cp>How do you know your doctor is right? Ideally you and your doctor have a relationship based on trust. That is, you believe she knows the best options to recommend to you. \u003cem>You\u003c/em> may think your doctor is right, but -- how does \u003cem>your doctor \u003c/em>know she's right? We'd like to think physicians are relying on the latest evidence of medical practice. But not all physicians do that.\u003c/p>\n\u003cp>I recently joined in a robust, four-day discussion designed to address this issue at the \u003ca title=\"http://www.cochrane.org/news/tags/authors/14th-rocky-mountain-workshop-how-practice-evidence-based-health-care-steamboat-spr\" href=\"http://www.cochrane.org/news/tags/authors/14th-rocky-mountain-workshop-how-practice-evidence-based-health-care-steamboat-spr\" target=\"_blank\">14th Rocky Mountain Workshop on How to Practice Evidence-Based Health Care\u003c/a>. Doctors, policy makers and yes, journalists gathered to explore what many patients might have thought they were already getting: evidence-based health care, also called evidence based medicine.\u003c/p>\n\u003cp>In evidence based medicine, a hierarchy of evidence\u003cem> \u003c/em>guides decisions about patient care. But at the same time, evidence based medicine recognizes that \u003cem>evidence alone is not sufficient\u003c/em>. That's because treatment options come with risks, and different patients will react differently to different risks. It's not a simple matter of \"Drug X\" or \"Treatment Y\" has a five percent higher likelihood of success. If \"Treatment Y\" involves a risk or side effect a patient finds unacceptable, then this patient's preference is part of the decision process.\u003c/p>\n\u003cp>Decision makers \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/8963526\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/8963526\" target=\"_blank\">must always acknowledge these trade offs\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>The emphasis on patients’ considerations makes evidence based medicine a patient-centered practice, ideal for the coming age of healthcare reform. It’s imperative that both providers and patients learn to properly evaluate their sources of medical information. Even tougher -- old habits die hard, as we all know. Earlier this year in the \u003ca title=\"http://jama.jamanetwork.com/article.aspx?articleid=1104821\" href=\"http://jama.jamanetwork.com/article.aspx?articleid=1104821\" target=\"_blank\">Journal of the American Medical Association\u003c/a>, Stanford professor \u003ca href=\"http://med.stanford.edu/profiles/John_Ioannidis/\">John Ioannidis\u003c/a> (and others) wrote of just how hard it is to reverse established medical practice:\u003c/p>\n\u003cblockquote>\u003cp>\u003cem>\u003c/em>Ideally, good medical practices are replaced by better ones, based on robust comparative trials in which new interventions outperform older ones and establish new standards of care. Often, however … what was thought to be beneficial was not. In these cases, it becomes apparent that clinicians, encouraged by professional societies and guidelines, have been using medications, procedures, or preventive measures in vain.\u003c/p>\u003c/blockquote>\n\u003cp>Factors beyond science -- including bias -- can alter the outcome of a study. They can even affect what research is conducted and published. Ioannidis is well known for exposing ways this happens and why it is harmful to patients and physicians.\u003c/p>\n\u003cp>One take-away from the workshop I particularly endorse came from the U.S. Preventive Services Task Force chair \u003ca href=\"http://www.uspreventiveservicestaskforce.org/tflongbios.htm\">Virginia Moyer\u003c/a>: researchers should stop designing research around outcomes that don't matter to patients! One example we discussed was bone density. What patients care about is preventing fractures. But studies looked at bone density, believing bone density was linked to fractures. Turns out it's not. In this case, studies that look at fractures are what's needed.\u003c/p>\n\u003cp>But overall it appears that patient perspectives and values are increasingly part of research design. The Patient Centered Outcomes Research Institute (PCORI) is funding innovative new studies. In a recent article, PCORI explains \"\u003ca href=\"http://www.pcori.org/blog/why-methods-matter/\" target=\"_blank\">Why Methods Matter\u003c/a>.\" Today, patients have more treatment options than ever, and changes in the way we receive our healthcare today – shorter hospital stays, for example -- may affect outcomes. So although difficult, it’s crucial for patients and providers to understand and use the most relevant information when making decisions.\u003c/p>\n\u003cp>Doctors and patients are making progress in defining and trying out new ways of communicating about treatment decisions. Achieving the best outcomes via this newer, more participatory practice of medicine requires attention not only to the evidence provided by high quality studies but also clinical judgment and the bottom line: patient values.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Eve Harris is a Bay Area writer. Check out her health blog, \u003ca href=\"http://eve-harris.blogspot.com/\">A Healthy Piece of My Mind\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "'Youth Speaks' Against Diabetes",
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"content": "\u003cp>By \u003cstrong>\u003ca title=\"http://gracerubenstein.com/\" href=\"http://gracerubenstein.com/\" target=\"_blank\">Grace Rubenstein\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_7749\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Screen-Shot-2012-07-31-at-9.44.14-AM.png\">\u003cimg class=\"size-medium wp-image-7749 \" title=\"Still from Jose Vadi's video-poem "The Corner." (Courtesy: The Bigger Picture)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Screen-Shot-2012-07-31-at-9.44.14-AM-300x170.png\" alt=\"Still from Jose Vadi's video-poem "The Corner." \" width=\"300\" height=\"170\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Still from Jose Vadi's video-poem \"The Corner.\" (Courtesy: The Bigger Picture)\u003c/figcaption>\u003c/figure>\n\u003cp>So long to the purely pious messages about eating right and exercising to ward off diabetes, Type II diabetes, that is.\u003c/p>\n\u003cp>A group of Bay Area youth have a new message for their peers about the disease, which afflicts poor people of color in disproportionately high numbers. Their rallying cry: \u003cem>It’s about justice, man\u003c/em>.\u003c/p>\n\u003cp>The spoken-word poetry organization \u003ca title=\"http://youthspeaks.org/\" href=\"http://youthspeaks.org/\" target=\"_blank\">Youth Speaks\u003c/a> has teamed up with U.C. San Francisco to train young poets on how living conditions common in poor neighborhoods — unsafe streets, few green spaces, a preponderance of fast-food joints — appear to propel people toward diabetes. (For more on this line of research, see the \u003ca href=\"http://www.who.int/social_determinants/en/\">World Health Organization\u003c/a> and this \u003ca href=\"http://www.barhii.org/press/download/barhii_report08.pdf\">report\u003c/a> [PDF] from the Bay Area Regional Health Inequities Initiative.)\u003c/p>\n\u003cp>Twenty poet-mentors have already been trained as part of the program, \u003ca title=\"http://youthspeaks.org/thebiggerpicture/\" href=\"http://youthspeaks.org/thebiggerpicture/\" target=\"_blank\">The Bigger Picture\u003c/a> (website under construction). They worked with Oakland-native slam poet and videographer \u003ca title=\"http://en.wikipedia.org/wiki/Jamie_DeWolf\" href=\"http://en.wikipedia.org/wiki/Jamie_DeWolf\" target=\"_blank\">Jamie DeWolf\u003c/a> to turn their poems into online videos, delivered in a lyrical and cinematic style that 21st century teens relate to. In the coming school year, they’ll visit 10 Bay Area high schools to perform their poems, educate students on diabetes, and coach them to write health-justice poetry themselves.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ultimately, they hope to expand the program statewide and inspire an army of young activists to change their communities, demand healthy food in schools, and press local governments to help make their neighborhoods more conducive to good health.\u003c/p>\n\u003cp>“We’re putting the onus not just on the individual but also on the community, and that begins on the street, at home and at school,” poet-mentor José Vadi, 27, of Oakland told me. “It’s a new approach that can be seen as very political.”\u003c/p>\n\u003cp>The new tactic comes none too soon, says Dr. Dean Schillinger with the \u003ca href=\"http://www.caldiabetes.org/index.cfm\">California Diabetes Program\u003c/a>, run jointly between the state and UCSF. When we discussed that project’s mission, he minced no words about the severity of the diabetes epidemic.\u003c/p>\n\u003cp>“We’re at a tipping point with diabetes,” he said. He called “frightening” a \u003ca href=\"http://pediatrics.aappublications.org/content/early/2012/05/15/peds.2011-1082.abstract\">study\u003c/a> published in May in the journal \u003cem>Pediatrics \u003c/em>which found that just between 2000 and 2008, rates of diabetes and prediabetes among U.S. youth ages 12 to 19 shot from 9 percent to 23 percent.\u003c/p>\n\u003cp>One in seven Californian adults has the disease, and the number is rising, reports the California Diabetes Program. Diabetes is the leading cause of blindness, amputations and kidney failure, and a major contributor to heart attacks and strokes. It doubles a person’s risk of death.\u003c/p>\n\u003cp>Individual health choices are still an important factor in the disease, say Schillinger and Vadi. But they don’t believe we’ll ever defeat diabetes if we focus on that aspect alone.\u003c/p>\n\u003cp>“We understand that diabetes is the result of a complex interplay between genetic risk, environment and behavior, and those three things are very tightly woven,” Schillinger said. “They’re not three independent pillars.”\u003c/p>\n\u003cp>Vadi, whose grandmother died of diabetes, feels the effects personally. Where he used to live, in downtown Oakland, his most practical food options within a mile and a half were a pricey natural-foods store and a McDonald’s, kitty-corner from each other. Day to day, he said he faced a choice between health and cost.\u003c/p>\n\u003cp>In Vadi’s video-poem, “\u003ca href=\"http://www.youtube.com/watch?v=18DZ8MjhxLc&feature=player_embedded\">The Corner\u003c/a>,” he rails against the food industry’s marketing of “deep-fried death” and “corporate-sponsored deadly delicacies.”\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=18DZ8MjhxLc]\u003c/p>\n\u003cp>There’s a clear common enemy, a sinister, selfish villain in Vadi’s verse: Big Food. In “\u003ca href=\"http://www.youtube.com/watch?v=oTxxm-EeCug&feature=player_embedded\">Pushin’ Weight\u003c/a>,” poet Simone Bridges portrays herself as a cold-blooded drug dealer pushing sugar to kids as if it were cocaine. In “\u003ca href=\"http://www.youtube.com/watch?v=zjASMfhNW-w&feature=player_embedded\">Health Justice Manifesto\u003c/a>,” the poets’ collaborative theme poem, they assert: “We believe it is the individual’s responsibility to maintain physical fitness. However, it is nearly impossible for those of us who live in neighborhoods without safe streets, parks or playgrounds, where the nearest substitute is often inside a fast food restaurant’s playpen,” all benefits which they add are “readily available for wealthy neighborhoods.”\u003c/p>\n\u003cp>When I first heard about the Bigger Picture, that struck me as its most astute aspect: framing diabetes as a matter not simply of health, but of inequality. Little inspires youth quite like a fight for justice.\u003c/p>\n\u003cp>Schillinger agrees. “That’s the innovation,” he told me. “Youth are especially incensed by any form of injustice.”\u003c/p>\n\u003cp>Less political poems, like Joshua Merchant’s “\u003ca href=\"http://www.youtube.com/watch?v=ijmyey2VkuA&feature=relmfu\">Hear No\u003c/a>” and Erica McMath Sheppard’s “\u003ca href=\"http://www.youtube.com/watch?v=QOiPOSOGvS8&feature=player_embedded\">Death Recipe\u003c/a>,” also pack emotional power. They describe in painful, personal detail the unhealthy habits embedded in their families, and how hard it is to change.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Schillinger is especially eager to reach Central Valley sites like Stockton and Fresno, “where rates of diabetes are just astounding, and often we don’t hear the stories from these highly impacted areas.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003cstrong>\u003ca title=\"http://gracerubenstein.com/\" href=\"http://gracerubenstein.com/\" target=\"_blank\">Grace Rubenstein\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_7749\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Screen-Shot-2012-07-31-at-9.44.14-AM.png\">\u003cimg class=\"size-medium wp-image-7749 \" title=\"Still from Jose Vadi's video-poem "The Corner." (Courtesy: The Bigger Picture)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Screen-Shot-2012-07-31-at-9.44.14-AM-300x170.png\" alt=\"Still from Jose Vadi's video-poem "The Corner." \" width=\"300\" height=\"170\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Still from Jose Vadi's video-poem \"The Corner.\" (Courtesy: The Bigger Picture)\u003c/figcaption>\u003c/figure>\n\u003cp>So long to the purely pious messages about eating right and exercising to ward off diabetes, Type II diabetes, that is.\u003c/p>\n\u003cp>A group of Bay Area youth have a new message for their peers about the disease, which afflicts poor people of color in disproportionately high numbers. Their rallying cry: \u003cem>It’s about justice, man\u003c/em>.\u003c/p>\n\u003cp>The spoken-word poetry organization \u003ca title=\"http://youthspeaks.org/\" href=\"http://youthspeaks.org/\" target=\"_blank\">Youth Speaks\u003c/a> has teamed up with U.C. San Francisco to train young poets on how living conditions common in poor neighborhoods — unsafe streets, few green spaces, a preponderance of fast-food joints — appear to propel people toward diabetes. (For more on this line of research, see the \u003ca href=\"http://www.who.int/social_determinants/en/\">World Health Organization\u003c/a> and this \u003ca href=\"http://www.barhii.org/press/download/barhii_report08.pdf\">report\u003c/a> [PDF] from the Bay Area Regional Health Inequities Initiative.)\u003c/p>\n\u003cp>Twenty poet-mentors have already been trained as part of the program, \u003ca title=\"http://youthspeaks.org/thebiggerpicture/\" href=\"http://youthspeaks.org/thebiggerpicture/\" target=\"_blank\">The Bigger Picture\u003c/a> (website under construction). They worked with Oakland-native slam poet and videographer \u003ca title=\"http://en.wikipedia.org/wiki/Jamie_DeWolf\" href=\"http://en.wikipedia.org/wiki/Jamie_DeWolf\" target=\"_blank\">Jamie DeWolf\u003c/a> to turn their poems into online videos, delivered in a lyrical and cinematic style that 21st century teens relate to. In the coming school year, they’ll visit 10 Bay Area high schools to perform their poems, educate students on diabetes, and coach them to write health-justice poetry themselves.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ultimately, they hope to expand the program statewide and inspire an army of young activists to change their communities, demand healthy food in schools, and press local governments to help make their neighborhoods more conducive to good health.\u003c/p>\n\u003cp>“We’re putting the onus not just on the individual but also on the community, and that begins on the street, at home and at school,” poet-mentor José Vadi, 27, of Oakland told me. “It’s a new approach that can be seen as very political.”\u003c/p>\n\u003cp>The new tactic comes none too soon, says Dr. Dean Schillinger with the \u003ca href=\"http://www.caldiabetes.org/index.cfm\">California Diabetes Program\u003c/a>, run jointly between the state and UCSF. When we discussed that project’s mission, he minced no words about the severity of the diabetes epidemic.\u003c/p>\n\u003cp>“We’re at a tipping point with diabetes,” he said. He called “frightening” a \u003ca href=\"http://pediatrics.aappublications.org/content/early/2012/05/15/peds.2011-1082.abstract\">study\u003c/a> published in May in the journal \u003cem>Pediatrics \u003c/em>which found that just between 2000 and 2008, rates of diabetes and prediabetes among U.S. youth ages 12 to 19 shot from 9 percent to 23 percent.\u003c/p>\n\u003cp>One in seven Californian adults has the disease, and the number is rising, reports the California Diabetes Program. Diabetes is the leading cause of blindness, amputations and kidney failure, and a major contributor to heart attacks and strokes. It doubles a person’s risk of death.\u003c/p>\n\u003cp>Individual health choices are still an important factor in the disease, say Schillinger and Vadi. But they don’t believe we’ll ever defeat diabetes if we focus on that aspect alone.\u003c/p>\n\u003cp>“We understand that diabetes is the result of a complex interplay between genetic risk, environment and behavior, and those three things are very tightly woven,” Schillinger said. “They’re not three independent pillars.”\u003c/p>\n\u003cp>Vadi, whose grandmother died of diabetes, feels the effects personally. Where he used to live, in downtown Oakland, his most practical food options within a mile and a half were a pricey natural-foods store and a McDonald’s, kitty-corner from each other. Day to day, he said he faced a choice between health and cost.\u003c/p>\n\u003cp>In Vadi’s video-poem, “\u003ca href=\"http://www.youtube.com/watch?v=18DZ8MjhxLc&feature=player_embedded\">The Corner\u003c/a>,” he rails against the food industry’s marketing of “deep-fried death” and “corporate-sponsored deadly delicacies.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/18DZ8MjhxLc'\n title='//www.youtube.com/embed/18DZ8MjhxLc'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>There’s a clear common enemy, a sinister, selfish villain in Vadi’s verse: Big Food. In “\u003ca href=\"http://www.youtube.com/watch?v=oTxxm-EeCug&feature=player_embedded\">Pushin’ Weight\u003c/a>,” poet Simone Bridges portrays herself as a cold-blooded drug dealer pushing sugar to kids as if it were cocaine. In “\u003ca href=\"http://www.youtube.com/watch?v=zjASMfhNW-w&feature=player_embedded\">Health Justice Manifesto\u003c/a>,” the poets’ collaborative theme poem, they assert: “We believe it is the individual’s responsibility to maintain physical fitness. However, it is nearly impossible for those of us who live in neighborhoods without safe streets, parks or playgrounds, where the nearest substitute is often inside a fast food restaurant’s playpen,” all benefits which they add are “readily available for wealthy neighborhoods.”\u003c/p>\n\u003cp>When I first heard about the Bigger Picture, that struck me as its most astute aspect: framing diabetes as a matter not simply of health, but of inequality. Little inspires youth quite like a fight for justice.\u003c/p>\n\u003cp>Schillinger agrees. “That’s the innovation,” he told me. “Youth are especially incensed by any form of injustice.”\u003c/p>\n\u003cp>Less political poems, like Joshua Merchant’s “\u003ca href=\"http://www.youtube.com/watch?v=ijmyey2VkuA&feature=relmfu\">Hear No\u003c/a>” and Erica McMath Sheppard’s “\u003ca href=\"http://www.youtube.com/watch?v=QOiPOSOGvS8&feature=player_embedded\">Death Recipe\u003c/a>,” also pack emotional power. They describe in painful, personal detail the unhealthy habits embedded in their families, and how hard it is to change.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Schillinger is especially eager to reach Central Valley sites like Stockton and Fresno, “where rates of diabetes are just astounding, and often we don’t hear the stories from these highly impacted areas.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_7616\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Doctor_Patient_MercyHealth_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7616\" title=\"(Mercy Health: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Doctor_Patient_MercyHealth_Flickr-300x256.jpg\" alt=\"(Mercy Health: Flickr)\" width=\"300\" height=\"256\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mercy Health: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>All day, every day, people make medical choices that have repercussions for common yet dangerous conditions like asthma, heart disease and diabetes. Although chronic disease takes a \u003ca title=\"http://www.cdph.ca.gov/programs/cvd/Documents/CHDSP-BurdenReport-LowRes.pdf\" href=\"http://www.cdph.ca.gov/programs/cvd/Documents/CHDSP-BurdenReport-LowRes.pdf\" target=\"_blank\">greater toll\u003c/a> [PDF] on people with lower socioeconomic status, chronically ill patients are part of every community. In California and across the country, public health officials and physicians keep searching for the best way to get patients involved in improving their health.\u003c/p>\n\u003cp>Some patients naturally want to be \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/07/23/what-do-engaged-patients-do/\" href=\"http://ww2.kqed.org/stateofhealth/2012/07/23/what-do-engaged-patients-do/\" target=\"_blank\">involved with their care\u003c/a>. Other times it's doctors and nurses who must try to encourage more engagement by their patients. “Whether to exercise or change their diet, take medication,\" \u003ca title=\"http://familymedicine.medschool.ucsf.edu/faculty/bios/thom_d.aspx\" href=\"http://familymedicine.medschool.ucsf.edu/faculty/bios/thom_d.aspx\" target=\"_blank\">Dr. David Thom\u003c/a> told me recently, \"those are the bread and butter decisions that go into primary care.\"\u003c/p>\n\u003cp>Thom, director of research in the UC San Francisco department of Family and Community Medicine, is launching a new study, exploring how patients make decisions when they work with a “health coach.\" Often health coaches are trained medical assistants who join the primary care team. “Our belief is that health coaches are going to have a fairly different relationship with patients than providers do,” he says. “Their role in helping the patients make decisions will be clearly different than the providers’ role.”\u003c!--more-->\u003c/p>\n\u003cp>For example, coaches may help patients prepare questions in order to make the best use of limited face time with their doctors. Coaches might also accompany patients to appointments or help them navigate between multiple departments in a medical center.\u003c/p>\n\u003cp>Many \u003ca title=\"http://www.naph.org/Homepage-Sections/Explore/Innovations/Minority-Health/SFGH-Language-Concordant-Health-Coaches.aspx\" href=\"http://www.naph.org/Homepage-Sections/Explore/Innovations/Minority-Health/SFGH-Language-Concordant-Health-Coaches.aspx\" target=\"_blank\">coaches\u003c/a> are bilingual and for Thom's research some are already trained and in place. \u003ca href=\"http://www.mnhc.org/\" target=\"_blank\">Mission Neighborhood Health Center\u003c/a> and \u003ca href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/SEHlthCtr.asp\" target=\"_blank\">Southeast Health Center\u003c/a>, both part of the healthcare safety net in San Francisco, will be the first sites studied. Coaches meet with patients and sometimes patients’ families, follow up on the phone, and sometimes sit in on appointments. They have access to the doctors and other members of the primary care team.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As part of the \u003ca title=\"http://www.healthcare.gov\" href=\"http://www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a>, the federal health care overhaul, patient engagement is linked to reimbursement for providers. Hospitals and outpatient providers alike have new incentives to successfully educate their patients and demonstrate that their patients are participating in their own treatment. With a two-year grant from the newly formed \u003ca href=\"http://www.pcori.org/\" target=\"_blank\">Patient-Centered Outcomes Research Institute \u003c/a>the UCSF researchers hope to discover which elements of coaching improve patients’ abilities to make medical decisions, improve clinical practice and improve the patient's experience of care. \u003cem>\u003c/em>\u003c/p>\n\u003cp>And it's not just safety net patients who can benefit from coaches. In the heart of Silicon Valley, researchers studied a group of patients to determine how confidently patients were engaged in discussing their care with their healthcare providers.\u003c/p>\n\u003cp>Nearly all the patients in \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1212630\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1212630\" target=\"_blank\">this study\u003c/a> by the\u003ca title=\"http://www.pamf.org/\" href=\"http://www.pamf.org/\" target=\"_blank\"> Palo Alto Medical Foundation\u003c/a> (PAMF) were well-educated and had health insurance. More than a third had a chronic illness. These patients could easily envision asking questions and discussing preferences with their doctors. About 70 percent said they preferred a shared decision-making role, one in which patients and doctors contribute equally to medical decisions.\u003c/p>\n\u003cp>But drill down a bit more and that shared decision-making gets more difficult. Only 14 percent of patients said they would \"voice disagreement\" with their doctor if their own preferences conflicted with the doctor's recommendations.\u003c/p>\n\u003cp>According to PAMF researchers, patients want to participate with their physicians in decision-making, but worry they might be perceived as “difficult” and that their care in the future would be compromised.\u003c/p>\n\u003cp>Forget the future -- patients' care might be compromised right now, if they disagree with a recommended treatment, but say nothing. \"Reluctance to express disagreement in the office may correlate with poor adherence outside the office,\" the researchers noted. \"The findings point to the need to test interventions that explicitly allow patients to voice disagreement with their physicians.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Eve Harris is a Bay Area writer. Check out her health blog, \u003ca href=\"http://eve-harris.blogspot.com/\">A Healthy Piece of My Mind\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "All day, every day, people make medical choices that have repercussions for common yet dangerous conditions like asthma, heart disease and diabetes. Although chronic disease takes a greater toll [PDF] on people with lower socioeconomic status, chronically ill patients are part of every community. In California and across the country, public health officials and physicians keep searching for the best way to get patients involved in improving their health. Some patients naturally want to be involved with their care. Other times it's doctors and nurses who must try to encourage more engagement by their patients.\r\n\r\n“Whether to exercise or change their diet, take medication,\" Dr. David Thom told me recently, \"those are the bread and butter decisions that go into primary care.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_7616\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Doctor_Patient_MercyHealth_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7616\" title=\"(Mercy Health: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/Doctor_Patient_MercyHealth_Flickr-300x256.jpg\" alt=\"(Mercy Health: Flickr)\" width=\"300\" height=\"256\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mercy Health: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>All day, every day, people make medical choices that have repercussions for common yet dangerous conditions like asthma, heart disease and diabetes. Although chronic disease takes a \u003ca title=\"http://www.cdph.ca.gov/programs/cvd/Documents/CHDSP-BurdenReport-LowRes.pdf\" href=\"http://www.cdph.ca.gov/programs/cvd/Documents/CHDSP-BurdenReport-LowRes.pdf\" target=\"_blank\">greater toll\u003c/a> [PDF] on people with lower socioeconomic status, chronically ill patients are part of every community. In California and across the country, public health officials and physicians keep searching for the best way to get patients involved in improving their health.\u003c/p>\n\u003cp>Some patients naturally want to be \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/07/23/what-do-engaged-patients-do/\" href=\"http://ww2.kqed.org/stateofhealth/2012/07/23/what-do-engaged-patients-do/\" target=\"_blank\">involved with their care\u003c/a>. Other times it's doctors and nurses who must try to encourage more engagement by their patients. “Whether to exercise or change their diet, take medication,\" \u003ca title=\"http://familymedicine.medschool.ucsf.edu/faculty/bios/thom_d.aspx\" href=\"http://familymedicine.medschool.ucsf.edu/faculty/bios/thom_d.aspx\" target=\"_blank\">Dr. David Thom\u003c/a> told me recently, \"those are the bread and butter decisions that go into primary care.\"\u003c/p>\n\u003cp>Thom, director of research in the UC San Francisco department of Family and Community Medicine, is launching a new study, exploring how patients make decisions when they work with a “health coach.\" Often health coaches are trained medical assistants who join the primary care team. “Our belief is that health coaches are going to have a fairly different relationship with patients than providers do,” he says. “Their role in helping the patients make decisions will be clearly different than the providers’ role.”\u003c!--more-->\u003c/p>\n\u003cp>For example, coaches may help patients prepare questions in order to make the best use of limited face time with their doctors. Coaches might also accompany patients to appointments or help them navigate between multiple departments in a medical center.\u003c/p>\n\u003cp>Many \u003ca title=\"http://www.naph.org/Homepage-Sections/Explore/Innovations/Minority-Health/SFGH-Language-Concordant-Health-Coaches.aspx\" href=\"http://www.naph.org/Homepage-Sections/Explore/Innovations/Minority-Health/SFGH-Language-Concordant-Health-Coaches.aspx\" target=\"_blank\">coaches\u003c/a> are bilingual and for Thom's research some are already trained and in place. \u003ca href=\"http://www.mnhc.org/\" target=\"_blank\">Mission Neighborhood Health Center\u003c/a> and \u003ca href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/SEHlthCtr.asp\" target=\"_blank\">Southeast Health Center\u003c/a>, both part of the healthcare safety net in San Francisco, will be the first sites studied. Coaches meet with patients and sometimes patients’ families, follow up on the phone, and sometimes sit in on appointments. They have access to the doctors and other members of the primary care team.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As part of the \u003ca title=\"http://www.healthcare.gov\" href=\"http://www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a>, the federal health care overhaul, patient engagement is linked to reimbursement for providers. Hospitals and outpatient providers alike have new incentives to successfully educate their patients and demonstrate that their patients are participating in their own treatment. With a two-year grant from the newly formed \u003ca href=\"http://www.pcori.org/\" target=\"_blank\">Patient-Centered Outcomes Research Institute \u003c/a>the UCSF researchers hope to discover which elements of coaching improve patients’ abilities to make medical decisions, improve clinical practice and improve the patient's experience of care. \u003cem>\u003c/em>\u003c/p>\n\u003cp>And it's not just safety net patients who can benefit from coaches. In the heart of Silicon Valley, researchers studied a group of patients to determine how confidently patients were engaged in discussing their care with their healthcare providers.\u003c/p>\n\u003cp>Nearly all the patients in \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1212630\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1212630\" target=\"_blank\">this study\u003c/a> by the\u003ca title=\"http://www.pamf.org/\" href=\"http://www.pamf.org/\" target=\"_blank\"> Palo Alto Medical Foundation\u003c/a> (PAMF) were well-educated and had health insurance. More than a third had a chronic illness. These patients could easily envision asking questions and discussing preferences with their doctors. About 70 percent said they preferred a shared decision-making role, one in which patients and doctors contribute equally to medical decisions.\u003c/p>\n\u003cp>But drill down a bit more and that shared decision-making gets more difficult. Only 14 percent of patients said they would \"voice disagreement\" with their doctor if their own preferences conflicted with the doctor's recommendations.\u003c/p>\n\u003cp>According to PAMF researchers, patients want to participate with their physicians in decision-making, but worry they might be perceived as “difficult” and that their care in the future would be compromised.\u003c/p>\n\u003cp>Forget the future -- patients' care might be compromised right now, if they disagree with a recommended treatment, but say nothing. \"Reluctance to express disagreement in the office may correlate with poor adherence outside the office,\" the researchers noted. \"The findings point to the need to test interventions that explicitly allow patients to voice disagreement with their physicians.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Eve Harris is a Bay Area writer. Check out her health blog, \u003ca href=\"http://eve-harris.blogspot.com/\">A Healthy Piece of My Mind\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_7553\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/DoctorsWithPatient_SeattleMunicipalArchives_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7553\" title=\"(Seattle Municipal Archives: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/DoctorsWithPatient_SeattleMunicipalArchives_Flickr-300x197.jpg\" alt=\"(Seattle Municipal Archives: Flickr)\" width=\"300\" height=\"197\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Seattle Municipal Archives: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Desiree Basila was 52 when her stage zero breast cancer -- also called ductal carcinoma in situ -- was diagnosed. While her cancer was found very early, she was ultimately diagnosed with the disease in both breasts. In addition, it was found in several locations. For Basila, doctors said her only realistic treatment option was double mastectomy -- which Basila opposed. “If I die at 75 instead of 95 I think I can live with that,\" she told me recently. \"I did not really want to have a double mastectomy.\"\u003c/p>\n\u003cp>Basila is strong evidence that individuals react differently to their treatment choices\u003cem>. \u003c/em>The new healthcare buzzword is the \u003cem>engaged\u003c/em> patient, generally referring to someone who is collaborating with doctors in the decision-making process and, conversely, where a patient's individual preferences are respected.\u003c/p>\n\u003cp>Basila became just such an engaged patient. After a cancer diagnosis, people usually have a few weeks to investigate treatment options, options that may be life altering. While Basila had little prior experience with cancer, she had been a science teacher and put her skills to use, digging into the research. She sought a second opinion at UC San Francisco and discovered a new \u003c!--more-->research trial which appealed to her. Instead of double mastectomy, she enrolled in a trial on \"\u003ca title=\"http://www.cancer.gov/dictionary?cdrid=616060\" href=\"http://www.cancer.gov/dictionary?cdrid=616060\" target=\"_blank\">Active Surveillance\u003c/a>\" of her slow-growing cancer. As part of the trial, she would go in twice a year for mammograms and she also received MRI images of her breasts once a year. “If it starts showing signs of aggression we can catch it and start more treatment at that point,” she said.\u003c/p>\n\u003cp>In addition to the trial, Basila had support from the \u003ca href=\"http://www.decisionservices.ucsf.edu/\" target=\"_blank\">Decision Services\u003c/a> group at UCSF. There, a newly-diagnosed cancer patient can elect to work with specially trained interns. These interns are often recent college graduates on their way to medical school or other health professions. They help patients find and review accurate information, determine their priorities, and create lists of questions. An intern may also accompany a patient as a note taker during medical appointments.\u003c/p>\n\u003cp>Such strategies have been been shown to improve patients’ understanding of their cancer as well as their sense of engagement in their care. In a \u003ca title=\"http://www.cancersupportcommunity.org/Press-Releases/2012/Open-to-Options.pdf\" href=\"http://www.cancersupportcommunity.org/Press-Releases/2012/Open-to-Options.pdf\" target=\"_blank\">pilot program,\u003c/a> [PDF] nine out of ten patients felt that the list of questions, concerns and expectations contributed to a more productive appointment with their doctor. Both patients and physicians reported satisfaction with these techniques.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But this decision support was available only to a fraction of the nation’s cancer patients until earlier this summer, when the \u003cem>Open to Options\u003c/em>\u003ca href=\"http://www.cancersupportcommunity.org/MainMenu/About-Cancer/Treatment/Making-a-Treatment-Decision/Open-to-Options-2\" target=\"_blank\"> program\u003c/a> was launched by the \u003ca href=\"http://www.cancersupportcommunity.org/\" target=\"_blank\">Cancer Support Community\u003c/a>. This new program was inspired by UCSF’s decision-support service, and its counselors were trained by\u003ca title=\"http://cancer.ucsf.edu/people/profiles/belkora_jeffrey.3767\" href=\"http://cancer.ucsf.edu/people/profiles/belkora_jeffrey.3767\" target=\"_blank\"> Professor Jeffrey Belkora\u003c/a>, Director of Decision Services for the UCSF Breast Care Center.\u003c/p>\n\u003cp>The nonprofit Cancer Support Community (CSC) has a network of 150 locations across the country. The \u003cem>Open to Options \u003c/em>program adds a toll-free phone number and other engagement tools to dramatically expand the reach of the services.\u003c/p>\n\u003cp>The new program targets patients who are “newly diagnosed, facing recurrence or at some other point during their survivorship when they’re faced with making decisions,” Belkora said. “After diagnosis but before treatment is a very vulnerable time for people. … They’re overloaded and overwhelmed.\"\u003c/p>\n\u003cp>Meanwhile, it's been five years since the self-described “risk-tolerant” Basila made her own decision. She admits her background in science made her diagnosis somewhat less confusing for her. After collaborating with decision-support interns, Basila said she felt she could “ask the right questions and give real thought to the answers. ... I didn’t want my decision to be a reaction to fear.\" Although she lives with an “ongoing process” of decision, she hasn’t wavered for the past five years. Her early stage breast cancer has not progressed and she is \"thrilled\" with her choice.\u003c/p>\n\u003cp>Active surveillance is common in prostate cancer but considered experimental for breast cancer. The outcome, while under study, is unknown. “Every one of us,” Basila said, “has to decide what will be our quality vs. quantity of life.”\u003c/p>\n\u003cp>\u003cem>\u003cstrong>This blog has been updated to remove estimates of how many people might be served by the new service.\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Eve Harris is a Bay Area health writer. Check out her blog, \u003ca href=\"http://eve-harris.blogspot.com/\">A Healthy Piece of My Mind\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Desiree Basila was 52 when her stage zero breast cancer was diagnosed. While her cancer was found very early, she was ultimately diagnosed with the disease in both breasts. In addition, it was found in several locations. For Basila, this meant her only treatment option was double mastectomy -- which Basila opposed. “If I die at 75 instead of 95 I think I can live with that,\" she told me recently. \"I did not really want to have a double mastectomy.\"\r\n\r\nBasila is strong evidence that individuals react differently to their treatment choices. The new healthcare buzzword is the engaged patient, generally referring to someone who is collaborating with doctors in the decision-making process and, conversely, where a patient's individual preferences are respected.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_7553\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/DoctorsWithPatient_SeattleMunicipalArchives_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7553\" title=\"(Seattle Municipal Archives: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/DoctorsWithPatient_SeattleMunicipalArchives_Flickr-300x197.jpg\" alt=\"(Seattle Municipal Archives: Flickr)\" width=\"300\" height=\"197\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Seattle Municipal Archives: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Desiree Basila was 52 when her stage zero breast cancer -- also called ductal carcinoma in situ -- was diagnosed. While her cancer was found very early, she was ultimately diagnosed with the disease in both breasts. In addition, it was found in several locations. For Basila, doctors said her only realistic treatment option was double mastectomy -- which Basila opposed. “If I die at 75 instead of 95 I think I can live with that,\" she told me recently. \"I did not really want to have a double mastectomy.\"\u003c/p>\n\u003cp>Basila is strong evidence that individuals react differently to their treatment choices\u003cem>. \u003c/em>The new healthcare buzzword is the \u003cem>engaged\u003c/em> patient, generally referring to someone who is collaborating with doctors in the decision-making process and, conversely, where a patient's individual preferences are respected.\u003c/p>\n\u003cp>Basila became just such an engaged patient. After a cancer diagnosis, people usually have a few weeks to investigate treatment options, options that may be life altering. While Basila had little prior experience with cancer, she had been a science teacher and put her skills to use, digging into the research. She sought a second opinion at UC San Francisco and discovered a new \u003c!--more-->research trial which appealed to her. Instead of double mastectomy, she enrolled in a trial on \"\u003ca title=\"http://www.cancer.gov/dictionary?cdrid=616060\" href=\"http://www.cancer.gov/dictionary?cdrid=616060\" target=\"_blank\">Active Surveillance\u003c/a>\" of her slow-growing cancer. As part of the trial, she would go in twice a year for mammograms and she also received MRI images of her breasts once a year. “If it starts showing signs of aggression we can catch it and start more treatment at that point,” she said.\u003c/p>\n\u003cp>In addition to the trial, Basila had support from the \u003ca href=\"http://www.decisionservices.ucsf.edu/\" target=\"_blank\">Decision Services\u003c/a> group at UCSF. There, a newly-diagnosed cancer patient can elect to work with specially trained interns. These interns are often recent college graduates on their way to medical school or other health professions. They help patients find and review accurate information, determine their priorities, and create lists of questions. An intern may also accompany a patient as a note taker during medical appointments.\u003c/p>\n\u003cp>Such strategies have been been shown to improve patients’ understanding of their cancer as well as their sense of engagement in their care. In a \u003ca title=\"http://www.cancersupportcommunity.org/Press-Releases/2012/Open-to-Options.pdf\" href=\"http://www.cancersupportcommunity.org/Press-Releases/2012/Open-to-Options.pdf\" target=\"_blank\">pilot program,\u003c/a> [PDF] nine out of ten patients felt that the list of questions, concerns and expectations contributed to a more productive appointment with their doctor. Both patients and physicians reported satisfaction with these techniques.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But this decision support was available only to a fraction of the nation’s cancer patients until earlier this summer, when the \u003cem>Open to Options\u003c/em>\u003ca href=\"http://www.cancersupportcommunity.org/MainMenu/About-Cancer/Treatment/Making-a-Treatment-Decision/Open-to-Options-2\" target=\"_blank\"> program\u003c/a> was launched by the \u003ca href=\"http://www.cancersupportcommunity.org/\" target=\"_blank\">Cancer Support Community\u003c/a>. This new program was inspired by UCSF’s decision-support service, and its counselors were trained by\u003ca title=\"http://cancer.ucsf.edu/people/profiles/belkora_jeffrey.3767\" href=\"http://cancer.ucsf.edu/people/profiles/belkora_jeffrey.3767\" target=\"_blank\"> Professor Jeffrey Belkora\u003c/a>, Director of Decision Services for the UCSF Breast Care Center.\u003c/p>\n\u003cp>The nonprofit Cancer Support Community (CSC) has a network of 150 locations across the country. The \u003cem>Open to Options \u003c/em>program adds a toll-free phone number and other engagement tools to dramatically expand the reach of the services.\u003c/p>\n\u003cp>The new program targets patients who are “newly diagnosed, facing recurrence or at some other point during their survivorship when they’re faced with making decisions,” Belkora said. “After diagnosis but before treatment is a very vulnerable time for people. … They’re overloaded and overwhelmed.\"\u003c/p>\n\u003cp>Meanwhile, it's been five years since the self-described “risk-tolerant” Basila made her own decision. She admits her background in science made her diagnosis somewhat less confusing for her. After collaborating with decision-support interns, Basila said she felt she could “ask the right questions and give real thought to the answers. ... I didn’t want my decision to be a reaction to fear.\" Although she lives with an “ongoing process” of decision, she hasn’t wavered for the past five years. Her early stage breast cancer has not progressed and she is \"thrilled\" with her choice.\u003c/p>\n\u003cp>Active surveillance is common in prostate cancer but considered experimental for breast cancer. The outcome, while under study, is unknown. “Every one of us,” Basila said, “has to decide what will be our quality vs. quantity of life.”\u003c/p>\n\u003cp>\u003cem>\u003cstrong>This blog has been updated to remove estimates of how many people might be served by the new service.\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Eve Harris is a Bay Area health writer. Check out her blog, \u003ca href=\"http://eve-harris.blogspot.com/\">A Healthy Piece of My Mind\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "FDA Approves First Drug to Help Prevent HIV Infection",
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"content": "\u003cfigure id=\"attachment_7357\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/TruvadaBottle_05102012_JustinSullivan_GettyImages.jpg\">\u003cimg class=\"size-medium wp-image-7357\" title=\"(Justin Sullivan: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/TruvadaBottle_05102012_JustinSullivan_GettyImages-300x206.jpg\" alt=\"(Justin Sullivan: Getty Images)\" width=\"300\" height=\"206\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Justin Sullivan: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Food and Drug Administration has approved Truvada, the first drug shown to reduce the risk of HIV infection in people who are at high risk of acquiring HIV, the virus that causes AIDS.\u003c/p>\n\u003cp>Truvada was already approved as a medication for treatment of people already infected with HIV.\u003c/p>\n\u003cp>Truvada is to be taken twice a day in what is known as pre-exposure prophylaxis, or PrEP.\u003c/p>\n\u003cp>From the FDA's \u003ca title=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm\" href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm\" target=\"_blank\">press release\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As part of PrEP, HIV-uninfected individuals who are at high risk will take Truvada daily to lower their chances of becoming infected with HIV should they be exposed to the virus. A PrEP indication means Truvada is approved for use as part of a comprehensive HIV prevention strategy that includes other prevention methods, such as safe sex practices, risk reduction counseling, and regular HIV testing.\u003c!--more-->\u003c/p>\n\u003cp>\"Today’s approval marks an important milestone in our fight against HIV,\" said FDA Commissioner Margaret A. Hamburg, M.D. \"Every year, about 50,000 U.S. adults and adolescents are diagnosed with HIV infection, despite the availability of prevention methods and strategies to educate, test, and care for people living with the disease. New treatments as well as prevention methods are needed to fight the HIV epidemic in this country.\"\u003c/p>\u003c/blockquote>\n\u003cp>Two large studies (both randomized, double-blind, placebo-controlled) showed Truvada's efficacy in reducing the risk of HIV infection in uninfected individuals. In one trial, 2,499 HIV-negative men and transgender women who have sex with men and engage in high risk behavior for HIV infection, results showed Truvada reduced the risk of HIV infection by 42 percent.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a study of 4,758 heterosexual couples where one partner was HIV-positive and the other was not, Truvada reduced the non-infected partner's risk of becoming infected by 75 percent.\u003c/p>\n\u003cp>Last summer, KQED’s News Fix editor Jon Brooks interviewed \u003ca title=\"http://hivinsite.ucsf.edu/InSite?page=ab-01-01-02\" href=\"http://hivinsite.ucsf.edu/InSite?page=ab-01-01-02\" target=\"_blank\">Dr. Paul Volberding\u003c/a>, co-director of the Center for AIDS Research at the University of California, San Francisco, about the research into Truvada up to that time. Volberding said results showed “the kind of effect we might expect from a very good vaccine.” They also discussed what populations might consider using Truvada as a prophylactic and whether giving healthy people a preventative drug might induce them to engage in riskier sexual activity.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission/\" href=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission/\" target=\"_blank\">You can read or listen to the interview here.\u003c/a>\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "The Food and Drug Administration has approved Truvada, the first drug shown to reduce the risk of HIV infection in people who are at high risk of acquiring HIV, the virus that causes AIDS.\r\n\r\nTruvada was already approved as a medication for treatment of people already infected with HIV.\r\n\r\nTruvada is to be taken twice a day in what is known as pre-exposure prophylaxis, or PrEP.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_7357\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/TruvadaBottle_05102012_JustinSullivan_GettyImages.jpg\">\u003cimg class=\"size-medium wp-image-7357\" title=\"(Justin Sullivan: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/TruvadaBottle_05102012_JustinSullivan_GettyImages-300x206.jpg\" alt=\"(Justin Sullivan: Getty Images)\" width=\"300\" height=\"206\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Justin Sullivan: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Food and Drug Administration has approved Truvada, the first drug shown to reduce the risk of HIV infection in people who are at high risk of acquiring HIV, the virus that causes AIDS.\u003c/p>\n\u003cp>Truvada was already approved as a medication for treatment of people already infected with HIV.\u003c/p>\n\u003cp>Truvada is to be taken twice a day in what is known as pre-exposure prophylaxis, or PrEP.\u003c/p>\n\u003cp>From the FDA's \u003ca title=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm\" href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm\" target=\"_blank\">press release\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As part of PrEP, HIV-uninfected individuals who are at high risk will take Truvada daily to lower their chances of becoming infected with HIV should they be exposed to the virus. A PrEP indication means Truvada is approved for use as part of a comprehensive HIV prevention strategy that includes other prevention methods, such as safe sex practices, risk reduction counseling, and regular HIV testing.\u003c!--more-->\u003c/p>\n\u003cp>\"Today’s approval marks an important milestone in our fight against HIV,\" said FDA Commissioner Margaret A. Hamburg, M.D. \"Every year, about 50,000 U.S. adults and adolescents are diagnosed with HIV infection, despite the availability of prevention methods and strategies to educate, test, and care for people living with the disease. New treatments as well as prevention methods are needed to fight the HIV epidemic in this country.\"\u003c/p>\u003c/blockquote>\n\u003cp>Two large studies (both randomized, double-blind, placebo-controlled) showed Truvada's efficacy in reducing the risk of HIV infection in uninfected individuals. In one trial, 2,499 HIV-negative men and transgender women who have sex with men and engage in high risk behavior for HIV infection, results showed Truvada reduced the risk of HIV infection by 42 percent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a study of 4,758 heterosexual couples where one partner was HIV-positive and the other was not, Truvada reduced the non-infected partner's risk of becoming infected by 75 percent.\u003c/p>\n\u003cp>Last summer, KQED’s News Fix editor Jon Brooks interviewed \u003ca title=\"http://hivinsite.ucsf.edu/InSite?page=ab-01-01-02\" href=\"http://hivinsite.ucsf.edu/InSite?page=ab-01-01-02\" target=\"_blank\">Dr. Paul Volberding\u003c/a>, co-director of the Center for AIDS Research at the University of California, San Francisco, about the research into Truvada up to that time. Volberding said results showed “the kind of effect we might expect from a very good vaccine.” They also discussed what populations might consider using Truvada as a prophylactic and whether giving healthy people a preventative drug might induce them to engage in riskier sexual activity.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission/\" href=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission/\" target=\"_blank\">You can read or listen to the interview here.\u003c/a>\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_7266\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/HospitalSafety_LabScienceCareer_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7266\" title=\"(Lab Science Career: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/HospitalSafety_LabScienceCareer_Flickr-300x300.jpg\" alt=\"(Lab Science Career: Flickr)\" width=\"300\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Lab Science Career: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Ever used \u003ca title=\"http://www.consumerreports.org/cro/index.htm\" href=\"http://www.consumerreports.org/cro/index.htm\" target=\"_blank\">Consumer Reports\u003c/a> to check out an appliance or help decide which car to buy? Now you can do the same thing with many hospitals. Consumer Reports, best known for testing consumer products, released its first-ever \u003ca title=\"http://www.consumerreports.org/cro/magazine/2012/08/how-safe-is-your-hospital/index.htm\" href=\"http://www.consumerreports.org/cro/magazine/2012/08/how-safe-is-your-hospital/index.htm\" target=\"_blank\">hospital safety ratings \u003c/a>and many of California’s most prestigious hospitals, including several from the Bay Area, were among them.\u003c/p>\n\u003cp>\u003cem>Consumer Reports \u003c/em>judged roughly 1,100 of the country's 6,300 hospitals in six different categories -- from hospital-acquired infections to mortality -- and then combined scores for a final overall safety score out of 100 possible points. Perhaps the most surprising news is that the highest scoring hospital, \u003ca title=\"http://www.billingsclinic.com/\" href=\"http://www.billingsclinic.com/\" target=\"_blank\">Billings Clinic\u003c/a> in Montana, scored only a 72. The lowest scoring in the country was Chicago's\u003ca title=\"http://www.sacredheartchicago.com/\" href=\"http://www.sacredheartchicago.com/\" target=\"_blank\"> Sacred Heart Hospital\u003c/a>, with a meager 16. The reason so few hospitals were ranked overall is because many hospitals simply do not consistently track safety data.\u003c/p>\n\u003caside class=\"pullquote alignright\">“We think all hospitals need to make this the top priority.\"\u003c/aside>\n\u003cp>Dr. John Santa, director of the Consumer Reports Health Ratings Center, sounded a note of frustration on the difficulty of acquiring complete data. \"It’s just time for hospitals to accept this is a high priority,\" he told me in an interview. \"They need to make it so. They need to share what’s going on with the public. And we all need to hold them accountable.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In Northern California, many hospitals could provide all the data but didn't score exceptionally well. \u003ca title=\"http://stanfordhospital.org/\" href=\"http://stanfordhospital.org/\" target=\"_blank\">Stanford Hospital and Clinics\u003c/a> received an overall score of 57 out of 100, \u003ca title=\"http://www.ucsfhealth.org/\" href=\"http://www.ucsfhealth.org/\" target=\"_blank\">UCSF Medical Center\u003c/a> a 48, and \u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/sfgh/default.asp\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/sfgh/default.asp\" target=\"_blank\">San Francisco General Hospital \u003c/a>a 47. \u003ca title=\"http://www.bakersfieldhearthospital.com/\" href=\"http://www.bakersfieldhearthospital.com/\" target=\"_blank\">Bakersfield Heart Hospital\u003c/a> received a 68 making it the highest scoring hospital in California.\u003c/p>\n\u003cp>“I don’t think there is perfection in these areas at any hospital currently but it is definitely something that all hospitals are working toward, and San Francisco General is no exception,” says \u003ca title=\"http://futurehealth.ucsf.edu/Public/Leadership-Programs/MiniProfile.aspx?pid=144&asuid=12213\" href=\"http://futurehealth.ucsf.edu/Public/Leadership-Programs/MiniProfile.aspx?pid=144&asuid=12213\" target=\"_blank\">Rachael Kagan\u003c/a>, a spokeswoman for San Francisco General Hospital.\u003c/p>\n\u003cp>Kagan also advised consumers to consider the ratings among others currently available. “We’re shown to be above average in some areas and below average in others. I think that’s a fair statement.\" Kagan said she plans to review the ratings further to see how scores were calculated, but says she doesn’t find the Consumer Reports’ ratings worrisome. “We’re very committed to improving in these areas,\" she asserted. \"We have initiatives around all of these areas that are (the) subject of this report and many more that are not included in this report.\"\u003c/p>\n\u003cp>Santa thinks even the most renowned hospitals can improve. “We do have high expectations for safety at Consumer Reports,” Santa told me. “We think all hospitals need to make this the top priority and all hospitals need to get better.” According to Santa, it is difficult for many hospitals to make safety their main priority when there are other areas including research and teaching to focus on. “That’s a challenge for teaching hospitals, for bigger public or county hospitals. Having said that, it’s doable,” Santa added.\u003c/p>\n\u003cp>And what is Santa’s advice to the Bay Area’s teaching hospitals with so many priorities?\u003c/p>\n\u003cp>“To get better at this, they will need to make safety a priority. It’s likely that means they’ll need to figure out how to teach it to their medical students and residents. They’ll need to figure out how to do research to figure out how to improve it. And they will need to work more with their patients to make progress,” Santa explained, who pointed to\u003ca title=\"http://www.baylorhealth.com/Pages/Default.aspx\" href=\"http://www.baylorhealth.com/Pages/Default.aspx\" target=\"_blank\"> Baylor University Medical Center\u003c/a> in Dallas as a high scoring hospital because it makes safety a top priority.\u003c/p>\n\u003cp>\u003cem>Consumer Reports\u003c/em> did mention several limitations in its new report. For starters, only 18 percent of all U.S. hospitals were rated. \u003ca title=\"http://www2.va.gov/directory/guide/home.asp\" href=\"http://www2.va.gov/directory/guide/home.asp\" target=\"_blank\">Veterans Affairs\u003c/a> hospitals and children’s hospitals were not included because they currently are not required by the government to measure the clarity of communication with patients. \u003ca title=\"https://healthy.kaiserpermanente.org/html/kaiser/index.shtml\" href=\"https://healthy.kaiserpermanente.org/html/kaiser/index.shtml\" target=\"_blank\">Kaiser Permanente\u003c/a> hospitals were excluded from the ratings because they did not report data in one or more of the measures.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“\u003cem>Consumer Reports\u003c/em> has always prided itself on our independence from industry and our independence from other groups weighing in on a topic,” Santa added. “While we look at other groups in terms of ratings, these are what we think are the most reliable indicators for consumers in terms of safety.”\u003c/p>\n\n",
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"excerpt": "Ever used Consumer Reports to check out an appliance or help decide which car to buy? Now you can do the same thing with many hospitals. Consumer Reports, best known for testing consumer products, released its first-ever hospital safety ratings and many of California’s most prestigious hospitals, including several from the Bay Area, were among them.\r\n\r\nConsumer Reportsjudged 1,100 of the country's 6,268 hospitals in six different categories -- from hospital-acquired infections to mortality -- and then combined scores for a final overall safety score out of 100 possible points. Perhaps the most surprising news is that the highest scoring hospital, Billings Clinic in Montana, scored only a 72. The lowest scoring in the country was Chicago's Sacred Heart Hospital, with a meager 16. The reason so few hospitals were ranked overall is because many hospitals simply do not consistently track safety data.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_7266\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/HospitalSafety_LabScienceCareer_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7266\" title=\"(Lab Science Career: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/HospitalSafety_LabScienceCareer_Flickr-300x300.jpg\" alt=\"(Lab Science Career: Flickr)\" width=\"300\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Lab Science Career: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Ever used \u003ca title=\"http://www.consumerreports.org/cro/index.htm\" href=\"http://www.consumerreports.org/cro/index.htm\" target=\"_blank\">Consumer Reports\u003c/a> to check out an appliance or help decide which car to buy? Now you can do the same thing with many hospitals. Consumer Reports, best known for testing consumer products, released its first-ever \u003ca title=\"http://www.consumerreports.org/cro/magazine/2012/08/how-safe-is-your-hospital/index.htm\" href=\"http://www.consumerreports.org/cro/magazine/2012/08/how-safe-is-your-hospital/index.htm\" target=\"_blank\">hospital safety ratings \u003c/a>and many of California’s most prestigious hospitals, including several from the Bay Area, were among them.\u003c/p>\n\u003cp>\u003cem>Consumer Reports \u003c/em>judged roughly 1,100 of the country's 6,300 hospitals in six different categories -- from hospital-acquired infections to mortality -- and then combined scores for a final overall safety score out of 100 possible points. Perhaps the most surprising news is that the highest scoring hospital, \u003ca title=\"http://www.billingsclinic.com/\" href=\"http://www.billingsclinic.com/\" target=\"_blank\">Billings Clinic\u003c/a> in Montana, scored only a 72. The lowest scoring in the country was Chicago's\u003ca title=\"http://www.sacredheartchicago.com/\" href=\"http://www.sacredheartchicago.com/\" target=\"_blank\"> Sacred Heart Hospital\u003c/a>, with a meager 16. The reason so few hospitals were ranked overall is because many hospitals simply do not consistently track safety data.\u003c/p>\n\u003caside class=\"pullquote alignright\">“We think all hospitals need to make this the top priority.\"\u003c/aside>\n\u003cp>Dr. John Santa, director of the Consumer Reports Health Ratings Center, sounded a note of frustration on the difficulty of acquiring complete data. \"It’s just time for hospitals to accept this is a high priority,\" he told me in an interview. \"They need to make it so. They need to share what’s going on with the public. And we all need to hold them accountable.\"\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>In Northern California, many hospitals could provide all the data but didn't score exceptionally well. \u003ca title=\"http://stanfordhospital.org/\" href=\"http://stanfordhospital.org/\" target=\"_blank\">Stanford Hospital and Clinics\u003c/a> received an overall score of 57 out of 100, \u003ca title=\"http://www.ucsfhealth.org/\" href=\"http://www.ucsfhealth.org/\" target=\"_blank\">UCSF Medical Center\u003c/a> a 48, and \u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/sfgh/default.asp\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/sfgh/default.asp\" target=\"_blank\">San Francisco General Hospital \u003c/a>a 47. \u003ca title=\"http://www.bakersfieldhearthospital.com/\" href=\"http://www.bakersfieldhearthospital.com/\" target=\"_blank\">Bakersfield Heart Hospital\u003c/a> received a 68 making it the highest scoring hospital in California.\u003c/p>\n\u003cp>“I don’t think there is perfection in these areas at any hospital currently but it is definitely something that all hospitals are working toward, and San Francisco General is no exception,” says \u003ca title=\"http://futurehealth.ucsf.edu/Public/Leadership-Programs/MiniProfile.aspx?pid=144&asuid=12213\" href=\"http://futurehealth.ucsf.edu/Public/Leadership-Programs/MiniProfile.aspx?pid=144&asuid=12213\" target=\"_blank\">Rachael Kagan\u003c/a>, a spokeswoman for San Francisco General Hospital.\u003c/p>\n\u003cp>Kagan also advised consumers to consider the ratings among others currently available. “We’re shown to be above average in some areas and below average in others. I think that’s a fair statement.\" Kagan said she plans to review the ratings further to see how scores were calculated, but says she doesn’t find the Consumer Reports’ ratings worrisome. “We’re very committed to improving in these areas,\" she asserted. \"We have initiatives around all of these areas that are (the) subject of this report and many more that are not included in this report.\"\u003c/p>\n\u003cp>Santa thinks even the most renowned hospitals can improve. “We do have high expectations for safety at Consumer Reports,” Santa told me. “We think all hospitals need to make this the top priority and all hospitals need to get better.” According to Santa, it is difficult for many hospitals to make safety their main priority when there are other areas including research and teaching to focus on. “That’s a challenge for teaching hospitals, for bigger public or county hospitals. Having said that, it’s doable,” Santa added.\u003c/p>\n\u003cp>And what is Santa’s advice to the Bay Area’s teaching hospitals with so many priorities?\u003c/p>\n\u003cp>“To get better at this, they will need to make safety a priority. It’s likely that means they’ll need to figure out how to teach it to their medical students and residents. They’ll need to figure out how to do research to figure out how to improve it. And they will need to work more with their patients to make progress,” Santa explained, who pointed to\u003ca title=\"http://www.baylorhealth.com/Pages/Default.aspx\" href=\"http://www.baylorhealth.com/Pages/Default.aspx\" target=\"_blank\"> Baylor University Medical Center\u003c/a> in Dallas as a high scoring hospital because it makes safety a top priority.\u003c/p>\n\u003cp>\u003cem>Consumer Reports\u003c/em> did mention several limitations in its new report. For starters, only 18 percent of all U.S. hospitals were rated. \u003ca title=\"http://www2.va.gov/directory/guide/home.asp\" href=\"http://www2.va.gov/directory/guide/home.asp\" target=\"_blank\">Veterans Affairs\u003c/a> hospitals and children’s hospitals were not included because they currently are not required by the government to measure the clarity of communication with patients. \u003ca title=\"https://healthy.kaiserpermanente.org/html/kaiser/index.shtml\" href=\"https://healthy.kaiserpermanente.org/html/kaiser/index.shtml\" target=\"_blank\">Kaiser Permanente\u003c/a> hospitals were excluded from the ratings because they did not report data in one or more of the measures.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“\u003cem>Consumer Reports\u003c/em> has always prided itself on our independence from industry and our independence from other groups weighing in on a topic,” Santa added. “While we look at other groups in terms of ratings, these are what we think are the most reliable indicators for consumers in terms of safety.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New In-Home HIV Test Raises Follow-Up Concerns",
"title": "New In-Home HIV Test Raises Follow-Up Concerns",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_7139\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/in-home-test-hiv.jpg\">\u003cimg class=\"size-medium wp-image-7139\" title=\"The FDA recently approved an over-the-counter, in-home HIV testing kit. \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/07/in-home-test-hiv-300x252.jpg\" alt=\"The FDA recently approved an over-the-counter, in-home HIV testing kit. (Photo: FDA.gov)\" width=\"300\" height=\"252\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA recently approved an over-the-counter, in-home HIV testing kit. (Photo: FDA.gov)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>\u003c/p>\n\u003cp>Beginning this October, Americans will have the opportunity to test themselves for HIV in the comfort and privacy of their own homes. The \u003ca href=\"http://www.orasure.com/\" target=\"_blank\">OraQuick In-Home HIV Test \u003c/a>will be the first ever self-administered HIV-test made available for over-the-counter purchase.\u003c/p>\n\u003cp>The Food and Drug Administration approved the test earlier this week, but it warned the test’s results are a “preliminary” diagnosis, so check-ups are still necessary. Some Bay Area researchers said a key challenge will be ensuring that people actually seek out a confirmation test and additional services from their doctors, regardless of testing positive or negative for the virus.\u003c/p>\n\u003cp>“The home test is another mechanism for testing but it shouldn’t be [used] in isolation,” said \u003ca href=\"http://sfhiv.org/profiles/tracey_packer.php\" target=\"_blank\">Tracey Packer\u003c/a>, the Acting Director of \u003ca href=\"http://sfhiv.org/\" target=\"_blank\">HIV Prevention for the San Francisco Department of Public Health\u003c/a>. Packer says that having an in-home HIV test raises the issue of people not getting accurate information.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"They have to know the test may take a while to become positive. It may take several months. If they’ve had a very recent exposure, getting a negative test result is not enough.”\u003c/aside>\n\u003cp>According to the FDA, a positive test does not necessarily mean a person is HIV-positive. The FDA suggests that people who test positive to quickly seek confirmation with their doctors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>People with a negative test should also be wary. A negative test does not mean a person is free from HIV. \u003ca href=\"http://cancer.ucsf.edu/people/profiles/buchbinder_susan.3722\" target=\"_blank\">Susan Buchbinder\u003c/a>, MD, the Director of HIV Research Section at the San Francisco Department of Public Health, and a former panel member on the FDA’s advisory committee that recommended OraQuick’s approval, said OraQuick can't determine if a person has contracted HIV within the past three months.\u003c/p>\n\u003cp>\u003c!--more-->\"If they [test] HIV-negative but may have had recent exposures, they have to know the test may take a while to become positive,\" Buchbinder said. \"It may take several months. If they’ve had a very recent exposure, getting a negative test result is not enough.”\u003c/p>\n\u003cp>Regardless of the diagnosis, Buchbinder urges people to quickly seek an additional test to confirm their results with a doctor. She said she is also concerned about how people will perceive their test results, and the potential effects of stigma. “There could be some psychological harm [and] there could be social harm if somebody found out that you were testing and thereby inferred something about you.\"\u003c/p>\n\u003cp>As opposed to being tested at a clinic or in a hospital, Buchbinder said people using in-home HIV test won’t have the benefit of a doctor or health care provider’s counseling services when they get their results.\u003c/p>\n\u003cp>However, Buchbinder said people do have access to a 24-hour, toll-free number linking them to a supportive services. She added that it may be helpful for people to test with someone they trust, and would feel comfortable being close to, once they get their results.\u003c/p>\n\u003cp>Though there are concerns, Buchbinder said she believed that the new test has the potential to change people’s risk behaviors. “It has the potential to reduce new infections by getting people who learn that they’re infected into care and treatment, and [reduces] the risk of exposure to HIV-negative individuals,” she said. “[But] we won’t know until we actually see how this rolls out.”\u003c/p>\n\u003cp>Buchbinder said she also hopes that OraQuick users will share all of their positive and negative experiences. “The more information we get back from the community about what’s working and what’s not working, the better able we are to build services and build programs that can support people,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The San Francisco Public Health Department is currently working on strategies to figure out the most effective means of using OraQuick in local areas where testing rates are lower and where there is a higher rate of health risk behaviors.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>People with a negative test should also be wary. A negative test does not mean a person is free from HIV. \u003ca href=\"http://cancer.ucsf.edu/people/profiles/buchbinder_susan.3722\" target=\"_blank\">Susan Buchbinder\u003c/a>, MD, the Director of HIV Research Section at the San Francisco Department of Public Health, and a former panel member on the FDA’s advisory committee that recommended OraQuick’s approval, said OraQuick can't determine if a person has contracted HIV within the past three months.\u003c/p>\n\u003cp>\u003c!--more-->\"If they [test] HIV-negative but may have had recent exposures, they have to know the test may take a while to become positive,\" Buchbinder said. \"It may take several months. If they’ve had a very recent exposure, getting a negative test result is not enough.”\u003c/p>\n\u003cp>Regardless of the diagnosis, Buchbinder urges people to quickly seek an additional test to confirm their results with a doctor. She said she is also concerned about how people will perceive their test results, and the potential effects of stigma. “There could be some psychological harm [and] there could be social harm if somebody found out that you were testing and thereby inferred something about you.\"\u003c/p>\n\u003cp>As opposed to being tested at a clinic or in a hospital, Buchbinder said people using in-home HIV test won’t have the benefit of a doctor or health care provider’s counseling services when they get their results.\u003c/p>\n\u003cp>However, Buchbinder said people do have access to a 24-hour, toll-free number linking them to a supportive services. She added that it may be helpful for people to test with someone they trust, and would feel comfortable being close to, once they get their results.\u003c/p>\n\u003cp>Though there are concerns, Buchbinder said she believed that the new test has the potential to change people’s risk behaviors. “It has the potential to reduce new infections by getting people who learn that they’re infected into care and treatment, and [reduces] the risk of exposure to HIV-negative individuals,” she said. “[But] we won’t know until we actually see how this rolls out.”\u003c/p>\n\u003cp>Buchbinder said she also hopes that OraQuick users will share all of their positive and negative experiences. “The more information we get back from the community about what’s working and what’s not working, the better able we are to build services and build programs that can support people,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The San Francisco Public Health Department is currently working on strategies to figure out the most effective means of using OraQuick in local areas where testing rates are lower and where there is a higher rate of health risk behaviors.\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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"masters-of-scale": {
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"mindshift": {
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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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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
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"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"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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},
"pbs-newshour": {
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},
"perspectives": {
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"order": 14
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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"link": "/radio/program/planet-money",
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"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.",
"airtime": "THU 6:30pm-7pm",
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"order": 5
},
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
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