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"content": "\u003cfigure id=\"attachment_1063\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011.jpg\">\u003cimg class=\"size-medium wp-image-1063 \" title=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011-300x225.jpg\" alt=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Suspicious mass on mammogram. (KristieWells: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Seventy percent of women who develop breast cancer have \u003ca title=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" href=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" target=\"_blank\">no known risk factors\u003c/a>. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious \u003ca title=\"http://www.iom.edu/\" href=\"http://www.iom.edu/\" target=\"_blank\">Institute of Medicine\u003c/a> (IOM) released a much anticipated 360 page study, \u003ca title=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" href=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" target=\"_blank\">Breast Cancer and the Environment\u003c/a>. But it unfortunately was unable to give women or their doctors any new environmental clues.\u003c/p>\n\u003cp>As the \u003ca title=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" href=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" target=\"_blank\">New York Times reports\u003c/a>, most of what the IOM did recommend is already known and might not have much effect anyway.\u003c/p>\n\u003cblockquote>\u003cp>The most consistent data suggest that women can reduce their risk by avoiding unnecessary medical radiation, forgoing hormone treatments for menopause that combine estrogen and progestin, limiting alcohol intake and minimizing weight gain, the report found. (Controlling weight appears helpful only in preventing postmenopausal breast cancers, not those in younger women.) Overuse of CT scans, which deliver a relatively high dose of radiation, was a particular concern, but the report stated that women should not be deterred from having routine mammograms, which use a much smaller dose. ...\u003c/p>\n\u003cp>\u003c!--more-->For women who were hoping for definitive safety information about the huge number of chemicals to which people are exposed — from air pollution and cosmetics to cleaning products, food and drinking water — the report may come as a disappointment. It is based largely on a review of existing research, and its limited advice reflects the lack of solid scientific information in many areas of concern to the public.\u003c/p>\u003c/blockquote>\n\u003cp>One of those who was disappointed was Karuna Jaggar, Executive Director of \u003ca href=\"http://bcaction.org/\" target=\"_blank\">Breast Cancer Action\u003c/a>. \"I'm frankly shocked. I expected something different,\" she says. \"In a way the report highlights the need for a report about breast cancer and the environment.\"\u003c/p>\n\u003cp>Jaggar said she appreciated how difficult it is to prove a link between a specific chemical and breast cancer. Studies of a possible carcinogen cannot be done on humans for ethical reasons, for example.\u003c/p>\n\u003cp>\"The question is what do we do in the meantime?\" she said. \"Do we wait decades for measurement tools to measure lifetime exposures to many of these chemicals?\" She argued for more caution in allowing suspected chemicals or products to be on the market.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was requested and sponsored entirely by the breast cancer advocacy group \u003ca title=\"http://ww5.komen.org/\" href=\"http://ww5.komen.org/\" target=\"_blank\">Susan G. Komen for the Cure\u003c/a>.\u003c/p>\n\n",
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"excerpt": "Seventy percent of women who develop breast cancer have no known risk factors. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious Institute of Medicine released a much anticipated 360 page study, Breast Cancer and the Environment. But it unfortunately was unable to give women or their doctors any new environmental clues.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1063\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011.jpg\">\u003cimg class=\"size-medium wp-image-1063 \" title=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Mammogram_KristieWells_Flickr_12072011-300x225.jpg\" alt=\"Suspicious mass on mammogram. (KristieWells: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Suspicious mass on mammogram. (KristieWells: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Seventy percent of women who develop breast cancer have \u003ca title=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" href=\"http://www.dslrf.org/breastcancer/content.asp?L2=7&L3=2&SID=232\" target=\"_blank\">no known risk factors\u003c/a>. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious \u003ca title=\"http://www.iom.edu/\" href=\"http://www.iom.edu/\" target=\"_blank\">Institute of Medicine\u003c/a> (IOM) released a much anticipated 360 page study, \u003ca title=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" href=\"http://www.iom.edu/Reports/2011/Breast-Cancer-and-the-Environment-A-Life-Course-Approach.aspx\" target=\"_blank\">Breast Cancer and the Environment\u003c/a>. But it unfortunately was unable to give women or their doctors any new environmental clues.\u003c/p>\n\u003cp>As the \u003ca title=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" href=\"http://www.nytimes.com/2011/12/08/health/scientific-panel-finds-few-clear-environmental-links-to-breast-cancer.html?ref=health\" target=\"_blank\">New York Times reports\u003c/a>, most of what the IOM did recommend is already known and might not have much effect anyway.\u003c/p>\n\u003cblockquote>\u003cp>The most consistent data suggest that women can reduce their risk by avoiding unnecessary medical radiation, forgoing hormone treatments for menopause that combine estrogen and progestin, limiting alcohol intake and minimizing weight gain, the report found. (Controlling weight appears helpful only in preventing postmenopausal breast cancers, not those in younger women.) Overuse of CT scans, which deliver a relatively high dose of radiation, was a particular concern, but the report stated that women should not be deterred from having routine mammograms, which use a much smaller dose. ...\u003c/p>\n\u003cp>\u003c!--more-->For women who were hoping for definitive safety information about the huge number of chemicals to which people are exposed — from air pollution and cosmetics to cleaning products, food and drinking water — the report may come as a disappointment. It is based largely on a review of existing research, and its limited advice reflects the lack of solid scientific information in many areas of concern to the public.\u003c/p>\u003c/blockquote>\n\u003cp>One of those who was disappointed was Karuna Jaggar, Executive Director of \u003ca href=\"http://bcaction.org/\" target=\"_blank\">Breast Cancer Action\u003c/a>. \"I'm frankly shocked. I expected something different,\" she says. \"In a way the report highlights the need for a report about breast cancer and the environment.\"\u003c/p>\n\u003cp>Jaggar said she appreciated how difficult it is to prove a link between a specific chemical and breast cancer. Studies of a possible carcinogen cannot be done on humans for ethical reasons, for example.\u003c/p>\n\u003cp>\"The question is what do we do in the meantime?\" she said. \"Do we wait decades for measurement tools to measure lifetime exposures to many of these chemicals?\" She argued for more caution in allowing suspected chemicals or products to be on the market.\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>The study was requested and sponsored entirely by the breast cancer advocacy group \u003ca title=\"http://ww5.komen.org/\" href=\"http://ww5.komen.org/\" target=\"_blank\">Susan G. Komen for the Cure\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Doing Things Right: Why Three Hospitals Didn't Hurt My Wife",
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"content": "\u003cdiv>\n\u003cfigure id=\"attachment_972\" class=\"wp-caption alignleft\" style=\"max-width: 176px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\">\u003cimg class=\"size-full wp-image-972 \" title=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\" alt=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" width=\"176\" height=\"250\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By: Michael Millenson\u003c/strong>\u003c/p>\n\u003cp>My wife was lying in the back of an ambulance, dazed and bloody, while I sat in the front, distraught and distracted. We had been bicycling in a quiet neighborhood in southern Maine when she hit the handbrakes too hard and catapulted over the handlebars, turning our first day of vacation into a race to the nearest hospital.\u003c/p>\n\u003cp>The anxiety when a loved one is injured is compounded when you know just how risky making things better can get. As a long-time advocate for patient safety, my interest in the topic has always been passionate, but never personal. Now, as Susan was being rushed into the emergency room, I wanted to keep it that way. \"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid. \u003c/aside>\n\u003cp>In the weeks after the accident, we spent time at a 50-bed hospital in Maine; a Boston teaching hospital where Susan was transferred with a small vertebra fracture at the base of her neck and broken bones in her left elbow and hand; and a large community hospital near our suburban Chicago home. There were plenty of opportunities for bad things to happen -- but nothing did. As far as I could tell, we didn't even experience any near misses.\u003c/p>\n\u003cp>\u003c!--more-->What went right? After all, though our health care system knows how to prevent errors that kill 44,000 to 98,000 people in hospitals each year, that death toll \u003ca href=\"http://www.nytimes.com/2010/11/25/health/research/25patient.html\">has remained stubbornly constant\u003c/a>. Based on personal and professional observations, I'd simplify the formula that kept Susan safe into three variables: consciousness, culture and cash.\u003c/p>\n\u003cp>Consciousness of patient safety sounds easy, but it isn't. The harm caused patients is inadvertent and often occurs as part of complex interventions. As a result, \u003ca href=\"http://jama.ama-assn.org/content/301/12/1273.short\" target=\"_blank\">a 2009 JAMA commentary\u003c/a> pointedly noted, \"clinicians have labeled virtually all harm as inevitable for decades.\"\u003c/p>\n\u003cp>But today, the cloak of invisibility is being lifted. Twenty-six states require hospitals to report certain medical errors; Medicare and some private insurers won't pay for problems caused by a growing list of quality and safety lapses, and the government has launched the $1 billion Partnership for Patients to dramatically reduce avoidable harm.\u003c/p>\n\u003cp>Just as importantly, patients are worried. In a poll by Consumers Union, 77 percent of respondents expressed high or moderate concern that they might be harmed by a hospital infection and 71 percent had the same concern about medication errors. Inevitably, more patients and their families are speaking up -- as I most certainly did, albeit as politely as possible.\u003c/p>\n\u003cp>When the ER nurse at Maine's York Hospital gave Susan morphine, I asked about the dosage and timing. When she was transferred to Massachusetts General Hospital in Boston, I asked each medical professional to identify themselves and what they were doing. Although it's impossible to know if my questions had any positive impact, at a minimum they reinforced an existing safety consciousness.\u003c/p>\n\u003cp>Although consciousness of a problem can spur change, sustaining it requires a supportive culture. Can there be any more graphic expression of a safety culture commitment than Baylor Health Care System's mission to eliminate preventable deaths, preventable injuries and preventable risk? Or Ascension Health's \"healing without harm\" initiative and its goal of reducing preventable deaths by 900 each year? (They've reached a minimum of 1,500 so far.) Both organizations have published results in the peer-reviewed literature.\u003c/p>\n\u003cp>Glenbrook Hospital in suburban Chicago -- it's part of the NorthShore University HealthSystem -- isn't quite as ambitious in its objectives. Still, its culture was obvious even before I peeked at the monthly infection report left sitting on a reception desk. When the orthopedic surgeon was explaining the procedure he would be doing, he talked about safety. The consulting neurosurgeon (due to Susan's neck injury) talked about safety. The anesthesiologist talked about safety. Right before surgery, nurses fitted Susan with surgical stockings to prevent deep vein thrombosis -- an evidence-based guideline followed by fewer than half of hospitals. When I challenged the surgical team on appropriate prophylactic antibiotic use, a nurse indignantly cited a study showing I was mistaken.\u003c/p>\n\u003cp>I backed off, happy they'd thought about the issue seriously. But I did feel emboldened to ask whether the team in the operating room took time-outs before surgery (the evidence shows it helps make sure everyone's on the same page before you start cutting) and whether the team introduced themselves before proceeding (believe it or not, even the doctors may not be entirely certain who is behind those masks). Yes and yes, the answers came back.\u003c/p>\n\u003cp>Culture change at hospitals is easier these days with \u003ca href=\"http://www.implementationscience.com/content/4/1/25/\">role models\u003c/a> like Ascension and Baylor, and with safety checklists like the one developed by Johns Hopkins' critical care specialist \u003ca href=\"http://www.hopkinsmedicine.org/quality/safety/pronovost/index.html\" target=\"_blank\">Peter Pronovost\u003c/a>. But if consciousness is one barrier to culture change, another one of at least equal importance is cash.\u003c/p>\n\u003cp>There's a link between financial stress and patient distress. A recent study in \u003ca href=\"http://content.healthaffairs.org/content/30/10/1904.abstract\" target=\"_blank\">Health Affairs\u003c/a> found the 178 \"worst\" hospitals in the United States care for more than twice the proportion of elderly minority and poor patients as the nation's 122 \"best\" hospitals, where costs are lowest and quality highest. As one headline put it, \"Bad Hospitals, Poor Patients.\"\u003c/p>\n\u003cp>Money talks in other ways. I've written about how some hospitals implicitly see adverse events \u003ca href=\"http://healthaffairs.org/blog/2010/12/06/why-we-still-kill-patients-invisibility-inertia-and-income/\">as a way to keep beds filled\u003c/a> (although, of course, actual patient deaths thwart that goal). The hospitals where my wife was treated were all prosperous. Even without worrying about a reluctance to confront complications, would a cash-strapped York have transferred Susan to a tertiary care facility, or would they have assured a well-insured patient they could take care of her broken neck? Would a bottom line-driven Mass General or Glenbrook have angled for a longer hospital stay?\u003c/p>\n\u003cp>It's tough enough to change culture. It's even tougher if it you think you’ll lose money doing so. That's why Medicare is increasingly linking payment to explicit quality and safety indicators.\u003c/p>\n\u003cp>We ask a great deal of physicians, nurses and other professionals. Those whom we encountered juggled multiple roles -- healers attending to the ill and scared, prudent managers of health-care resources and team players in system improvement. For the skill and grace with which they performed all those roles we were deeply grateful. Thanks to them, Susan has now recovered to the point that to the casual observer there's no obvious evidence of her multiple injuries.\u003c/p>\n\u003cp>Our experience showed that \"doing the right thing\" -- appropriate care -- and \"doing the right thing right\" -- safe and effective care -- can become the norm at rural, suburban and big urban teaching hospitals alike. On a personal level for the two of us, and on a system level for all of us, that's very good news.\u003c/p>\n\u003cp>\u003cem>Michael L. Millenson is a Highland Park, Illinois-based consultant, a visiting scholar at the Kellogg School of Management and the author of \u003c/em>\u003ca href=\"http://www.press.uchicago.edu/Misc/Chicago/525872.html\" target=\"_blank\">\u003cem>Demanding Medical Excellence: Doctors and Accountability in the Information Age\u003c/em>\u003c/a>\u003cem>. This article first appeared in \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cfigure id=\"attachment_972\" class=\"wp-caption alignleft\" style=\"max-width: 176px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\">\u003cimg class=\"size-full wp-image-972 \" title=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Millenson_and_Susan.jpg\" alt=\"Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\" width=\"176\" height=\"250\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Millenson and his wife, Susan. (Photo: Michael Millenson)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By: Michael Millenson\u003c/strong>\u003c/p>\n\u003cp>My wife was lying in the back of an ambulance, dazed and bloody, while I sat in the front, distraught and distracted. We had been bicycling in a quiet neighborhood in southern Maine when she hit the handbrakes too hard and catapulted over the handlebars, turning our first day of vacation into a race to the nearest hospital.\u003c/p>\n\u003cp>The anxiety when a loved one is injured is compounded when you know just how risky making things better can get. As a long-time advocate for patient safety, my interest in the topic has always been passionate, but never personal. Now, as Susan was being rushed into the emergency room, I wanted to keep it that way. \"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Wife of patient safety expert is victim\" was a headline I deeply hoped to avoid. \u003c/aside>\n\u003cp>In the weeks after the accident, we spent time at a 50-bed hospital in Maine; a Boston teaching hospital where Susan was transferred with a small vertebra fracture at the base of her neck and broken bones in her left elbow and hand; and a large community hospital near our suburban Chicago home. There were plenty of opportunities for bad things to happen -- but nothing did. As far as I could tell, we didn't even experience any near misses.\u003c/p>\n\u003cp>\u003c!--more-->What went right? After all, though our health care system knows how to prevent errors that kill 44,000 to 98,000 people in hospitals each year, that death toll \u003ca href=\"http://www.nytimes.com/2010/11/25/health/research/25patient.html\">has remained stubbornly constant\u003c/a>. Based on personal and professional observations, I'd simplify the formula that kept Susan safe into three variables: consciousness, culture and cash.\u003c/p>\n\u003cp>Consciousness of patient safety sounds easy, but it isn't. The harm caused patients is inadvertent and often occurs as part of complex interventions. As a result, \u003ca href=\"http://jama.ama-assn.org/content/301/12/1273.short\" target=\"_blank\">a 2009 JAMA commentary\u003c/a> pointedly noted, \"clinicians have labeled virtually all harm as inevitable for decades.\"\u003c/p>\n\u003cp>But today, the cloak of invisibility is being lifted. Twenty-six states require hospitals to report certain medical errors; Medicare and some private insurers won't pay for problems caused by a growing list of quality and safety lapses, and the government has launched the $1 billion Partnership for Patients to dramatically reduce avoidable harm.\u003c/p>\n\u003cp>Just as importantly, patients are worried. In a poll by Consumers Union, 77 percent of respondents expressed high or moderate concern that they might be harmed by a hospital infection and 71 percent had the same concern about medication errors. Inevitably, more patients and their families are speaking up -- as I most certainly did, albeit as politely as possible.\u003c/p>\n\u003cp>When the ER nurse at Maine's York Hospital gave Susan morphine, I asked about the dosage and timing. When she was transferred to Massachusetts General Hospital in Boston, I asked each medical professional to identify themselves and what they were doing. Although it's impossible to know if my questions had any positive impact, at a minimum they reinforced an existing safety consciousness.\u003c/p>\n\u003cp>Although consciousness of a problem can spur change, sustaining it requires a supportive culture. Can there be any more graphic expression of a safety culture commitment than Baylor Health Care System's mission to eliminate preventable deaths, preventable injuries and preventable risk? Or Ascension Health's \"healing without harm\" initiative and its goal of reducing preventable deaths by 900 each year? (They've reached a minimum of 1,500 so far.) Both organizations have published results in the peer-reviewed literature.\u003c/p>\n\u003cp>Glenbrook Hospital in suburban Chicago -- it's part of the NorthShore University HealthSystem -- isn't quite as ambitious in its objectives. Still, its culture was obvious even before I peeked at the monthly infection report left sitting on a reception desk. When the orthopedic surgeon was explaining the procedure he would be doing, he talked about safety. The consulting neurosurgeon (due to Susan's neck injury) talked about safety. The anesthesiologist talked about safety. Right before surgery, nurses fitted Susan with surgical stockings to prevent deep vein thrombosis -- an evidence-based guideline followed by fewer than half of hospitals. When I challenged the surgical team on appropriate prophylactic antibiotic use, a nurse indignantly cited a study showing I was mistaken.\u003c/p>\n\u003cp>I backed off, happy they'd thought about the issue seriously. But I did feel emboldened to ask whether the team in the operating room took time-outs before surgery (the evidence shows it helps make sure everyone's on the same page before you start cutting) and whether the team introduced themselves before proceeding (believe it or not, even the doctors may not be entirely certain who is behind those masks). Yes and yes, the answers came back.\u003c/p>\n\u003cp>Culture change at hospitals is easier these days with \u003ca href=\"http://www.implementationscience.com/content/4/1/25/\">role models\u003c/a> like Ascension and Baylor, and with safety checklists like the one developed by Johns Hopkins' critical care specialist \u003ca href=\"http://www.hopkinsmedicine.org/quality/safety/pronovost/index.html\" target=\"_blank\">Peter Pronovost\u003c/a>. But if consciousness is one barrier to culture change, another one of at least equal importance is cash.\u003c/p>\n\u003cp>There's a link between financial stress and patient distress. A recent study in \u003ca href=\"http://content.healthaffairs.org/content/30/10/1904.abstract\" target=\"_blank\">Health Affairs\u003c/a> found the 178 \"worst\" hospitals in the United States care for more than twice the proportion of elderly minority and poor patients as the nation's 122 \"best\" hospitals, where costs are lowest and quality highest. As one headline put it, \"Bad Hospitals, Poor Patients.\"\u003c/p>\n\u003cp>Money talks in other ways. I've written about how some hospitals implicitly see adverse events \u003ca href=\"http://healthaffairs.org/blog/2010/12/06/why-we-still-kill-patients-invisibility-inertia-and-income/\">as a way to keep beds filled\u003c/a> (although, of course, actual patient deaths thwart that goal). The hospitals where my wife was treated were all prosperous. Even without worrying about a reluctance to confront complications, would a cash-strapped York have transferred Susan to a tertiary care facility, or would they have assured a well-insured patient they could take care of her broken neck? Would a bottom line-driven Mass General or Glenbrook have angled for a longer hospital stay?\u003c/p>\n\u003cp>It's tough enough to change culture. It's even tougher if it you think you’ll lose money doing so. That's why Medicare is increasingly linking payment to explicit quality and safety indicators.\u003c/p>\n\u003cp>We ask a great deal of physicians, nurses and other professionals. Those whom we encountered juggled multiple roles -- healers attending to the ill and scared, prudent managers of health-care resources and team players in system improvement. For the skill and grace with which they performed all those roles we were deeply grateful. Thanks to them, Susan has now recovered to the point that to the casual observer there's no obvious evidence of her multiple injuries.\u003c/p>\n\u003cp>Our experience showed that \"doing the right thing\" -- appropriate care -- and \"doing the right thing right\" -- safe and effective care -- can become the norm at rural, suburban and big urban teaching hospitals alike. On a personal level for the two of us, and on a system level for all of us, that's very good news.\u003c/p>\n\u003cp>\u003cem>Michael L. Millenson is a Highland Park, Illinois-based consultant, a visiting scholar at the Kellogg School of Management and the author of \u003c/em>\u003ca href=\"http://www.press.uchicago.edu/Misc/Chicago/525872.html\" target=\"_blank\">\u003cem>Demanding Medical Excellence: Doctors and Accountability in the Information Age\u003c/em>\u003c/a>\u003cem>. This article first appeared in \u003ca title=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" href=\"http://www.kaiserhealthnews.org/Stories/2011/December/05/millenson-first-person-patient-safety.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "HIV/AIDS Cases Up Most for People of Color",
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"content": "\u003cfigure id=\"attachment_811\" class=\"wp-caption alignleft\" style=\"max-width: 225px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/AIDSredribbon_Flickr_gernhaex.jpg\">\u003cimg class=\"size-medium wp-image-811\" title=\"(gernhaex: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/AIDSredribbon_Flickr_gernhaex-300x400.jpg\" alt=\"(gernhaex: Flickr)\" width=\"225\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(gernhaex: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Timed to today's observance of \u003ca title=\"http://www.worldaidsday.org/\" href=\"http://www.worldaidsday.org/\" target=\"_blank\">World AIDS Day\u003c/a>, California's Office of Statewide Health Planning and Development \u003ca title=\"http://oshpd.ca.gov/HID/Products/Health_Facts/HealthFacts_HIV_AIDS_WEB.pdf\" href=\"http://oshpd.ca.gov/HID/Products/Health_Facts/HealthFacts_HIV_AIDS_WEB.pdf\" target=\"_blank\">released a brief\u003c/a> [PDF] looking at over 20 years of hospitalization trends for people with HIV and AIDS.\u003c/p>\n\u003cp>The state's analysis showed that the number of people living with HIV and AIDS is up most significantly among blacks and Hispanics. Between 1988 and 2008, the number of white people with HIV/AIDS had nearly doubled, but the number of cases for blacks had more than tripled and were up more than five times for Hispanics.\u003c/p>\n\u003cp>Native Americans and Asian/Pacific Islanders with HIV/AIDS were also up dramatically, although these groups represent a small percentage of the total number of Californians living with HIV/AIDS.\u003c/p>\n\u003cp>The State's analysis looked in detail at hospitalization rates for people with HIV/AIDS and found they have dropped dramatically, largely due to the introduction of \u003ca href=\"http://www.cancer.gov/dictionary?cdrid=306492\" target=\"_blank\">antiretroviral therapy\u003c/a> in 1997.\u003cbr>\n\u003c!--more-->Other findings include:\u003c/p>\n\u003cul>\n\u003cli>Cases in women are up significantly, more than sixfold since 1988. While HIV/AIDS overwhelmingly affects men, today women make up about 10 percent of total cases.\u003c/li>\n\u003cli>The patient population is older. 70 percent of people with HIV/AIDS are between ages 40-64, a big change since 1988, when the majority of cases were in people ages 20-39. Patients today are developing the illnesses associated with aging that are seen in the general population.\u003c/li>\n\u003cli>Hospitalization for mental and alcohol/drug-related issues more than doubled.\u003c/li>\n\u003c/ul>\n\u003cdiv>Public health officials encourage people to get tested for HIV. \"One important way we can prevent the spread of HIV is to ensure that everyone knows their HIV status,\" said Dr. Ron Chapman, Director of the California Department of Public Health in a statement.\u003c/div>\n\u003cdiv>Nationally, the Centers for Disease Control and Prevention says 20 percent of people with HIV don't know they are infected. Without effective HIV treatment, patients are at greater risk of developing AIDS. \"HIV medications not only help HIV infected persons live longer, healthier lives, but also decrease the chance that they will transmit HIV,\" Dr. Chapman added.\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Timed to today's observance of World AIDS Day, California's Office of Statewide Health Planning and Development released a brief [PDF] looking at over 20 years of hospitalization trends for people with HIV and AIDS.\r\n\r\nThe state's analysis showed that the number of people living with HIV and AIDS is up most significantly among blacks and Hispanics. Between 1988 and 2008, the number of white people with HIV/AIDS had nearly doubled, but the number of cases for blacks had more than tripled and were up more than five times for Hispanics.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_811\" class=\"wp-caption alignleft\" style=\"max-width: 225px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/AIDSredribbon_Flickr_gernhaex.jpg\">\u003cimg class=\"size-medium wp-image-811\" title=\"(gernhaex: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/AIDSredribbon_Flickr_gernhaex-300x400.jpg\" alt=\"(gernhaex: Flickr)\" width=\"225\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(gernhaex: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Timed to today's observance of \u003ca title=\"http://www.worldaidsday.org/\" href=\"http://www.worldaidsday.org/\" target=\"_blank\">World AIDS Day\u003c/a>, California's Office of Statewide Health Planning and Development \u003ca title=\"http://oshpd.ca.gov/HID/Products/Health_Facts/HealthFacts_HIV_AIDS_WEB.pdf\" href=\"http://oshpd.ca.gov/HID/Products/Health_Facts/HealthFacts_HIV_AIDS_WEB.pdf\" target=\"_blank\">released a brief\u003c/a> [PDF] looking at over 20 years of hospitalization trends for people with HIV and AIDS.\u003c/p>\n\u003cp>The state's analysis showed that the number of people living with HIV and AIDS is up most significantly among blacks and Hispanics. Between 1988 and 2008, the number of white people with HIV/AIDS had nearly doubled, but the number of cases for blacks had more than tripled and were up more than five times for Hispanics.\u003c/p>\n\u003cp>Native Americans and Asian/Pacific Islanders with HIV/AIDS were also up dramatically, although these groups represent a small percentage of the total number of Californians living with HIV/AIDS.\u003c/p>\n\u003cp>The State's analysis looked in detail at hospitalization rates for people with HIV/AIDS and found they have dropped dramatically, largely due to the introduction of \u003ca href=\"http://www.cancer.gov/dictionary?cdrid=306492\" target=\"_blank\">antiretroviral therapy\u003c/a> in 1997.\u003cbr>\n\u003c!--more-->Other findings include:\u003c/p>\n\u003cul>\n\u003cli>Cases in women are up significantly, more than sixfold since 1988. While HIV/AIDS overwhelmingly affects men, today women make up about 10 percent of total cases.\u003c/li>\n\u003cli>The patient population is older. 70 percent of people with HIV/AIDS are between ages 40-64, a big change since 1988, when the majority of cases were in people ages 20-39. Patients today are developing the illnesses associated with aging that are seen in the general population.\u003c/li>\n\u003cli>Hospitalization for mental and alcohol/drug-related issues more than doubled.\u003c/li>\n\u003c/ul>\n\u003cdiv>Public health officials encourage people to get tested for HIV. \"One important way we can prevent the spread of HIV is to ensure that everyone knows their HIV status,\" said Dr. Ron Chapman, Director of the California Department of Public Health in a statement.\u003c/div>\n\u003cdiv>Nationally, the Centers for Disease Control and Prevention says 20 percent of people with HIV don't know they are infected. Without effective HIV treatment, patients are at greater risk of developing AIDS. \"HIV medications not only help HIV infected persons live longer, healthier lives, but also decrease the chance that they will transmit HIV,\" Dr. Chapman added.\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Could Acetaminophen Worsen Asthma?",
"title": "Could Acetaminophen Worsen Asthma?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_701\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1.jpg\">\u003cimg class=\"size-medium wp-image-701\" title=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1-300x217.jpg\" alt=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" width=\"300\" height=\"217\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>A study published earlier this month in \u003ca title=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" target=\"_blank\">Pediatrics \u003c/a>finds a strong association between the use of acetaminophen and asthma, both in symptoms and number of cases, for children and adults.\u003c/p>\n\u003cp>\u003ca title=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" href=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" target=\"_blank\">John McBride\u003c/a>, Director of the Respiratory Center at Akron Children's Hospital, reviewed studies going back more than a decade, one of which looked at 300,000 children around the world. \"Looking at the data,\" he said, \"it's quite likely that acetaminophen is a problem for patients that have asthma.\"\u003c/p>\n\u003cp>The association between asthma and acetaminophen, which many people know by the brand name, Tylenol, caught him by surprise, he says. \"I read the literature and was stunned. I decided the people who really needed to know were primary are physicians and patients.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">“The children who took acetaminophen were twice as likely to be seen for an asthma attack.\"\u003c/aside>\n\u003cp> Among the most compelling studies was one done in 2000 at Boston University. Ironically, it was a follow up to research that had established the safety of ibuprofen.\u003c/p>\n\u003cp>The ibuprofen study followed 84,000 children with a fever who were randomly treated with either ibuprofen or acetaminophen. In 2000, researchers looked at the 1800 children who had previously been diagnosed with asthma. \"The children who took acetaminophen were twice as likely to be seen for an asthma attack than kids who got ibuprofen, and the more acetaminophen they took, the more likely they were to be seen for an asthma attack,\" McBride learned.\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But an association between acetaminophen and asthma is different from showing that acetaminophen causes an asthma episode. \u003ca title=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" href=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" target=\"_blank\">Dr. David Cornfield\u003c/a>, Chief of Pediatric Pulmonary Medicine at Stanford's Lucile Packard Children's Hospital agrees that an association exists. \"What's really needed now,\" he says, \"is a trial that would establish causation. To do that, you have to have a well-powered placebo controlled trial, several years long.\"\u003c/p>\n\u003cp>The Boston University study was a great starting point, says \u003ca title=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" href=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" target=\"_blank\">Dr. Maria Garcia-Lloret\u003c/a>, Professor of Pediatric Allergy at Mattel Children's Hospital at UCLA. But the majority of the children in the study were caucasian. In addition, she says, a new study should include a control group, that receives placebo. \"This is a study that could be repeated as a prospective, randomized study, with a broader population, with a different genetic makeup. The kids in this study were 77% white. Blacks, in particular, are more prone to more severe asthma, more severe allergies.\"\u003c/p>\n\u003cp>Doctors point to a couple theories as to why acetaminophen may be problematic for people with asthma. Acetaminophen has \"long been shown to diminish the response of the immune system to viruses,\" Dr. Cornfield explained, specifically two molecules which help the lungs defend against viruses.\u003c/p>\n\u003cp>Johnson & Johnson, maker of Tylenol, provided a statement today stating, \"Tylenol (acetaminophen) has over 50 years of clinical history to support its safety and efficacy and, when used as directed, Tylenol, has a superior safety profile, compared with other OTC [over the counter] pain relievers.\"\u003c/p>\n\u003cp>But Dr. McBride questions the safety of acetaminophen for people with asthma. He agrees more thorough research is needed, but for a different reason. He closes his study:\u003c/p>\n\u003cblockquote>\u003cp>At present, however, I need further studies not to prove that acetaminophen is dangerous but, rather, to prove that it is safe. Until such evidence is forthcoming, I will recommend avoidance of acetaminophen by all children with asthma or those at risk for asthma and will work to make patients, parents, and primary care providers aware of the possibility that acetaminophen is detrimental to children with asthma.\u003c/p>\u003c/blockquote>\n\u003cp>In the meantime, every doctor we contacted reminded us that over-the-counter medicines are still medicines, with side effects. \"You have to think twice before you give yourself or your child a medicine,\" says Dr. Garcia-Lloret. \"Do they really need it? Or will they get better on their own? You have to balance whether it’s necessary or whether you can wait a bit and it will resolve by itself.\"\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_701\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1.jpg\">\u003cimg class=\"size-medium wp-image-701\" title=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1-300x217.jpg\" alt=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" width=\"300\" height=\"217\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>A study published earlier this month in \u003ca title=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" target=\"_blank\">Pediatrics \u003c/a>finds a strong association between the use of acetaminophen and asthma, both in symptoms and number of cases, for children and adults.\u003c/p>\n\u003cp>\u003ca title=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" href=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" target=\"_blank\">John McBride\u003c/a>, Director of the Respiratory Center at Akron Children's Hospital, reviewed studies going back more than a decade, one of which looked at 300,000 children around the world. \"Looking at the data,\" he said, \"it's quite likely that acetaminophen is a problem for patients that have asthma.\"\u003c/p>\n\u003cp>The association between asthma and acetaminophen, which many people know by the brand name, Tylenol, caught him by surprise, he says. \"I read the literature and was stunned. I decided the people who really needed to know were primary are physicians and patients.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">“The children who took acetaminophen were twice as likely to be seen for an asthma attack.\"\u003c/aside>\n\u003cp> Among the most compelling studies was one done in 2000 at Boston University. Ironically, it was a follow up to research that had established the safety of ibuprofen.\u003c/p>\n\u003cp>The ibuprofen study followed 84,000 children with a fever who were randomly treated with either ibuprofen or acetaminophen. In 2000, researchers looked at the 1800 children who had previously been diagnosed with asthma. \"The children who took acetaminophen were twice as likely to be seen for an asthma attack than kids who got ibuprofen, and the more acetaminophen they took, the more likely they were to be seen for an asthma attack,\" McBride learned.\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But an association between acetaminophen and asthma is different from showing that acetaminophen causes an asthma episode. \u003ca title=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" href=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" target=\"_blank\">Dr. David Cornfield\u003c/a>, Chief of Pediatric Pulmonary Medicine at Stanford's Lucile Packard Children's Hospital agrees that an association exists. \"What's really needed now,\" he says, \"is a trial that would establish causation. To do that, you have to have a well-powered placebo controlled trial, several years long.\"\u003c/p>\n\u003cp>The Boston University study was a great starting point, says \u003ca title=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" href=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" target=\"_blank\">Dr. Maria Garcia-Lloret\u003c/a>, Professor of Pediatric Allergy at Mattel Children's Hospital at UCLA. But the majority of the children in the study were caucasian. In addition, she says, a new study should include a control group, that receives placebo. \"This is a study that could be repeated as a prospective, randomized study, with a broader population, with a different genetic makeup. The kids in this study were 77% white. Blacks, in particular, are more prone to more severe asthma, more severe allergies.\"\u003c/p>\n\u003cp>Doctors point to a couple theories as to why acetaminophen may be problematic for people with asthma. Acetaminophen has \"long been shown to diminish the response of the immune system to viruses,\" Dr. Cornfield explained, specifically two molecules which help the lungs defend against viruses.\u003c/p>\n\u003cp>Johnson & Johnson, maker of Tylenol, provided a statement today stating, \"Tylenol (acetaminophen) has over 50 years of clinical history to support its safety and efficacy and, when used as directed, Tylenol, has a superior safety profile, compared with other OTC [over the counter] pain relievers.\"\u003c/p>\n\u003cp>But Dr. McBride questions the safety of acetaminophen for people with asthma. He agrees more thorough research is needed, but for a different reason. He closes his study:\u003c/p>\n\u003cblockquote>\u003cp>At present, however, I need further studies not to prove that acetaminophen is dangerous but, rather, to prove that it is safe. Until such evidence is forthcoming, I will recommend avoidance of acetaminophen by all children with asthma or those at risk for asthma and will work to make patients, parents, and primary care providers aware of the possibility that acetaminophen is detrimental to children with asthma.\u003c/p>\u003c/blockquote>\n\u003cp>In the meantime, every doctor we contacted reminded us that over-the-counter medicines are still medicines, with side effects. \"You have to think twice before you give yourself or your child a medicine,\" says Dr. Garcia-Lloret. \"Do they really need it? Or will they get better on their own? You have to balance whether it’s necessary or whether you can wait a bit and it will resolve by itself.\"\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_634\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Turkey_Rene-Schwietzke_Flickr_11222011.jpg\">\u003cimg class=\"size-medium wp-image-634 \" title=\"While doctors say you should get some Thanksgiving Day exercise, it's a question of timing. (Rene Schwietzke/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Turkey_Rene-Schwietzke_Flickr_11222011-300x199.jpg\" alt=\"While doctors say you should get some Thanksgiving Day exercise, it's a question of timing. (Rene Schwietzke/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While doctors say you should get some Thanksgiving Day exercise, it's a question of timing. (Rene Schwietzke/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It's Thanksgiving week and that means extra helpings of stories to keep you healthy, despite the fact that you're about to eat the biggest meal of the year.\u003c/p>\n\u003cp>This post is no exception, but don't click away yet! This one is easy. Midway through a great article from \u003ca title=\"http://online.wsj.com/article/SB10001424052970204517204577046772508688922.html#project%3DTURKEY1121%26articleTabs%3Darticle\" href=\"http://online.wsj.com/article/SB10001424052970204517204577046772508688922.html#project%3DTURKEY1121%26articleTabs%3Darticle\" target=\"_blank\">The Wall Street Journal\u003c/a> (with everything you want to know about your triglyceride levels after a meal, the so-called \"postprandial\" period) comes a morsel of easy-to-implement health info.\u003c/p>\n\u003cp>It's simple: get some exercise \u003cem>hours before \u003c/em>the big meal:\u003c/p>\n\u003cblockquote>\u003cp>Light exercise like a slow walk, done continuously for 30 minutes or more, appears to reduce the peak in triglycerides that occurs after eating a meal some 12 to 16 hours later, according to research led by Peter Grandjean, director for the Center for Healthy Living at Baylor University in Waco, Texas.\u003cbr>\n\u003c!--more-->It's unclear exactly why there is a delay, but exercise induces a number of cellular responses that require different amounts of time before taking effect, Dr. Grandjean says.\u003c/p>\n\u003cp>The findings were reported in 2008 in the American Journal of Clinical Nutrition. Other research has suggested that the benefits of exercise on fat processing can last as long as 48 hours.\u003c/p>\n\u003cp>The ideal is to be consistently active. But if people are more sedentary and want to time their exercise, it is best to take that long walk half a day before a big meal, Dr. Grandjean says.\u003c/p>\n\u003cp>\"Those people wishing to start an exercise regimen can see beneficial effects on postprandial lipids with just one session,\" Dr. Grandjean says.\u003c/p>\u003c/blockquote>\n\u003cp>In other words, on Thanksgiving morning, put the turkey in the oven and go for a short walk.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_634\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Turkey_Rene-Schwietzke_Flickr_11222011.jpg\">\u003cimg class=\"size-medium wp-image-634 \" title=\"While doctors say you should get some Thanksgiving Day exercise, it's a question of timing. (Rene Schwietzke/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Turkey_Rene-Schwietzke_Flickr_11222011-300x199.jpg\" alt=\"While doctors say you should get some Thanksgiving Day exercise, it's a question of timing. (Rene Schwietzke/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While doctors say you should get some Thanksgiving Day exercise, it's a question of timing. (Rene Schwietzke/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It's Thanksgiving week and that means extra helpings of stories to keep you healthy, despite the fact that you're about to eat the biggest meal of the year.\u003c/p>\n\u003cp>This post is no exception, but don't click away yet! This one is easy. Midway through a great article from \u003ca title=\"http://online.wsj.com/article/SB10001424052970204517204577046772508688922.html#project%3DTURKEY1121%26articleTabs%3Darticle\" href=\"http://online.wsj.com/article/SB10001424052970204517204577046772508688922.html#project%3DTURKEY1121%26articleTabs%3Darticle\" target=\"_blank\">The Wall Street Journal\u003c/a> (with everything you want to know about your triglyceride levels after a meal, the so-called \"postprandial\" period) comes a morsel of easy-to-implement health info.\u003c/p>\n\u003cp>It's simple: get some exercise \u003cem>hours before \u003c/em>the big meal:\u003c/p>\n\u003cblockquote>\u003cp>Light exercise like a slow walk, done continuously for 30 minutes or more, appears to reduce the peak in triglycerides that occurs after eating a meal some 12 to 16 hours later, according to research led by Peter Grandjean, director for the Center for Healthy Living at Baylor University in Waco, Texas.\u003cbr>\n\u003c!--more-->It's unclear exactly why there is a delay, but exercise induces a number of cellular responses that require different amounts of time before taking effect, Dr. Grandjean says.\u003c/p>\n\u003cp>The findings were reported in 2008 in the American Journal of Clinical Nutrition. Other research has suggested that the benefits of exercise on fat processing can last as long as 48 hours.\u003c/p>\n\u003cp>The ideal is to be consistently active. But if people are more sedentary and want to time their exercise, it is best to take that long walk half a day before a big meal, Dr. Grandjean says.\u003c/p>\n\u003cp>\"Those people wishing to start an exercise regimen can see beneficial effects on postprandial lipids with just one session,\" Dr. Grandjean says.\u003c/p>\u003c/blockquote>\n\u003cp>In other words, on Thanksgiving morning, put the turkey in the oven and go for a short walk.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Something's Been Bugging Me",
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"content": "\u003cp>By: \u003ca title=\"http://www.thepatientpod.com/team.html\" href=\"http://www.thepatientpod.com/team.html\" target=\"_blank\">Pat Mastors\u003c/a>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>\u003cem>Editor's Note: Pat Mastors is CEO of Pear Health, LLC. She formed the company after her father's death, due to complications following a surgical procedure. CBS correspondent Andy Rooney's death earlier this month prompted her to write this in his voice.\u003c/em>\u003c/strong>\u003cbr>\n\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_519\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/AndyRooney2.jpg\">\u003cimg class=\"size-medium wp-image-519 \" title=\"Andy Rooney, the CBS News Correspondent, in 2008. (Flickr: Stephenson Brown)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/AndyRooney2-300x450.jpg\" alt=\"Andy Rooney, the CBS News Correspondent, died following complications from minor surgery. (Flickr: Stephenson Brown)\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Andy Rooney, the CBS News Correspondent, died following complications from minor surgery. (Flickr: Stephenson Brown)\u003c/figcaption>\u003c/figure>\n\u003cp>“I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.\u003c/p>\n\u003cp>But then I read what killed me: ‘serious complications following minor surgery.’\u003c/p>\n\u003cp>Now what the heck is that?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nobody gets run over by a ‘serious complication.’ You don’t hear about a guy getting shot in the chest with a ‘serious complication.’ Sure, I didn’t expect to live forever (well, maybe only a little bit), but I was sorta going for passing out some Saturday night into my strip steak at that great restaurant on Broadway. Maybe nodding off in my favorite chair, dreaming of reeling in a 40-pound striper. You know, not waking up. This whole ‘death by complication’ thing is just so, I don’t know … vague and annoying.\u003c/p>\n\u003caside class=\"pullquote alignleft\">But then I read what killed me: ‘serious complications following minor surgery.’ Now what the heck is that?\u003c/aside>\n\u003cp>Here’s something else that bothers me. This note I got a few days ago from a lady who says she’s a fan. She talked to a reporter at a national newspaper the other day. Asked the reporter, basically, what kind of complication ‘did me in'? The reporter said, ‘No idea what killed him. Unless someone dies unusually young, we don’t deal with the cause of death.'\u003c/p>\n\u003cp>\u003c!--more-->Now I know reporters have lots to do. I was one myself before they started paying me to just say what I think. But I guess what this reporter means is, if I was 29 instead of 92, they mighta thought it was worth asking why I went in for minor surgery and died of 'serious complications.'\u003c/p>\n\u003cp>Remember a guy named John Murtha? A Congressman. Democrat from Pennsylvania. He made it to 77, a real spring chicken next to me. We were talking about this the other day, and guess what he told me? He went in the hospital last year to get his gallbladder taken out. A tiny incision, they said. Laparascopic surgery. Only he died, too. The reason, you guessed it: 'complications of surgery.' The docs looked really sad about it but they wouldn’t give out any details. They said they couldn’t, because of family privacy, and federal privacy laws. But you know, people talk. Someone on the inside came out with it: 'they hit his intestines.'\u003c/p>\n\u003cp>John figures it’s better that people know what happened. Maybe it’ll help docs figure out a way not to hit intestines when they do that surgery next time. Now what’s wrong with that?\u003c/p>\n\u003cp>I know what you’re thinking. That Andy Rooney – something’s always bugging him. Well, I guess it’s like my mom told me a zillion years ago, when she asked me at dinner if I knew anything about how the window in the garage got broken. I said no because I didn’t want to admit I’d been throwing a baseball with Tommy McNamara, and I guess my aim was really off. She looked at me with that look moms have … the one that makes you squirm and try to change the subject and finally offer to do the dishes if only she’ll stop looking at you like that. She said ‘Andy, just tell the truth.’\u003c/p>\n\u003cp>So … do me a favor. Something killed me. And it would be good to know what. You don’t have to squirm, or do the dishes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Just tell folks what happened.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By: \u003ca title=\"http://www.thepatientpod.com/team.html\" href=\"http://www.thepatientpod.com/team.html\" target=\"_blank\">Pat Mastors\u003c/a>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>\u003cem>Editor's Note: Pat Mastors is CEO of Pear Health, LLC. She formed the company after her father's death, due to complications following a surgical procedure. CBS correspondent Andy Rooney's death earlier this month prompted her to write this in his voice.\u003c/em>\u003c/strong>\u003cbr>\n\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_519\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/AndyRooney2.jpg\">\u003cimg class=\"size-medium wp-image-519 \" title=\"Andy Rooney, the CBS News Correspondent, in 2008. (Flickr: Stephenson Brown)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/AndyRooney2-300x450.jpg\" alt=\"Andy Rooney, the CBS News Correspondent, died following complications from minor surgery. (Flickr: Stephenson Brown)\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Andy Rooney, the CBS News Correspondent, died following complications from minor surgery. (Flickr: Stephenson Brown)\u003c/figcaption>\u003c/figure>\n\u003cp>“I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.\u003c/p>\n\u003cp>But then I read what killed me: ‘serious complications following minor surgery.’\u003c/p>\n\u003cp>Now what the heck is that?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nobody gets run over by a ‘serious complication.’ You don’t hear about a guy getting shot in the chest with a ‘serious complication.’ Sure, I didn’t expect to live forever (well, maybe only a little bit), but I was sorta going for passing out some Saturday night into my strip steak at that great restaurant on Broadway. Maybe nodding off in my favorite chair, dreaming of reeling in a 40-pound striper. You know, not waking up. This whole ‘death by complication’ thing is just so, I don’t know … vague and annoying.\u003c/p>\n\u003caside class=\"pullquote alignleft\">But then I read what killed me: ‘serious complications following minor surgery.’ Now what the heck is that?\u003c/aside>\n\u003cp>Here’s something else that bothers me. This note I got a few days ago from a lady who says she’s a fan. She talked to a reporter at a national newspaper the other day. Asked the reporter, basically, what kind of complication ‘did me in'? The reporter said, ‘No idea what killed him. Unless someone dies unusually young, we don’t deal with the cause of death.'\u003c/p>\n\u003cp>\u003c!--more-->Now I know reporters have lots to do. I was one myself before they started paying me to just say what I think. But I guess what this reporter means is, if I was 29 instead of 92, they mighta thought it was worth asking why I went in for minor surgery and died of 'serious complications.'\u003c/p>\n\u003cp>Remember a guy named John Murtha? A Congressman. Democrat from Pennsylvania. He made it to 77, a real spring chicken next to me. We were talking about this the other day, and guess what he told me? He went in the hospital last year to get his gallbladder taken out. A tiny incision, they said. Laparascopic surgery. Only he died, too. The reason, you guessed it: 'complications of surgery.' The docs looked really sad about it but they wouldn’t give out any details. They said they couldn’t, because of family privacy, and federal privacy laws. But you know, people talk. Someone on the inside came out with it: 'they hit his intestines.'\u003c/p>\n\u003cp>John figures it’s better that people know what happened. Maybe it’ll help docs figure out a way not to hit intestines when they do that surgery next time. Now what’s wrong with that?\u003c/p>\n\u003cp>I know what you’re thinking. That Andy Rooney – something’s always bugging him. Well, I guess it’s like my mom told me a zillion years ago, when she asked me at dinner if I knew anything about how the window in the garage got broken. I said no because I didn’t want to admit I’d been throwing a baseball with Tommy McNamara, and I guess my aim was really off. She looked at me with that look moms have … the one that makes you squirm and try to change the subject and finally offer to do the dishes if only she’ll stop looking at you like that. She said ‘Andy, just tell the truth.’\u003c/p>\n\u003cp>So … do me a favor. Something killed me. And it would be good to know what. You don’t have to squirm, or do the dishes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Just tell folks what happened.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>\u003cem>Editor's Note: This post originally appeared in the \u003ca title=\"http://www.jhartfound.org/blog/?p=4387\" href=\"http://www.jhartfound.org/blog/?p=4387\" target=\"_blank\">health AGEnda\u003c/a> blog\u003c/em>\u003c/strong>. \u003cstrong>\u003cem>On the day the FDA revoked its approval of Avastin, Ms. Berman's perspective is particularly insightful.\u003c/em>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_417\" class=\"wp-caption alignleft\" style=\"max-width: 80px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/amy-berman.thumbnail.jpg\">\u003cimg class=\"size-full wp-image-417\" title=\"Amy Berman\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/amy-berman.thumbnail.jpg\" alt=\"Amy Berman\" width=\"80\" height=\"80\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail.jpg 80w, https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail-75x75.jpg 75w\" sizes=\"(max-width: 80px) 100vw, 80px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Amy Berman\u003c/figcaption>\u003c/figure>\n\u003cp>I have been celebrating Breast Cancer Awareness month. This isn’t just because I had the good fortune to celebrate my birthday in October, but because one year after being diagnosed with a terminal illness and choosing to treat it non-aggressively, I feel great. I have less pain than I did one year ago. The shooting pains I often felt last year in my right breast have almost entirely vanished, thanks to my hormone-suppressing drugs. My lower spine—the site of metastasis—aches only occasionally, and only when I overdo it. If I get plenty of rest and fluids, eat right, and avoid standing for long periods or lifting heavy objects, I remain pain free. Although I may take a few more breaks than I used to or find myself more tired at night, I can still fill each day with meaningful activities, just as I always have.\u003c/p>\n\u003caside class=\"pullquote alignleft\">I can honestly say that this has been the best year of my life, both personally and professionally. \u003c/aside>\n\u003cp>I have been able to spend quality time with my family, while taking advantage of numerous opportunities to speak and write about the importance of individuals being involved in decisions about their own health care, in addition to my ongoing work as senior program officer for the \u003ca href=\"http://www.jhartfound.org/\">John A. Hartford Foundation\u003c/a>. I have been more loving, more accepting of love, and I believe more effective personally and professionally than at any other point in my life. And I feel good.\u003c/p>\n\u003cp>\u003c!--more-->It may sound odd but—honestly—I am living with Stage IV cancer and it’s been a great year.\u003c/p>\n\u003cp>Yet while celebrating my unexpected and very welcome happiness, I cannot help but think about others living with cancer and other serious illness this month. My experience is atypical, and not just because I chose a palliative, non-aggressive treatment. I am atypical because I am in my fifties. Most cancer patients—63 percent, in fact—are over age 65. This means that most cancer patients aren’t suffering only from cancer, as I am. Most are also simultaneously coping with other chronic diseases, such as diabetes or congestive heart failure, making it more difficult for them to tolerate debilitating treatments. And for some older adults, their health status before the cancer diagnosis may challenge their recovery.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Because cancer is primarily a disease of aging, we shouldn’t be thinking pink for Breast Cancer Awareness month—we should be thinking\u003cstrong> silver\u003c/strong>.\u003c/p>\n\u003cp>I shudder to think of how I would be feeling had I not been an informed patient, able to fully participate in my own treatment decisions with the help of my medical team. Had I been \u003ca href=\"http://www.jhartfound.org/blog/?p=2765\">steered into aggressive treatment\u003c/a>, I would likely be recovering from painful surgery while incapacitated due to the overwhelming fatigue, pain, and nausea that go hand in hand with radiation and chemotherapy. If patient-centered care can do so much to keep the quality in what remains of my life, how much more important is patient-centered care for older adults facing not only a terminal diagnosis, but also the presence of one or more chronic diseases? Older adults need care tailored to their individual diagnosis, health status, goals, and beliefs long before they grapple with terminal illness such as mine.\u003c/p>\n\u003cp>Thankfully, I am not the only one concerned about this issue. The \u003ca href=\"http://www.aannet.org/i4a/pages/index.cfm?pageid=3301\">Raise the Voice campaign\u003c/a>, an initiative of the American Academy of Nursing, recently hosted a Critical Conversation on best practices in advanced care planning and decision making. The organizers gathered nurse and physician experts in advanced care planning to share best practices, and also included a nurse who could serve as a patient voice. That was my role. When I had the opportunity to speak, I noted that even though death is a common occurrence—\u003ca href=\"http://www.cdc.gov/nchs/fastats/deaths.htm\">2.4 million Americans die each year\u003c/a>—conversations around end of life care remain uncommon.\u003c/p>\n\u003cp>This seems strange to me. We are consumers of health care. In most other areas of our economy, our consumer protection laws afford us safeguards. Health care is, ultimately, a product that we all have to buy, either directly or indirectly through our insurance companies. Yet when we are making the most critical decisions about our health, we are not routinely guaranteed as patients to have full information about our condition and all possible treatment approaches. The decisions are left entirely to the discretion of the doctors and hospitals patients use. And while some health care providers integrate the patient and family in the planning process, we are guaranteed a more full disclosure when buying a house than when battling serious illness.\u003c/p>\n\u003cp>I believe disclosures about treatment for serious and potentially life-limiting illness should be required. Conversations about the end of life are difficult, but not impossible. Doctors, nurses, and all health professionals have more and more tools at their disposal. We can help patients choose a health care proxy and fill out the \u003ca href=\"http://www.jhartfound.org/blog/?p=2452\">POLST form\u003c/a>, as my oncology center, \u003ca href=\"http://www.jhartfound.org/blog/?p=3670\">Maimonides\u003c/a>, does so well. Many organizations are now providing training for providers to help them learn how to approach end of life conversations with their patients, such as the End-of-Life Nursing Education Consortium (\u003ca href=\"http://www.aacn.nche.edu/faculty/elnec/2012schedule\">ELNEC\u003c/a>) led by the \u003ca href=\"http://www.cityofhope.org/\">City of Hope\u003c/a> and the \u003ca href=\"http://www.aacn.nche.edu/\">American Association of Colleges of Nursing\u003c/a>. At the Raise the Voice meeting, Suzanne Prevost, President Elect of \u003ca href=\"http://www.nursingsociety.org/default.aspx\">Sigma Theta Tau\u003c/a> (the Honor Society of Nursing) and Associate Dean of the University of Kentucky, shared an interesting approach to helping patients understand the differences between treatment options. In a small \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040012/?tool=pubmed\">study\u003c/a>, researchers showed terminal cancer patients a video that included patients who chose aggressive care and patients who chose palliative care. The images were neither shocking nor graphic. After seeing the video, many patients who had intended to choose aggressive care changed their minds and chose palliative care.\u003c/p>\n\u003cp>I am not saying, of course, that palliative care alone is always the right choice. I just believe that patients deserve to make informed choices. All I ask, as Breast Cancer Awareness month comes to a close, is for providers and policymakers to understand that every person experiencing cancer or other serious illness deserves an opportunity to choose a treatment approach tailored to his or her beliefs, hopes, and tolerance, based on the diagnosis, the likely course of the disease, and the chances for survival. Think about the older adults in your life. Would you want them to have a say in decisions that affect how they live for their remaining days and how they die? If we can all “think silver,” perhaps we can make health care better for older Americans. Here’s to another good year. Cheers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Sixth in this series [from the health AGEnda blog]:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=3973\">“Can the Blind Lead the Seeing?”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=3670\">“Making Hard Decisions Easier”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=3224\">“Death Panels and Decision Making: A Radio Interview”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=2957\">“I’m Dying to Know”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=2765\">“Can Good Care Produce Bad Health?”\u003c/a>\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cem>Editor's Note: This post originally appeared in the \u003ca title=\"http://www.jhartfound.org/blog/?p=4387\" href=\"http://www.jhartfound.org/blog/?p=4387\" target=\"_blank\">health AGEnda\u003c/a> blog\u003c/em>\u003c/strong>. \u003cstrong>\u003cem>On the day the FDA revoked its approval of Avastin, Ms. Berman's perspective is particularly insightful.\u003c/em>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_417\" class=\"wp-caption alignleft\" style=\"max-width: 80px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/amy-berman.thumbnail.jpg\">\u003cimg class=\"size-full wp-image-417\" title=\"Amy Berman\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/amy-berman.thumbnail.jpg\" alt=\"Amy Berman\" width=\"80\" height=\"80\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail.jpg 80w, https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/27/2011/11/amy-berman.thumbnail-75x75.jpg 75w\" sizes=\"(max-width: 80px) 100vw, 80px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Amy Berman\u003c/figcaption>\u003c/figure>\n\u003cp>I have been celebrating Breast Cancer Awareness month. This isn’t just because I had the good fortune to celebrate my birthday in October, but because one year after being diagnosed with a terminal illness and choosing to treat it non-aggressively, I feel great. I have less pain than I did one year ago. The shooting pains I often felt last year in my right breast have almost entirely vanished, thanks to my hormone-suppressing drugs. My lower spine—the site of metastasis—aches only occasionally, and only when I overdo it. If I get plenty of rest and fluids, eat right, and avoid standing for long periods or lifting heavy objects, I remain pain free. Although I may take a few more breaks than I used to or find myself more tired at night, I can still fill each day with meaningful activities, just as I always have.\u003c/p>\n\u003caside class=\"pullquote alignleft\">I can honestly say that this has been the best year of my life, both personally and professionally. \u003c/aside>\n\u003cp>I have been able to spend quality time with my family, while taking advantage of numerous opportunities to speak and write about the importance of individuals being involved in decisions about their own health care, in addition to my ongoing work as senior program officer for the \u003ca href=\"http://www.jhartfound.org/\">John A. Hartford Foundation\u003c/a>. I have been more loving, more accepting of love, and I believe more effective personally and professionally than at any other point in my life. And I feel good.\u003c/p>\n\u003cp>\u003c!--more-->It may sound odd but—honestly—I am living with Stage IV cancer and it’s been a great year.\u003c/p>\n\u003cp>Yet while celebrating my unexpected and very welcome happiness, I cannot help but think about others living with cancer and other serious illness this month. My experience is atypical, and not just because I chose a palliative, non-aggressive treatment. I am atypical because I am in my fifties. Most cancer patients—63 percent, in fact—are over age 65. This means that most cancer patients aren’t suffering only from cancer, as I am. Most are also simultaneously coping with other chronic diseases, such as diabetes or congestive heart failure, making it more difficult for them to tolerate debilitating treatments. And for some older adults, their health status before the cancer diagnosis may challenge their recovery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Because cancer is primarily a disease of aging, we shouldn’t be thinking pink for Breast Cancer Awareness month—we should be thinking\u003cstrong> silver\u003c/strong>.\u003c/p>\n\u003cp>I shudder to think of how I would be feeling had I not been an informed patient, able to fully participate in my own treatment decisions with the help of my medical team. Had I been \u003ca href=\"http://www.jhartfound.org/blog/?p=2765\">steered into aggressive treatment\u003c/a>, I would likely be recovering from painful surgery while incapacitated due to the overwhelming fatigue, pain, and nausea that go hand in hand with radiation and chemotherapy. If patient-centered care can do so much to keep the quality in what remains of my life, how much more important is patient-centered care for older adults facing not only a terminal diagnosis, but also the presence of one or more chronic diseases? Older adults need care tailored to their individual diagnosis, health status, goals, and beliefs long before they grapple with terminal illness such as mine.\u003c/p>\n\u003cp>Thankfully, I am not the only one concerned about this issue. The \u003ca href=\"http://www.aannet.org/i4a/pages/index.cfm?pageid=3301\">Raise the Voice campaign\u003c/a>, an initiative of the American Academy of Nursing, recently hosted a Critical Conversation on best practices in advanced care planning and decision making. The organizers gathered nurse and physician experts in advanced care planning to share best practices, and also included a nurse who could serve as a patient voice. That was my role. When I had the opportunity to speak, I noted that even though death is a common occurrence—\u003ca href=\"http://www.cdc.gov/nchs/fastats/deaths.htm\">2.4 million Americans die each year\u003c/a>—conversations around end of life care remain uncommon.\u003c/p>\n\u003cp>This seems strange to me. We are consumers of health care. In most other areas of our economy, our consumer protection laws afford us safeguards. Health care is, ultimately, a product that we all have to buy, either directly or indirectly through our insurance companies. Yet when we are making the most critical decisions about our health, we are not routinely guaranteed as patients to have full information about our condition and all possible treatment approaches. The decisions are left entirely to the discretion of the doctors and hospitals patients use. And while some health care providers integrate the patient and family in the planning process, we are guaranteed a more full disclosure when buying a house than when battling serious illness.\u003c/p>\n\u003cp>I believe disclosures about treatment for serious and potentially life-limiting illness should be required. Conversations about the end of life are difficult, but not impossible. Doctors, nurses, and all health professionals have more and more tools at their disposal. We can help patients choose a health care proxy and fill out the \u003ca href=\"http://www.jhartfound.org/blog/?p=2452\">POLST form\u003c/a>, as my oncology center, \u003ca href=\"http://www.jhartfound.org/blog/?p=3670\">Maimonides\u003c/a>, does so well. Many organizations are now providing training for providers to help them learn how to approach end of life conversations with their patients, such as the End-of-Life Nursing Education Consortium (\u003ca href=\"http://www.aacn.nche.edu/faculty/elnec/2012schedule\">ELNEC\u003c/a>) led by the \u003ca href=\"http://www.cityofhope.org/\">City of Hope\u003c/a> and the \u003ca href=\"http://www.aacn.nche.edu/\">American Association of Colleges of Nursing\u003c/a>. At the Raise the Voice meeting, Suzanne Prevost, President Elect of \u003ca href=\"http://www.nursingsociety.org/default.aspx\">Sigma Theta Tau\u003c/a> (the Honor Society of Nursing) and Associate Dean of the University of Kentucky, shared an interesting approach to helping patients understand the differences between treatment options. In a small \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040012/?tool=pubmed\">study\u003c/a>, researchers showed terminal cancer patients a video that included patients who chose aggressive care and patients who chose palliative care. The images were neither shocking nor graphic. After seeing the video, many patients who had intended to choose aggressive care changed their minds and chose palliative care.\u003c/p>\n\u003cp>I am not saying, of course, that palliative care alone is always the right choice. I just believe that patients deserve to make informed choices. All I ask, as Breast Cancer Awareness month comes to a close, is for providers and policymakers to understand that every person experiencing cancer or other serious illness deserves an opportunity to choose a treatment approach tailored to his or her beliefs, hopes, and tolerance, based on the diagnosis, the likely course of the disease, and the chances for survival. Think about the older adults in your life. Would you want them to have a say in decisions that affect how they live for their remaining days and how they die? If we can all “think silver,” perhaps we can make health care better for older Americans. Here’s to another good year. Cheers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Sixth in this series [from the health AGEnda blog]:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=3973\">“Can the Blind Lead the Seeing?”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=3670\">“Making Hard Decisions Easier”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=3224\">“Death Panels and Decision Making: A Radio Interview”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=2957\">“I’m Dying to Know”\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.jhartfound.org/blog/?p=2765\">“Can Good Care Produce Bad Health?”\u003c/a>\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_184\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Pills.Credit_Grumpy-Puddin2.jpg\">\u003cimg class=\"size-medium wp-image-184 \" title=\"(Paul Wilson/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Pills.Credit_Grumpy-Puddin2-300x199.jpg\" alt=\"(Paul Wilson/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Wilson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Say you were worried about having a heart attack. Which drug would you rather take:\u003c/p>\n\u003cul>\n\u003cli>Magic Drug A: reduces your risk of a heart attack by 50%\u003c/li>\n\u003cli>Magic Drug B: reduces your risk of a heart attack by 1%\u003c/li>\n\u003c/ul>\n\u003cp>Presumably, you'd pick Magic Drug A.\u003c/p>\n\u003cp>But, what if you found out Magic Drug A and Magic Drug B were really the same drug?\u003c/p>\n\u003cp>Huh? How can that be? It has to do with something Graham Walker, an emergency department physician at Stanford, calls “statistical trickery.”\u003c!--more-->Here’s how:\u003c/p>\n\u003col>\n\u003cli>There’s “\u003cstrong>absolute risk\u003c/strong>,” your risk of something bad happening, compared to everyone else. It’s a general population risk.\u003c/li>\n\u003cli>There’s “\u003cstrong>relative risk\u003c/strong>.” This is your reduced risk of something bad happening in relation to something else, such as taking a drug. In our example, it’s our Magic Drug, to reduce risk of that heart attack. For people not working in numbers every day, this takes a moment to get your mind around, so bear with us for a walk-through.Let’s give our Magic Drug to 100 people. Time goes by, and the people who got the drug had 50% fewer heart attacks than 100 people who didn’t get the drug.Here’s where the statistical trickery comes in. \u003cem>How many people who were taking the drug actually had heart attacks? \u003c/em>One.\n\u003cp>And of the 100 people who did NOT get the drug? How many of them had heart attacks? Two.\u003cbr>\nSo, yes, one heart attack is half as many heart attacks as two. So relatively speaking, it’s a 50% reduction. But, in absolute terms, the risk was reduced from 2% to 1%, a much less compelling 1% reduction.\u003c/p>\n\u003cp>Diana Stilwell of the \u003ca title=\"http://www.informedmedicaldecisions.org/\" href=\"http://www.informedmedicaldecisions.org/\" target=\"_blank\">Foundation for Informed Decision Making\u003c/a> compares it to shopping. “It’s like going into a store that’s selling things at 20% off. The 20% is only meaningful to you if you know what you’re going to be buying.”\u003c/p>\n\u003cp>If you’re buying a pair of shoes, your 20% savings could be a lot of money. If you’re buying a loaf of bread, not so much.\u003c/p>\u003c/li>\n\u003cli>Which brings us to the next thing to know, \u003cstrong>“What was my risk in the first place?” \u003cspan class=\"Apple-style-span\" style=\"font-weight: normal\">If your risk of something bad happening is just two in a hundred, you may feel less excited about the prospect of reducing your risk by 50%. (You might also want to keep this in mind when you see drug ads, which tend to focus on relative risks).\u003c/span>\u003c/strong>\u003c/li>\n\u003cli>The next thing you should find out is “\u003cstrong>What are the side effects?” \u003c/strong>All drugs have them.\u003c/li>\n\u003cli>Finally, our fifth thing to know. Statisticians (the ones not engaged in trickery) call it\u003cstrong> the Number Needed to Treat, \u003c/strong>or NNT. In our example, we gave the drug to 100 people and prevented one heart attack. The Number Needed to Treat was 100. In other words, for every heart attack prevented, 99 people were exposed to a drug and its potential side effects. Graham Walker believes those risks should be part of the equation when people are considering whether to take the drug. “You want to be that person who has their life saved, but the flip side is any time you expose someone to medicine, you’re going to give some harm to some of them.”\u003c/li>\n\u003c/ol>\n\u003cp>Walker is one of the founders of a terrific website, \u003ca title=\"http://www.thennt.com/\" href=\"http://www.thennt.com/\" target=\"_blank\">theNNT.com\u003c/a>. Visitors can get easily digestible information about risks and benefits for a range of drugs and other medical treatments. Walker says the website is entirely supported by the handful of doctors who put it together. For fun, you can watch \u003ca title=\"http://www.thennt.com/the-nnt-explained/\" href=\"http://www.thennt.com/the-nnt-explained/\" target=\"_blank\">Walker’s video\u003c/a> about the NNT.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "First, there’s “absolute risk,” your risk of something bad happening, compared to everyone else. It’s a general population risk.\r\n\r\nThen there’s “relative risk.” This is your reduced risk of something bad happening in relation to something else, such as taking a drug. In our example, it’s our Magic Drug, to reduce risk of that heart attack.\r\n\r\nLet’s give our Magic Drug to 100 people. Time goes by, and the people who got the drug had 50% fewer heart attacks than 100 people who didn’t get the drug.\r\n\r\nHere’s where the statistical trickery comes in. How many people who were taking the drug actually had heart attacks?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_184\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Pills.Credit_Grumpy-Puddin2.jpg\">\u003cimg class=\"size-medium wp-image-184 \" title=\"(Paul Wilson/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Pills.Credit_Grumpy-Puddin2-300x199.jpg\" alt=\"(Paul Wilson/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Wilson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Say you were worried about having a heart attack. Which drug would you rather take:\u003c/p>\n\u003cul>\n\u003cli>Magic Drug A: reduces your risk of a heart attack by 50%\u003c/li>\n\u003cli>Magic Drug B: reduces your risk of a heart attack by 1%\u003c/li>\n\u003c/ul>\n\u003cp>Presumably, you'd pick Magic Drug A.\u003c/p>\n\u003cp>But, what if you found out Magic Drug A and Magic Drug B were really the same drug?\u003c/p>\n\u003cp>Huh? How can that be? It has to do with something Graham Walker, an emergency department physician at Stanford, calls “statistical trickery.”\u003c!--more-->Here’s how:\u003c/p>\n\u003col>\n\u003cli>There’s “\u003cstrong>absolute risk\u003c/strong>,” your risk of something bad happening, compared to everyone else. It’s a general population risk.\u003c/li>\n\u003cli>There’s “\u003cstrong>relative risk\u003c/strong>.” This is your reduced risk of something bad happening in relation to something else, such as taking a drug. In our example, it’s our Magic Drug, to reduce risk of that heart attack. For people not working in numbers every day, this takes a moment to get your mind around, so bear with us for a walk-through.Let’s give our Magic Drug to 100 people. Time goes by, and the people who got the drug had 50% fewer heart attacks than 100 people who didn’t get the drug.Here’s where the statistical trickery comes in. \u003cem>How many people who were taking the drug actually had heart attacks? \u003c/em>One.\n\u003cp>And of the 100 people who did NOT get the drug? How many of them had heart attacks? Two.\u003cbr>\nSo, yes, one heart attack is half as many heart attacks as two. So relatively speaking, it’s a 50% reduction. But, in absolute terms, the risk was reduced from 2% to 1%, a much less compelling 1% reduction.\u003c/p>\n\u003cp>Diana Stilwell of the \u003ca title=\"http://www.informedmedicaldecisions.org/\" href=\"http://www.informedmedicaldecisions.org/\" target=\"_blank\">Foundation for Informed Decision Making\u003c/a> compares it to shopping. “It’s like going into a store that’s selling things at 20% off. The 20% is only meaningful to you if you know what you’re going to be buying.”\u003c/p>\n\u003cp>If you’re buying a pair of shoes, your 20% savings could be a lot of money. If you’re buying a loaf of bread, not so much.\u003c/p>\u003c/li>\n\u003cli>Which brings us to the next thing to know, \u003cstrong>“What was my risk in the first place?” \u003cspan class=\"Apple-style-span\" style=\"font-weight: normal\">If your risk of something bad happening is just two in a hundred, you may feel less excited about the prospect of reducing your risk by 50%. (You might also want to keep this in mind when you see drug ads, which tend to focus on relative risks).\u003c/span>\u003c/strong>\u003c/li>\n\u003cli>The next thing you should find out is “\u003cstrong>What are the side effects?” \u003c/strong>All drugs have them.\u003c/li>\n\u003cli>Finally, our fifth thing to know. Statisticians (the ones not engaged in trickery) call it\u003cstrong> the Number Needed to Treat, \u003c/strong>or NNT. In our example, we gave the drug to 100 people and prevented one heart attack. The Number Needed to Treat was 100. In other words, for every heart attack prevented, 99 people were exposed to a drug and its potential side effects. Graham Walker believes those risks should be part of the equation when people are considering whether to take the drug. “You want to be that person who has their life saved, but the flip side is any time you expose someone to medicine, you’re going to give some harm to some of them.”\u003c/li>\n\u003c/ol>\n\u003cp>Walker is one of the founders of a terrific website, \u003ca title=\"http://www.thennt.com/\" href=\"http://www.thennt.com/\" target=\"_blank\">theNNT.com\u003c/a>. Visitors can get easily digestible information about risks and benefits for a range of drugs and other medical treatments. Walker says the website is entirely supported by the handful of doctors who put it together. For fun, you can watch \u003ca title=\"http://www.thennt.com/the-nnt-explained/\" href=\"http://www.thennt.com/the-nnt-explained/\" target=\"_blank\">Walker’s video\u003c/a> about the NNT.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "3 Different Vaccines with 1 Thing in Common",
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"content": "\u003cfigure id=\"attachment_190\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/VaccineInjection_Credit_Blakespot.jpg\">\u003cimg class=\"size-medium wp-image-190 \" title=\"(Blake Patterson/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/VaccineInjection_Credit_Blakespot-300x246.jpg\" alt=\"(Blake Patterson/Flickr)\" width=\"300\" height=\"246\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Blake Patterson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>There's news today about three different vaccines--HPV for boys, varicella vaccine (against chickenpox) and flu vaccines.\u003c/p>\n\u003cp>The common thread? Public health officials repeat the recommendations to get them.\u003c/p>\n\u003cp>First, a study in today's \u003cem>Pediatrics\u003c/em> shows why the 2009 H1N1 pandemic was so lethal in previously healthy children. If those children were simultaneously carrying MRSA, a common staph infection, they were eight times more likely to die. \u003cem>\u003ca title=\"http://well.blogs.nytimes.com/2011/11/07/flu-can-be-fatal-in-children-with-mrsa/?ref=health\" href=\"http://well.blogs.nytimes.com/2011/11/07/flu-can-be-fatal-in-children-with-mrsa/?ref=health\" target=\"_blank\">The New York Times\u003c/a>\u003c/em> summarizes the story.\u003c/p>\n\u003cp>The authors conclude the study with this plea, \"New therapies for treating severe influenza and new treatment strategies for MRSA pneumonia complicating influenza are urgently needed for children.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003cem>The Times\u003c/em> also stresses the importance of prevention.\u003c/p>\n\u003cblockquote>\u003cp>“There’s a nice message here about vaccines: that even otherwise healthy children are still at risk, and they are at risk of death,” said Dr. Lisa Saiman, a professor of clinical pediatrics at Columbia. The Centers for Disease Control and Prevention recommends the flu vaccine for everyone over the age of 6 months, and stresses that pregnant women, children younger than 2 and people over 50 are at especially high risk of having serious flu-related complications.\u003c/p>\u003c/blockquote>\n\u003cp>Next, HPV for boys. \u003ca title=\"http://www.npr.org/blogs/health/2011/11/07/142030282/why-hpv-vaccination-of-boys-may-be-easier?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2011/11/07/142030282/why-hpv-vaccination-of-boys-may-be-easier?ps=sh_sthdl\" target=\"_blank\">Richard Knox at NPR \u003c/a>does a great job outlining why it might be easier to convince parents to vaccinate their sons instead of daughters. It has to do with the double standard about sexual activity. Knox interviews Dr. Don Dizon, a Brown University oncologist who speculates that sexual activity,\"is something that's almost expected of boys.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Parents may disagree that sexual activity is expected of their sons, but it's harder to disagree with the spectrum of protection the HPV vaccine provides. For girls, the vaccine protects against cancers of the cervix, vagina and vulva. For boys, penile cancers. But it also protects both sexes against other, sometimes more common, cancers. From Knox's report:\u003c/p>\n\u003cblockquote>\u003cp>But \u003ca href=\"http://www.cancer.org/Cancer/AnalCancer/DetailedGuide/anal-cancer-what-is-key-statistics\">both sexes get anal cancer\u003c/a> linked to HPV — sometimes without ever having had anal sex. That's because the virus can migrate from the genitalia. And even though anal cancer is thought to be mainly a risk among men who have sex with men, more women get it than men.\u003c/p>\n\u003cp>But Dizon worries most about \u003ca href=\"http://www.cancer.net/patient/Cancer+Types/Head+and+Neck+Cancer?sectionTitle=Statistics\">cancers of the head and neck\u003c/a> — devastating, often disfiguring and hard-to-treat malignancies that used to be strongly linked to smoking and alcohol abuse.\u003c/p>\n\u003cp>\"There's an epidemic of head and neck cancers, and we are seeing this increase in ... nonsmokers,\" he says. \"And it's being tied to HPV.\"\u003c/p>\u003c/blockquote>\n\u003cp>Finally, a woman in Nashville was caught selling varicella laden lollipops at $50 each. Varicella is the virus that causes Chickenpox. She was advertising on Facebook pages created for people wanting to have \"Chickenpox parties.\" Presumably, these parties are for parents who prefer their children get the disease instead of the vaccine.\u003c/p>\n\u003cp>Kimberly Curth and an investigative team at \u003ca title=\"http://www.wsmv.com/story/15954675/mail-order-diseases\" href=\"http://www.wsmv.com/story/15954675/mail-order-diseases\" target=\"_blank\">WSMV-TV\u003c/a> in Nashville reported the story which was later picked up by NPR (with a great headline,\"\u003ca title=\"http://www.npr.org/blogs/health/2011/11/07/142098710/what-not-to-buy-online-lollipops-laced-with-chickenpox?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2011/11/07/142098710/what-not-to-buy-online-lollipops-laced-with-chickenpox?ps=sh_sthdl\" target=\"_blank\">What Not to Buy Online\u003c/a>.\") Curth reached one of the people who posted the ads, Wendy Werkit, and the two had this exchange:\u003c/p>\n\u003cblockquote>\u003cp>Kimberly Curth: \"Have you been shipping it in the past? Contaminated bodily fluids to other states? \"\u003c/p>\n\u003cp>Wendy Werkit: \"I've shipped suckers.\"\u003c/p>\n\u003cp>Kimberly Curth: \"Okay, tell us about that those, lollipops, right?\u003c/p>\n\u003cp>Wendy Werkit: \"Yes, they were sucked on by my kids.\"\u003c/p>\n\u003cp>Kimberly Curth: \"And why would you do that?\u003c/p>\n\u003cp>Wendy Werkit: \"So that other peoples' kids can get chicken pox.\u003c/p>\u003c/blockquote>\n\u003cp>If Werkit shipped the contaminated suckers over state lines, Curth reports, she has potentially violated federal law and could be criminally charged.\u003c/p>\n\u003cp>Chicken Pox has long been seen as much more benign than other childhood illnesses such as polio or measles. But in the years before the varicella vaccine was introduced, about 150 people died a year from Chickenpox. After the vaccine was widely implemented, death rates among children 19 and younger declined by a whopping 97%.\u003c/p>\n\u003cp>The Centers for Disease Control recommend \u003ca title=\"http://www.cdc.gov/vaccines/vpd-vac/varicella/vac-faqs-gen.htm\" href=\"http://www.cdc.gov/vaccines/vpd-vac/varicella/vac-faqs-gen.htm\" target=\"_blank\">a two-dose regimen\u003c/a>. In addition to the dramatic drop in deaths, the vaccination is almost 100% effective in preventing serious disease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_190\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/VaccineInjection_Credit_Blakespot.jpg\">\u003cimg class=\"size-medium wp-image-190 \" title=\"(Blake Patterson/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/VaccineInjection_Credit_Blakespot-300x246.jpg\" alt=\"(Blake Patterson/Flickr)\" width=\"300\" height=\"246\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Blake Patterson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>There's news today about three different vaccines--HPV for boys, varicella vaccine (against chickenpox) and flu vaccines.\u003c/p>\n\u003cp>The common thread? Public health officials repeat the recommendations to get them.\u003c/p>\n\u003cp>First, a study in today's \u003cem>Pediatrics\u003c/em> shows why the 2009 H1N1 pandemic was so lethal in previously healthy children. If those children were simultaneously carrying MRSA, a common staph infection, they were eight times more likely to die. \u003cem>\u003ca title=\"http://well.blogs.nytimes.com/2011/11/07/flu-can-be-fatal-in-children-with-mrsa/?ref=health\" href=\"http://well.blogs.nytimes.com/2011/11/07/flu-can-be-fatal-in-children-with-mrsa/?ref=health\" target=\"_blank\">The New York Times\u003c/a>\u003c/em> summarizes the story.\u003c/p>\n\u003cp>The authors conclude the study with this plea, \"New therapies for treating severe influenza and new treatment strategies for MRSA pneumonia complicating influenza are urgently needed for children.\"\u003c/p>\n\u003cp>\u003c!--more-->\u003cem>The Times\u003c/em> also stresses the importance of prevention.\u003c/p>\n\u003cblockquote>\u003cp>“There’s a nice message here about vaccines: that even otherwise healthy children are still at risk, and they are at risk of death,” said Dr. Lisa Saiman, a professor of clinical pediatrics at Columbia. The Centers for Disease Control and Prevention recommends the flu vaccine for everyone over the age of 6 months, and stresses that pregnant women, children younger than 2 and people over 50 are at especially high risk of having serious flu-related complications.\u003c/p>\u003c/blockquote>\n\u003cp>Next, HPV for boys. \u003ca title=\"http://www.npr.org/blogs/health/2011/11/07/142030282/why-hpv-vaccination-of-boys-may-be-easier?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2011/11/07/142030282/why-hpv-vaccination-of-boys-may-be-easier?ps=sh_sthdl\" target=\"_blank\">Richard Knox at NPR \u003c/a>does a great job outlining why it might be easier to convince parents to vaccinate their sons instead of daughters. It has to do with the double standard about sexual activity. Knox interviews Dr. Don Dizon, a Brown University oncologist who speculates that sexual activity,\"is something that's almost expected of boys.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Parents may disagree that sexual activity is expected of their sons, but it's harder to disagree with the spectrum of protection the HPV vaccine provides. For girls, the vaccine protects against cancers of the cervix, vagina and vulva. For boys, penile cancers. But it also protects both sexes against other, sometimes more common, cancers. From Knox's report:\u003c/p>\n\u003cblockquote>\u003cp>But \u003ca href=\"http://www.cancer.org/Cancer/AnalCancer/DetailedGuide/anal-cancer-what-is-key-statistics\">both sexes get anal cancer\u003c/a> linked to HPV — sometimes without ever having had anal sex. That's because the virus can migrate from the genitalia. And even though anal cancer is thought to be mainly a risk among men who have sex with men, more women get it than men.\u003c/p>\n\u003cp>But Dizon worries most about \u003ca href=\"http://www.cancer.net/patient/Cancer+Types/Head+and+Neck+Cancer?sectionTitle=Statistics\">cancers of the head and neck\u003c/a> — devastating, often disfiguring and hard-to-treat malignancies that used to be strongly linked to smoking and alcohol abuse.\u003c/p>\n\u003cp>\"There's an epidemic of head and neck cancers, and we are seeing this increase in ... nonsmokers,\" he says. \"And it's being tied to HPV.\"\u003c/p>\u003c/blockquote>\n\u003cp>Finally, a woman in Nashville was caught selling varicella laden lollipops at $50 each. Varicella is the virus that causes Chickenpox. She was advertising on Facebook pages created for people wanting to have \"Chickenpox parties.\" Presumably, these parties are for parents who prefer their children get the disease instead of the vaccine.\u003c/p>\n\u003cp>Kimberly Curth and an investigative team at \u003ca title=\"http://www.wsmv.com/story/15954675/mail-order-diseases\" href=\"http://www.wsmv.com/story/15954675/mail-order-diseases\" target=\"_blank\">WSMV-TV\u003c/a> in Nashville reported the story which was later picked up by NPR (with a great headline,\"\u003ca title=\"http://www.npr.org/blogs/health/2011/11/07/142098710/what-not-to-buy-online-lollipops-laced-with-chickenpox?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2011/11/07/142098710/what-not-to-buy-online-lollipops-laced-with-chickenpox?ps=sh_sthdl\" target=\"_blank\">What Not to Buy Online\u003c/a>.\") Curth reached one of the people who posted the ads, Wendy Werkit, and the two had this exchange:\u003c/p>\n\u003cblockquote>\u003cp>Kimberly Curth: \"Have you been shipping it in the past? Contaminated bodily fluids to other states? \"\u003c/p>\n\u003cp>Wendy Werkit: \"I've shipped suckers.\"\u003c/p>\n\u003cp>Kimberly Curth: \"Okay, tell us about that those, lollipops, right?\u003c/p>\n\u003cp>Wendy Werkit: \"Yes, they were sucked on by my kids.\"\u003c/p>\n\u003cp>Kimberly Curth: \"And why would you do that?\u003c/p>\n\u003cp>Wendy Werkit: \"So that other peoples' kids can get chicken pox.\u003c/p>\u003c/blockquote>\n\u003cp>If Werkit shipped the contaminated suckers over state lines, Curth reports, she has potentially violated federal law and could be criminally charged.\u003c/p>\n\u003cp>Chicken Pox has long been seen as much more benign than other childhood illnesses such as polio or measles. But in the years before the varicella vaccine was introduced, about 150 people died a year from Chickenpox. After the vaccine was widely implemented, death rates among children 19 and younger declined by a whopping 97%.\u003c/p>\n\u003cp>The Centers for Disease Control recommend \u003ca title=\"http://www.cdc.gov/vaccines/vpd-vac/varicella/vac-faqs-gen.htm\" href=\"http://www.cdc.gov/vaccines/vpd-vac/varicella/vac-faqs-gen.htm\" target=\"_blank\">a two-dose regimen\u003c/a>. In addition to the dramatic drop in deaths, the vaccination is almost 100% effective in preventing serious disease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_28\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Jobs_2003_rev1.jpg\">\u003cimg class=\"size-medium wp-image-28\" title=\"Steve Jobs announces the availability of iTunes for PC computers in October, 2003. He was diagnosed with cancer the same month. (Justin Sullivan/Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Jobs_2003_rev1-300x274.jpg\" alt=\"Steve Jobs announces the availability of iTunes for PC computers in October, 2003. He was diagnosed with cancer the same month. (Justin Sullivan/Getty Images)\" width=\"300\" height=\"274\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Steve Jobs announces the availability of iTunes for PC computers in October, 2003. He was diagnosed with cancer the same month. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>\u003cstrong>This post originally appeared on KQED's NewsFix on October 7, 2011\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>Since Steve Jobs’ resignation as Apple CEO in August, many of the basic facts of his disease have been widely written about. Jobs had a rare form of pancreatic cancer, Pancreatic Neuroendocrine Tumors. \u003ca title=\"http://blogs.wsj.com/health/2011/10/06/jobs-death-focuses-attention-on-rare-form-of-pancreatic-cancer/\" href=\"http://blogs.wsj.com/health/2011/10/06/jobs-death-focuses-attention-on-rare-form-of-pancreatic-cancer/\" target=\"_blank\">The Wall Street Journal\u003c/a> and \u003ca title=\"http://live.washingtonpost.com/pancreatic-cancer.html\" href=\"http://live.washingtonpost.com/pancreatic-cancer.html\" target=\"_blank\">The Washington Post\u003c/a> both feature solid pieces with additional detail about this disease.\u003c/p>\n\u003cp>The American Cancer Society’s \u003ca title=\"http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates\" href=\"http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates\" target=\"_blank\">five-year survival rates\u003c/a> for the more frequently diagnosed type of Pancreatic Cancer are bleak. But for those afflicted with the rare type of this cancer Jobs had, survival \u003ca href=\"http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates\">rates\u003c/a> are much higher.\u003c/p>\n\u003cp>For a \u003ca title=\"http://webcache.googleusercontent.com/search?q=cache:sm2kJv-xm2EJ:www.cancer.org/AboutUs/DrLensBlog/post/2011/10/05/Steve-Jobs.aspx+american+cancer+society+steve+jobs&cd=3&hl=en&ct=clnk&gl=us&client=firefox-a\" href=\"http://webcache.googleusercontent.com/search?q=cache:sm2kJv-xm2EJ:www.cancer.org/AboutUs/DrLensBlog/post/2011/10/05/Steve-Jobs.aspx+american+cancer+society+steve+jobs&cd=3&hl=en&ct=clnk&gl=us&client=firefox-a\" target=\"_blank\">moving obituary\u003c/a>, the American Cancer Society’s Dr. Len Lichtenfeld had a surprising approach. He writes about Steve Jobs as a \u003cem>survivor\u003c/em>.\u003c/p>\n\u003cblockquote>\u003cp> …his greatness is amplified by what he accomplished under the most difficult of circumstances. For here was a man who had an uncommon cancer that recurred and required a liver transplant. Here was a man who was failing in his health, yet had the fortitude to face every day as a new challenge, to do what he wanted to do, to accomplish successes that had never been accomplished before. Here was a man who embodied the drive and the spirit that so many cancer survivors possess every day of their lives, even when facing the ultimate moment as Steve Jobs faced today.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here was a man living, really living, with cancer. But along with Jobs’ drive came a fabled stubborn streak. When his cancer was diagnosed in 2003, he initially refused the recommended surgery. \u003ca title=\"http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm?postversion=2008030510\" href=\"http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm?postversion=2008030510\" target=\"_blank\">\u003cem>Fortune\u003c/em> magazine reported in 2008\u003c/a> that those closest to him were concerned.\u003c/p>\n\u003cblockquote>\u003cp> By the standards of medical science, it was an open-and-shut case: There was no serious alternative to surgery. ‘Surgery is the only treatment modality that can result in cure,’ Dr. Jeffrey Norton, chief of surgical oncology at Stanford, wrote in a 2006 medical journal article about this kind of pancreatic cancer.\u003c/p>\u003c/blockquote>\n\u003cp>On Wednesday, The Daily Beast built on the \u003cem>Fortune\u003c/em> report in a \u003ca title=\"http://www.thedailybeast.com/articles/2011/10/05/steve-jobs-dies-his-unorthodox-treatment-for-neuroendocrine-cancer.html\" href=\"http://www.thedailybeast.com/articles/2011/10/05/steve-jobs-dies-his-unorthodox-treatment-for-neuroendocrine-cancer.html\" target=\"_blank\">lengthy critique of Jobs’ personal treatment decisions.\u003c/a> In her post, Sharon Begley includes everything anyone would want to know about pancreatic neuroendocrine tumor, but also makes the case that Jobs’ insistence on directing his own treatment could have worsened his condition and perhaps even shortened his life. Again from the \u003ca href=\"http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm?postversion=2008030510\" target=\"_blank\">Fortune piece\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>A Buddhist and vegetarian, the Apple CEO was skeptical of mainstream medicine. Jobs decided to employ alternative methods to treat his pancreatic cancer, hoping to avoid the operation through a special diet - a course of action that hasn't been disclosed until now.\u003c/p>\n\u003cp>For nine months Jobs pursued this approach, as Apple's board of directors and executive team secretly agonized over the situation - and whether the company needed to disclose anything about its CEO's health to investors.\u003c/p>\u003c/blockquote>\n\u003cp>After the initial surgery, Jobs lived in apparent good health for several years, then in 2009 he received a liver transplant. Begley writes, “… removing the liver because it had become riddled with tumors that originated elsewhere [i.e. the pancreas] is rare. For one thing, liver metastases probably meant the cancer is elsewhere, too, such as in the bones or brain. Swapping out a cancer-ridden liver for a new one may therefore buy some time, but not much.” Begley further states the transplant itself could have been \"counter-productive.\" The regimen of immune-suppressing drugs needed to prevent rejection of a transplanted organ may hinder the body's ability to fight the cancer.\u003c/p>\n\u003cp>We’ll never know if Jobs’ treatment decisions shortened, lengthened or had no effect on the length of his life. But we do know that he faced death squarely, as he outlined in his now widely circulating \u003ca title=\"http://www.ted.com/talks/steve_jobs_how_to_live_before_you_die.html\" href=\"http://www.ted.com/talks/steve_jobs_how_to_live_before_you_die.html\" target=\"_blank\">2005 Stanford Commencement speech\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. … Your time is limited. Don’t waste it living someone else’s life.”\u003c/p>\n\n",
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"excerpt": "Since Steve Jobs’ resignation as Apple CEO in August, many of the basic facts of his disease have been widely written about. Jobs had a rare form of pancreatic cancer, Pancreatic Neuroendocrine Tumors. The Wall Street Journal and The Washington Post both feature solid pieces with additional detail about this disease.\r\n\r\nThe American Cancer Society’s five-year survival rates for the more frequently diagnosed type of Pancreatic Cancer are bleak. But for those afflicted with the rare type of this cancer Jobs had, survival rates are much higher.\r\n\r\nFor a moving obituary, the American Cancer Society’s Dr. Len Lichtenfeld had a surprising approach. He writes about Steve Jobs as a survivor.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_28\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Jobs_2003_rev1.jpg\">\u003cimg class=\"size-medium wp-image-28\" title=\"Steve Jobs announces the availability of iTunes for PC computers in October, 2003. He was diagnosed with cancer the same month. (Justin Sullivan/Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/Jobs_2003_rev1-300x274.jpg\" alt=\"Steve Jobs announces the availability of iTunes for PC computers in October, 2003. He was diagnosed with cancer the same month. (Justin Sullivan/Getty Images)\" width=\"300\" height=\"274\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Steve Jobs announces the availability of iTunes for PC computers in October, 2003. He was diagnosed with cancer the same month. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>\u003cstrong>This post originally appeared on KQED's NewsFix on October 7, 2011\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>Since Steve Jobs’ resignation as Apple CEO in August, many of the basic facts of his disease have been widely written about. Jobs had a rare form of pancreatic cancer, Pancreatic Neuroendocrine Tumors. \u003ca title=\"http://blogs.wsj.com/health/2011/10/06/jobs-death-focuses-attention-on-rare-form-of-pancreatic-cancer/\" href=\"http://blogs.wsj.com/health/2011/10/06/jobs-death-focuses-attention-on-rare-form-of-pancreatic-cancer/\" target=\"_blank\">The Wall Street Journal\u003c/a> and \u003ca title=\"http://live.washingtonpost.com/pancreatic-cancer.html\" href=\"http://live.washingtonpost.com/pancreatic-cancer.html\" target=\"_blank\">The Washington Post\u003c/a> both feature solid pieces with additional detail about this disease.\u003c/p>\n\u003cp>The American Cancer Society’s \u003ca title=\"http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates\" href=\"http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates\" target=\"_blank\">five-year survival rates\u003c/a> for the more frequently diagnosed type of Pancreatic Cancer are bleak. But for those afflicted with the rare type of this cancer Jobs had, survival \u003ca href=\"http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-survival-rates\">rates\u003c/a> are much higher.\u003c/p>\n\u003cp>For a \u003ca title=\"http://webcache.googleusercontent.com/search?q=cache:sm2kJv-xm2EJ:www.cancer.org/AboutUs/DrLensBlog/post/2011/10/05/Steve-Jobs.aspx+american+cancer+society+steve+jobs&cd=3&hl=en&ct=clnk&gl=us&client=firefox-a\" href=\"http://webcache.googleusercontent.com/search?q=cache:sm2kJv-xm2EJ:www.cancer.org/AboutUs/DrLensBlog/post/2011/10/05/Steve-Jobs.aspx+american+cancer+society+steve+jobs&cd=3&hl=en&ct=clnk&gl=us&client=firefox-a\" target=\"_blank\">moving obituary\u003c/a>, the American Cancer Society’s Dr. Len Lichtenfeld had a surprising approach. He writes about Steve Jobs as a \u003cem>survivor\u003c/em>.\u003c/p>\n\u003cblockquote>\u003cp> …his greatness is amplified by what he accomplished under the most difficult of circumstances. For here was a man who had an uncommon cancer that recurred and required a liver transplant. Here was a man who was failing in his health, yet had the fortitude to face every day as a new challenge, to do what he wanted to do, to accomplish successes that had never been accomplished before. Here was a man who embodied the drive and the spirit that so many cancer survivors possess every day of their lives, even when facing the ultimate moment as Steve Jobs faced today.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here was a man living, really living, with cancer. But along with Jobs’ drive came a fabled stubborn streak. When his cancer was diagnosed in 2003, he initially refused the recommended surgery. \u003ca title=\"http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm?postversion=2008030510\" href=\"http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm?postversion=2008030510\" target=\"_blank\">\u003cem>Fortune\u003c/em> magazine reported in 2008\u003c/a> that those closest to him were concerned.\u003c/p>\n\u003cblockquote>\u003cp> By the standards of medical science, it was an open-and-shut case: There was no serious alternative to surgery. ‘Surgery is the only treatment modality that can result in cure,’ Dr. Jeffrey Norton, chief of surgical oncology at Stanford, wrote in a 2006 medical journal article about this kind of pancreatic cancer.\u003c/p>\u003c/blockquote>\n\u003cp>On Wednesday, The Daily Beast built on the \u003cem>Fortune\u003c/em> report in a \u003ca title=\"http://www.thedailybeast.com/articles/2011/10/05/steve-jobs-dies-his-unorthodox-treatment-for-neuroendocrine-cancer.html\" href=\"http://www.thedailybeast.com/articles/2011/10/05/steve-jobs-dies-his-unorthodox-treatment-for-neuroendocrine-cancer.html\" target=\"_blank\">lengthy critique of Jobs’ personal treatment decisions.\u003c/a> In her post, Sharon Begley includes everything anyone would want to know about pancreatic neuroendocrine tumor, but also makes the case that Jobs’ insistence on directing his own treatment could have worsened his condition and perhaps even shortened his life. Again from the \u003ca href=\"http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm?postversion=2008030510\" target=\"_blank\">Fortune piece\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>A Buddhist and vegetarian, the Apple CEO was skeptical of mainstream medicine. Jobs decided to employ alternative methods to treat his pancreatic cancer, hoping to avoid the operation through a special diet - a course of action that hasn't been disclosed until now.\u003c/p>\n\u003cp>For nine months Jobs pursued this approach, as Apple's board of directors and executive team secretly agonized over the situation - and whether the company needed to disclose anything about its CEO's health to investors.\u003c/p>\u003c/blockquote>\n\u003cp>After the initial surgery, Jobs lived in apparent good health for several years, then in 2009 he received a liver transplant. Begley writes, “… removing the liver because it had become riddled with tumors that originated elsewhere [i.e. the pancreas] is rare. For one thing, liver metastases probably meant the cancer is elsewhere, too, such as in the bones or brain. Swapping out a cancer-ridden liver for a new one may therefore buy some time, but not much.” Begley further states the transplant itself could have been \"counter-productive.\" The regimen of immune-suppressing drugs needed to prevent rejection of a transplanted organ may hinder the body's ability to fight the cancer.\u003c/p>\n\u003cp>We’ll never know if Jobs’ treatment decisions shortened, lengthened or had no effect on the length of his life. But we do know that he faced death squarely, as he outlined in his now widely circulating \u003ca title=\"http://www.ted.com/talks/steve_jobs_how_to_live_before_you_die.html\" href=\"http://www.ted.com/talks/steve_jobs_how_to_live_before_you_die.html\" target=\"_blank\">2005 Stanford Commencement speech\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. … Your time is limited. Don’t waste it living someone else’s life.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/news/series/baycurious",
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"source": "kqed",
"order": 3
},
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}
},
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"id": "bbc-world-service",
"title": "BBC World Service",
"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
"airtime": "MON-FRI 9pm-10pm, TUE-FRI 1am-2am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.bbc.co.uk/sounds/play/live:bbc_world_service",
"meta": {
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"source": "BBC World Service"
},
"link": "/radio/program/bbc-world-service",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"source": "kqed",
"order": 1
},
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
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},
"link": "/radio/program/code-switch-life-kit",
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},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
"link": "/forum",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
"spotify": "https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"
}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
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