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"content": "\u003cp>\u003cstrong>By Eve Harris\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5241\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/doctor-patient300x300.gif\">\u003cimg class=\"size-full wp-image-5241\" title=\"doctor-patient300x300\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/doctor-patient300x300.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The doctor-patient relationship has become more collaborative as patients use technology to better understand their health. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Not very long ago, a patient’s medical chart was considered proprietary information belonging to a doctor or a hospital. But just as technology is remaking the rest of the world, it’s also contributing to remaking the relationship between your doctor and you.\u003c/p>\n\u003cp>More patients have access to their data now that more doctors are moving to electronic medical records. Emerging technologies are also driving change. People with diabetes might use mobile apps to keep track of blood sugar levels, for example. So, with all this data at a patient’s fingertips, how is the doctor-patient relationship changing?\u003c/p>\n\u003cp>“Patients, when they come to the doctor seeking health care, aren’t necessarily looking for ‘raw data’ – they have already looked it up online. Instead, they are looking for meaning,” \u003ca href=\"http://www.kevinmd.com/blog/2012/03/patient-experience-enhanced-modern-technology.html\">wrote Dr. Robert Rowley\u003c/a> recently. Rowley is a family practice doctor in Hayward … but he’s also the medical director of \u003ca href=\"http://www.practicefusion.com/pages/physician-expert-robert-rowley.html\">Practice Fusion\u003c/a>, an electronic medical record company.\u003c/p>\n\u003cp>Searching for meaning in the doctor’s office, I was intrigued. In an interview, Rowley told me that the role of the physician is shifting to “somewhat of a coach, a trusted advisor.” For example, a patient may want to discuss their medication if new or dangerous side effects were recently reported in the news. In a situation like that, Rowley told me, “My role is more of an interpreter.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rowley believes that the best care he can deliver today includes helping patients sort through and understand the “chaotic array of overwhelming data” as it relates to each person’s health. After doing a web search on their diagnosis, he said, “a patient will say, ‘help me understand this. Help me find meaning.’”\u003c/p>\n\u003cp>A study presented recently at the American College of Cardiology Scientific Session demonstrates the effect a personal doctor-patient exchange can have – not just on patients’ experience, but on their health outcomes. Cardiac patients in Los Angeles who had the opportunity to see their heart scans -- clogged arteries and all -- were more likely to follow risk reduction measures such as losing weight.\u003c/p>\n\u003cp>In short, the didactic, authoritative physician of the old days is giving way to that of highly trained medical coach or collaborator. In a recent \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1109283\">New England Journal of Medicine editorial\u003c/a> two doctors wrote, “The clinician needs to explain what is possible and negotiate potentially achievable goals with the patient. Then the clinician should provide a treatment plan, encouragement and advocacy to help the patient.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.howardluksmd.com/about/about-me/\">Howard Luks\u003c/a> is an orthopedic surgeon at and social media enthusiast currently serving on the board of the Mayo Clinic Center for Social Media. In blog posts and public addresses he, too, stresses that the doctor-patient relationship should be just that – a relationship. He tells doctors, “This is about stories. We treat patients. We don’t treat x-rays or MRI findings.”\u003c/p>\n\u003cp>But technology has a substantial influence on how the relationship changes, as with the cardiac patients who committed to losing weight not because the doctor prescribed it, but because the doctor showed them their clogged arteries.\u003c/p>\n\u003cp>Luks said recently in an \u003ca href=\"https://www.inspire.com/John2/journal/the-inspire-q-and-a-inspire-talks-with-howard-luks-md/\">interview\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Patients are…researching and diagnosing themselves through WebMD and then they’re searching for physicians who have expertise in that particular area.\u003c/p>\n\u003cp>Physicians are starting to realize that it helps us regain or recapture those relationships that older physicians had with their patients. They knew their patients…They knew their patients had a recent baby, or that they just bought a new house, that they moved, or they got a new job, or got a puppy, or whatever. Having a relationship with your patient in that respect for some is special and meaningful.\u003c/p>\u003c/blockquote>\n\u003cp>Much of that information is shared now via social media. Luks – considered when he speaks at medical conferences to be an evangelist about healthcare social media -- tells physicians, “If you choose not to engage, then I feel that is to ignore your own relevance as a health care practitioner.”\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>\u003cp>\u003cstrong>By Eve Harris\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5241\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/doctor-patient300x300.gif\">\u003cimg class=\"size-full wp-image-5241\" title=\"doctor-patient300x300\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/doctor-patient300x300.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/doctor-patient300x300-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The doctor-patient relationship has become more collaborative as patients use technology to better understand their health. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Not very long ago, a patient’s medical chart was considered proprietary information belonging to a doctor or a hospital. But just as technology is remaking the rest of the world, it’s also contributing to remaking the relationship between your doctor and you.\u003c/p>\n\u003cp>More patients have access to their data now that more doctors are moving to electronic medical records. Emerging technologies are also driving change. People with diabetes might use mobile apps to keep track of blood sugar levels, for example. So, with all this data at a patient’s fingertips, how is the doctor-patient relationship changing?\u003c/p>\n\u003cp>“Patients, when they come to the doctor seeking health care, aren’t necessarily looking for ‘raw data’ – they have already looked it up online. Instead, they are looking for meaning,” \u003ca href=\"http://www.kevinmd.com/blog/2012/03/patient-experience-enhanced-modern-technology.html\">wrote Dr. Robert Rowley\u003c/a> recently. Rowley is a family practice doctor in Hayward … but he’s also the medical director of \u003ca href=\"http://www.practicefusion.com/pages/physician-expert-robert-rowley.html\">Practice Fusion\u003c/a>, an electronic medical record company.\u003c/p>\n\u003cp>Searching for meaning in the doctor’s office, I was intrigued. In an interview, Rowley told me that the role of the physician is shifting to “somewhat of a coach, a trusted advisor.” For example, a patient may want to discuss their medication if new or dangerous side effects were recently reported in the news. In a situation like that, Rowley told me, “My role is more of an interpreter.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rowley believes that the best care he can deliver today includes helping patients sort through and understand the “chaotic array of overwhelming data” as it relates to each person’s health. After doing a web search on their diagnosis, he said, “a patient will say, ‘help me understand this. Help me find meaning.’”\u003c/p>\n\u003cp>A study presented recently at the American College of Cardiology Scientific Session demonstrates the effect a personal doctor-patient exchange can have – not just on patients’ experience, but on their health outcomes. Cardiac patients in Los Angeles who had the opportunity to see their heart scans -- clogged arteries and all -- were more likely to follow risk reduction measures such as losing weight.\u003c/p>\n\u003cp>In short, the didactic, authoritative physician of the old days is giving way to that of highly trained medical coach or collaborator. In a recent \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1109283\">New England Journal of Medicine editorial\u003c/a> two doctors wrote, “The clinician needs to explain what is possible and negotiate potentially achievable goals with the patient. Then the clinician should provide a treatment plan, encouragement and advocacy to help the patient.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.howardluksmd.com/about/about-me/\">Howard Luks\u003c/a> is an orthopedic surgeon at and social media enthusiast currently serving on the board of the Mayo Clinic Center for Social Media. In blog posts and public addresses he, too, stresses that the doctor-patient relationship should be just that – a relationship. He tells doctors, “This is about stories. We treat patients. We don’t treat x-rays or MRI findings.”\u003c/p>\n\u003cp>But technology has a substantial influence on how the relationship changes, as with the cardiac patients who committed to losing weight not because the doctor prescribed it, but because the doctor showed them their clogged arteries.\u003c/p>\n\u003cp>Luks said recently in an \u003ca href=\"https://www.inspire.com/John2/journal/the-inspire-q-and-a-inspire-talks-with-howard-luks-md/\">interview\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Patients are…researching and diagnosing themselves through WebMD and then they’re searching for physicians who have expertise in that particular area.\u003c/p>\n\u003cp>Physicians are starting to realize that it helps us regain or recapture those relationships that older physicians had with their patients. They knew their patients…They knew their patients had a recent baby, or that they just bought a new house, that they moved, or they got a new job, or got a puppy, or whatever. Having a relationship with your patient in that respect for some is special and meaningful.\u003c/p>\u003c/blockquote>\n\u003cp>Much of that information is shared now via social media. Luks – considered when he speaks at medical conferences to be an evangelist about healthcare social media -- tells physicians, “If you choose not to engage, then I feel that is to ignore your own relevance as a health care practitioner.”\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": "Talking About Choices May Encourage Colon Cancer Screening",
"title": "Talking About Choices May Encourage Colon Cancer Screening",
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"content": "\u003cp>\u003cstrong>By: Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4913\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012.jpg\">\u003cimg class=\"size-medium wp-image-4913\" title=\"Doctor greating patient\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012-300x200.jpg\" alt=\"Doctor greating patient\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Although about 50,000 people in the U.S. \u003ca href=\"http://seer.cancer.gov/statfacts/html/colorect.html\">died from colorectal cancer\u003c/a> (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\u003c/p>\n\u003cp>The problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. \u003ca href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\">Alternatives do exist\u003c/a>, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, \u003ca href=\"../2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\">new tools are also being developed\u003c/a> that use more advanced science to check for markers of cancer, though these are still gaining traction.\u003c/p>\n\u003cp>But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.\u003c/p>\n\u003cp>In a study published today in the \u003ca title=\"http://archinte.ama-assn.org/\" href=\"http://archinte.ama-assn.org/\" target=\"_blank\">Archives of Internal Medicine\u003c/a>, researchers from three medical schools, including \u003ca title=\"http://www.ucsf.edu/\" href=\"http://www.ucsf.edu/\" target=\"_blank\">UCSF\u003c/a>, focused on just colonoscopies and FOBT. The study was done in San Francisco through the\u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" target=\"_blank\"> Community Health Network\u003c/a>, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.\u003c/p>\n\u003cp>They were wrong.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>What they found instead was that patients who were recommended to get a colonoscopy only followed through 38 percent of the time. Compare that to patients who got a recommendation for FOBT and got screened 67 percent of the time, or those given a choice between the two -- who underwent screening 69 percent of the time.\u003c/p>\n\u003cp>As the researchers say, “Giving choices through shared decision making can improve adherence by increasing patient engagement and allowing for individual patient preferences.”\u003c/p>\n\u003cp>The finding was surprising because previous studies had suggested that talking to patients about the wide range of available options often led them to do nothing at all. As the study authors put it, “[E]vidence also illustrates that providing options of similar value and characteristics can sometimes have a negative impact on adherence due to people defaulting to inertia, presumably because of confusion or indecision between choices.”\u003c/p>\n\u003cp>Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California, wrote a commentary in response to the publication. In his words:\u003c/p>\n\u003cblockquote>\u003cp> “If having too many choices leads to confusion, the study by Inadomi et al. demonstrates that not having enough choice may lead to inaction when the only choice is colonoscopy ... When it comes to CRC screening, providing an option other than colonoscopy for our patients is not overwhelming, but necessary.”\u003c/p>\n\u003cp>“What should physicians recommend when talking with patients about CRC? The psychology literature has noted that too much choice is a problem in current society. Patients may be overwhelmed by the options and feel that no option is perfect and therefore choose to do nothing out of confusion. However, every option for CRC screening has its own unique strengths and limitations. A patient-centered approach would take each patient’s perspective into account when designing a screening strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>The study further looked at differences among groups of people to find barriers to screening. The authors wrote:\u003c/p>\n\u003cblockquote>\u003cp>“Prior studies reported low CRC screening rates among racial/ethnic minorities, especially among Asians, Latinos, and African Americans. While the present study confirms the disparity among African Americans, we observed higher adherence among Asians and Latinos than for whites. Our population had established access to health care, which may have reduced these racial differences.”\u003c/p>\u003c/blockquote>\n\u003cp>The study authors also found that people who did their patient-doctor visits in Spanish, Cantonese, or Mandarin were more likely to get screened than people of the same race/ethnicity who chose to do their visits in English.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, not surprisingly, patients with insurance (public or private) completed screening more often than those without insurance.\u003c/p>\n\n",
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"excerpt": "Although about 50,000 people in the U.S. died from colorectal cancer (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\r\n\r\nThe problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. Alternatives do exist, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, new tools are also being developed that use more advanced science to check for markers of cancer, though these are still gaining traction.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By: Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4913\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012.jpg\">\u003cimg class=\"size-medium wp-image-4913\" title=\"Doctor greating patient\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012-300x200.jpg\" alt=\"Doctor greating patient\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Although about 50,000 people in the U.S. \u003ca href=\"http://seer.cancer.gov/statfacts/html/colorect.html\">died from colorectal cancer\u003c/a> (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\u003c/p>\n\u003cp>The problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. \u003ca href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\">Alternatives do exist\u003c/a>, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, \u003ca href=\"../2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\">new tools are also being developed\u003c/a> that use more advanced science to check for markers of cancer, though these are still gaining traction.\u003c/p>\n\u003cp>But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.\u003c/p>\n\u003cp>In a study published today in the \u003ca title=\"http://archinte.ama-assn.org/\" href=\"http://archinte.ama-assn.org/\" target=\"_blank\">Archives of Internal Medicine\u003c/a>, researchers from three medical schools, including \u003ca title=\"http://www.ucsf.edu/\" href=\"http://www.ucsf.edu/\" target=\"_blank\">UCSF\u003c/a>, focused on just colonoscopies and FOBT. The study was done in San Francisco through the\u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" target=\"_blank\"> Community Health Network\u003c/a>, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.\u003c/p>\n\u003cp>They were wrong.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>What they found instead was that patients who were recommended to get a colonoscopy only followed through 38 percent of the time. Compare that to patients who got a recommendation for FOBT and got screened 67 percent of the time, or those given a choice between the two -- who underwent screening 69 percent of the time.\u003c/p>\n\u003cp>As the researchers say, “Giving choices through shared decision making can improve adherence by increasing patient engagement and allowing for individual patient preferences.”\u003c/p>\n\u003cp>The finding was surprising because previous studies had suggested that talking to patients about the wide range of available options often led them to do nothing at all. As the study authors put it, “[E]vidence also illustrates that providing options of similar value and characteristics can sometimes have a negative impact on adherence due to people defaulting to inertia, presumably because of confusion or indecision between choices.”\u003c/p>\n\u003cp>Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California, wrote a commentary in response to the publication. In his words:\u003c/p>\n\u003cblockquote>\u003cp> “If having too many choices leads to confusion, the study by Inadomi et al. demonstrates that not having enough choice may lead to inaction when the only choice is colonoscopy ... When it comes to CRC screening, providing an option other than colonoscopy for our patients is not overwhelming, but necessary.”\u003c/p>\n\u003cp>“What should physicians recommend when talking with patients about CRC? The psychology literature has noted that too much choice is a problem in current society. Patients may be overwhelmed by the options and feel that no option is perfect and therefore choose to do nothing out of confusion. However, every option for CRC screening has its own unique strengths and limitations. A patient-centered approach would take each patient’s perspective into account when designing a screening strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>The study further looked at differences among groups of people to find barriers to screening. The authors wrote:\u003c/p>\n\u003cblockquote>\u003cp>“Prior studies reported low CRC screening rates among racial/ethnic minorities, especially among Asians, Latinos, and African Americans. While the present study confirms the disparity among African Americans, we observed higher adherence among Asians and Latinos than for whites. Our population had established access to health care, which may have reduced these racial differences.”\u003c/p>\u003c/blockquote>\n\u003cp>The study authors also found that people who did their patient-doctor visits in Spanish, Cantonese, or Mandarin were more likely to get screened than people of the same race/ethnicity who chose to do their visits in English.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, not surprisingly, patients with insurance (public or private) completed screening more often than those without insurance.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Video: Spurned Fruit Flies Turn to Alcohol for Solace",
"title": "Video: Spurned Fruit Flies Turn to Alcohol for Solace",
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"content": "\u003cp>Don't laugh. And don't roll your eyes, either--because this research could lead to new approaches to treating addiction.\u003c/p>\n\u003cp>When male fruit flies are rejected by their female fruit fly paramours, they turn to the bottle--or in this case the straw--that serves up food laced with alcohol. Just watch the video--kindly provided by Science/AAAS:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.youtube.com/embed/sH9Xjk28cZ0\" frameborder=\"0\" width=\"420\" height=\"315\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>This new research is from U.C. San Francisco, and the science lies in a tiny molecule in the fly's brain called neuropeptide F. Researchers paired fruit flies, the moved the males to a separate container where they could choose from one of two straws: one that was just plain old fly food; and one that had food supplemented with alcohol.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers found the fruit flies who successfully mated had higher levels of neuropeptide F in their brains and so drank little alcohol. But the jilted male fruit flies? They went straight for the booze.\u003c/p>\n\u003cp>Humans have a similar molecule called neuropeptide Y. Scientists have already found a connection between lower levels of this neuropeptide in people suffering from depression and post-traumatic stress disorder. But figuring out how to alter those levels is tricky and could take years.\u003c/p>\n\u003cp>But in the meantime, the video is pretty entertaining!\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.nytimes.com/2012/03/16/health/male-fruit-flies-spurned-by-females-turn-to-alcohol.html?_r=1&scp=1&sq=fruit%20fly&st=cse\" href=\"http://www.nytimes.com/2012/03/16/health/male-fruit-flies-spurned-by-females-turn-to-alcohol.html?_r=1&scp=1&sq=fruit%20fly&st=cse\" target=\"_blank\">Learning From the Spurned and Tipsy Fruit Fly\u003c/a> (New York Times)\u003c/p>\n\n",
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"excerpt": "Don't laugh. And don't roll your eyes, either--because this research could lead to new approaches to treating addiction.\r\n\r\nWhen male fruit flies are rejected by their female fruit fly paramours, they turn to the bottle--or in this case a straw--that serves up food laced with alcohol. Just watch the video--kindly provided (and copyrighted) by Science/AAAS:\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Don't laugh. And don't roll your eyes, either--because this research could lead to new approaches to treating addiction.\u003c/p>\n\u003cp>When male fruit flies are rejected by their female fruit fly paramours, they turn to the bottle--or in this case the straw--that serves up food laced with alcohol. Just watch the video--kindly provided by Science/AAAS:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.youtube.com/embed/sH9Xjk28cZ0\" frameborder=\"0\" width=\"420\" height=\"315\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>This new research is from U.C. San Francisco, and the science lies in a tiny molecule in the fly's brain called neuropeptide F. Researchers paired fruit flies, the moved the males to a separate container where they could choose from one of two straws: one that was just plain old fly food; and one that had food supplemented with alcohol.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers found the fruit flies who successfully mated had higher levels of neuropeptide F in their brains and so drank little alcohol. But the jilted male fruit flies? They went straight for the booze.\u003c/p>\n\u003cp>Humans have a similar molecule called neuropeptide Y. Scientists have already found a connection between lower levels of this neuropeptide in people suffering from depression and post-traumatic stress disorder. But figuring out how to alter those levels is tricky and could take years.\u003c/p>\n\u003cp>But in the meantime, the video is pretty entertaining!\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.nytimes.com/2012/03/16/health/male-fruit-flies-spurned-by-females-turn-to-alcohol.html?_r=1&scp=1&sq=fruit%20fly&st=cse\" href=\"http://www.nytimes.com/2012/03/16/health/male-fruit-flies-spurned-by-females-turn-to-alcohol.html?_r=1&scp=1&sq=fruit%20fly&st=cse\" target=\"_blank\">Learning From the Spurned and Tipsy Fruit Fly\u003c/a> (New York Times)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_3687\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/ShapeUP_OfficialGDC_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-3687 \" title=\"People outside at the Game Developers' Conference at the Moscone Center in San Francisco. (Official GDC: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/ShapeUP_OfficialGDC_Flickr-300x199.jpg\" alt=\"People outside at the Game Developers' Conference at the Moscone Center in San Francisco. (Official GDC: Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People outside the Game Developers' Conference at the Moscone Center in San Francisco. (Official GDC: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cp>We all know we're supposed to eat a healthy diet, get exercise and reduce stress. But a lot of people don't find these things very much fun. Employers--who have seen their health premiums shoot up--are trying to inject some excitement into their employee wellness programs.\u003c/p>\n\u003cp>At the \u003ca href=\"http://www.gdconf.com/\" target=\"_blank\">Game Developers’ Conference\u003c/a> in San Francisco last week, Rajiv Kumar talked up \u003ca title=\"http://www.shapeup.com/\" href=\"http://www.shapeup.com/\" target=\"_blank\">ShapeUp\u003c/a>--a platform that combines games and social networks to get employees revved up, engaged and, hopefully, more healthy.\u003c/p>\n\u003cp>ShapeUp works by dividing employees into teams and pitting them head-to-head in a challenge -- for example, challenging teams to walk or run the most over the course of three months. The key component of ShapeUp is its social network, where employees can motivate each other by virtual high-fiving and trash-talking throughout the competition.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Think Facebook for health, if you will.\"\u003c/aside>\n\u003cp>San Francisco-based \u003ca href=\"https://www.blueshieldca.com/\" target=\"_blank\">Blue Shield\u003c/a> has been using ShapeUp since 2010. “Think Facebook for health, if you will,\" said wellness plan director Bryce Williams.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Creator Kumar claims his Rhode Island-based company has garnered results. “We published a whole host of clinical studies to show that these people are actually losing weight and maintaining that weight loss, which is exciting.” A \"whole host\" may be a bit of an exaggeration. Two we did find are \u003ca title=\"http://www.nature.com/oby/journal/v17/n5/full/oby2008655a.html\" href=\"http://www.nature.com/oby/journal/v17/n5/full/oby2008655a.html\" target=\"_blank\">here\u003c/a> and \u003ca title=\"http://www.cfah.org/hbns/archives/viewSupportDoc.cfm?supportingDocID=965\" href=\"http://www.cfah.org/hbns/archives/viewSupportDoc.cfm?supportingDocID=965\" target=\"_blank\">here\u003c/a>.\u003c/p>\n\u003cp>Despite its merits, the platform alone may not be enough. Southern California's \u003ca href=\"http://www.lifetechnologies.com/\" target=\"_blank\">Life Technologies\u003c/a> has been using ShapeUp since June, 2010, initially with mixed results. “It was effective in some challenges and not in others,” Erica Ullman, Global Wellness Manager for the company, told me.\u003c/p>\n\u003cp>Initially only 20 percent of their employees joined ShapeUp for a first competition focused on better eating habits. There was no incentive to do the challenge, other than the vague promise of better health.\u003c/p>\n\u003cp>For a different challenge, focused on getting active and moving more, the company gave away pedometers -- and saw increased enrollment of 29 percent.\u003c/p>\n\u003cp>Several factors could account for the nine percent difference between the two challenges. But Ullman says, “We’ve learned that our population does respond well to incentives. It’s pretty much in the marketplace. If you reward an employee or spouse for doing something, they’re more interested in participating. If that’s the gateway for getting in, then we’ll support that.”\u003c/p>\n\u003cp>Blue Shield has also been using ShapeUp with incentives tied in, says Williams.\u003c/p>\n\u003cp>“By participating in ShapeUp Shield, you can actually earn a medical plan discount on your premium. But also we give some very small, yet hip, yet cool gifts and swag to those who win, or the most improved, or the best teams, as well,” he said.\u003c/p>\n\u003cp>While providing incentives for wellness is controversial – those opposed to it worry that the practice could translate into discrimination against people based on their health status – it seems to be working to promote healthier behaviors in this context.\u003c/p>\n\u003cp>Both Life Technologies and Blue Shield are using ShapeUp in addition to other initiatives focused at improving employee health. They recognize that part of their success is in providing a variety of activities for employees with different health goals to choose from.\u003c/p>\n\u003cp>Both companies told me that ShapeUp has become a popular choice with employees because they don’t have to pursue their health goals all alone.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When you make it social, it does make it more enjoyable. Because, let's be honest, wellness is hard enough work as it is, making sure you get enough exercise and eating right. So we should make it as fun and enjoyable as possible, rather than make it about suffering,” Williams said.\u003c/p>\n\n",
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"excerpt": "We all know we're supposed to eat a healthy diet, get exercise and reduce stress. But a lot of people don't find these things very much fun. Employers--who have seen their health premiums shoot up--are trying to inject some excitement into their employee wellness programs.\r\n\r\nAt the Game Developers’ Conference in San Francisco last week, Rajiv Kumar talked up ShapeUp--a platform that combines games and social networks to get employees revved up, engaged and, hopefully, more healthy.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3687\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/ShapeUP_OfficialGDC_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-3687 \" title=\"People outside at the Game Developers' Conference at the Moscone Center in San Francisco. (Official GDC: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/ShapeUP_OfficialGDC_Flickr-300x199.jpg\" alt=\"People outside at the Game Developers' Conference at the Moscone Center in San Francisco. (Official GDC: Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People outside the Game Developers' Conference at the Moscone Center in San Francisco. (Official GDC: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cp>We all know we're supposed to eat a healthy diet, get exercise and reduce stress. But a lot of people don't find these things very much fun. Employers--who have seen their health premiums shoot up--are trying to inject some excitement into their employee wellness programs.\u003c/p>\n\u003cp>At the \u003ca href=\"http://www.gdconf.com/\" target=\"_blank\">Game Developers’ Conference\u003c/a> in San Francisco last week, Rajiv Kumar talked up \u003ca title=\"http://www.shapeup.com/\" href=\"http://www.shapeup.com/\" target=\"_blank\">ShapeUp\u003c/a>--a platform that combines games and social networks to get employees revved up, engaged and, hopefully, more healthy.\u003c/p>\n\u003cp>ShapeUp works by dividing employees into teams and pitting them head-to-head in a challenge -- for example, challenging teams to walk or run the most over the course of three months. The key component of ShapeUp is its social network, where employees can motivate each other by virtual high-fiving and trash-talking throughout the competition.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Think Facebook for health, if you will.\"\u003c/aside>\n\u003cp>San Francisco-based \u003ca href=\"https://www.blueshieldca.com/\" target=\"_blank\">Blue Shield\u003c/a> has been using ShapeUp since 2010. “Think Facebook for health, if you will,\" said wellness plan director Bryce Williams.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Creator Kumar claims his Rhode Island-based company has garnered results. “We published a whole host of clinical studies to show that these people are actually losing weight and maintaining that weight loss, which is exciting.” A \"whole host\" may be a bit of an exaggeration. Two we did find are \u003ca title=\"http://www.nature.com/oby/journal/v17/n5/full/oby2008655a.html\" href=\"http://www.nature.com/oby/journal/v17/n5/full/oby2008655a.html\" target=\"_blank\">here\u003c/a> and \u003ca title=\"http://www.cfah.org/hbns/archives/viewSupportDoc.cfm?supportingDocID=965\" href=\"http://www.cfah.org/hbns/archives/viewSupportDoc.cfm?supportingDocID=965\" target=\"_blank\">here\u003c/a>.\u003c/p>\n\u003cp>Despite its merits, the platform alone may not be enough. Southern California's \u003ca href=\"http://www.lifetechnologies.com/\" target=\"_blank\">Life Technologies\u003c/a> has been using ShapeUp since June, 2010, initially with mixed results. “It was effective in some challenges and not in others,” Erica Ullman, Global Wellness Manager for the company, told me.\u003c/p>\n\u003cp>Initially only 20 percent of their employees joined ShapeUp for a first competition focused on better eating habits. There was no incentive to do the challenge, other than the vague promise of better health.\u003c/p>\n\u003cp>For a different challenge, focused on getting active and moving more, the company gave away pedometers -- and saw increased enrollment of 29 percent.\u003c/p>\n\u003cp>Several factors could account for the nine percent difference between the two challenges. But Ullman says, “We’ve learned that our population does respond well to incentives. It’s pretty much in the marketplace. If you reward an employee or spouse for doing something, they’re more interested in participating. If that’s the gateway for getting in, then we’ll support that.”\u003c/p>\n\u003cp>Blue Shield has also been using ShapeUp with incentives tied in, says Williams.\u003c/p>\n\u003cp>“By participating in ShapeUp Shield, you can actually earn a medical plan discount on your premium. But also we give some very small, yet hip, yet cool gifts and swag to those who win, or the most improved, or the best teams, as well,” he said.\u003c/p>\n\u003cp>While providing incentives for wellness is controversial – those opposed to it worry that the practice could translate into discrimination against people based on their health status – it seems to be working to promote healthier behaviors in this context.\u003c/p>\n\u003cp>Both Life Technologies and Blue Shield are using ShapeUp in addition to other initiatives focused at improving employee health. They recognize that part of their success is in providing a variety of activities for employees with different health goals to choose from.\u003c/p>\n\u003cp>Both companies told me that ShapeUp has become a popular choice with employees because they don’t have to pursue their health goals all alone.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When you make it social, it does make it more enjoyable. Because, let's be honest, wellness is hard enough work as it is, making sure you get enough exercise and eating right. So we should make it as fun and enjoyable as possible, rather than make it about suffering,” Williams said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Infection Rates: Did Your Hospital Earn a White Dot?",
"title": "Infection Rates: Did Your Hospital Earn a White Dot?",
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"content": "\u003cp>By Deborah Schoch,\u003ca title=\"http://centerforhealthreporting.org/blog/infection-ratings-did-your-hospital-earn-white-dot818\" href=\"http://centerforhealthreporting.org/blog/infection-ratings-did-your-hospital-earn-white-dot818\" target=\"_blank\"> Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_3644\" class=\"wp-caption alignleft\" style=\"max-width: 255px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Surgery_Christiana-Care_Flickr_03082012.jpg\">\u003cimg class=\"size-medium wp-image-3644\" title=\"(Christiana Care:Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Surgery_Christiana-Care_Flickr_03082012-300x352.jpg\" alt=\"(Christiana Care:Flickr)\" width=\"255\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Christiana Care:Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Last week, a friend of mine was showing her Cal State Long Beach journalism students how to check \u003ca href=\"http://www2.mbc.ca.gov/LicenseLookupSystem/PhysicianSurgeon/Search.aspx\" target=\"_blank\">physicians’ credentials\u003c/a> on line when a student’s question stopped her short.\u003c/p>\n\u003cp>Where is the website, the student asked, that grades the hospitals where those doctors work?\u003c/p>\n\u003cp>The simple answer: The web abounds in hospital ratings these days, most of them based on consumer comments rather than hard data.\u003c/p>\n\u003cp>Readers of Yelp, for instance, can rate, not only the local Chinese takeout place, but the hospital up the street. \u003ca href=\"http://www.memorialcare.org/long_beach/about.cfm\" target=\"_blank\">Long Beach Memorial Medical Center\u003c/a> -- generally respected among its peers -- \u003ca href=\"http://www.yelp.com/biz/long-beach-memorial-medical-center-long-beach\" target=\"_blank\">earned only two and a half gold stars\u003c/a> out of five on Yelp. It received plenty of comments like AWFUL and NEVER, a complaint about a broken parking pay machine, and a few kind words for its cafeteria’s Chinese chicken salad.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These comments have value, of course, but they don’t reflect the views of the regulatory experts charged with assessing health care quality.\u003c/p>\n\u003cp>Fortunately, Cal State Long Beach students don’t have to rely solely on Yelp to judge their local hospitals .\u003c/p>\n\u003cp>The national push for health care transparency has produced several high-quality sites that use credible data from government regulatory agencies.\u003c/p>\n\u003cp>I told my teacher friend about a few well-known sites, including Medicare’s \u003ca href=\"http://www.hospitalcompare.hhs.gov/\" target=\"_blank\">Hospital Compare\u003c/a>, but also about a \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/T2-CLABSI-%202010-2011.pdf\" target=\"_blank\">new report on hospital infections\u003c/a> on the website of the \u003ca href=\"http://www.cdph.ca.gov/Pages/DEFAULT.aspx\" target=\"_blank\">California Department of Public Health\u003c/a>.\u003c/p>\n\u003cp>Borrowing from Yelp and Consumer Reports, it’s one of the most readable reports that I’ve seen from an agency rightfully criticized in the past for technical, impenetrable infection reporting.\u003c/p>\n\u003cp>This year, state infection experts rethought how to inform consumers about the incidence of central line-associated bloodstream infections at hospitals across the state in the year ending in March 2011.\u003c/p>\n\u003cp>For seriously ill patients, these lines are critical for delivering food and medication. But they can turn into conduits for bacteria, spawning infections with a 25-percent mortality rate.\u003c/p>\n\u003cp>Such infections are relatively easy to prevent, however, and some consumer groups use line infection rates to measure the rigor of a hospital’s infection control program.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/Central-Line-Associated-Bloodstream-Infections-April-2010--3-2011.pdf\" target=\"_blank\">complete 146-page state report\u003c/a> on line infections is highly complex, but the consumer-friendly 16-page \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/T2-CLABSI-%202010-2011.pdf\" target=\"_blank\">summary\u003c/a> uses simple black, gray and white dots to put rates in context.\u003c/p>\n\u003cp>White dots show that a hospital’s rate is significantly better than the state norm.\u003c/p>\n\u003cp>Black dots show that the rate is significantly worse than the norm.\u003c/p>\n\u003cp>Gray dots—circles with specks inside—indicate that the rate is no different statistically than those of other hospitals\u003c/p>\n\u003cp>The system allows consumers to check out a hospital’s performance at a glance.\u003c/p>\n\u003cp>\u003ca href=\"http://cedars-sinai.edu/\" target=\"_blank\">Cedars-Sinai Medical Center\u003c/a> in Los Angeles excelled in the report, winning two white dots and 14 gray “average” dots. Cedars has targeted central line infections in a facility-wide campaign called “Zero is the Greatest Number,” \u003ca href=\"http://centerforhealthreporting.org/article/hospitals-actively-seeking-reduce-infections-facilities\" target=\"_blank\">as I wrote about last year\u003c/a> in the Riverside Press-Enterprise.\u003c/p>\n\u003cp>Long Beach Memorial received one black dot and seven “average” dots in the eight categories in which it was rated. The black dot showed its rates in oncology care, where patients are among those most prone to infection.\u003c/p>\n\u003cp>It could do better. But that’s a better performance than many hospitals in Southern California—and it’s far more statistically precise than those two-and-a-half stars and AWFUL comments on Yelp.\u003c/p>\n\u003cp>\u003cstrong>UPDATE:\u003c/strong> A reader asked why hospitals don’t have dots in every category. That’s largely because the state collects its infection data according to the types of patient care offered by each hospital — whether in a trauma unit, neonatal unit, burn unit, and so on. If a hospital doesn’t have a burn unit — and most hospitals don’t — it won’t have a dot in the burn category.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>By the way, readers can see details about infections in each category by clicking on the links at the top of each page.\u003c/p>\n\n",
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"excerpt": "Last week, a friend of mine was showing her Cal State Long Beach journalism students how to check physicians’ credentials on line when a student’s question stopped her short.\r\n\r\nWhere is the website, the student asked, that grades the hospitals where those doctors work?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Deborah Schoch,\u003ca title=\"http://centerforhealthreporting.org/blog/infection-ratings-did-your-hospital-earn-white-dot818\" href=\"http://centerforhealthreporting.org/blog/infection-ratings-did-your-hospital-earn-white-dot818\" target=\"_blank\"> Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_3644\" class=\"wp-caption alignleft\" style=\"max-width: 255px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Surgery_Christiana-Care_Flickr_03082012.jpg\">\u003cimg class=\"size-medium wp-image-3644\" title=\"(Christiana Care:Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Surgery_Christiana-Care_Flickr_03082012-300x352.jpg\" alt=\"(Christiana Care:Flickr)\" width=\"255\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Christiana Care:Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Last week, a friend of mine was showing her Cal State Long Beach journalism students how to check \u003ca href=\"http://www2.mbc.ca.gov/LicenseLookupSystem/PhysicianSurgeon/Search.aspx\" target=\"_blank\">physicians’ credentials\u003c/a> on line when a student’s question stopped her short.\u003c/p>\n\u003cp>Where is the website, the student asked, that grades the hospitals where those doctors work?\u003c/p>\n\u003cp>The simple answer: The web abounds in hospital ratings these days, most of them based on consumer comments rather than hard data.\u003c/p>\n\u003cp>Readers of Yelp, for instance, can rate, not only the local Chinese takeout place, but the hospital up the street. \u003ca href=\"http://www.memorialcare.org/long_beach/about.cfm\" target=\"_blank\">Long Beach Memorial Medical Center\u003c/a> -- generally respected among its peers -- \u003ca href=\"http://www.yelp.com/biz/long-beach-memorial-medical-center-long-beach\" target=\"_blank\">earned only two and a half gold stars\u003c/a> out of five on Yelp. It received plenty of comments like AWFUL and NEVER, a complaint about a broken parking pay machine, and a few kind words for its cafeteria’s Chinese chicken salad.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These comments have value, of course, but they don’t reflect the views of the regulatory experts charged with assessing health care quality.\u003c/p>\n\u003cp>Fortunately, Cal State Long Beach students don’t have to rely solely on Yelp to judge their local hospitals .\u003c/p>\n\u003cp>The national push for health care transparency has produced several high-quality sites that use credible data from government regulatory agencies.\u003c/p>\n\u003cp>I told my teacher friend about a few well-known sites, including Medicare’s \u003ca href=\"http://www.hospitalcompare.hhs.gov/\" target=\"_blank\">Hospital Compare\u003c/a>, but also about a \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/T2-CLABSI-%202010-2011.pdf\" target=\"_blank\">new report on hospital infections\u003c/a> on the website of the \u003ca href=\"http://www.cdph.ca.gov/Pages/DEFAULT.aspx\" target=\"_blank\">California Department of Public Health\u003c/a>.\u003c/p>\n\u003cp>Borrowing from Yelp and Consumer Reports, it’s one of the most readable reports that I’ve seen from an agency rightfully criticized in the past for technical, impenetrable infection reporting.\u003c/p>\n\u003cp>This year, state infection experts rethought how to inform consumers about the incidence of central line-associated bloodstream infections at hospitals across the state in the year ending in March 2011.\u003c/p>\n\u003cp>For seriously ill patients, these lines are critical for delivering food and medication. But they can turn into conduits for bacteria, spawning infections with a 25-percent mortality rate.\u003c/p>\n\u003cp>Such infections are relatively easy to prevent, however, and some consumer groups use line infection rates to measure the rigor of a hospital’s infection control program.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/Central-Line-Associated-Bloodstream-Infections-April-2010--3-2011.pdf\" target=\"_blank\">complete 146-page state report\u003c/a> on line infections is highly complex, but the consumer-friendly 16-page \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/T2-CLABSI-%202010-2011.pdf\" target=\"_blank\">summary\u003c/a> uses simple black, gray and white dots to put rates in context.\u003c/p>\n\u003cp>White dots show that a hospital’s rate is significantly better than the state norm.\u003c/p>\n\u003cp>Black dots show that the rate is significantly worse than the norm.\u003c/p>\n\u003cp>Gray dots—circles with specks inside—indicate that the rate is no different statistically than those of other hospitals\u003c/p>\n\u003cp>The system allows consumers to check out a hospital’s performance at a glance.\u003c/p>\n\u003cp>\u003ca href=\"http://cedars-sinai.edu/\" target=\"_blank\">Cedars-Sinai Medical Center\u003c/a> in Los Angeles excelled in the report, winning two white dots and 14 gray “average” dots. Cedars has targeted central line infections in a facility-wide campaign called “Zero is the Greatest Number,” \u003ca href=\"http://centerforhealthreporting.org/article/hospitals-actively-seeking-reduce-infections-facilities\" target=\"_blank\">as I wrote about last year\u003c/a> in the Riverside Press-Enterprise.\u003c/p>\n\u003cp>Long Beach Memorial received one black dot and seven “average” dots in the eight categories in which it was rated. The black dot showed its rates in oncology care, where patients are among those most prone to infection.\u003c/p>\n\u003cp>It could do better. But that’s a better performance than many hospitals in Southern California—and it’s far more statistically precise than those two-and-a-half stars and AWFUL comments on Yelp.\u003c/p>\n\u003cp>\u003cstrong>UPDATE:\u003c/strong> A reader asked why hospitals don’t have dots in every category. That’s largely because the state collects its infection data according to the types of patient care offered by each hospital — whether in a trauma unit, neonatal unit, burn unit, and so on. If a hospital doesn’t have a burn unit — and most hospitals don’t — it won’t have a dot in the burn category.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>By the way, readers can see details about infections in each category by clicking on the links at the top of each page.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Chemicals in Consumer Products a Concern -- even in \"Green\" Ones",
"title": "Chemicals in Consumer Products a Concern -- even in \"Green\" Ones",
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"content": "\u003cfigure id=\"attachment_3621\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Chemicals_GerberGrinsandGiggles.jpg\">\u003cimg class=\"size-medium wp-image-3621 \" title=\"(Image: Environmental Working Group)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Chemicals_GerberGrinsandGiggles-300x200.jpg\" alt=\"(Image: Environmental Working Group)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA requires listing of \"fragrance\" but not the chemicals in it. (Image: Environmental Working Group)\u003c/figcaption>\u003c/figure>\n\u003cp>It's a topic well known to advocates, but perhaps surprise the average consumer--not all chemicals need to be listed on a product's ingredients labels. Worse, little research has been done on many chemicals, including those in common household products. Today,\u003ca title=\"http://www.forbes.com/sites/amywestervelt/2012/03/08/study-highlights-hidden-dangers-in-everyday-products/\" href=\"http://www.forbes.com/sites/amywestervelt/2012/03/08/study-highlights-hidden-dangers-in-everyday-products/\" target=\"_blank\"> Forbes\u003c/a> reports on a major peer-reviewed study in \u003ca title=\"http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1104052#top\" href=\"http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1104052#top\" target=\"_blank\">Environmental Health Perspectives\u003c/a>--published by the \u003ca title=\"http://www.niehs.nih.gov/\" href=\"http://www.niehs.nih.gov/\" target=\"_blank\">National Institute for Environmental Health Sciences\u003c/a>.\u003c/p>\n\u003cp>Researchers tested 213 products across 50 different categories, looking specifically at 66 chemicals associated with endocrine disruption or asthma. As Forbes reports:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>The study included both conventional products, such as Windex original glass cleaner and Irish Spring deodorant soap, as well as “alternative” products marketed as containing safer ingredients than their conventional counterparts, such as Seventh Generation Free and Clear natural glass and surface cleaner and Tom’s of Maine natural moisturizing body bar. Lab tests detected 55 chemicals of concern–including parabens, phthalates, bisphenol A (BPA), antimicrobials, cyclosiloxanes, glycol ethers, and fragrances–in the conventional product samples tested and also found 41 concerning chemical compounds in all but 11 alternative products. Very few of these chemicals were included on product labels.\u003c/p>\u003c/blockquote>\n\u003cp>The Silent Spring Institute funded the study. In its \u003ca title=\"http://www.silentspring.org/pdf/in_the_news/product-test-press-release.pdf\" href=\"http://www.silentspring.org/pdf/in_the_news/product-test-press-release.pdf\" target=\"_blank\">press release\u003c/a>, the Institute listed the following findings as being especially important:\u003c/p>\n\u003cblockquote>\n\u003cul>\n\u003cli>Vinyl products, such as shower curtains and pillow protectors, contain more than 10% by weight of the phthalate DEHP, an endocrine disruptor (anti‐androgen) that has also been associated with increased respiratory symptoms in some studies.\u003c/li>\n\u003cli>Fragranced products – including air fresheners, dryer sheets, and perfume – and sunscreens had the largest number of target chemicals and some of the highest concentrations. Fragrances can trigger asthma and some have been shown to mimic estrogen, including making breast cancer cells grow in laboratory studies.\u003c/li>\n\u003cli>In addition to the labeled ingredients, alternative sunscreens contained up to 7 target chemicals that were unlabeled, including estrogenic UV filters. The alternative sunscreen with the highest number of target chemicals was a product marketed for babies, children, and sensitive adults.\u003c/li>\n\u003cli>A consumer who used the tested alternative surface cleaner, tub and tile cleaner, laundry detergent, bar soap, shampoo and conditioner, facial cleanser and lotion, and toothpaste would be exposed to 19 of the target compounds.\u003c/li>\n\u003c/ul>\n\u003c/blockquote>\n\u003cp>Sunscreens? Bar soap? Shampoo? You might think that these are the very products which are heavily regulated, but no.\u003c/p>\n\u003cp>In the study, the researchers spotlight the limited regulation by the Food and Drug Administration around labeling of ingredients. Many regulations for consumer products were last updated more than 40 years ago. For cosmetics, while the word \"fragrance\" must be labelled, the individual chemicals of a fragrance and \"incidental ingredients\" do not need to be itemized. The terms \"natural,\" \"non-toxic\" and \"green\" are unregulated, the researchers say.\u003ca title=\"http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.119-a16\" href=\"http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.119-a16\" target=\"_blank\"> Another study\u003c/a> looked at \"green\" labelled fragranced products and found that \"VOC\"s--volatile organic compounds--were just as plentiful in the \"green\" products than in those products not labelled \"green.\" (I liked the title of that study, \"Scented Products Emit a Bouquet of VOCs.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Robin Dodson of the Centers for Disease Control was the lead author of the study. Just about the only approach Dodson can argue for at this point is avoidance. As Forbes reports:\u003c/p>\n\u003cblockquote>\u003cp>“Avoiding fragrance products can significantly reduce exposure to many of these compounds,” she says. ”Another one that’s easy to avoid is antibacterials; people are often using them when they don’t really need to, and they are typically labeled.”\u003c/p>\n\u003cp>Silent Spring has prepared\u003ca title=\"Silent Spring Consumer Products Tip Sheet\" href=\"http://www.silentspring.org/tips-card-top-12-tips-greening-your-cleaning-and-personal-care\" target=\"_blank\"> a list\u003c/a> of other consumer tips, including looking for products with plant-based ingredients and using plain water, baking soda, and vinegar for cleaning. Perhaps surprisingly, the tip list also includes opting for shade, hats, and cover-ups for sun protection.\u003c/p>\n\u003cp>“The results of the tests on sunscreen are worrisome,” Dodson says. “We tested four conventional and five alternative brands, and some were better than others, but all contained some of the concerning chemical compounds. We did only test five of the available alternative sunscreen products, so there may very well be one out there that doesn’t contain any of these chemicals. That said, there may be times where it’s best to use sunscreen, but if you can avoid it, and opt for shade and hats, then great.”\u003c/p>\n\u003cp>“Sunscreen could really become the poster child for the green chemistry movement,” Dodson adds. “Can we engineer something that is not an endocrine disruptor and that still protects from skin cancer?”\u003c/p>\u003c/blockquote>\n\u003cdiv>The Washington, D.C. advocacy organization, \u003ca title=\"http://www.ewg.org/\" href=\"http://www.ewg.org/\" target=\"_blank\">Environmental Working Group\u003c/a>, has long followed the issue of chemicals in consumer products. In an email, senior analyst Sonya Lunder said of the study, \"It is a fascinating read, and confirms many of our concerns about the widespread use of suspect chemicals in consumer products, particularly air fresheners, dryer sheets and sunscreens. With the oil spill dispersant 2-butoxyethanol in glass cleaner and hormone-disrupting phthalates in pillow protectors, the findings remind us how difficult it can be to avoid exposure to these ubiquitous hazards.\"\u003c/div>\n\n",
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"excerpt": "It's a topic well known to advocates, but perhaps surprise the average consumer--not all chemicals need to be listed on a product's ingredients labels. Worse, little research has been done on many chemicals, including those in common household products. Today, Forbes reports on a major peer-reviewed study in Environmental Health Perspectives--published by the National Institute for Environmental Health Sciences.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3621\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Chemicals_GerberGrinsandGiggles.jpg\">\u003cimg class=\"size-medium wp-image-3621 \" title=\"(Image: Environmental Working Group)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Chemicals_GerberGrinsandGiggles-300x200.jpg\" alt=\"(Image: Environmental Working Group)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA requires listing of \"fragrance\" but not the chemicals in it. (Image: Environmental Working Group)\u003c/figcaption>\u003c/figure>\n\u003cp>It's a topic well known to advocates, but perhaps surprise the average consumer--not all chemicals need to be listed on a product's ingredients labels. Worse, little research has been done on many chemicals, including those in common household products. Today,\u003ca title=\"http://www.forbes.com/sites/amywestervelt/2012/03/08/study-highlights-hidden-dangers-in-everyday-products/\" href=\"http://www.forbes.com/sites/amywestervelt/2012/03/08/study-highlights-hidden-dangers-in-everyday-products/\" target=\"_blank\"> Forbes\u003c/a> reports on a major peer-reviewed study in \u003ca title=\"http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1104052#top\" href=\"http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1104052#top\" target=\"_blank\">Environmental Health Perspectives\u003c/a>--published by the \u003ca title=\"http://www.niehs.nih.gov/\" href=\"http://www.niehs.nih.gov/\" target=\"_blank\">National Institute for Environmental Health Sciences\u003c/a>.\u003c/p>\n\u003cp>Researchers tested 213 products across 50 different categories, looking specifically at 66 chemicals associated with endocrine disruption or asthma. As Forbes reports:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>The study included both conventional products, such as Windex original glass cleaner and Irish Spring deodorant soap, as well as “alternative” products marketed as containing safer ingredients than their conventional counterparts, such as Seventh Generation Free and Clear natural glass and surface cleaner and Tom’s of Maine natural moisturizing body bar. Lab tests detected 55 chemicals of concern–including parabens, phthalates, bisphenol A (BPA), antimicrobials, cyclosiloxanes, glycol ethers, and fragrances–in the conventional product samples tested and also found 41 concerning chemical compounds in all but 11 alternative products. Very few of these chemicals were included on product labels.\u003c/p>\u003c/blockquote>\n\u003cp>The Silent Spring Institute funded the study. In its \u003ca title=\"http://www.silentspring.org/pdf/in_the_news/product-test-press-release.pdf\" href=\"http://www.silentspring.org/pdf/in_the_news/product-test-press-release.pdf\" target=\"_blank\">press release\u003c/a>, the Institute listed the following findings as being especially important:\u003c/p>\n\u003cblockquote>\n\u003cul>\n\u003cli>Vinyl products, such as shower curtains and pillow protectors, contain more than 10% by weight of the phthalate DEHP, an endocrine disruptor (anti‐androgen) that has also been associated with increased respiratory symptoms in some studies.\u003c/li>\n\u003cli>Fragranced products – including air fresheners, dryer sheets, and perfume – and sunscreens had the largest number of target chemicals and some of the highest concentrations. Fragrances can trigger asthma and some have been shown to mimic estrogen, including making breast cancer cells grow in laboratory studies.\u003c/li>\n\u003cli>In addition to the labeled ingredients, alternative sunscreens contained up to 7 target chemicals that were unlabeled, including estrogenic UV filters. The alternative sunscreen with the highest number of target chemicals was a product marketed for babies, children, and sensitive adults.\u003c/li>\n\u003cli>A consumer who used the tested alternative surface cleaner, tub and tile cleaner, laundry detergent, bar soap, shampoo and conditioner, facial cleanser and lotion, and toothpaste would be exposed to 19 of the target compounds.\u003c/li>\n\u003c/ul>\n\u003c/blockquote>\n\u003cp>Sunscreens? Bar soap? Shampoo? You might think that these are the very products which are heavily regulated, but no.\u003c/p>\n\u003cp>In the study, the researchers spotlight the limited regulation by the Food and Drug Administration around labeling of ingredients. Many regulations for consumer products were last updated more than 40 years ago. For cosmetics, while the word \"fragrance\" must be labelled, the individual chemicals of a fragrance and \"incidental ingredients\" do not need to be itemized. The terms \"natural,\" \"non-toxic\" and \"green\" are unregulated, the researchers say.\u003ca title=\"http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.119-a16\" href=\"http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.119-a16\" target=\"_blank\"> Another study\u003c/a> looked at \"green\" labelled fragranced products and found that \"VOC\"s--volatile organic compounds--were just as plentiful in the \"green\" products than in those products not labelled \"green.\" (I liked the title of that study, \"Scented Products Emit a Bouquet of VOCs.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Robin Dodson of the Centers for Disease Control was the lead author of the study. Just about the only approach Dodson can argue for at this point is avoidance. As Forbes reports:\u003c/p>\n\u003cblockquote>\u003cp>“Avoiding fragrance products can significantly reduce exposure to many of these compounds,” she says. ”Another one that’s easy to avoid is antibacterials; people are often using them when they don’t really need to, and they are typically labeled.”\u003c/p>\n\u003cp>Silent Spring has prepared\u003ca title=\"Silent Spring Consumer Products Tip Sheet\" href=\"http://www.silentspring.org/tips-card-top-12-tips-greening-your-cleaning-and-personal-care\" target=\"_blank\"> a list\u003c/a> of other consumer tips, including looking for products with plant-based ingredients and using plain water, baking soda, and vinegar for cleaning. Perhaps surprisingly, the tip list also includes opting for shade, hats, and cover-ups for sun protection.\u003c/p>\n\u003cp>“The results of the tests on sunscreen are worrisome,” Dodson says. “We tested four conventional and five alternative brands, and some were better than others, but all contained some of the concerning chemical compounds. We did only test five of the available alternative sunscreen products, so there may very well be one out there that doesn’t contain any of these chemicals. That said, there may be times where it’s best to use sunscreen, but if you can avoid it, and opt for shade and hats, then great.”\u003c/p>\n\u003cp>“Sunscreen could really become the poster child for the green chemistry movement,” Dodson adds. “Can we engineer something that is not an endocrine disruptor and that still protects from skin cancer?”\u003c/p>\u003c/blockquote>\n\u003cdiv>The Washington, D.C. advocacy organization, \u003ca title=\"http://www.ewg.org/\" href=\"http://www.ewg.org/\" target=\"_blank\">Environmental Working Group\u003c/a>, has long followed the issue of chemicals in consumer products. In an email, senior analyst Sonya Lunder said of the study, \"It is a fascinating read, and confirms many of our concerns about the widespread use of suspect chemicals in consumer products, particularly air fresheners, dryer sheets and sunscreens. With the oil spill dispersant 2-butoxyethanol in glass cleaner and hormone-disrupting phthalates in pillow protectors, the findings remind us how difficult it can be to avoid exposure to these ubiquitous hazards.\"\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Avoiding a Colonoscopy? You're Not Alone",
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"content": "\u003cfigure id=\"attachment_3269\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock.jpg\">\u003cimg class=\"size-medium wp-image-3269 \" title=\"colonoscope-thinkstock\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock-300x449.jpg\" alt=\"\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If the sight of a colonoscope like this one makes you shudder, there are other options for colorectal cancer screening.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" target=\"_blank\">Colorectal cancer\u003c/a> is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" target=\"_blank\"> successful\u003c/a> screening method--it cuts the death rate of colorectal cancer in half.\u003c/p>\n\u003cp>Still, getting a colonoscopy has a problem: the yuck factor. That's why a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" target=\"_blank\"> study\u003c/a> in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus \"FIT,\" a non-invasive test to screen for colorectal cancer. FIT--fecal immunochemical testing--looks for the presence of blood in the stool, a marker for benign polyps or cancer. Patients have either one colonoscopy during the ten years of the study or FIT every other year. (Note that the \u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" target=\"_blank\">American Cancer Society \u003c/a>has a great explainer of the different screening methods available and pros and cons of each).\u003c/p>\n\u003caside class=\"pullquote alignleft\">“In order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.”\u003c/aside>\n\u003cp>In today's study researchers say colonoscopy and FIT detected roughly the same number of cancers. The report comes at the two year point of what will be a ten year study. We have to wait the full ten years to see how death rates from colorectal cancer compare between the two types of screening.\u003c!--more-->\u003c/p>\n\u003cp>In the meantime, some interesting factoids that hint at the yuck factor popped up in the breakdown of which patients participated in which screening. Fully 94 percent of patients who responded to an invitation to participate in the FIT trial completed the test. But in the colonoscopy group, the rate dropped to 67 percent. In addition, more than 20 percent of the people who were assigned to colonoscopy opted for FIT instead. Apparently, they weren't so interested in having a colonoscopy. But they WERE interested in being screened.\u003c/p>\n\u003cp>For a little perspective on the study, I called Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California. \"What's clearly shown here,\" he told me, \"is that in order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For the last several years, Kaiser Permanente has been making aggressive strides to screen its own patient population. Individual doctors may still continue to recommend colonoscopy to patients ages 50 to 75 -- the recommended ages for colorectal cancer screening. But Levin says that Kaiser wanted something they could mail out -- something that people could do at home, then mail back to the lab. Kaiser put in place an automated system of phone calls and reminder postcards to encourage people to complete the FIT test and send it in. Unlike the study in Spain, Kaiser recommends patients get a FIT test every year, instead of every other year.\u003c/p>\n\u003cp>The effort has been working. Levin says Kaiser has seen their colorectal cancer screening rates \"march up.\" In 2011, 80 percent of its members ages 50 to 75 had been screened, he says. About twice as many people had FIT as colonoscopy\u003cstrong>\u003c/strong>. And the screening appears to be leading to earlier diagnosis. \"We're diagnosing much earlier stage cancers and fewer of them,\" Levin says. \"Two hundred fewer colon cancer in 2010 than in 2009 across Northern California Kaiser, even with membership growth.\"\u003c/p>\n\u003cp>Levin cautions that he is waiting for one more year of data to be sure Kaiser is on the right track. As for cost, Levin also believes the screening will save money. \"Cost of treating advanced colon cancer keeps getting more expensive, so we think any way you can get people screened is a cost saving endeavor through the whole cycle of screening through treatment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Choice in screening also speaks to the importance of patient decision-making. \"We're definitely making a difference,\" Levin says, \"and we'll be most effective in giving patients what they want, instead of telling them what they need.\"\u003c/p>\n\n",
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"excerpt": "Colorectal cancer is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a successful screening method--it cuts the death rate of colorectal cancer in half.\r\n\r\nStill, getting a colonoscopy has a problem: the yuck factor. That's why a study in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus \"FIT,\" a non-invasive test to screen for colorectal cancer. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3269\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock.jpg\">\u003cimg class=\"size-medium wp-image-3269 \" title=\"colonoscope-thinkstock\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock-300x449.jpg\" alt=\"\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If the sight of a colonoscope like this one makes you shudder, there are other options for colorectal cancer screening.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" target=\"_blank\">Colorectal cancer\u003c/a> is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" target=\"_blank\"> successful\u003c/a> screening method--it cuts the death rate of colorectal cancer in half.\u003c/p>\n\u003cp>Still, getting a colonoscopy has a problem: the yuck factor. That's why a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" target=\"_blank\"> study\u003c/a> in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus \"FIT,\" a non-invasive test to screen for colorectal cancer. FIT--fecal immunochemical testing--looks for the presence of blood in the stool, a marker for benign polyps or cancer. Patients have either one colonoscopy during the ten years of the study or FIT every other year. (Note that the \u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" target=\"_blank\">American Cancer Society \u003c/a>has a great explainer of the different screening methods available and pros and cons of each).\u003c/p>\n\u003caside class=\"pullquote alignleft\">“In order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.”\u003c/aside>\n\u003cp>In today's study researchers say colonoscopy and FIT detected roughly the same number of cancers. The report comes at the two year point of what will be a ten year study. We have to wait the full ten years to see how death rates from colorectal cancer compare between the two types of screening.\u003c!--more-->\u003c/p>\n\u003cp>In the meantime, some interesting factoids that hint at the yuck factor popped up in the breakdown of which patients participated in which screening. Fully 94 percent of patients who responded to an invitation to participate in the FIT trial completed the test. But in the colonoscopy group, the rate dropped to 67 percent. In addition, more than 20 percent of the people who were assigned to colonoscopy opted for FIT instead. Apparently, they weren't so interested in having a colonoscopy. But they WERE interested in being screened.\u003c/p>\n\u003cp>For a little perspective on the study, I called Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California. \"What's clearly shown here,\" he told me, \"is that in order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For the last several years, Kaiser Permanente has been making aggressive strides to screen its own patient population. Individual doctors may still continue to recommend colonoscopy to patients ages 50 to 75 -- the recommended ages for colorectal cancer screening. But Levin says that Kaiser wanted something they could mail out -- something that people could do at home, then mail back to the lab. Kaiser put in place an automated system of phone calls and reminder postcards to encourage people to complete the FIT test and send it in. Unlike the study in Spain, Kaiser recommends patients get a FIT test every year, instead of every other year.\u003c/p>\n\u003cp>The effort has been working. Levin says Kaiser has seen their colorectal cancer screening rates \"march up.\" In 2011, 80 percent of its members ages 50 to 75 had been screened, he says. About twice as many people had FIT as colonoscopy\u003cstrong>\u003c/strong>. And the screening appears to be leading to earlier diagnosis. \"We're diagnosing much earlier stage cancers and fewer of them,\" Levin says. \"Two hundred fewer colon cancer in 2010 than in 2009 across Northern California Kaiser, even with membership growth.\"\u003c/p>\n\u003cp>Levin cautions that he is waiting for one more year of data to be sure Kaiser is on the right track. As for cost, Levin also believes the screening will save money. \"Cost of treating advanced colon cancer keeps getting more expensive, so we think any way you can get people screened is a cost saving endeavor through the whole cycle of screening through treatment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Choice in screening also speaks to the importance of patient decision-making. \"We're definitely making a difference,\" Levin says, \"and we'll be most effective in giving patients what they want, instead of telling them what they need.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Disparity Between Preferences and Actions in End-of-Life Care",
"title": "Disparity Between Preferences and Actions in End-of-Life Care",
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"content": "\u003cfigure id=\"attachment_3050\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/EndOfLife_Hands_RosieOBeirne_Flickr_02142012.jpg\">\u003cimg class=\"size-medium wp-image-3050\" title=\"(Rosie O'Beirne: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/EndOfLife_Hands_RosieOBeirne_Flickr_02142012-300x199.jpg\" alt=\"(Rosie O'Beirne: Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Rosie O'Beirne: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It's a paradox of American health care that has been present for years, and a new study reinforces it: the overwhelming majority of Californians say they want to die a natural death, at home, but less than one in four has actually put their wishes in writing. This lack of clarity can leave loved ones and doctors to try to sort out wishes, often during a time of crisis.\u003c/p>\n\u003cp>The statewide survey is from the Oakland-based \u003ca title=\"http://www.chcf.org/\" href=\"http://www.chcf.org/\" target=\"_blank\">California HealthCare Foundation\u003c/a>. While so few have put their wishes in writing, the poll also found that 82 percent of Californians said it was important to do so. Another paradox.\u003c/p>\n\u003cp>\"When we juxtapose that to what actually happens to people,\" said \u003ca title=\"http://www.chcf.org/about/staff/kate-omalley\" href=\"http://www.chcf.org/about/staff/kate-omalley\" target=\"_blank\">Kate O'Malley\u003c/a>, senior program officer at the Foundation, \"We realize there is a lot of work to be done in helping people find a way to state their preferences and make sure that their family members and their providers know what their preferences are.\"\u003c!--more-->\u003c/p>\n\u003cp>The survey, \u003ca title=\"http://www.chcf.org/publications/2012/02/final-chapter-death-dying\" href=\"http://www.chcf.org/publications/2012/02/final-chapter-death-dying\" target=\"_blank\">Final Chapter: Californians' Attitudes and Experiences with Death and Dying\u003c/a>, found many other wide-ranging disparities between what people said they wanted and what actually happened:\u003c/p>\n\u003cul>\n\u003cli>70 percent want to die at home, but 32 percent actually do so; most die in a hospital or nursing home\u003c/li>\n\u003cli>60 percent do not want family members burdened by tough decisions, saying it's \"extremely important,\" but fewer than half have talked to loved one about personal wishes\u003c/li>\n\u003cli>8 in 10 say if they were seriously ill, they would like to talk to a doctor about their treatment wishes, but only 7 percent have done so\u003c/li>\n\u003c/ul>\n\u003cp>On this last question of doctors and patients talking about end-of-life wishes, Kate O'Malley pointed to a chicken or the egg problem. \"There was one study that showed that 75 percent of patients wanted to talk about this and were waiting for their doctors to bring it up,\" she said. \"Then when they (researchers) talked to the doctors, they found that many of them wanted to talk to their patients about this, but they were waiting for their patients to bring it up. So there's this question about what is the right moment?\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This desire to talk with their doctor about end-of-life wishes is especially true for older patients, yet only 13 percent of those over 65 have done so. In a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\">New England Journal of Medicine commentary\u003c/a> last December, a team of palliative care experts strongly encouraged doctors with elderly patients to bring up the subject.\u003c/p>\n\u003cp>Just over a week ago, Lisa Krieger, a reporter at the San Jose Mercury News, wrote movingly of the story of her\u003ca title=\"http://www.mercurynews.com/cost-of-dying\" href=\"http://www.mercurynews.com/cost-of-dying\" target=\"_blank\"> own father's death\u003c/a>. He had left clearly written instructions, yet what she experienced during the final ten days of his life captures the difficulty of making wrenching decisions, incrementally, during a health crisis. Her story triggered an outpouring of reader comments, with overwhelming support for being clear about wishes, well in advance. Sharone Demaree posted this comment on the Mercury News' Facebook page:\u003c/p>\n\u003cblockquote>\u003cp>My mother died one year ago, March 1. The hardest decision I think we ever had to make was to decide when to cease all attempts at prolonging death. I strongly urge any and all who read this to sit down and talk with your family and document their wishes.\u003c/p>\u003c/blockquote>\n\u003cp>Yet, even when wishes are made clear in advance, the survey found only 44 percent of Californians said those wishes were completely followed. But for a patient with a language barrier, that number drops to 26 percent. Kate O'Malley encourages people who feel that their wishes are not being respected to \"ask to be cared for by a different person,\" adding that it's also critical that the entire family be clear of the loved one's wishes as well.\u003c/p>\n\u003cp>The survey was conducted last fall and included 1,669 Claifornians 18 and older, including 393 people who had lost a loved one in the prior year. The survey was conducted by Lake Research Partners.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Related:\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>KQED's \u003ca title=\"http://www.kqed.org/a/forum/R201202150900\" href=\"http://www.kqed.org/a/forum/R201202150900\" target=\"_blank\">Forum: End-of-Life Decisions\u003c/a>\u003c/p>\n\u003cp>California HealthCare Foundation Video about the\u003ca title=\"http://www.capolst.org/\" href=\"http://www.capolst.org/\" target=\"_blank\"> Physicians Orders for Life-Saving Treatment\u003c/a> or \"POLST\" form:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=Os2mr2eVWTk]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3050\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/EndOfLife_Hands_RosieOBeirne_Flickr_02142012.jpg\">\u003cimg class=\"size-medium wp-image-3050\" title=\"(Rosie O'Beirne: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/EndOfLife_Hands_RosieOBeirne_Flickr_02142012-300x199.jpg\" alt=\"(Rosie O'Beirne: Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Rosie O'Beirne: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It's a paradox of American health care that has been present for years, and a new study reinforces it: the overwhelming majority of Californians say they want to die a natural death, at home, but less than one in four has actually put their wishes in writing. This lack of clarity can leave loved ones and doctors to try to sort out wishes, often during a time of crisis.\u003c/p>\n\u003cp>The statewide survey is from the Oakland-based \u003ca title=\"http://www.chcf.org/\" href=\"http://www.chcf.org/\" target=\"_blank\">California HealthCare Foundation\u003c/a>. While so few have put their wishes in writing, the poll also found that 82 percent of Californians said it was important to do so. Another paradox.\u003c/p>\n\u003cp>\"When we juxtapose that to what actually happens to people,\" said \u003ca title=\"http://www.chcf.org/about/staff/kate-omalley\" href=\"http://www.chcf.org/about/staff/kate-omalley\" target=\"_blank\">Kate O'Malley\u003c/a>, senior program officer at the Foundation, \"We realize there is a lot of work to be done in helping people find a way to state their preferences and make sure that their family members and their providers know what their preferences are.\"\u003c!--more-->\u003c/p>\n\u003cp>The survey, \u003ca title=\"http://www.chcf.org/publications/2012/02/final-chapter-death-dying\" href=\"http://www.chcf.org/publications/2012/02/final-chapter-death-dying\" target=\"_blank\">Final Chapter: Californians' Attitudes and Experiences with Death and Dying\u003c/a>, found many other wide-ranging disparities between what people said they wanted and what actually happened:\u003c/p>\n\u003cul>\n\u003cli>70 percent want to die at home, but 32 percent actually do so; most die in a hospital or nursing home\u003c/li>\n\u003cli>60 percent do not want family members burdened by tough decisions, saying it's \"extremely important,\" but fewer than half have talked to loved one about personal wishes\u003c/li>\n\u003cli>8 in 10 say if they were seriously ill, they would like to talk to a doctor about their treatment wishes, but only 7 percent have done so\u003c/li>\n\u003c/ul>\n\u003cp>On this last question of doctors and patients talking about end-of-life wishes, Kate O'Malley pointed to a chicken or the egg problem. \"There was one study that showed that 75 percent of patients wanted to talk about this and were waiting for their doctors to bring it up,\" she said. \"Then when they (researchers) talked to the doctors, they found that many of them wanted to talk to their patients about this, but they were waiting for their patients to bring it up. So there's this question about what is the right moment?\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This desire to talk with their doctor about end-of-life wishes is especially true for older patients, yet only 13 percent of those over 65 have done so. In a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\">New England Journal of Medicine commentary\u003c/a> last December, a team of palliative care experts strongly encouraged doctors with elderly patients to bring up the subject.\u003c/p>\n\u003cp>Just over a week ago, Lisa Krieger, a reporter at the San Jose Mercury News, wrote movingly of the story of her\u003ca title=\"http://www.mercurynews.com/cost-of-dying\" href=\"http://www.mercurynews.com/cost-of-dying\" target=\"_blank\"> own father's death\u003c/a>. He had left clearly written instructions, yet what she experienced during the final ten days of his life captures the difficulty of making wrenching decisions, incrementally, during a health crisis. Her story triggered an outpouring of reader comments, with overwhelming support for being clear about wishes, well in advance. Sharone Demaree posted this comment on the Mercury News' Facebook page:\u003c/p>\n\u003cblockquote>\u003cp>My mother died one year ago, March 1. The hardest decision I think we ever had to make was to decide when to cease all attempts at prolonging death. I strongly urge any and all who read this to sit down and talk with your family and document their wishes.\u003c/p>\u003c/blockquote>\n\u003cp>Yet, even when wishes are made clear in advance, the survey found only 44 percent of Californians said those wishes were completely followed. But for a patient with a language barrier, that number drops to 26 percent. Kate O'Malley encourages people who feel that their wishes are not being respected to \"ask to be cared for by a different person,\" adding that it's also critical that the entire family be clear of the loved one's wishes as well.\u003c/p>\n\u003cp>The survey was conducted last fall and included 1,669 Claifornians 18 and older, including 393 people who had lost a loved one in the prior year. The survey was conducted by Lake Research Partners.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Related:\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>KQED's \u003ca title=\"http://www.kqed.org/a/forum/R201202150900\" href=\"http://www.kqed.org/a/forum/R201202150900\" target=\"_blank\">Forum: End-of-Life Decisions\u003c/a>\u003c/p>\n\u003cp>California HealthCare Foundation Video about the\u003ca title=\"http://www.capolst.org/\" href=\"http://www.capolst.org/\" target=\"_blank\"> Physicians Orders for Life-Saving Treatment\u003c/a> or \"POLST\" form:\u003c/p>\n\u003cp>\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/Os2mr2eVWTk'\n title='//www.youtube.com/embed/Os2mr2eVWTk'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Did Susan G. Komen Do the Right Thing for the Wrong Reason?",
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"content": "\u003cfigure id=\"attachment_2988\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/SusanGKomen_BrandiKorte_Flickr_02102012.jpg\">\u003cimg class=\"size-medium wp-image-2988\" title=\"(Brandi Korte: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/SusanGKomen_BrandiKorte_Flickr_02102012-300x200.jpg\" alt=\"(Brandi Korte: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Brandi Korte: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While the widely regarded \u003ca title=\"http://www.cancerletter.com/articles/20120210\" href=\"http://www.cancerletter.com/articles/20120210\" target=\"_blank\">Cancer Letter\u003c/a> is usually available only by subscription at a hefty $405 a year, the current issue is available for free. It looks at the Susan G. Komen Foundation's \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/02/01/susan-g-komen-vs-planned-parenthood/\" href=\"http://ww2.kqed.org/stateofhealth/2012/02/01/susan-g-komen-vs-planned-parenthood/\" target=\"_blank\">decision to stop funding Planned Parenthood\u003c/a>. But the Cancer Letter is not concerned with the politics behind the story.\u003c/p>\n\u003cp>Instead, the Cancer Letter takes an extensive look at Planned Parenthood itself and why the organization is worried about screening mammography for the women it serves.\u003c/p>\n\u003cp>Remember, women who benefit most from mammography are post-menopausal, usually over age 50. Mammograms have been fiercely debated most for women in their 40's. But no credible organization recommends screening mammograms for women younger than 40.\u003c/p>\n\u003cp>And how old is the population served by Planned Parenthood? Nearly 90 percent are 35 and younger, according to a Planned Parenthood spokesperson quoted in the article.\u003c!--more-->\u003c/p>\n\u003cp>The Cancer Letter consulted with four experts in evidence-based medicine, people who have been trying to get the public to understand that all screening exams bring risks, chief among them the possibility of overtreatment. Mammography's rate of false positives means many women end up worrying needlessly until they have a biopsy. One of the experts consulted also mentioned the possibility of a woman being treated for a cancer that never would have caused a serious problem.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here's \u003ca title=\"http://faculty.mdanderson.org/Donald_Berry/Default.asp?SNID=1201078252\" href=\"http://faculty.mdanderson.org/Donald_Berry/Default.asp?SNID=1201078252\" target=\"_blank\">Donald Berry\u003c/a>, a biostatisician at M.D. Anderson Cancer Center, as quoted in the Cancer Letter:\u003c/p>\n\u003cblockquote>\u003cp>\"It is far from clear that screening for breast cancer in the context of Planned Parenthood is an appropriate use of Komen’s money or Planned Parenthood’s time,” Berry wrote. “Had Komen chosen to cut funding on this basis and not on the basis of a political agenda, then this would have been a powerful and important statement.”\u003c/p>\u003c/blockquote>\n\u003cp>Specifically, the Cancer Letter asked its panel to review information about breast cancer screening on the Planned Parenthood website. All four were concerned about what they found.\u003c/p>\n\u003cp>As \u003ca title=\"http://tdi.dartmouth.edu/faculty/details/94\" href=\"http://tdi.dartmouth.edu/faculty/details/94\" target=\"_blank\">Lisa Schwartz\u003c/a> and \u003ca title=\"http://dms.dartmouth.edu/faculty/facultydb/view.php?uid=76\" href=\"http://dms.dartmouth.edu/faculty/facultydb/view.php?uid=76\" target=\"_blank\">Steven Woloshin\u003c/a> of Dartmouth Medical School said:\u003c/p>\n\u003cblockquote>\u003cp>\"The website presents screening the way a screening advocacy group might—persuading women to be screened rather than helping them understand the benefits and harms—an approach at odds with Planned Parenthood’s philosophy of 'respect for each individual’s right to make informed, independent decisions about health, sex, and family planning.'\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>It's worth reading \u003ca title=\"http://www.cancerletter.com/articles/20120210_2\" href=\"http://www.cancerletter.com/articles/20120210_2\" target=\"_blank\">the entire report.\u003c/a>\u003c/p>\n\u003cdiv>\u003c/div>\n\n",
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"excerpt": "The widely regarded Cancer Letter is usually available only by subscription at a hefty $405 a year. But the current issue looks at the Susan G. Komen Foundation's decision to stop funding Planned Parenthood and has been made available for free.\r\n\r\nThe Cancer Letter isn't concerned with the politics of the decision, and Foundation's reversal. Instead, the Cancer Letter publisher wonders why Planned Parenthood is worrying about screening mammograms when \"88 percent of women who relied on Planned Parenthood were 35 and younger,\" according to a Planned Parenthood spokesperson quoted in the article.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2988\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/SusanGKomen_BrandiKorte_Flickr_02102012.jpg\">\u003cimg class=\"size-medium wp-image-2988\" title=\"(Brandi Korte: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/SusanGKomen_BrandiKorte_Flickr_02102012-300x200.jpg\" alt=\"(Brandi Korte: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Brandi Korte: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While the widely regarded \u003ca title=\"http://www.cancerletter.com/articles/20120210\" href=\"http://www.cancerletter.com/articles/20120210\" target=\"_blank\">Cancer Letter\u003c/a> is usually available only by subscription at a hefty $405 a year, the current issue is available for free. It looks at the Susan G. Komen Foundation's \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/02/01/susan-g-komen-vs-planned-parenthood/\" href=\"http://ww2.kqed.org/stateofhealth/2012/02/01/susan-g-komen-vs-planned-parenthood/\" target=\"_blank\">decision to stop funding Planned Parenthood\u003c/a>. But the Cancer Letter is not concerned with the politics behind the story.\u003c/p>\n\u003cp>Instead, the Cancer Letter takes an extensive look at Planned Parenthood itself and why the organization is worried about screening mammography for the women it serves.\u003c/p>\n\u003cp>Remember, women who benefit most from mammography are post-menopausal, usually over age 50. Mammograms have been fiercely debated most for women in their 40's. But no credible organization recommends screening mammograms for women younger than 40.\u003c/p>\n\u003cp>And how old is the population served by Planned Parenthood? Nearly 90 percent are 35 and younger, according to a Planned Parenthood spokesperson quoted in the article.\u003c!--more-->\u003c/p>\n\u003cp>The Cancer Letter consulted with four experts in evidence-based medicine, people who have been trying to get the public to understand that all screening exams bring risks, chief among them the possibility of overtreatment. Mammography's rate of false positives means many women end up worrying needlessly until they have a biopsy. One of the experts consulted also mentioned the possibility of a woman being treated for a cancer that never would have caused a serious problem.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here's \u003ca title=\"http://faculty.mdanderson.org/Donald_Berry/Default.asp?SNID=1201078252\" href=\"http://faculty.mdanderson.org/Donald_Berry/Default.asp?SNID=1201078252\" target=\"_blank\">Donald Berry\u003c/a>, a biostatisician at M.D. Anderson Cancer Center, as quoted in the Cancer Letter:\u003c/p>\n\u003cblockquote>\u003cp>\"It is far from clear that screening for breast cancer in the context of Planned Parenthood is an appropriate use of Komen’s money or Planned Parenthood’s time,” Berry wrote. “Had Komen chosen to cut funding on this basis and not on the basis of a political agenda, then this would have been a powerful and important statement.”\u003c/p>\u003c/blockquote>\n\u003cp>Specifically, the Cancer Letter asked its panel to review information about breast cancer screening on the Planned Parenthood website. All four were concerned about what they found.\u003c/p>\n\u003cp>As \u003ca title=\"http://tdi.dartmouth.edu/faculty/details/94\" href=\"http://tdi.dartmouth.edu/faculty/details/94\" target=\"_blank\">Lisa Schwartz\u003c/a> and \u003ca title=\"http://dms.dartmouth.edu/faculty/facultydb/view.php?uid=76\" href=\"http://dms.dartmouth.edu/faculty/facultydb/view.php?uid=76\" target=\"_blank\">Steven Woloshin\u003c/a> of Dartmouth Medical School said:\u003c/p>\n\u003cblockquote>\u003cp>\"The website presents screening the way a screening advocacy group might—persuading women to be screened rather than helping them understand the benefits and harms—an approach at odds with Planned Parenthood’s philosophy of 'respect for each individual’s right to make informed, independent decisions about health, sex, and family planning.'\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>It's worth reading \u003ca title=\"http://www.cancerletter.com/articles/20120210_2\" href=\"http://www.cancerletter.com/articles/20120210_2\" target=\"_blank\">the entire report.\u003c/a>\u003c/p>\n\u003cdiv>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Gives Hair-Straightening Product \"Caution\" Label",
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"content": "\u003cfigure id=\"attachment_2961\" class=\"wp-caption alignleft\" style=\"max-width: 224px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/hair-salon.jpg\">\u003cimg class=\"size-medium wp-image-2961 \" title=\"Patricia Davis straightens a clients hair at her salon in Oakland.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/hair-salon-300x401.jpg\" alt=\"Patricia Davis straightens a clients hair at her salon in Oakland.\" width=\"224\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patricia Davis straightens a client's hair at her salon in Oakland. (Photo: Shuka Kalantari)\u003c/figcaption>\u003c/figure>\n\u003cp>Oakland salon owner Patricia Davis leans over her client to get a better angle on the flat iron that's clamped to her hair. Steam rises up from the woman's hair and a spinning fan above spreads the steam throughout the room and out the windows. Sometimes, formaldehyde gas, a known carcinogen, is in that steam. And if that product is called \"Brazilian Blowout,\" then formaldehyde is definitely in there ... despite the fact that it says \"formaldehyde-free.\"\u003c/p>\n\u003cp>In a \u003ca title=\"http://oag.ca.gov/news/press_release?id=2617\" href=\"http://oag.ca.gov/news/press_release?id=2617\" target=\"_blank\">recent settlement agreement\u003c/a> with the California Attorney General, GIB, the company that makes the popular \u003ca title=\"http://www.brazilianblowout.com/\" href=\"http://www.brazilianblowout.com/\" target=\"_blank\">Brazilian Blowout\u003c/a> hair straightening treatment, will drop the claim that they're formaldehyde-free. They also have to add a caution label to their product.\u003c/p>\n\u003cp>\"California laws protect consumers and workers and give them fair notice about the health risks associated with the products they use,\" said Attorney General Harris. \"This settlement requires the company to disclose any hazard so that Californians can make more informed decisions.\"\u003c/p>\n\u003cp>But salon owner Davis says the controversy is overblown. \"I think it's much ado about nothing,\" she says as she continues flat-ironing her client's hair.\u003c/p>\n\u003cp>\u003c!--more-->Davis has been straightening hair at \u003ca title=\"http://www.firstimpressionhairdesigns.com/\" href=\"http://www.firstimpressionhairdesigns.com/\" target=\"_blank\">First Impressions Hair Designs\u003c/a> in downtown Oakland for over 20 years. She says most hair-straightening treatments have one thing in common: they emit smoke. So regardless of whether or not a product contains formaldehyde, or any other of the host of toxins in hair products, she says a salon owner must always get the smoke out of their salon.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It can cause your eyes to burn and probably your skin to burn,\" Davis said. \"Absolutely. But only \u003cem>without\u003c/em> the proper ventilation and the circulation of air within your salon.\"\u003c/p>\n\u003cp>Davis points to two fans running in the room. She said she's never had health problems as long as she followed \u003ca title=\"http://www.dir.ca.gov/dosh/HairSmoothingPageVersion1Nov182010.pdf\" href=\"http://www.dir.ca.gov/dosh/HairSmoothingPageVersion1Nov182010.pdf\" target=\"_blank\">the guidelines\u003c/a> [PDF] of the Occupational Safety and Health Administration (OSHA) on proper ventilation. \"So even if it has a [label saying] ‘caution: formaldehyde in it,’ basically I’m like, 'And? We already have smoke in our salons.'”\u003c/p>\n\u003cp>Davis notes that ethnic hair salons have used hair straightening treatments with toxic chemicals for decades. She believes the reason the FDA is now receiving complaints may be because hair-straightening treatments have become popular outside of ethnic salons. \"[Ethnic salons] know all about the need for ventilation,\" Davis says. \"My point is as white-oriented salons become more familiar with strong chemicals, they are more challenged to not overlook the ventilation issues.\"\u003c/p>\n\u003cp>But Renee Sharpe, a scientist and the California director of the \u003ca title=\"http://www.ewg.org/\" href=\"http://www.ewg.org/\" target=\"_blank\">Environmental Working Group\u003c/a>, or EWG, says all salon owners should be concerned. The EWG did a \u003ca title=\"http://www.ewg.org/hair-straighteners/our-report/executive-summary/\" href=\"http://www.ewg.org/hair-straighteners/our-report/executive-summary/\" target=\"_blank\">study on formaldehyde\u003c/a> in hair products and say their \u003ca title=\"http://ewg.org/hair-straighteners/our-report/adverse-reactions-and-injuries-hair-straighteners/\" href=\"http://ewg.org/hair-straighteners/our-report/adverse-reactions-and-injuries-hair-straighteners/\" target=\"_blank\">reports\u003c/a> clearly show that some salon workers were having negative health effects.\u003c/p>\n\u003cp>\"People have really different sensitivities to chemicals. So what is fine for one person may not be fine for another person. Do you really want to have a product on the market where OSHA is saying that you have to follow all these precautions? Ultimately that means that product is toxic and shouldn’t remain on the market.\"\u003c/p>\n\u003cp>Sharpe says while the EWG welcomes the California Attorney General's decision, it's only a first step. They want the Food and Drug Administration (FDA) to ban all formaldehyde beauty products. Sharpe says the EWG filed a Freedom of Information Act request to the FDA and got back scores of consumer complaints about hair products containing formaldehyde.\u003c/p>\n\u003cp>\"We got back so many records of people complaining of nausea, of vomiting, of hair loss, of actually scalp burns, skin burns. There’s a huge volume of consumer experiences with this product that shows that this is dangerous.\" Indeed, these are all commonly known side effects of formaldehyde exposure.\u003c/p>\n\u003cp>Sharpe says EWG’s research shows that there are sixteen other companies that make hair-straightening products that contain formaldehyde, but many still claim to be formaldehyde-free. But you may find the ingredient methylene glycol, which Sharpe says is formaldehyde in solution. This was the case with Brazilian Blowout.\u003c/p>\n\u003cp>\"People have this perception that it’s just about Brazilian Blowout when it’s really this much wider class of products,\" she said. \"And it’s not just California, of course. This is an issue that is nationwide.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As part of the settlement, the makers of Brazilian Blowout must send warning letters to salon owners using their products, make changes to their website, and pay $600,000 in fines. In a statement they wrote, \"We believe the settlement reached with Attorney General Harris represents a fair and equitable resolution.\"\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cdiv>\n\u003cp>\u003cstrong>This post was updated to include Ms. Davis' views about ethnic vs. white-oriented salons' approaches to ventilation of hair straightening products.\u003c/strong>\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2961\" class=\"wp-caption alignleft\" style=\"max-width: 224px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/hair-salon.jpg\">\u003cimg class=\"size-medium wp-image-2961 \" title=\"Patricia Davis straightens a clients hair at her salon in Oakland.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/hair-salon-300x401.jpg\" alt=\"Patricia Davis straightens a clients hair at her salon in Oakland.\" width=\"224\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patricia Davis straightens a client's hair at her salon in Oakland. (Photo: Shuka Kalantari)\u003c/figcaption>\u003c/figure>\n\u003cp>Oakland salon owner Patricia Davis leans over her client to get a better angle on the flat iron that's clamped to her hair. Steam rises up from the woman's hair and a spinning fan above spreads the steam throughout the room and out the windows. Sometimes, formaldehyde gas, a known carcinogen, is in that steam. And if that product is called \"Brazilian Blowout,\" then formaldehyde is definitely in there ... despite the fact that it says \"formaldehyde-free.\"\u003c/p>\n\u003cp>In a \u003ca title=\"http://oag.ca.gov/news/press_release?id=2617\" href=\"http://oag.ca.gov/news/press_release?id=2617\" target=\"_blank\">recent settlement agreement\u003c/a> with the California Attorney General, GIB, the company that makes the popular \u003ca title=\"http://www.brazilianblowout.com/\" href=\"http://www.brazilianblowout.com/\" target=\"_blank\">Brazilian Blowout\u003c/a> hair straightening treatment, will drop the claim that they're formaldehyde-free. They also have to add a caution label to their product.\u003c/p>\n\u003cp>\"California laws protect consumers and workers and give them fair notice about the health risks associated with the products they use,\" said Attorney General Harris. \"This settlement requires the company to disclose any hazard so that Californians can make more informed decisions.\"\u003c/p>\n\u003cp>But salon owner Davis says the controversy is overblown. \"I think it's much ado about nothing,\" she says as she continues flat-ironing her client's hair.\u003c/p>\n\u003cp>\u003c!--more-->Davis has been straightening hair at \u003ca title=\"http://www.firstimpressionhairdesigns.com/\" href=\"http://www.firstimpressionhairdesigns.com/\" target=\"_blank\">First Impressions Hair Designs\u003c/a> in downtown Oakland for over 20 years. She says most hair-straightening treatments have one thing in common: they emit smoke. So regardless of whether or not a product contains formaldehyde, or any other of the host of toxins in hair products, she says a salon owner must always get the smoke out of their salon.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It can cause your eyes to burn and probably your skin to burn,\" Davis said. \"Absolutely. But only \u003cem>without\u003c/em> the proper ventilation and the circulation of air within your salon.\"\u003c/p>\n\u003cp>Davis points to two fans running in the room. She said she's never had health problems as long as she followed \u003ca title=\"http://www.dir.ca.gov/dosh/HairSmoothingPageVersion1Nov182010.pdf\" href=\"http://www.dir.ca.gov/dosh/HairSmoothingPageVersion1Nov182010.pdf\" target=\"_blank\">the guidelines\u003c/a> [PDF] of the Occupational Safety and Health Administration (OSHA) on proper ventilation. \"So even if it has a [label saying] ‘caution: formaldehyde in it,’ basically I’m like, 'And? We already have smoke in our salons.'”\u003c/p>\n\u003cp>Davis notes that ethnic hair salons have used hair straightening treatments with toxic chemicals for decades. She believes the reason the FDA is now receiving complaints may be because hair-straightening treatments have become popular outside of ethnic salons. \"[Ethnic salons] know all about the need for ventilation,\" Davis says. \"My point is as white-oriented salons become more familiar with strong chemicals, they are more challenged to not overlook the ventilation issues.\"\u003c/p>\n\u003cp>But Renee Sharpe, a scientist and the California director of the \u003ca title=\"http://www.ewg.org/\" href=\"http://www.ewg.org/\" target=\"_blank\">Environmental Working Group\u003c/a>, or EWG, says all salon owners should be concerned. The EWG did a \u003ca title=\"http://www.ewg.org/hair-straighteners/our-report/executive-summary/\" href=\"http://www.ewg.org/hair-straighteners/our-report/executive-summary/\" target=\"_blank\">study on formaldehyde\u003c/a> in hair products and say their \u003ca title=\"http://ewg.org/hair-straighteners/our-report/adverse-reactions-and-injuries-hair-straighteners/\" href=\"http://ewg.org/hair-straighteners/our-report/adverse-reactions-and-injuries-hair-straighteners/\" target=\"_blank\">reports\u003c/a> clearly show that some salon workers were having negative health effects.\u003c/p>\n\u003cp>\"People have really different sensitivities to chemicals. So what is fine for one person may not be fine for another person. Do you really want to have a product on the market where OSHA is saying that you have to follow all these precautions? Ultimately that means that product is toxic and shouldn’t remain on the market.\"\u003c/p>\n\u003cp>Sharpe says while the EWG welcomes the California Attorney General's decision, it's only a first step. They want the Food and Drug Administration (FDA) to ban all formaldehyde beauty products. Sharpe says the EWG filed a Freedom of Information Act request to the FDA and got back scores of consumer complaints about hair products containing formaldehyde.\u003c/p>\n\u003cp>\"We got back so many records of people complaining of nausea, of vomiting, of hair loss, of actually scalp burns, skin burns. There’s a huge volume of consumer experiences with this product that shows that this is dangerous.\" Indeed, these are all commonly known side effects of formaldehyde exposure.\u003c/p>\n\u003cp>Sharpe says EWG’s research shows that there are sixteen other companies that make hair-straightening products that contain formaldehyde, but many still claim to be formaldehyde-free. But you may find the ingredient methylene glycol, which Sharpe says is formaldehyde in solution. This was the case with Brazilian Blowout.\u003c/p>\n\u003cp>\"People have this perception that it’s just about Brazilian Blowout when it’s really this much wider class of products,\" she said. \"And it’s not just California, of course. This is an issue that is nationwide.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As part of the settlement, the makers of Brazilian Blowout must send warning letters to salon owners using their products, make changes to their website, and pay $600,000 in fines. In a statement they wrote, \"We believe the settlement reached with Attorney General Harris represents a fair and equitable resolution.\"\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cdiv>\n\u003cp>\u003cstrong>This post was updated to include Ms. Davis' views about ethnic vs. white-oriented salons' approaches to ventilation of hair straightening products.\u003c/strong>\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Apparently all of New York is Super Bowl crazed, because no less than the \u003ca title=\"http://blogs.wsj.com/health/2012/02/02/health-blog-video-how-serious-a-party-foul-is-double-dipping/\" href=\"http://blogs.wsj.com/health/2012/02/02/health-blog-video-how-serious-a-party-foul-is-double-dipping/\" target=\"_blank\" rel=\"noopener\">Wall Street Journal’s Health Blog\u003c/a> today explores the safety of double dipping. Don’t get too carried away by the graphics depicting the exponential growth of bacteria in your party dip. The video compares the amount of bacteria you might actually pick up to “sharing a kiss with one of your fellow dippers.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"disqusTitle": "HIV Prevention Drug to be Considered by FDA",
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"content": "\u003cp>By Bernice Yeung, \u003ca title=\"http://californiawatch.org/dailyreport/calif-drugmakers-hiv-prevention-pill-draws-concern-14668\" href=\"http://californiawatch.org/dailyreport/calif-drugmakers-hiv-prevention-pill-draws-concern-14668\" target=\"_blank\">California Watch\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_2693\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Truvada.jpg\">\u003cimg class=\"size-medium wp-image-2693\" title=\"The antiretroviral drug Truvada. (Justin Sullivan: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Truvada-300x202.jpg\" alt=\"The antiretroviral drug Truvada. (Justin Sullivan: Getty Images)\" width=\"300\" height=\"202\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The antiretroviral drug Truvada. (Justin Sullivan: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Foster City drugmaker Gilead recently updated its application with the federal Food and Drug Administration for approval to market its HIV treatment medication Truvada as a HIV prevention pill.\u003c/p>\n\u003cp>If the FDA approves Truvada for preventive use, it “would be the first agent indicated for uninfected individuals to reduce the risk of acquiring HIV through sex,” according to a company statement at the time of the \u003ca title=\"http://www.gilead.com/pr_1640306\" href=\"http://www.gilead.com/pr_1640306\" target=\"_blank\">filing\u003c/a> last month.\u003c/p>\n\u003cp>Gilead’s application, however, has sparked debate among public health advocates who argue that the wide availability of the drug would discourage safe sex and would, in fact, increase the incidence of HIV.\u003c!--more-->\u003c/p>\n\u003cp>“I believe that this could be catastrophic in terms of HIV prevention,” said Michael Weinstein, president the AIDS Healthcare Foundation, based in Los Angeles. There are \u003ca title=\"http://www.cdph.ca.gov/programs/aids/Documents/SSSemiAnnualRptJun2011.pdf\" href=\"http://www.cdph.ca.gov/programs/aids/Documents/SSSemiAnnualRptJun2011.pdf\" target=\"_blank\">\u003cstrong>nearly 42,000 Californians [PDF]\u003c/strong>\u003c/a> living with HIV as of June 2011.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Weinstein added that as an HIV treatment, he thinks Truvada is a “fabulous drug – it’s one pill once a day, and it has a low side-effect burden,” which include nausea, vomiting and weight loss.\u003c/p>\n\u003cp>This new pharmaceutical prevention approach to HIV and AIDS is known in scientific circles as “pre-exposure prophylaxis,” or PrEP, and it involves taking the antiretroviral medications on a daily basis. Clinical trials supported by the National Institutes of Health have shown that when taken daily, Truvada, a blue oval pill, reduced the risk for contracting HIV by between\u003ca title=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa1011205\" href=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa1011205\" target=\"_blank\"> \u003cstrong>44 percent\u003c/strong>\u003c/a> among gay men in four countries and 73 percent by heterosexual couples in Uganda and Kenya. One trial among women in sub-Saharan Africa was stopped in April 2011.\u003c/p>\n\u003cp>Overall, these studies have generated enthusiasm among many medical researchers.\u003c/p>\n\u003cp>The drug is “an incredible achievement, a wonderful new tool that could be available to people who need additional protection against the acquisition of HIV,” said Veronica Miller, executive director of The Forum for Collaborative HIV Research and a visiting professor at the UC Berkeley School of Public Health.\u003c/p>\n\u003cp>But Weinstein said he’s not yet convinced by the research, and he wouldn’t want to see future mass marketing of the drug discourage gay men – the risk group \u003cstrong>\u003ca title=\"http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf\" href=\"http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf\" target=\"_blank\">most seriously affected \u003c/a>[PDF]\u003c/strong> by HIV, according to the Centers for Disease Control and Prevention – from using condoms based on “the false belief that they are protected by this,” when there’s a possibility that those taking the medication still could contract the disease.\u003c/p>\n\u003cp>\u003ca title=\"http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70219-5/fulltext\" href=\"http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70219-5/fulltext\" target=\"_blank\">An article\u003c/a> in the British medical journal \u003cem>The Lancet\u003c/em> last year also argued that “although some of the trial results have been very impressive, the protection with pre-exposure prophylaxis is unlikely to be 100 percent, and making drugs available as prophylaxis could encourage high-risk sexual behaviour among those who believe themselves to be protected.”\u003c/p>\n\u003cp>Dr. Albert Liu of the San Francisco Department of Public Health's HIV Research Section is working on two studies, one that started last fall and one that will launch this spring, to determine who is interested in using the drug and how they adhere to it \"in the real world.\" Whether widespread access to the pill would lead to unsafe sex practices is a \"good question, and part of the goal of (the upcoming studies) is to evaluate what happens with people's sexual practices when they're taking PrEP,\" he said. \"We don't know the answer, and that's why it's important to study it.\"\u003c/p>\n\u003cp>The \u003ca title=\"http://hivforumannals.org/index.php/annals/article/view/91\" href=\"http://hivforumannals.org/index.php/annals/article/view/91\" target=\"_blank\">Annals of the Forum for Collaborative HIV Research\u003c/a> \u003ca href=\"http://hivforumannals.org/index.php/annals/article/view/91\">noted\u003c/a> that the drug had performed well in clinical trials; the safety risk is relatively low; and as a result, doctors can currently prescribe the drug for prevention off-label. However, those who use the drug could develop resistance to it, and if they don’t use it daily, the risk for contracting HIV increases, the forum said.\u003c/p>\n\u003cp>An article [PDF] by UCLA public affairs and medical school professors in the \u003ca title=\"http://nomagicpills.org/docs/US_Policy_Perspective_PrEP.pdf\" href=\"http://nomagicpills.org/docs/US_Policy_Perspective_PrEP.pdf\" target=\"_blank\">American Journal of Public Health\u003c/a> [PDF] also urged caution.\u003c/p>\n\u003cp>“These randomized clinical trial results suggest that PrEP is a promising strategy, but we must temper this promise with a healthy dose of caution,\" the authors wrote. \"PrEP is an intensive intervention for which cost, feasibility, and behavioral considerations may be as important as clinical efficacy.”\u003c/p>\n\u003cp>But the forum’s Miller said that these concerns, while valid, “can be dealt with” through additional research and planning.\u003c/p>\n\u003cp>Other drug companies, including ViiV Healthcare, also are planning studies to sell similar prevention drugs, but given the number of clinical trials performed or under way on Truvada, Gilead's product is likely to be the first to make it to market.\u003c/p>\n\u003cp>Gilead's total product sales were\u003ca title=\"http://www.sec.gov/Archives/edgar/data/882095/000119312511297580/d226980d10q.htm\" href=\"http://www.sec.gov/Archives/edgar/data/882095/000119312511297580/d226980d10q.htm\" target=\"_blank\"> $2 billion for the third quarter of 2011\u003c/a>, driven primarily by sales of Truvada and other antiviral drugs. Gilead did not respond to requests for comment.\u003c/p>\n\u003cp>Some HIV and AIDS awareness organizations say that while they wouldn't want to see Truvada trump other forms of prevention, they are hopeful that the drug will help reach high-risk individuals.\u003c/p>\n\u003cp>“It comes down to choices,” said David Evans, director of research advocacy at Project Inform, a San Francisco organization focused on improving the health of people with HIV. “For those who are high at risk, we want them to know that there is something new and a better option available to them.”\u003c/p>\n\u003cp>Nevertheless, Evans said he shares some of the drug critics' concerns. “We don’t want to see people give up safe sex practices,\" he said. \"We hope and expect that PrEP will not be given to people who do well with condoms, but to people who struggle with making safer choices.”\u003c/p>\n\u003cp>\u003cstrong>Read More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"Interview: Drug May Be First to Prevent HIV Transmission in Healthy\" href=\"Drug%20May%20Be%20First%20to%20Prevent%20HIV%20Transmission%20in%20Healthy\" target=\"_blank\">Drug May Be First to Prevent HIV Transmission in Health\u003c/a> (from KQED News Fix blog)\u003c/p>\n\n",
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"excerpt": "Foster City drugmaker Gilead recently updated its application with the federal Food and Drug Administration for approval to market its HIV treatment medication Truvada as a HIV prevention pill.\r\n\r\nIf the FDA approves Truvada for preventive use, it “would be the first agent indicated for uninfected individuals to reduce the risk of acquiring HIV through sex,” according to a company statement at the time of the filing last month.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Bernice Yeung, \u003ca title=\"http://californiawatch.org/dailyreport/calif-drugmakers-hiv-prevention-pill-draws-concern-14668\" href=\"http://californiawatch.org/dailyreport/calif-drugmakers-hiv-prevention-pill-draws-concern-14668\" target=\"_blank\">California Watch\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_2693\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Truvada.jpg\">\u003cimg class=\"size-medium wp-image-2693\" title=\"The antiretroviral drug Truvada. (Justin Sullivan: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Truvada-300x202.jpg\" alt=\"The antiretroviral drug Truvada. (Justin Sullivan: Getty Images)\" width=\"300\" height=\"202\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The antiretroviral drug Truvada. (Justin Sullivan: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Foster City drugmaker Gilead recently updated its application with the federal Food and Drug Administration for approval to market its HIV treatment medication Truvada as a HIV prevention pill.\u003c/p>\n\u003cp>If the FDA approves Truvada for preventive use, it “would be the first agent indicated for uninfected individuals to reduce the risk of acquiring HIV through sex,” according to a company statement at the time of the \u003ca title=\"http://www.gilead.com/pr_1640306\" href=\"http://www.gilead.com/pr_1640306\" target=\"_blank\">filing\u003c/a> last month.\u003c/p>\n\u003cp>Gilead’s application, however, has sparked debate among public health advocates who argue that the wide availability of the drug would discourage safe sex and would, in fact, increase the incidence of HIV.\u003c!--more-->\u003c/p>\n\u003cp>“I believe that this could be catastrophic in terms of HIV prevention,” said Michael Weinstein, president the AIDS Healthcare Foundation, based in Los Angeles. There are \u003ca title=\"http://www.cdph.ca.gov/programs/aids/Documents/SSSemiAnnualRptJun2011.pdf\" href=\"http://www.cdph.ca.gov/programs/aids/Documents/SSSemiAnnualRptJun2011.pdf\" target=\"_blank\">\u003cstrong>nearly 42,000 Californians [PDF]\u003c/strong>\u003c/a> living with HIV as of June 2011.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Weinstein added that as an HIV treatment, he thinks Truvada is a “fabulous drug – it’s one pill once a day, and it has a low side-effect burden,” which include nausea, vomiting and weight loss.\u003c/p>\n\u003cp>This new pharmaceutical prevention approach to HIV and AIDS is known in scientific circles as “pre-exposure prophylaxis,” or PrEP, and it involves taking the antiretroviral medications on a daily basis. Clinical trials supported by the National Institutes of Health have shown that when taken daily, Truvada, a blue oval pill, reduced the risk for contracting HIV by between\u003ca title=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa1011205\" href=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa1011205\" target=\"_blank\"> \u003cstrong>44 percent\u003c/strong>\u003c/a> among gay men in four countries and 73 percent by heterosexual couples in Uganda and Kenya. One trial among women in sub-Saharan Africa was stopped in April 2011.\u003c/p>\n\u003cp>Overall, these studies have generated enthusiasm among many medical researchers.\u003c/p>\n\u003cp>The drug is “an incredible achievement, a wonderful new tool that could be available to people who need additional protection against the acquisition of HIV,” said Veronica Miller, executive director of The Forum for Collaborative HIV Research and a visiting professor at the UC Berkeley School of Public Health.\u003c/p>\n\u003cp>But Weinstein said he’s not yet convinced by the research, and he wouldn’t want to see future mass marketing of the drug discourage gay men – the risk group \u003cstrong>\u003ca title=\"http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf\" href=\"http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf\" target=\"_blank\">most seriously affected \u003c/a>[PDF]\u003c/strong> by HIV, according to the Centers for Disease Control and Prevention – from using condoms based on “the false belief that they are protected by this,” when there’s a possibility that those taking the medication still could contract the disease.\u003c/p>\n\u003cp>\u003ca title=\"http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70219-5/fulltext\" href=\"http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70219-5/fulltext\" target=\"_blank\">An article\u003c/a> in the British medical journal \u003cem>The Lancet\u003c/em> last year also argued that “although some of the trial results have been very impressive, the protection with pre-exposure prophylaxis is unlikely to be 100 percent, and making drugs available as prophylaxis could encourage high-risk sexual behaviour among those who believe themselves to be protected.”\u003c/p>\n\u003cp>Dr. Albert Liu of the San Francisco Department of Public Health's HIV Research Section is working on two studies, one that started last fall and one that will launch this spring, to determine who is interested in using the drug and how they adhere to it \"in the real world.\" Whether widespread access to the pill would lead to unsafe sex practices is a \"good question, and part of the goal of (the upcoming studies) is to evaluate what happens with people's sexual practices when they're taking PrEP,\" he said. \"We don't know the answer, and that's why it's important to study it.\"\u003c/p>\n\u003cp>The \u003ca title=\"http://hivforumannals.org/index.php/annals/article/view/91\" href=\"http://hivforumannals.org/index.php/annals/article/view/91\" target=\"_blank\">Annals of the Forum for Collaborative HIV Research\u003c/a> \u003ca href=\"http://hivforumannals.org/index.php/annals/article/view/91\">noted\u003c/a> that the drug had performed well in clinical trials; the safety risk is relatively low; and as a result, doctors can currently prescribe the drug for prevention off-label. However, those who use the drug could develop resistance to it, and if they don’t use it daily, the risk for contracting HIV increases, the forum said.\u003c/p>\n\u003cp>An article [PDF] by UCLA public affairs and medical school professors in the \u003ca title=\"http://nomagicpills.org/docs/US_Policy_Perspective_PrEP.pdf\" href=\"http://nomagicpills.org/docs/US_Policy_Perspective_PrEP.pdf\" target=\"_blank\">American Journal of Public Health\u003c/a> [PDF] also urged caution.\u003c/p>\n\u003cp>“These randomized clinical trial results suggest that PrEP is a promising strategy, but we must temper this promise with a healthy dose of caution,\" the authors wrote. \"PrEP is an intensive intervention for which cost, feasibility, and behavioral considerations may be as important as clinical efficacy.”\u003c/p>\n\u003cp>But the forum’s Miller said that these concerns, while valid, “can be dealt with” through additional research and planning.\u003c/p>\n\u003cp>Other drug companies, including ViiV Healthcare, also are planning studies to sell similar prevention drugs, but given the number of clinical trials performed or under way on Truvada, Gilead's product is likely to be the first to make it to market.\u003c/p>\n\u003cp>Gilead's total product sales were\u003ca title=\"http://www.sec.gov/Archives/edgar/data/882095/000119312511297580/d226980d10q.htm\" href=\"http://www.sec.gov/Archives/edgar/data/882095/000119312511297580/d226980d10q.htm\" target=\"_blank\"> $2 billion for the third quarter of 2011\u003c/a>, driven primarily by sales of Truvada and other antiviral drugs. Gilead did not respond to requests for comment.\u003c/p>\n\u003cp>Some HIV and AIDS awareness organizations say that while they wouldn't want to see Truvada trump other forms of prevention, they are hopeful that the drug will help reach high-risk individuals.\u003c/p>\n\u003cp>“It comes down to choices,” said David Evans, director of research advocacy at Project Inform, a San Francisco organization focused on improving the health of people with HIV. “For those who are high at risk, we want them to know that there is something new and a better option available to them.”\u003c/p>\n\u003cp>Nevertheless, Evans said he shares some of the drug critics' concerns. “We don’t want to see people give up safe sex practices,\" he said. \"We hope and expect that PrEP will not be given to people who do well with condoms, but to people who struggle with making safer choices.”\u003c/p>\n\u003cp>\u003cstrong>Read More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"Interview: Drug May Be First to Prevent HIV Transmission in Healthy\" href=\"Drug%20May%20Be%20First%20to%20Prevent%20HIV%20Transmission%20in%20Healthy\" target=\"_blank\">Drug May Be First to Prevent HIV Transmission in Health\u003c/a> (from KQED News Fix blog)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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