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"content": "\u003cp>On the big screen, Hazel and Gus, the teenage couple from \u003cem>The Fault in Our Stars\u003c/em>, walk the streets of Amsterdam hand in hand, sip champagne at a fancy restaurant and gaze at each other lovingly on a park bench overlooking a canal. For a moment, you almost forget that Hazel has thyroid cancer and Gus has osteosarcoma.\u003c/p>\n\u003cp>In real life, most teenagers and young adults with terminal cancer have to suffer through chemotherapy and other intensive treatments in their final days of life, a study finds. Augustus Waters did too — he died in the ICU soon after their Europe adventures, off-screen.\u003c/p>\n\u003cp>For 68 percent of patients, those interventions include chemotherapy, treatment in the intensive care unit or emergency department, or hospitalization in their final month.\u003c/p>\n\u003cp>The \u003ca href=\"http://oncology.jamanetwork.com/article.aspx?articleid=2383144\" target=\"_blank\">study\u003c/a>, published in \u003cem>JAMA Oncology\u003c/em> on Thursday, is the first of its kind to study end-of-life care for people ages 15 through 39. They either had stage 1 to 3 cancer, with evidence that cancer came back, or stage 4 cancer when they were first diagnosed. They died between 2001 and 2010 before reaching the age of 40.\u003c/p>\n\u003cp>Eleven percent of patients received chemotherapy within 14 days of death. In their last month, 22 percent of patients received care in the ICU and 22 percent had more than one trip to the emergency department. Sixty-two percent were hospitalized.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In comparison, the desired standard rate for intensive end-of-life care in cancer patients among older adults is less than 4 percent when it comes to both ICU and ED visits.\u003c/p>\n\u003cp>Are higher numbers necessarily bad?\u003c/p>\n\u003cp>\"We don't know,\" says Jennifer Mack, a pediatric oncologist at Dana-Farber/Boston Children's Cancer and Blood Disorders Center and lead author of the study. \"For a patient who is well-informed and wishes to pursue all possible measure to prolong life, it may be a very reasonable choice. It may be that these patients are receiving the exact care they wanted.\"\u003c/p>\n\u003cp>At the same time, these medically intensive measures can undermine the quality of life in patients' last days. And it's worrying to Mack, because some of these patients might have benefited from having hospice care and being at home surrounded by loved ones rather than hooked up to machines in the ICU.\u003c/p>\n\u003cp>One possible reason behind the high number for adolescents and young adults is personal preferences. It's pretty well established that older adults with terminal cancer don't want these intensive measures at the end stage, says Mack, citing previous studies. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23440934\" target=\"_blank\">Most\u003c/a> Americans prefer to die at home if given the choice.\u003c/p>\n\u003cp>But it may be a different story for younger patients.\u003c/p>\n\u003cp>\"Young people are very concerned about people in their lives and how their decisions and death will affect their loved ones,\" says Mack. Adolescents with cancer are concerned about their parents. Young parents with cancer are concerned about their children.\u003c/p>\n\u003cp>For Mack, there's a bigger underlying question than the intensity level of end-of-life care that cancer patients are receiving, which applies to cancer patients of all ages.\u003c/p>\n\u003cp>\"We have to ask the question about whether this kind of care is something that reflects their values,\" she says.\u003c/p>\n\u003cp>\"It's critically important that we move to actually discuss what you want when and if you're seriously ill,\" says Tom Smith, director of palliative medicine and a professor of oncology at Johns Hopkins Medicine. Smith is not part of this study.\u003c/p>\n\u003cp>We all have \"the deep and abiding desire not to be dead,\" says Smith. \"Everyone wants to do every possible thing.\" But there comes a point when procedures like chemotherapy may actually make the patient worse and shorten his or her life.\u003c/p>\n\u003cp>That's when you really need to say, \"We might not have a good way to keep you up and going for as long as possible, so help me take care of you and your family in the best way possible if we can't cure the disease anymore,\" Smith says.\u003c/p>\n\u003cp>\"Communications is a problem across the board,\" Smith says. \"It's harder to bring up in young people, but there's no excuse for not doing it.\"\u003c/p>\n\u003cp>At Johns Hopkins, there's a checklist that oncologists go through, starting with \"What is your understanding of your situation?\" and asking what's important and what the patient is hoping for at the end of life.\u003c/p>\n\u003cp>\"Having that script makes it easier to go where doctors don't like to go and where patients are reluctant to go,\" Smith says. It's also helpful to write everything down and revisit the conversation every time there's a change in the patient's prognosis or treatment plan.\u003c/p>\n\u003cp>But those important conversations aren't happening with teenagers or adults, according to Amol Narang, a resident physician in the department of radiation oncology at Johns Hopkins who has studied the question.\u003c/p>\n\u003cp>Narang's team looked at three different advance-care planning options for cancer patients: assigning someone to make medical decisions on the patient's behalf when he or she can no longer do it; writing down what types of medical treatment the patient would like to receive at the end of life; and having discussions with health care providers about these preferences. In 2012, the \u003ca href=\"http://oncology.jamanetwork.com/article.aspx?articleid=2383144\" target=\"_blank\">study\u003c/a> found, 40 percent of study participants still had not discussed their end-of-life care preferences at all prior to death.\u003c/p>\n\u003cp>\"It's important that patients receive the type of medical care in line with their values, and it's important that they communicate their preferences to ensure that's the care they receive,\" Narang says.\u003c/p>\n\u003cp>Oftentimes people will designate a close relative to make decisions on their behalf without having a detailed conversation about the type of care they want to receive. A surrogate who doesn't know what the patient wants might not guess right.\u003c/p>\n\u003cp>\"Don't let them intubate you or do CPR with almost no chance of making it if you don't want to,\" Smith says. \"Conversely, if every minute of life is precious, even on a ventilator, make sure they know that.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>On Wednesday, Medicare \u003ca href=\"http://www.npr.org/sections/thetwo-way/2015/07/08/421279312/medicare-to-pay-for-voluntary-end-of-life-counseling\" target=\"_blank\">announced\u003c/a> plans to reimburse doctors for having these conversations with patients about whether they want to be kept alive and, if so, how, when they're unable to advocate for themselves. The reimbursement change is expected to take effect in January. The goal is to encourage more health care providers to make time for these conversations.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teens+Dying+Of+Cancer+Face+Intensive+Treatments+In+The+Final+Days&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On the big screen, Hazel and Gus, the teenage couple from \u003cem>The Fault in Our Stars\u003c/em>, walk the streets of Amsterdam hand in hand, sip champagne at a fancy restaurant and gaze at each other lovingly on a park bench overlooking a canal. For a moment, you almost forget that Hazel has thyroid cancer and Gus has osteosarcoma.\u003c/p>\n\u003cp>In real life, most teenagers and young adults with terminal cancer have to suffer through chemotherapy and other intensive treatments in their final days of life, a study finds. Augustus Waters did too — he died in the ICU soon after their Europe adventures, off-screen.\u003c/p>\n\u003cp>For 68 percent of patients, those interventions include chemotherapy, treatment in the intensive care unit or emergency department, or hospitalization in their final month.\u003c/p>\n\u003cp>The \u003ca href=\"http://oncology.jamanetwork.com/article.aspx?articleid=2383144\" target=\"_blank\">study\u003c/a>, published in \u003cem>JAMA Oncology\u003c/em> on Thursday, is the first of its kind to study end-of-life care for people ages 15 through 39. They either had stage 1 to 3 cancer, with evidence that cancer came back, or stage 4 cancer when they were first diagnosed. They died between 2001 and 2010 before reaching the age of 40.\u003c/p>\n\u003cp>Eleven percent of patients received chemotherapy within 14 days of death. In their last month, 22 percent of patients received care in the ICU and 22 percent had more than one trip to the emergency department. Sixty-two percent were hospitalized.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In comparison, the desired standard rate for intensive end-of-life care in cancer patients among older adults is less than 4 percent when it comes to both ICU and ED visits.\u003c/p>\n\u003cp>Are higher numbers necessarily bad?\u003c/p>\n\u003cp>\"We don't know,\" says Jennifer Mack, a pediatric oncologist at Dana-Farber/Boston Children's Cancer and Blood Disorders Center and lead author of the study. \"For a patient who is well-informed and wishes to pursue all possible measure to prolong life, it may be a very reasonable choice. It may be that these patients are receiving the exact care they wanted.\"\u003c/p>\n\u003cp>At the same time, these medically intensive measures can undermine the quality of life in patients' last days. And it's worrying to Mack, because some of these patients might have benefited from having hospice care and being at home surrounded by loved ones rather than hooked up to machines in the ICU.\u003c/p>\n\u003cp>One possible reason behind the high number for adolescents and young adults is personal preferences. It's pretty well established that older adults with terminal cancer don't want these intensive measures at the end stage, says Mack, citing previous studies. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23440934\" target=\"_blank\">Most\u003c/a> Americans prefer to die at home if given the choice.\u003c/p>\n\u003cp>But it may be a different story for younger patients.\u003c/p>\n\u003cp>\"Young people are very concerned about people in their lives and how their decisions and death will affect their loved ones,\" says Mack. Adolescents with cancer are concerned about their parents. Young parents with cancer are concerned about their children.\u003c/p>\n\u003cp>For Mack, there's a bigger underlying question than the intensity level of end-of-life care that cancer patients are receiving, which applies to cancer patients of all ages.\u003c/p>\n\u003cp>\"We have to ask the question about whether this kind of care is something that reflects their values,\" she says.\u003c/p>\n\u003cp>\"It's critically important that we move to actually discuss what you want when and if you're seriously ill,\" says Tom Smith, director of palliative medicine and a professor of oncology at Johns Hopkins Medicine. Smith is not part of this study.\u003c/p>\n\u003cp>We all have \"the deep and abiding desire not to be dead,\" says Smith. \"Everyone wants to do every possible thing.\" But there comes a point when procedures like chemotherapy may actually make the patient worse and shorten his or her life.\u003c/p>\n\u003cp>That's when you really need to say, \"We might not have a good way to keep you up and going for as long as possible, so help me take care of you and your family in the best way possible if we can't cure the disease anymore,\" Smith says.\u003c/p>\n\u003cp>\"Communications is a problem across the board,\" Smith says. \"It's harder to bring up in young people, but there's no excuse for not doing it.\"\u003c/p>\n\u003cp>At Johns Hopkins, there's a checklist that oncologists go through, starting with \"What is your understanding of your situation?\" and asking what's important and what the patient is hoping for at the end of life.\u003c/p>\n\u003cp>\"Having that script makes it easier to go where doctors don't like to go and where patients are reluctant to go,\" Smith says. It's also helpful to write everything down and revisit the conversation every time there's a change in the patient's prognosis or treatment plan.\u003c/p>\n\u003cp>But those important conversations aren't happening with teenagers or adults, according to Amol Narang, a resident physician in the department of radiation oncology at Johns Hopkins who has studied the question.\u003c/p>\n\u003cp>Narang's team looked at three different advance-care planning options for cancer patients: assigning someone to make medical decisions on the patient's behalf when he or she can no longer do it; writing down what types of medical treatment the patient would like to receive at the end of life; and having discussions with health care providers about these preferences. In 2012, the \u003ca href=\"http://oncology.jamanetwork.com/article.aspx?articleid=2383144\" target=\"_blank\">study\u003c/a> found, 40 percent of study participants still had not discussed their end-of-life care preferences at all prior to death.\u003c/p>\n\u003cp>\"It's important that patients receive the type of medical care in line with their values, and it's important that they communicate their preferences to ensure that's the care they receive,\" Narang says.\u003c/p>\n\u003cp>Oftentimes people will designate a close relative to make decisions on their behalf without having a detailed conversation about the type of care they want to receive. A surrogate who doesn't know what the patient wants might not guess right.\u003c/p>\n\u003cp>\"Don't let them intubate you or do CPR with almost no chance of making it if you don't want to,\" Smith says. \"Conversely, if every minute of life is precious, even on a ventilator, make sure they know that.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On Wednesday, Medicare \u003ca href=\"http://www.npr.org/sections/thetwo-way/2015/07/08/421279312/medicare-to-pay-for-voluntary-end-of-life-counseling\" target=\"_blank\">announced\u003c/a> plans to reimburse doctors for having these conversations with patients about whether they want to be kept alive and, if so, how, when they're unable to advocate for themselves. The reimbursement change is expected to take effect in January. The goal is to encourage more health care providers to make time for these conversations.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teens+Dying+Of+Cancer+Face+Intensive+Treatments+In+The+Final+Days&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "More Mammograms May Not Reduce Breast Cancer Deaths, Study Finds",
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"content": "\u003cp>Here's more evidence that mammograms don't always deliver the results that women want. They find more small cancers, but don't lower a woman's risk of dying of breast cancer, a study finds.\u003c/p>\n\u003cp>The study looked at data from 547 U.S. counties that reported the percentage of women over age 40 who had a screening mammogram between 1998 and 2000. More than 16 million women lived in those counties, and 53,207 were diagnosed with breast cancer in 2000.\u003c/p>\n\u003cp>Over the next 10 years, 15 percent of the women died of breast cancer.\u003c/p>\n\u003cp>There was a lot of county-to-county variation in the number of women who got screening mammograms, from 38 percent to 78 percent. So you'd think that the counties that did a better job at screening would have fewer breast cancer deaths.\u003c/p>\n\u003cp>That wasn't the case. The risk of death from breast cancer over 10 years was pretty much the same.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the scanning did find more cancers. For every 10 percent increase in screening, the number of cancers found rose by 16 percent, the study found. The \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363025\" target=\"_blank\">results \u003c/a>were reported Tuesday in \u003cem>JAMA Internal Medicine.\u003c/em> This, the authors write, means \"the most prominent effect of screening mammography is overdiagnosis.\"\u003c/p>\n\u003cp>By that they mean identifying abnormalities that will never cause illness or death in the patient's lifetime. Overdiagnosis has become an issue in screening for breast, \u003ca href=\"http://www.npr.org/sections/health-shots/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says\" target=\"_blank\">prostate\u003c/a> and \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/21/280692601/overdiagnosis-could-be-behind-jump-in-thyroid-cancer-cases\" target=\"_blank\">thyroid cancer\u003c/a>.\u003c/p>\n\u003cp>So what's a woman supposed to do with this information? After giving a big fat dis to mammography, the authors write, \"Nonetheless, we do not believe that the right rate of screening mammography is zero.\" Focusing screening on higher-risk women would help, they say, as well as more watchful waiting instead of immediate treatment.\u003c/p>\n\u003cp>The study has its limitations, because it's comparing large groups of people, rather than tracking the health of individual women from mammogram on. Or it may be that even with this large number of cases, deaths are still rare enough that they're missed in this sort of study. Other studies have found a 20 percent reduction in breast cancer deaths as a result of mammography.\u003c/p>\n\u003cp>This is just the latest study pointing out the \u003ca href=\"http://www.npr.org/sections/health-shots/2014/04/01/297826238/review-finds-mammographys-benefits-overplayed-harms-dismissed\" target=\"_blank\">problem with overdiagnosis\u003c/a> of breast cancer.\u003c/p>\n\u003cp>\"This study shows that the more we look, the more you find,\" says Joann Elmore, a professor of medicine at the University of Washington who wrote a \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363022\" target=\"_blank\">commentary\u003c/a> accompanying the study. \"The more you screen, the more likely you are to detect early precancerous abnormalities like ductal carcinoma in situ and early-stage cancer.\"\u003c/p>\n\u003cp>It's not clear how many women are overdiagnosed; Elmore says 10 to 20 percent may be a good estimate. But with the current tests, there's no way for a woman to know if she's in that 10 to 20 percent or if she really does have a dangerous cancer. Thus most women who get a diagnosis of DCIS or early-stage invasive cancer opt for treatment, which can mean surgery, radiation or chemotherapy.\u003c/p>\n\u003cp>\"That is so hard,\" Elmore says. \"I really feel for those women. I need help both figuring out how to explain this to women, and I need better research helping me look at the tissue and figure out whether these women are overdiagnosed or not.\"\u003c/p>\n\u003cp>Elmore studies the reliability of breast cancer screening, and published a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25781441\" target=\"_blank\">study\u003c/a> in March that found that pathologists often misidentify DCIS and early-stage cancers when reading biopsies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The medical community has come to accept that overdiagnosis exists, Elmore says. \"This is something that wasn't even considered when I was in med school years ago. We're slowly realizing that we are taking healthy people and maybe potentially giving them harm.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=More+Mammograms+May+Not+Always+Mean+Fewer+Cancer+Deaths&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here's more evidence that mammograms don't always deliver the results that women want. They find more small cancers, but don't lower a woman's risk of dying of breast cancer, a study finds.\u003c/p>\n\u003cp>The study looked at data from 547 U.S. counties that reported the percentage of women over age 40 who had a screening mammogram between 1998 and 2000. More than 16 million women lived in those counties, and 53,207 were diagnosed with breast cancer in 2000.\u003c/p>\n\u003cp>Over the next 10 years, 15 percent of the women died of breast cancer.\u003c/p>\n\u003cp>There was a lot of county-to-county variation in the number of women who got screening mammograms, from 38 percent to 78 percent. So you'd think that the counties that did a better job at screening would have fewer breast cancer deaths.\u003c/p>\n\u003cp>That wasn't the case. The risk of death from breast cancer over 10 years was pretty much the same.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the scanning did find more cancers. For every 10 percent increase in screening, the number of cancers found rose by 16 percent, the study found. The \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363025\" target=\"_blank\">results \u003c/a>were reported Tuesday in \u003cem>JAMA Internal Medicine.\u003c/em> This, the authors write, means \"the most prominent effect of screening mammography is overdiagnosis.\"\u003c/p>\n\u003cp>By that they mean identifying abnormalities that will never cause illness or death in the patient's lifetime. Overdiagnosis has become an issue in screening for breast, \u003ca href=\"http://www.npr.org/sections/health-shots/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says\" target=\"_blank\">prostate\u003c/a> and \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/21/280692601/overdiagnosis-could-be-behind-jump-in-thyroid-cancer-cases\" target=\"_blank\">thyroid cancer\u003c/a>.\u003c/p>\n\u003cp>So what's a woman supposed to do with this information? After giving a big fat dis to mammography, the authors write, \"Nonetheless, we do not believe that the right rate of screening mammography is zero.\" Focusing screening on higher-risk women would help, they say, as well as more watchful waiting instead of immediate treatment.\u003c/p>\n\u003cp>The study has its limitations, because it's comparing large groups of people, rather than tracking the health of individual women from mammogram on. Or it may be that even with this large number of cases, deaths are still rare enough that they're missed in this sort of study. Other studies have found a 20 percent reduction in breast cancer deaths as a result of mammography.\u003c/p>\n\u003cp>This is just the latest study pointing out the \u003ca href=\"http://www.npr.org/sections/health-shots/2014/04/01/297826238/review-finds-mammographys-benefits-overplayed-harms-dismissed\" target=\"_blank\">problem with overdiagnosis\u003c/a> of breast cancer.\u003c/p>\n\u003cp>\"This study shows that the more we look, the more you find,\" says Joann Elmore, a professor of medicine at the University of Washington who wrote a \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363022\" target=\"_blank\">commentary\u003c/a> accompanying the study. \"The more you screen, the more likely you are to detect early precancerous abnormalities like ductal carcinoma in situ and early-stage cancer.\"\u003c/p>\n\u003cp>It's not clear how many women are overdiagnosed; Elmore says 10 to 20 percent may be a good estimate. But with the current tests, there's no way for a woman to know if she's in that 10 to 20 percent or if she really does have a dangerous cancer. Thus most women who get a diagnosis of DCIS or early-stage invasive cancer opt for treatment, which can mean surgery, radiation or chemotherapy.\u003c/p>\n\u003cp>\"That is so hard,\" Elmore says. \"I really feel for those women. I need help both figuring out how to explain this to women, and I need better research helping me look at the tissue and figure out whether these women are overdiagnosed or not.\"\u003c/p>\n\u003cp>Elmore studies the reliability of breast cancer screening, and published a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25781441\" target=\"_blank\">study\u003c/a> in March that found that pathologists often misidentify DCIS and early-stage cancers when reading biopsies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The medical community has come to accept that overdiagnosis exists, Elmore says. \"This is something that wasn't even considered when I was in med school years ago. We're slowly realizing that we are taking healthy people and maybe potentially giving them harm.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=More+Mammograms+May+Not+Always+Mean+Fewer+Cancer+Deaths&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Recognizing they lacked votes in a key Assembly committee, authors of legislation that would have allowed terminally ill Californians to legally end their lives pulled the bill Tuesday morning.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB128\" target=\"_blank\">Senate Bill 128\u003c/a>, the End of Life Option Act, had already cleared the state Senate, but faced opposition in the Assembly Health Committee, including from \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/02/physician-assisted-suicide-backers-try-to-woo-latinos/\" target=\"_blank\">a group of Southern California Democrats\u003c/a> from heavily Latino districts after the archbishop of Los Angeles increased its advocacy efforts in opposition to the bill.\u003c/p>\n\u003cp>\"We continue to work with Assembly Members to ensure they are comfortable with the bill,\" said Sens. Lois Wolk, (D-Davis), and Bill Monning, (D-Monterey), and Assemblywoman Susan Eggman, (D-Stockton) in a joint statement. \"For dying Californians, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/07/death-with-dignity-advocates-launch-new-campaign-for-physician-assisted-suicide-in-california/\" target=\"_blank\">like Jennifer Glass\u003c/a>, who was scheduled to testify today, this issue is urgent. We remain committed to passing the End of Life Option Act for all Californians who want and need the option of medical aid in dying.”\u003c/p>\n\u003cp>Under the bill, mentally competent adults who are terminally ill with less than six months to live could request lethal medication from a physician.\u003c/p>\n\u003cp>In an interview, Monning stressed that the bill is \"not dead\" and that it has two years -- not one -- for passage.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We're going to review our options,\" he said. \"We invested a lot of energy in the Senate side, and we walk away from the decision today knowing that we're going to have to spend more time cultivating our colleagues in the Assembly.\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/213838838\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003ca href=\"http://www.compassionandchoices.org/userfiles/PUBLIC-MEMO-EOL-OPTIONS-ACT-JUNE-2015.pdf\" target=\"_blank\">A poll \u003c/a>last month found that 69 percent of Californians -- and 70 percent of Latinos -- supported the bill. The poll was conducted by the advocacy group Compassion and Choices. \"The bill is still alive and well,\" Patricia Gonzalez-Portillo, a spokeswoman for the organization, said in an interview. She also said her organization would continue working with Assembly members to advocate for the bill.\u003c/p>\n\u003cp>The bill had received a boost after the California Medical Association changed its stance from opposed to neutral.\u003c/p>\n\u003cp>The bill is modeled after a 1994 Oregon law which permits aid-in-dying. Four other states -- Washington, Montana, Vermont and New Mexico -- have authorized it as well.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The issue was brought home to Californians after 29-year-old resident Brittany Maynard moved to Oregon so she could get a lethal prescription under that state's death with dignity law. She was terminally ill with brain cancer and died last November. A\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\"> video \u003c/a>she recorded 19 days before she took life-ending drugs was shown at a Senate hearing in March.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Recognizing they lacked votes in a key Assembly committee, authors of legislation that would have allowed terminally ill Californians to legally end their lives pulled the bill Tuesday morning.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB128\" target=\"_blank\">Senate Bill 128\u003c/a>, the End of Life Option Act, had already cleared the state Senate, but faced opposition in the Assembly Health Committee, including from \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/02/physician-assisted-suicide-backers-try-to-woo-latinos/\" target=\"_blank\">a group of Southern California Democrats\u003c/a> from heavily Latino districts after the archbishop of Los Angeles increased its advocacy efforts in opposition to the bill.\u003c/p>\n\u003cp>\"We continue to work with Assembly Members to ensure they are comfortable with the bill,\" said Sens. Lois Wolk, (D-Davis), and Bill Monning, (D-Monterey), and Assemblywoman Susan Eggman, (D-Stockton) in a joint statement. \"For dying Californians, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/07/death-with-dignity-advocates-launch-new-campaign-for-physician-assisted-suicide-in-california/\" target=\"_blank\">like Jennifer Glass\u003c/a>, who was scheduled to testify today, this issue is urgent. We remain committed to passing the End of Life Option Act for all Californians who want and need the option of medical aid in dying.”\u003c/p>\n\u003cp>Under the bill, mentally competent adults who are terminally ill with less than six months to live could request lethal medication from a physician.\u003c/p>\n\u003cp>In an interview, Monning stressed that the bill is \"not dead\" and that it has two years -- not one -- for passage.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're going to review our options,\" he said. \"We invested a lot of energy in the Senate side, and we walk away from the decision today knowing that we're going to have to spend more time cultivating our colleagues in the Assembly.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/213838838&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/213838838'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.compassionandchoices.org/userfiles/PUBLIC-MEMO-EOL-OPTIONS-ACT-JUNE-2015.pdf\" target=\"_blank\">A poll \u003c/a>last month found that 69 percent of Californians -- and 70 percent of Latinos -- supported the bill. The poll was conducted by the advocacy group Compassion and Choices. \"The bill is still alive and well,\" Patricia Gonzalez-Portillo, a spokeswoman for the organization, said in an interview. She also said her organization would continue working with Assembly members to advocate for the bill.\u003c/p>\n\u003cp>The bill had received a boost after the California Medical Association changed its stance from opposed to neutral.\u003c/p>\n\u003cp>The bill is modeled after a 1994 Oregon law which permits aid-in-dying. Four other states -- Washington, Montana, Vermont and New Mexico -- have authorized it as well.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The issue was brought home to Californians after 29-year-old resident Brittany Maynard moved to Oregon so she could get a lethal prescription under that state's death with dignity law. She was terminally ill with brain cancer and died last November. A\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\"> video \u003c/a>she recorded 19 days before she took life-ending drugs was shown at a Senate hearing in March.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "After Measles Outbreaks, Parents Shift Their Thinking On Vaccines",
"title": "After Measles Outbreaks, Parents Shift Their Thinking On Vaccines",
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"content": "\u003cp>Nothing like a good measles outbreak to get people thinking more kindly about vaccines.\u003c/p>\n\u003cp>One third of parents say they think vaccines have more benefit than they did a year ago, according to a poll conducted in May.\u003c/p>\n\u003cfigure id=\"attachment_44720\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d.png\">\u003cimg class=\"size-thumbnail wp-image-44720\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d-400x250.png\" alt=\"Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015\" width=\"400\" height=\"250\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d-400x250.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d.png 600w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015 \u003ccite>(NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That's compared to the 5 percent of parents who said they now think vaccines have fewer benefits and 61 percent who think the benefits are the same.\u003c/p>\n\u003cp>Vaccine safety also got a boost, with 25 percent of parents saying they believe vaccines are safer than they thought they were a year ago, compared to 7 percent of parents who think they're less safe. Sixty-eight percent didn't change their minds.\u003c/p>\n\u003cp>The numbers came from a \u003ca href=\"http://www.mottnpch.org/reports-surveys/safer-more-benefits-parents%E2%80%99-vaccines-views-shifting\" target=\"_blank\">poll\u003c/a> of 1,416 parents around the country conducted by the C.S. Mott Children's Hospital.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So far this year \u003ca href=\"http://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\">178 people\u003c/a> have come down with measles, and many became infected after visiting \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">Disneyland\u003c/a>, according to the federal Centers for Disease Control and Prevention. Most of those people were not vaccinated.\u003c/p>\n\u003cfigure id=\"attachment_44721\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26.png\">\u003cimg class=\"size-thumbnail wp-image-44721\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26-400x250.png\" alt=\"Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015\" width=\"400\" height=\"250\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26-400x250.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26.png 600w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015 \u003ccite>(NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even though the Disney outbreak got wide attention, 2014 was actually worse for measles, with 23 outbreaks including 383 cases among unvaccinated Amish communities in Ohio. In both 2014 and this year, measles is thought to have been brought to the U.S. by unvaccinated travelers.\u003c/p>\n\u003cp>Polls typically find that people's opinions change very little in the course of a year, according to Matthew Davis, a pediatrician who directs the C.S. Mott poll. \"These numbers are incredibly high, and suggest that parents are hearing about the outbreaks and responding.\"\u003c/p>\n\u003cp>Doctors should know that parents' opinions can change relatively quickly, Davis says, though in his medical practice, he still sees parents with a wide range of beliefs about vaccine safety.\u003c/p>\n\u003cp>\"It's important for the medical community to realize that parents care deeply about their children's well being,\" Davis told Shots. \"And that is reflected in a wide range of opinions about vaccination.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In May, a statewide poll in California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/03/two-thirds-of-californians-support-barring-unvaccinated-children-from-public-school/\" target=\"_blank\">found that\u003c/a> 67 percent of adults and 65 percent of public school parents think unvaccinated students should not be allowed in public school.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=After+Measles+Outbreaks%2C+Parents+Shift+Their+Thinking+On+Vaccines&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nothing like a good measles outbreak to get people thinking more kindly about vaccines.\u003c/p>\n\u003cp>One third of parents say they think vaccines have more benefit than they did a year ago, according to a poll conducted in May.\u003c/p>\n\u003cfigure id=\"attachment_44720\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d.png\">\u003cimg class=\"size-thumbnail wp-image-44720\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d-400x250.png\" alt=\"Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015\" width=\"400\" height=\"250\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d-400x250.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-benefit_enl-25fbea0844d16be2d08246f0d63d746b56d09f9d.png 600w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015 \u003ccite>(NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That's compared to the 5 percent of parents who said they now think vaccines have fewer benefits and 61 percent who think the benefits are the same.\u003c/p>\n\u003cp>Vaccine safety also got a boost, with 25 percent of parents saying they believe vaccines are safer than they thought they were a year ago, compared to 7 percent of parents who think they're less safe. Sixty-eight percent didn't change their minds.\u003c/p>\n\u003cp>The numbers came from a \u003ca href=\"http://www.mottnpch.org/reports-surveys/safer-more-benefits-parents%E2%80%99-vaccines-views-shifting\" target=\"_blank\">poll\u003c/a> of 1,416 parents around the country conducted by the C.S. Mott Children's Hospital.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So far this year \u003ca href=\"http://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\">178 people\u003c/a> have come down with measles, and many became infected after visiting \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">Disneyland\u003c/a>, according to the federal Centers for Disease Control and Prevention. Most of those people were not vaccinated.\u003c/p>\n\u003cfigure id=\"attachment_44721\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26.png\">\u003cimg class=\"size-thumbnail wp-image-44721\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26-400x250.png\" alt=\"Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015\" width=\"400\" height=\"250\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26-400x250.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/07/vaccine-safety_enl-aa35d7bee0cf76bb8312170ecc74194b411f2a26.png 600w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: C.S. Mott Children's Hospital National Poll on Children's Health, 2015 \u003ccite>(NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even though the Disney outbreak got wide attention, 2014 was actually worse for measles, with 23 outbreaks including 383 cases among unvaccinated Amish communities in Ohio. In both 2014 and this year, measles is thought to have been brought to the U.S. by unvaccinated travelers.\u003c/p>\n\u003cp>Polls typically find that people's opinions change very little in the course of a year, according to Matthew Davis, a pediatrician who directs the C.S. Mott poll. \"These numbers are incredibly high, and suggest that parents are hearing about the outbreaks and responding.\"\u003c/p>\n\u003cp>Doctors should know that parents' opinions can change relatively quickly, Davis says, though in his medical practice, he still sees parents with a wide range of beliefs about vaccine safety.\u003c/p>\n\u003cp>\"It's important for the medical community to realize that parents care deeply about their children's well being,\" Davis told Shots. \"And that is reflected in a wide range of opinions about vaccination.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In May, a statewide poll in California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/03/two-thirds-of-californians-support-barring-unvaccinated-children-from-public-school/\" target=\"_blank\">found that\u003c/a> 67 percent of adults and 65 percent of public school parents think unvaccinated students should not be allowed in public school.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=After+Measles+Outbreaks%2C+Parents+Shift+Their+Thinking+On+Vaccines&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Not Over Yet: Tim Donnelly Files for Referendum to Overturn California's New Vaccine Law",
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"content": "\u003cp>Well, that didn't take long.\u003c/p>\n\u003cp>Former California Assemblyman and \u003ca href=\"http://ww2.kqed.org/news/tim-donnelly-gop-for-governor\" target=\"_blank\">ex-gubernatorial candidate\u003c/a> Tim Donnelly Wednesday \u003ca href=\"https://oag.ca.gov/system/files/initiatives/pdfs/15-0035%20%28Referendum%20of%20SB%20277%29.pdf\" target=\"_blank\">filed paperwork\u003c/a> with the Office of the Attorney General for a referendum that would overturn California's brand-new law ending personal belief exemptions for vaccines. Donnelly filed the request just one day after Gov. Jerry Brown signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a> into law.\u003c/p>\n\u003cp>Donnelly, a tea party conservative who hosts an Inland Empire talk radio show on KIXW-AM, \u003ca href=\"https://www.facebook.com/tim.donnelly.372/posts/463441200498927?pnref=story\" target=\"_blank\"> posted his displeasure with the new law on Facebook\u003c/a> Tuesday.\u003c/p>\n\u003cp>\"Gov. Jerry Brown signed away a parent's right to choose what's best for their child,\" he wrote. \"This is a victory for leftists bent on absolute control. No more choice, no informed consent, only compliance or else!\"\u003c/p>\n\u003cp>Backers of the law's repeal now have 90 days from its enactment Tuesday to gather 365,880 signatures, the number needed to \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/referendum/\" target=\"_blank\">qualify the referendum \u003c/a>for the Nov. 1, 2016, ballot. Provided enough signatures are verified, the law would then be put on hold until after the election.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That would mean parents could at least temporarily slide by the July 1, 2016, implementation of the law, when any child entering preschool, kindergarten or seventh grade, or any student changing schools, is required to have the proper vaccinations if they have not already obtained a personal belief exemption by Jan. 1.\u003c/p>\n\u003cp>\"Even if they don’t have a chance of passing this, just getting it on the ballot box has a chance to throw a wrench in things,\" says KQED politics and government reporter Marisa Lagos.\u003c/p>\n\u003cp>Lagos said the success of the signature drive will depend -- what else? -- on money.\u003c/p>\n\u003cp>\"The question is whether they will have funding to send signature-gatherers out to do this work, enough boots on the ground to collect signatures,” she said.\u003c/p>\n\u003cp>Christina Hildebrand, founder of A Voice for Choice, a nonprofit group that worked against the vaccine bill, told KQED's April Dembosky that collecting the required signatures was doable.\u003c/p>\n\u003cp>\"We need 5 percent of what was cast in the governor’s election, which was a \u003ca href=\"http://ww2.kqed.org/news/2014/11/12-might-california-low-voter-turnout-spark-2016-initiative-frenzy/\" target=\"_blank\">very low turnout\u003c/a> vote, so I do believe we can get that,\" she said.\u003c/p>\n\u003cp>And then there's the \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article26061985.html\" target=\"_blank\">Jim Carrey factor\u003c/a> to consider.\u003c/p>\n\u003cp>State Sen. Richard Pan, a co-author of the law, responded to the referendum filing in a statement. “Californians overwhelmingly support requiring vaccinations for school,\" Pan said. \"Our bill was a reasonable, science-based approach to protecting children, and the most vulnerable among us, from dangerous diseases. Vaccines are one of the most powerful tools we have to prevent deadly communicable diseases.\"\u003c/p>\n\u003cp>Pan said he would fight \"any referendum that hurts Californians.\"\u003c/p>\n\u003cp>A May \u003ca href=\"http://www.ppic.org/main/publication.asp?i=1153\" target=\"_blank\"> poll by the Public Policy Institute of California\u003c/a> found that 67 percent of Californians and 65 percent of public school parents think children should not be allowed to attend public school without getting vaccinated. Large majorities also said that childhood vaccines are generally safe.\u003c/p>\n\u003cp>If a referendum fails, opponents of the law could turn to the courts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The California state constitution guarantees a free and public education for every child,\" said Hildebrand. Lawyers have been lining up to help with a lawsuit, she said. \"They keep coming out of the woodwork.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Well, that didn't take long.\u003c/p>\n\u003cp>Former California Assemblyman and \u003ca href=\"http://ww2.kqed.org/news/tim-donnelly-gop-for-governor\" target=\"_blank\">ex-gubernatorial candidate\u003c/a> Tim Donnelly Wednesday \u003ca href=\"https://oag.ca.gov/system/files/initiatives/pdfs/15-0035%20%28Referendum%20of%20SB%20277%29.pdf\" target=\"_blank\">filed paperwork\u003c/a> with the Office of the Attorney General for a referendum that would overturn California's brand-new law ending personal belief exemptions for vaccines. Donnelly filed the request just one day after Gov. Jerry Brown signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a> into law.\u003c/p>\n\u003cp>Donnelly, a tea party conservative who hosts an Inland Empire talk radio show on KIXW-AM, \u003ca href=\"https://www.facebook.com/tim.donnelly.372/posts/463441200498927?pnref=story\" target=\"_blank\"> posted his displeasure with the new law on Facebook\u003c/a> Tuesday.\u003c/p>\n\u003cp>\"Gov. Jerry Brown signed away a parent's right to choose what's best for their child,\" he wrote. \"This is a victory for leftists bent on absolute control. No more choice, no informed consent, only compliance or else!\"\u003c/p>\n\u003cp>Backers of the law's repeal now have 90 days from its enactment Tuesday to gather 365,880 signatures, the number needed to \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/referendum/\" target=\"_blank\">qualify the referendum \u003c/a>for the Nov. 1, 2016, ballot. Provided enough signatures are verified, the law would then be put on hold until after the election.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That would mean parents could at least temporarily slide by the July 1, 2016, implementation of the law, when any child entering preschool, kindergarten or seventh grade, or any student changing schools, is required to have the proper vaccinations if they have not already obtained a personal belief exemption by Jan. 1.\u003c/p>\n\u003cp>\"Even if they don’t have a chance of passing this, just getting it on the ballot box has a chance to throw a wrench in things,\" says KQED politics and government reporter Marisa Lagos.\u003c/p>\n\u003cp>Lagos said the success of the signature drive will depend -- what else? -- on money.\u003c/p>\n\u003cp>\"The question is whether they will have funding to send signature-gatherers out to do this work, enough boots on the ground to collect signatures,” she said.\u003c/p>\n\u003cp>Christina Hildebrand, founder of A Voice for Choice, a nonprofit group that worked against the vaccine bill, told KQED's April Dembosky that collecting the required signatures was doable.\u003c/p>\n\u003cp>\"We need 5 percent of what was cast in the governor’s election, which was a \u003ca href=\"http://ww2.kqed.org/news/2014/11/12-might-california-low-voter-turnout-spark-2016-initiative-frenzy/\" target=\"_blank\">very low turnout\u003c/a> vote, so I do believe we can get that,\" she said.\u003c/p>\n\u003cp>And then there's the \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article26061985.html\" target=\"_blank\">Jim Carrey factor\u003c/a> to consider.\u003c/p>\n\u003cp>State Sen. Richard Pan, a co-author of the law, responded to the referendum filing in a statement. “Californians overwhelmingly support requiring vaccinations for school,\" Pan said. \"Our bill was a reasonable, science-based approach to protecting children, and the most vulnerable among us, from dangerous diseases. Vaccines are one of the most powerful tools we have to prevent deadly communicable diseases.\"\u003c/p>\n\u003cp>Pan said he would fight \"any referendum that hurts Californians.\"\u003c/p>\n\u003cp>A May \u003ca href=\"http://www.ppic.org/main/publication.asp?i=1153\" target=\"_blank\"> poll by the Public Policy Institute of California\u003c/a> found that 67 percent of Californians and 65 percent of public school parents think children should not be allowed to attend public school without getting vaccinated. Large majorities also said that childhood vaccines are generally safe.\u003c/p>\n\u003cp>If a referendum fails, opponents of the law could turn to the courts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The California state constitution guarantees a free and public education for every child,\" said Hildebrand. Lawyers have been lining up to help with a lawsuit, she said. \"They keep coming out of the woodwork.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Insurers Predict Hepatitis C Drugs to Take Huge Toll on California Budget",
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"content": "\u003cp>California taxpayers could be on the hook for billions of dollars to treat hepatitis C patients in various state-funded programs, according to a report released Tuesday by an insurers’ trade group.\u003c/p>\n\u003cp>The analysis commissioned by the California Association of Health Plans estimates that paying for the patients’ high-priced hepatitis C medications in prisons and state hospitals, or through Medi-Cal and other state programs, could range from $512 million to $5.1 billion. The wide-ranging estimates depend on how many patients are treated and how much the drugs are discounted by manufacturers.\u003c/p>\n\u003cp>Charles Bacchi, president and CEO of the association, said the report underscores what is to come in the near future when more costly prescription drugs are approved. The high costs aren’t sustainable for health plans, consumers or taxpayers, Bacchi said.\u003c/p>\n\u003cp>“With a slew of new high-priced drugs set to hit the market this year … this report really shows how that number can be multiplied,” Bacchi said. “It could be a huge hit to the taxpayers.”\u003c/p>\n\u003cp>The new hepatitis C medications are a vast improvement over previous treatments and can cure patients. But their staggering cost has prompted a national debate about their outsized bite into health care budgets. The estimated costs have led to policy changes, hearings, lawsuits and ethical debates about who should receive the treatments.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An estimated 3.2 million people nationwide have hepatitis C, a virus that is the leading cause of cirrhosis and liver cancer.\u003c/p>\n\u003cp>Gilead Sciences Inc., which won approval for the drug Sovaldi in 2013, has been criticized for charging about $1,000 for each pill – or about $84,000 for the 12-week treatment. Another of its drugs, Harvoni, costs more.\u003c/p>\n\u003cp>Gilead has said the prices are fair because the drugs are highly effective and can prevent future medical costs to treat liver disease or provide transplants.\u003c/p>\n\u003cp>One study last year by the nonprofit Institute for Clinical & Economic Review found that if half of hepatitis C-infected Californians received the new medications, annual drug costs could rise by $22 billion.\u003c/p>\n\u003cp>“These cures are not free, “ said Steven Pearson, president of the Boston-based institute.\u003c/p>\n\u003cp>Health officials in most Medicaid programs around the country are prioritizing who receives the hepatitis C medication, according to a study published Tuesday in the Annals of Internal Medicine. The high costs are “forcing many payers to ration this lifesaving treatment,” the study said.\u003c/p>\n\u003cp>California’s Department of Health Care Services issued a new policy, effective Wednesday, which sets new guidelines on which patients can receive state-funded hepatitis C treatment. The department estimates that between 3,000 to 4,000 Medi-Cal members will seek treatment next year and says that decisions about who gets the new medications will be based upon medical necessity rather than cost.\u003c/p>\n\u003cp>California’s budget, which was signed last week, allotted $228 million in additional funds for specialty drugs to treat hepatitis C patients in the state hospitals and prisons and on state programs such as Medi-Cal. Covered California, the state’s health care marketplace, recently approved a cap on specialty drugs that would limit most consumers to paying $250 per month per prescription.\u003c/p>\n\u003cp>The state has convened a working group to review the state’s policies and expenditures on high-cost drugs, including those used to treat hepatitis C.\u003c/p>\n\u003cp>Hepatitis C medications have triggered more discussion about drug development, pricing and use than any drugs in recent history, and the debate is far from over, Pearson said.\u003c/p>\n\u003cp>“A lot of new expensive drugs are on the horizon,” Pearson said, referring to treatments for various conditions. “Drug costs could go up significantly and have a major impact on the budgets.”\u003c/p>\n\u003cp>Two costly medications — one for high cholesterol and one for heart disease — are expected to get FDA approval later this summer. Cancer drugs in the pipeline could have similarly high price tags.\u003c/p>\n\u003cp>The hepatitis C research was done by The Taylor Feldman Group for the health plan association, which seeks to raise awareness of the cost to taxpayers, health plans and consumers, Bacchi said. He noted that private health plans handle the vast majority of Medi-Cal patients through managed care.\u003c/p>\n\u003cp>Emalie Huriaux, director of federal and state programs for Project Inform, a patient advocacy group based in San Francisco, was skeptical of the findings.\u003c/p>\n\u003cp>The report is “based on a lot of assumptions that can’t be verified,” she said.\u003c/p>\n\u003cp>She said insurers and pharmaceutical companies are “throwing rocks at each other” rather than coming up with solutions to the high prices. The report, she said, is another example of that.\u003c/p>\n\u003cp>Huriaux said something has to be done to lower costs, reduce restrictions and improve access for consumers, many of whom have lived with the hepatitis C virus for decades yet have been told they aren’t sick enough to get the medications.\u003c/p>\n\u003cp>“It comes down to how much should you pay for a cure?” she said. “Giving people access shouldn’t bankrupt the public systems and it shouldn’t break individual’s bank accounts.”\u003c/p>\n\u003cp>\u003cem>Blue Shield of California Foundation helps fund KHN coverage in California.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a nonprofit national health policy news service.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California taxpayers could be on the hook for billions of dollars to treat hepatitis C patients in various state-funded programs, according to a report released Tuesday by an insurers’ trade group.\u003c/p>\n\u003cp>The analysis commissioned by the California Association of Health Plans estimates that paying for the patients’ high-priced hepatitis C medications in prisons and state hospitals, or through Medi-Cal and other state programs, could range from $512 million to $5.1 billion. The wide-ranging estimates depend on how many patients are treated and how much the drugs are discounted by manufacturers.\u003c/p>\n\u003cp>Charles Bacchi, president and CEO of the association, said the report underscores what is to come in the near future when more costly prescription drugs are approved. The high costs aren’t sustainable for health plans, consumers or taxpayers, Bacchi said.\u003c/p>\n\u003cp>“With a slew of new high-priced drugs set to hit the market this year … this report really shows how that number can be multiplied,” Bacchi said. “It could be a huge hit to the taxpayers.”\u003c/p>\n\u003cp>The new hepatitis C medications are a vast improvement over previous treatments and can cure patients. But their staggering cost has prompted a national debate about their outsized bite into health care budgets. The estimated costs have led to policy changes, hearings, lawsuits and ethical debates about who should receive the treatments.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An estimated 3.2 million people nationwide have hepatitis C, a virus that is the leading cause of cirrhosis and liver cancer.\u003c/p>\n\u003cp>Gilead Sciences Inc., which won approval for the drug Sovaldi in 2013, has been criticized for charging about $1,000 for each pill – or about $84,000 for the 12-week treatment. Another of its drugs, Harvoni, costs more.\u003c/p>\n\u003cp>Gilead has said the prices are fair because the drugs are highly effective and can prevent future medical costs to treat liver disease or provide transplants.\u003c/p>\n\u003cp>One study last year by the nonprofit Institute for Clinical & Economic Review found that if half of hepatitis C-infected Californians received the new medications, annual drug costs could rise by $22 billion.\u003c/p>\n\u003cp>“These cures are not free, “ said Steven Pearson, president of the Boston-based institute.\u003c/p>\n\u003cp>Health officials in most Medicaid programs around the country are prioritizing who receives the hepatitis C medication, according to a study published Tuesday in the Annals of Internal Medicine. The high costs are “forcing many payers to ration this lifesaving treatment,” the study said.\u003c/p>\n\u003cp>California’s Department of Health Care Services issued a new policy, effective Wednesday, which sets new guidelines on which patients can receive state-funded hepatitis C treatment. The department estimates that between 3,000 to 4,000 Medi-Cal members will seek treatment next year and says that decisions about who gets the new medications will be based upon medical necessity rather than cost.\u003c/p>\n\u003cp>California’s budget, which was signed last week, allotted $228 million in additional funds for specialty drugs to treat hepatitis C patients in the state hospitals and prisons and on state programs such as Medi-Cal. Covered California, the state’s health care marketplace, recently approved a cap on specialty drugs that would limit most consumers to paying $250 per month per prescription.\u003c/p>\n\u003cp>The state has convened a working group to review the state’s policies and expenditures on high-cost drugs, including those used to treat hepatitis C.\u003c/p>\n\u003cp>Hepatitis C medications have triggered more discussion about drug development, pricing and use than any drugs in recent history, and the debate is far from over, Pearson said.\u003c/p>\n\u003cp>“A lot of new expensive drugs are on the horizon,” Pearson said, referring to treatments for various conditions. “Drug costs could go up significantly and have a major impact on the budgets.”\u003c/p>\n\u003cp>Two costly medications — one for high cholesterol and one for heart disease — are expected to get FDA approval later this summer. Cancer drugs in the pipeline could have similarly high price tags.\u003c/p>\n\u003cp>The hepatitis C research was done by The Taylor Feldman Group for the health plan association, which seeks to raise awareness of the cost to taxpayers, health plans and consumers, Bacchi said. He noted that private health plans handle the vast majority of Medi-Cal patients through managed care.\u003c/p>\n\u003cp>Emalie Huriaux, director of federal and state programs for Project Inform, a patient advocacy group based in San Francisco, was skeptical of the findings.\u003c/p>\n\u003cp>The report is “based on a lot of assumptions that can’t be verified,” she said.\u003c/p>\n\u003cp>She said insurers and pharmaceutical companies are “throwing rocks at each other” rather than coming up with solutions to the high prices. The report, she said, is another example of that.\u003c/p>\n\u003cp>Huriaux said something has to be done to lower costs, reduce restrictions and improve access for consumers, many of whom have lived with the hepatitis C virus for decades yet have been told they aren’t sick enough to get the medications.\u003c/p>\n\u003cp>“It comes down to how much should you pay for a cure?” she said. “Giving people access shouldn’t bankrupt the public systems and it shouldn’t break individual’s bank accounts.”\u003c/p>\n\u003cp>\u003cem>Blue Shield of California Foundation helps fund KHN coverage in California.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a nonprofit national health policy news service.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Caveats About Favored Access Method For Dialysis",
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"headTitle": "State of Health | KQED News",
"content": "\u003cp>When it comes to dialysis, one method of accessing the blood to clean it gets championed above the rest. But quite a few specialists say there's not enough evidence to universally support the treatment's superiority or to run down the other options.\u003c/p>\n\u003cp>\"When we talk to [dialysis] patients in the clinic, we cannot address their profound question: 'Which access is better for me?' \" says \u003ca href=\"http://www.ucalgary.ca/communityhealthsciences/dr-pietro-ravani-supervisor-profile\">Dr. Pietro Ravani\u003c/a>, an epidemiologist at the University of Calgary in Canada. \"We just don't know, yet we are selling patients on a certain one.\"\u003c/p>\n\u003cp>Ravani is talking about guidelines that encourage doctors to pursue connections for dialysis known as \u003ca href=\"http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/vascular-access-for-hemodialysis/Pages/index.aspx\">arteriovenous fistulas\u003c/a>. Research ays hemodialysis patients with fistulas have a reduced risk of death, blood clots and infections compared with other access methods.\u003c/p>\n\u003cp>The connections require surgeons to stitch together an artery and vein, usually in the arm, to create a sturdier vein with greater blood flow. Patients are then pricked at the site of the fistula during each visit to connect to the blood-cleaning hemodialysis machine.\u003c/p>\n\u003cp>About \u003ca href=\"https://www.kidney.org/news/newsroom/factsheets/FastFacts\">450,000 people\u003c/a> in the U.S. are on dialysis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Studies, like \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2173312\">this one\u003c/a> that was published in May, have shown patients with the fistulas had a lower risk of death (about a third less) when they start dialysis with fistulas rather than \u003ca href=\"http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/vascular-access-for-hemodialysis/Pages/index.aspx\">catheter connections\u003c/a>.\u003c/p>\n\u003cp>But Ravani says not so fast. \"The literature that is available and used to promote fistulas is biased,\" he says, adding there is no way catheters, an alternative to fistulas, are as deadly as some others have concluded.\u003c/p>\n\u003cp>Catheters are small plastic tubes, usually placed in a vein along the neck, chest, leg or groin, that can also be conduits for infection. Catheters are the go-to method for access to the blood when the kidneys suddenly fail and patients crash into dialysis, requiring emergency hospitalization and treatment. Fistulas can't be used for one to three months after an operation. Catheters can be used immediately.\u003c/p>\n\u003cp>Studies comparing these two access types and their mortality rates have only been observational, Ravani argues. That means researchers have looked at what happens to patients after doctors decided on their own how to treat patients. A randomized controlled trial that assigns patients to one treatment or the other and then collects information on what happens to them is necessary to ultimately prove the superiority of one method over another, Ravani says.\u003c/p>\n\u003cp>Patients with catheters, he explains, are usually pretty sick. But because it takes fistulas several months to develop before use, they are typically given to healthier patients who aren't in immediate need of dialysis.\u003c/p>\n\u003cp>\"The very strong association between catheters and mortality could be related to how sick the patients were, not to the access type,\" Ravani says. \"When you need to start dialysis urgently, it's because you're very sick so you use catheters, \u003cem>not\u003c/em> fistulas. This makes it hard to determine if the poorer outcomes observed in patients with catheters are because of catheter \u003cem>or\u003c/em> because they are already very sick.\"\u003c/p>\n\u003cp>For this same reason — serious illness — Ravani argues that patients with catheters succumb to infection more often than healthy patients with fistulas. If a healthy patient used a catheter, they wouldn't be as likely to contract an infection.\u003c/p>\n\u003cp>Nephrologist \u003ca href=\"https://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/ClinicalServices/DeptPgrmCS/Departments/Nephrology/Physicians/DrSwapnilHiremath\">Swapnil Hiremath\u003c/a>, at Ottawa Hospital in Canada, agrees that more research is needed to fully assess the value of fistulas. \"The portrayal that fistulas are the ultimate access [for dialysis] and that if everyone has one, mortality rates will go down, is an exaggeration,\" Hiremath says. \"You cannot go around blaming catheters; it's the nature of things that these patients are sicker and have a higher risk of death.\"\u003c/p>\n\u003cp>Hiremath adds that despite initiatives to increase the number of dialysis patients with fistulas, the treatment method is extremely difficult to provide to patients in the first place.\u003c/p>\n\u003cp>Roughly half of fistulas \u003ca href=\"http://cjasn.asnjournals.org/content/1/2/332.full\">fail to mature\u003c/a>, particularly in older individuals, and don't end up being used to access the blood, he says. Doctors then resort to catheters or another method to connect patients to dialysis machines. What's more, some 30 percent of patients completely \u003ca href=\"http://www.ncbi.nlm.nih.gov/m/pubmed/21406543/\">reject the proposal of a fistula\u003c/a>, despite explanations of their benefits.\u003c/p>\n\u003cp>And patients with fistulas can develop complications, such as \u003ca href=\"http://www.ncbi.nlm.nih.gov/m/pubmed/23217335/\">heart failure\u003c/a>, blood clots and swelling.\u003c/p>\n\u003cp>\"To say that everyone who has a catheter should have a fistula, that's not easy,\" Hiremath says. \"Doctors need to have an open mind, but unfortunately many people have already decided that fistulas are the best option.\"\u003c/p>\n\u003cp>Johns Hopkins University surgeon \u003ca href=\"http://www.hopkinsmedicine.org/profiles/results/directory/profile/0020487/mahmoud-malas\">Dr. Mahmoud Malas\u003c/a>, lead author of the recent paper on the advantages of fistulas, says Ravani's and Hiremath's criticism doesn't make sense to him.\u003c/p>\n\u003cp>Malas and his colleagues were behind an observational \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2173312\">study\u003c/a> showing patients starting dialysis with fistulas had lower risks of death. Despite the fact that he and his colleagues only reviewed existing numbers in the \u003ca href=\"http://www.usrds.org/\">U.S. Renal Data System\u003c/a>, Malas says they were able to minimize bias by matching the characteristics of patients with fistulas and catheters.\u003c/p>\n\u003cp>\"If we saw a male patient with a catheter that was 40 years old who had diabetes and hypertension, we would find his exact match in a patient using a fistula,\" Malas explains. \"Even with this matching analysis, you still see a much higher mortality rate for those on catheters.\"\u003c/p>\n\u003cp>\"And our finding is not new, hundreds of prior studies have shown this difference,\" he adds.\u003c/p>\n\u003cp>Either way, Malas doubts a randomized trial could ever be carried out to truly compare those on fistulas and catheters. \"Nobody would approve that trial,\" he says. \"People will think it's unethical.\"\u003c/p>\n\u003cp>Ravani and Hiremath think differently. They are currently pursuing a randomized trial in Canada to tease out the differences between the two methods once and for all.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"For 40 years we have ignored this question with a randomized trial,\" Ravani says. \"And until we have this answer, we cannot say fistulas are better.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Caveats+About+Favored+Access+Method+For+Dialysis&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When it comes to dialysis, one method of accessing the blood to clean it gets championed above the rest. But quite a few specialists say there's not enough evidence to universally support the treatment's superiority or to run down the other options.\u003c/p>\n\u003cp>\"When we talk to [dialysis] patients in the clinic, we cannot address their profound question: 'Which access is better for me?' \" says \u003ca href=\"http://www.ucalgary.ca/communityhealthsciences/dr-pietro-ravani-supervisor-profile\">Dr. Pietro Ravani\u003c/a>, an epidemiologist at the University of Calgary in Canada. \"We just don't know, yet we are selling patients on a certain one.\"\u003c/p>\n\u003cp>Ravani is talking about guidelines that encourage doctors to pursue connections for dialysis known as \u003ca href=\"http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/vascular-access-for-hemodialysis/Pages/index.aspx\">arteriovenous fistulas\u003c/a>. Research ays hemodialysis patients with fistulas have a reduced risk of death, blood clots and infections compared with other access methods.\u003c/p>\n\u003cp>The connections require surgeons to stitch together an artery and vein, usually in the arm, to create a sturdier vein with greater blood flow. Patients are then pricked at the site of the fistula during each visit to connect to the blood-cleaning hemodialysis machine.\u003c/p>\n\u003cp>About \u003ca href=\"https://www.kidney.org/news/newsroom/factsheets/FastFacts\">450,000 people\u003c/a> in the U.S. are on dialysis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Studies, like \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2173312\">this one\u003c/a> that was published in May, have shown patients with the fistulas had a lower risk of death (about a third less) when they start dialysis with fistulas rather than \u003ca href=\"http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/vascular-access-for-hemodialysis/Pages/index.aspx\">catheter connections\u003c/a>.\u003c/p>\n\u003cp>But Ravani says not so fast. \"The literature that is available and used to promote fistulas is biased,\" he says, adding there is no way catheters, an alternative to fistulas, are as deadly as some others have concluded.\u003c/p>\n\u003cp>Catheters are small plastic tubes, usually placed in a vein along the neck, chest, leg or groin, that can also be conduits for infection. Catheters are the go-to method for access to the blood when the kidneys suddenly fail and patients crash into dialysis, requiring emergency hospitalization and treatment. Fistulas can't be used for one to three months after an operation. Catheters can be used immediately.\u003c/p>\n\u003cp>Studies comparing these two access types and their mortality rates have only been observational, Ravani argues. That means researchers have looked at what happens to patients after doctors decided on their own how to treat patients. A randomized controlled trial that assigns patients to one treatment or the other and then collects information on what happens to them is necessary to ultimately prove the superiority of one method over another, Ravani says.\u003c/p>\n\u003cp>Patients with catheters, he explains, are usually pretty sick. But because it takes fistulas several months to develop before use, they are typically given to healthier patients who aren't in immediate need of dialysis.\u003c/p>\n\u003cp>\"The very strong association between catheters and mortality could be related to how sick the patients were, not to the access type,\" Ravani says. \"When you need to start dialysis urgently, it's because you're very sick so you use catheters, \u003cem>not\u003c/em> fistulas. This makes it hard to determine if the poorer outcomes observed in patients with catheters are because of catheter \u003cem>or\u003c/em> because they are already very sick.\"\u003c/p>\n\u003cp>For this same reason — serious illness — Ravani argues that patients with catheters succumb to infection more often than healthy patients with fistulas. If a healthy patient used a catheter, they wouldn't be as likely to contract an infection.\u003c/p>\n\u003cp>Nephrologist \u003ca href=\"https://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/ClinicalServices/DeptPgrmCS/Departments/Nephrology/Physicians/DrSwapnilHiremath\">Swapnil Hiremath\u003c/a>, at Ottawa Hospital in Canada, agrees that more research is needed to fully assess the value of fistulas. \"The portrayal that fistulas are the ultimate access [for dialysis] and that if everyone has one, mortality rates will go down, is an exaggeration,\" Hiremath says. \"You cannot go around blaming catheters; it's the nature of things that these patients are sicker and have a higher risk of death.\"\u003c/p>\n\u003cp>Hiremath adds that despite initiatives to increase the number of dialysis patients with fistulas, the treatment method is extremely difficult to provide to patients in the first place.\u003c/p>\n\u003cp>Roughly half of fistulas \u003ca href=\"http://cjasn.asnjournals.org/content/1/2/332.full\">fail to mature\u003c/a>, particularly in older individuals, and don't end up being used to access the blood, he says. Doctors then resort to catheters or another method to connect patients to dialysis machines. What's more, some 30 percent of patients completely \u003ca href=\"http://www.ncbi.nlm.nih.gov/m/pubmed/21406543/\">reject the proposal of a fistula\u003c/a>, despite explanations of their benefits.\u003c/p>\n\u003cp>And patients with fistulas can develop complications, such as \u003ca href=\"http://www.ncbi.nlm.nih.gov/m/pubmed/23217335/\">heart failure\u003c/a>, blood clots and swelling.\u003c/p>\n\u003cp>\"To say that everyone who has a catheter should have a fistula, that's not easy,\" Hiremath says. \"Doctors need to have an open mind, but unfortunately many people have already decided that fistulas are the best option.\"\u003c/p>\n\u003cp>Johns Hopkins University surgeon \u003ca href=\"http://www.hopkinsmedicine.org/profiles/results/directory/profile/0020487/mahmoud-malas\">Dr. Mahmoud Malas\u003c/a>, lead author of the recent paper on the advantages of fistulas, says Ravani's and Hiremath's criticism doesn't make sense to him.\u003c/p>\n\u003cp>Malas and his colleagues were behind an observational \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2173312\">study\u003c/a> showing patients starting dialysis with fistulas had lower risks of death. Despite the fact that he and his colleagues only reviewed existing numbers in the \u003ca href=\"http://www.usrds.org/\">U.S. Renal Data System\u003c/a>, Malas says they were able to minimize bias by matching the characteristics of patients with fistulas and catheters.\u003c/p>\n\u003cp>\"If we saw a male patient with a catheter that was 40 years old who had diabetes and hypertension, we would find his exact match in a patient using a fistula,\" Malas explains. \"Even with this matching analysis, you still see a much higher mortality rate for those on catheters.\"\u003c/p>\n\u003cp>\"And our finding is not new, hundreds of prior studies have shown this difference,\" he adds.\u003c/p>\n\u003cp>Either way, Malas doubts a randomized trial could ever be carried out to truly compare those on fistulas and catheters. \"Nobody would approve that trial,\" he says. \"People will think it's unethical.\"\u003c/p>\n\u003cp>Ravani and Hiremath think differently. They are currently pursuing a randomized trial in Canada to tease out the differences between the two methods once and for all.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"For 40 years we have ignored this question with a randomized trial,\" Ravani says. \"And until we have this answer, we cannot say fistulas are better.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Caveats+About+Favored+Access+Method+For+Dialysis&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Resisting Vaccinations Has Long History",
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"content": "\u003cp>California is on the brink of enacting a law that would require nearly all children to be vaccinated in order to attend school. While the bill has passed the Legislature, public health officials have had to grapple with a strong, vocal opposition along the way. (\u003cstrong>Update July 1\u003c/strong>: Gov. Jerry Brown yesterday \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">signed the bill into law\u003c/a>.)\u003c/p>\n\u003cp>There's actually a long history to the anti-vaccination movement.\u003c/p>\n\u003cp>\"From the moment the very first vaccine came on the scene, which was the smallpox vaccine, there has been resistance to vaccines and vaccination,\" says Elena Conis, a history professor at Emory University and author of Vaccine Nation: America's Changing Relationship with Immunization.\u003c/p>\n\u003cp>She says that the modern-day resistance movement shares its roots and rhetoric with the social movements of the 1960s and '70s, including feminism, environmentalism and consumer rights.\u003c/p>\n\u003cp>\"They encouraged people to question sources of authority, including doctors,\" she says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For example, women's advocates started to question medical advice on reproductive health and childbirth.\u003c/p>\n\u003cp>\"Women also start opting to increasingly use midwives, have births outside the hospital,\" she says, \"And also reject professional advice about formula feeding over breastfeeding.\"\u003c/p>\n\u003cp>Environmental activists were also encouraging people to think about chemical exposures, even in small amounts, at the same time that drug manufacturers started including package inserts listing drug ingredients.\u003c/p>\n\u003cp>Conis says that this is the context for the list of vaccine recommendations, which has grown longer over the last generation. It can be overwhelming for today's parents to watch their babies cry through one shot after another.\u003c/p>\n\u003cp>\"We started looking at the vaccine schedule and how intense and frequent these vaccines seem to come up,\" says George McCann, a general contractor and father of two daughters, who lives north of San Francisco. \"So we started talking about whether or not this seemed to be the best approach for our children.\"\u003c/p>\n\u003cp>He and his wife decided to have their girls get some vaccines, but not all. They skipped vaccines for pneumonia and chicken pox and waited on polio until the girls were older.\u003c/p>\n\u003cp>\"The whole issue for me comes down to the idea that somehow the state would get to mandate that all of us have to do something, as if we don't have the ability to look into this with compassion and intelligence and critical thinking on behalf of our children,\" he explains.\u003c/p>\n\u003cp>But Carl Krawitt asks that those who don't vaccinate or delay think about other peoples' children. His son couldn't get vaccinated for five years while he was being treated for leukemia. He depended on others to be immunized so they couldn't spread potentially deadly diseases.\u003c/p>\n\u003cp>\"People often don't understand that their choices have an impact on others,\" he says. \"People take personal freedoms to such an extreme that they forget about the community.\"\u003c/p>\n\u003cp>These are the types of parental debates Dr. Matt Willis is navigating. He's the public health officer for Marin County. In some communities there, only half the kids are fully vaccinated.\u003c/p>\n\u003cp>His office is trying to figure out why. It did a survey and found a few common characteristics of today's parents who don't vaccinate.\u003c/p>\n\u003cp>\"A higher proportion are getting information from the Internet, and a higher number of the parents were seeing alternative medical providers,\" he says.\u003c/p>\n\u003cp>Willis has developed a list of talking points for each vaccine. He tells parents that there's no link between the measles vaccine and autism.\u003c/p>\n\u003cp>He says that polio is probably his toughest sell. The disease was eradicated from the United States in the late 1970s, so American parents today have no memory of how horrible the disease was. While the polio virus is not endemic to the U.S., he reminds parents that it still is in other parts of the world.\u003c/p>\n\u003cp>\"It's really just one plane ride away,\" he says.\u003c/p>\n\u003cp>Willis tell parents who want to delay some vaccines to think of them like a seat belt.\u003c/p>\n\u003cp>\"You could choose to put them in their safety belt as you leave your driveway and start driving, or you could choose to pull over 10 miles later and put it on,\" he says.\u003c/p>\n\u003cp>Willis is hoping California Gov. Jerry Brown will sign the bill prohibiting parents from opting out of vaccines for religious or personal beliefs. If passed, the law would take effect on Jan. 1, 2016.\u003c/p>\n\u003cp>\"It will certainly make my job a lot easier,\" he says, because controlling a disease outbreak is like fighting a fire. \"It's much easier to prevent a fire from happening in the first place than it is to try and extinguish it once it's spreading.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of a reporting partnership with NPR, KQED and Kaiser Health News.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California is on the brink of enacting a law that would require nearly all children to be vaccinated in order to attend school. While the bill has passed the Legislature, public health officials have had to grapple with a strong, vocal opposition along the way. (\u003cstrong>Update July 1\u003c/strong>: Gov. Jerry Brown yesterday \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">signed the bill into law\u003c/a>.)\u003c/p>\n\u003cp>There's actually a long history to the anti-vaccination movement.\u003c/p>\n\u003cp>\"From the moment the very first vaccine came on the scene, which was the smallpox vaccine, there has been resistance to vaccines and vaccination,\" says Elena Conis, a history professor at Emory University and author of Vaccine Nation: America's Changing Relationship with Immunization.\u003c/p>\n\u003cp>She says that the modern-day resistance movement shares its roots and rhetoric with the social movements of the 1960s and '70s, including feminism, environmentalism and consumer rights.\u003c/p>\n\u003cp>\"They encouraged people to question sources of authority, including doctors,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For example, women's advocates started to question medical advice on reproductive health and childbirth.\u003c/p>\n\u003cp>\"Women also start opting to increasingly use midwives, have births outside the hospital,\" she says, \"And also reject professional advice about formula feeding over breastfeeding.\"\u003c/p>\n\u003cp>Environmental activists were also encouraging people to think about chemical exposures, even in small amounts, at the same time that drug manufacturers started including package inserts listing drug ingredients.\u003c/p>\n\u003cp>Conis says that this is the context for the list of vaccine recommendations, which has grown longer over the last generation. It can be overwhelming for today's parents to watch their babies cry through one shot after another.\u003c/p>\n\u003cp>\"We started looking at the vaccine schedule and how intense and frequent these vaccines seem to come up,\" says George McCann, a general contractor and father of two daughters, who lives north of San Francisco. \"So we started talking about whether or not this seemed to be the best approach for our children.\"\u003c/p>\n\u003cp>He and his wife decided to have their girls get some vaccines, but not all. They skipped vaccines for pneumonia and chicken pox and waited on polio until the girls were older.\u003c/p>\n\u003cp>\"The whole issue for me comes down to the idea that somehow the state would get to mandate that all of us have to do something, as if we don't have the ability to look into this with compassion and intelligence and critical thinking on behalf of our children,\" he explains.\u003c/p>\n\u003cp>But Carl Krawitt asks that those who don't vaccinate or delay think about other peoples' children. His son couldn't get vaccinated for five years while he was being treated for leukemia. He depended on others to be immunized so they couldn't spread potentially deadly diseases.\u003c/p>\n\u003cp>\"People often don't understand that their choices have an impact on others,\" he says. \"People take personal freedoms to such an extreme that they forget about the community.\"\u003c/p>\n\u003cp>These are the types of parental debates Dr. Matt Willis is navigating. He's the public health officer for Marin County. In some communities there, only half the kids are fully vaccinated.\u003c/p>\n\u003cp>His office is trying to figure out why. It did a survey and found a few common characteristics of today's parents who don't vaccinate.\u003c/p>\n\u003cp>\"A higher proportion are getting information from the Internet, and a higher number of the parents were seeing alternative medical providers,\" he says.\u003c/p>\n\u003cp>Willis has developed a list of talking points for each vaccine. He tells parents that there's no link between the measles vaccine and autism.\u003c/p>\n\u003cp>He says that polio is probably his toughest sell. The disease was eradicated from the United States in the late 1970s, so American parents today have no memory of how horrible the disease was. While the polio virus is not endemic to the U.S., he reminds parents that it still is in other parts of the world.\u003c/p>\n\u003cp>\"It's really just one plane ride away,\" he says.\u003c/p>\n\u003cp>Willis tell parents who want to delay some vaccines to think of them like a seat belt.\u003c/p>\n\u003cp>\"You could choose to put them in their safety belt as you leave your driveway and start driving, or you could choose to pull over 10 miles later and put it on,\" he says.\u003c/p>\n\u003cp>Willis is hoping California Gov. Jerry Brown will sign the bill prohibiting parents from opting out of vaccines for religious or personal beliefs. If passed, the law would take effect on Jan. 1, 2016.\u003c/p>\n\u003cp>\"It will certainly make my job a lot easier,\" he says, because controlling a disease outbreak is like fighting a fire. \"It's much easier to prevent a fire from happening in the first place than it is to try and extinguish it once it's spreading.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of a reporting partnership with NPR, KQED and Kaiser Health News.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Vaccine Bill: Kids With Existing Personal Belief Exemptions Could Stay in School -- For a Time",
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"content": "\u003cp>SB277, the law passed by the Assembly today, contains language that would allow a certain amount of grandfathering for those who already have personal belief exemptions. To wit, unvaccinated kids can \u003cem>stay\u003c/em> unvaccinated and still remain in school until the next \"grade span,\" as long as their exemption is on file before Jan. 1, 2016. That means children cannot enter preschool, kindergarten or seventh grade without their shots, but can continue to go to school between those junctures.\u003c/p>\n\u003cp>So an unvaccinated child who is in kindergarten, for example, could avoid getting immunized for seven years, until she reaches seventh grade.\u003c/p>\n\u003cp>Jodi Hicks, with the California Academy of Family Physicians, a supporter of the bill, said that if you changed schools, you might also have to prove your child has been vaccinated, no matter which grade you were in.\u003c/p>\n\u003cp>Hicks said the grandfathering was included so schools could implement the new requirements \"with as little disruption as possible,\" retaining all the current \"checkpoints\" at which vaccinations are currently verified.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.mercurynews.com/science/ci_28115461/bill-restricting-vaccine-exemptions-overwhelmingly-passes-state-senate\" target=\"_blank\">Mercury News\u003c/a> had this to stay about this aspect of the bill after it passed the Senate in May:\u003c/p>\n\u003cblockquote>\u003cp>(P)erhaps the most significant compromise was the authors' pledge to \"grandfather in\" many public and private school students whose parents have claimed personal belief exemptions. That would mean that more than 13,000 children who have had no vaccinations by first grade won't have to get their shots until they enter seventh grade. And nearly 10,000 seventh-graders who today aren't fully vaccinated may be able to avoid future shots because the state does not always require them after that grade.\u003c/p>\n\u003cp>The move was aimed at mollifying hundreds of angry California parents who have staged rallies and jammed hearing rooms, citing their concerns over vaccine side effects and asserting their parental rights.\u003c/p>\n\u003cp>\"By scaling back the bill's reach, their chance of success becomes much greater,\" said Dan Schnur, director of the University of Southern California's Unruh Institute of Politics.\u003c/p>\u003c/blockquote>\n\u003cp>Because the bill was amended in the Assembly, it now goes back to the Senate for another vote before it can be sent to Gov. Jerry Brown. The governor has not said directly that he would sign the bill, but there have been indications that he is at least leaning that way.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Here's the exact language of the grandfathering section:\u003c/p>\n\u003cblockquote>\u003cp>A pupil who, prior to January 1, 2016, submitted a letter or affidavit on file at a private or public elementary or secondary school, child day care center, day nursery, nursery school, family day care home, or development center stating beliefs opposed to immunization shall be allowed enrollment to any private or public elementary or secondary school, child day care center, day nursery, nursery school, family day care home, or development center within the state until the pupil enrolls in the next grade span.\u003cbr>\n(2) For purposes of this subdivision, “grade span” means each of the following:\u003cbr>\n(A) Birth to preschool.\u003cbr>\n(B) Kindergarten and grades 1 to 6, inclusive, including transitional kindergarten.\u003cbr>\n(C) Grades 7 to 12, inclusive.\u003cbr>\n(3) Except as provided in this subdivision, on and after July 1, 2016, the governing authority shall not unconditionally admit to any of those institutions specified in this subdivision for the first time, or admit or advance any pupil to 7th grade level, unless the pupil has been immunized for his or her age as required by this section.\u003c/p>\u003c/blockquote>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SB277, the law passed by the Assembly today, contains language that would allow a certain amount of grandfathering for those who already have personal belief exemptions. To wit, unvaccinated kids can \u003cem>stay\u003c/em> unvaccinated and still remain in school until the next \"grade span,\" as long as their exemption is on file before Jan. 1, 2016. That means children cannot enter preschool, kindergarten or seventh grade without their shots, but can continue to go to school between those junctures.\u003c/p>\n\u003cp>So an unvaccinated child who is in kindergarten, for example, could avoid getting immunized for seven years, until she reaches seventh grade.\u003c/p>\n\u003cp>Jodi Hicks, with the California Academy of Family Physicians, a supporter of the bill, said that if you changed schools, you might also have to prove your child has been vaccinated, no matter which grade you were in.\u003c/p>\n\u003cp>Hicks said the grandfathering was included so schools could implement the new requirements \"with as little disruption as possible,\" retaining all the current \"checkpoints\" at which vaccinations are currently verified.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.mercurynews.com/science/ci_28115461/bill-restricting-vaccine-exemptions-overwhelmingly-passes-state-senate\" target=\"_blank\">Mercury News\u003c/a> had this to stay about this aspect of the bill after it passed the Senate in May:\u003c/p>\n\u003cblockquote>\u003cp>(P)erhaps the most significant compromise was the authors' pledge to \"grandfather in\" many public and private school students whose parents have claimed personal belief exemptions. That would mean that more than 13,000 children who have had no vaccinations by first grade won't have to get their shots until they enter seventh grade. And nearly 10,000 seventh-graders who today aren't fully vaccinated may be able to avoid future shots because the state does not always require them after that grade.\u003c/p>\n\u003cp>The move was aimed at mollifying hundreds of angry California parents who have staged rallies and jammed hearing rooms, citing their concerns over vaccine side effects and asserting their parental rights.\u003c/p>\n\u003cp>\"By scaling back the bill's reach, their chance of success becomes much greater,\" said Dan Schnur, director of the University of Southern California's Unruh Institute of Politics.\u003c/p>\u003c/blockquote>\n\u003cp>Because the bill was amended in the Assembly, it now goes back to the Senate for another vote before it can be sent to Gov. Jerry Brown. The governor has not said directly that he would sign the bill, but there have been indications that he is at least leaning that way.\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>Here's the exact language of the grandfathering section:\u003c/p>\n\u003cblockquote>\u003cp>A pupil who, prior to January 1, 2016, submitted a letter or affidavit on file at a private or public elementary or secondary school, child day care center, day nursery, nursery school, family day care home, or development center stating beliefs opposed to immunization shall be allowed enrollment to any private or public elementary or secondary school, child day care center, day nursery, nursery school, family day care home, or development center within the state until the pupil enrolls in the next grade span.\u003cbr>\n(2) For purposes of this subdivision, “grade span” means each of the following:\u003cbr>\n(A) Birth to preschool.\u003cbr>\n(B) Kindergarten and grades 1 to 6, inclusive, including transitional kindergarten.\u003cbr>\n(C) Grades 7 to 12, inclusive.\u003cbr>\n(3) Except as provided in this subdivision, on and after July 1, 2016, the governing authority shall not unconditionally admit to any of those institutions specified in this subdivision for the first time, or admit or advance any pupil to 7th grade level, unless the pupil has been immunized for his or her age as required by this section.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Assembly Votes to End Personal Belief Exemption for Vaccines",
"title": "California Assembly Votes to End Personal Belief Exemption for Vaccines",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>The state Assembly Thursday voted 46-30 to end California's personal belief exemption for vaccinating schoolchildren. The bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a>, now goes back to the Senate for a vote before it can be sent to the governor.\u003c/p>\n\u003cp>[contextly_sidebar id=\"1N1Ev5qBIHvvj01FW48IuCB9JdgyA2WC\"]The law would allows kids with existing personal belief exemptions to continue in school until their next \"grade span.\" That means those families can still rely on their exemptions until either entering preschool, kindergarten or seventh grade. Medical exemptions would also still be allowed.\u003c/p>\n\u003cp>The law, if signed, would go into effect Jan. 1, 2016. Starting July 1, 2016, students would need vaccinations to attend school.\u003c/p>\n\u003cp>Gov. Jerry Brown has not taken a position on the bill, but as noted on \u003ca href=\"http://ww2.kqed.org/news/2015/06/19/california-budget-deal-explained-kqed-politics-podcast/\" target=\"_blank\">KQED’s California Politics Podcast last week\u003c/a>, some Capitol observers think the fact that his cabinet secretary, Dana Williamson, testified in support of SB277 at the Assembly’s Health Committee hearing was an indication of which way the wind is blowing, even though Williamson emphasized she was speaking on her own behalf.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/health-shots/2015/06/25/417489013/california-law-to-curtail-vaccine-exemptions-clears-hurdle\" target=\"_blank\">NPR is reporting\u003c/a> that a spokesman for Brown said via email that the governor \"believes that vaccinations are profoundly important and a major public health benefit and any bill that reaches his desk will be closely considered.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One option for those opposing the bill, if it's signed, would be to try to undo it through a referendum. But that's easier said than done ...\u003c/p>\n\u003cp>https://twitter.com/johnmyers/status/614134251777339392\u003c/p>\n\u003cp>State Sen. Richard Pan (D-Sacramento), a physician and co-author of the bill, lauded its passage. \"Many of my colleagues have been under a lot of pressure because of the vociferousness of the opposition,\" he told KQED's April Dembosky. \"But when you look at the science and the facts, it's very clear this bill is what we need to do to make sure we protect our communities, protect our children from communicable disease.\"\u003c/p>\n\u003cp>The debate over the bill became a major battleground in the ongoing conflict between those who urge everyone to get vaccinated -- a group that includes the scientific and medical community -- and those who think the decision should remain personal. Many in that category believe vaccines are responsible for the rising autism rate, a proposition that has never been proved but remains an article of faith among some in the anti-vaccine movement.\u003c/p>\n\u003cp>The legislation gained steam in the wake of the measles outbreak that started in Disneyland last December and spread to at least half a dozen additional states. A total of \u003ca href=\"http://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\">117 cases\u003c/a> were associated with the outbreak, which was declared over on April 17 of this year.\u003c/p>\n\u003cp>Ninety percent of parents in California vaccinate their children, but there are pockets in the state where the rate of opting out is high. Marin County, for example, has the \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">highest rate of personal belief exemptions in the Bay Area\u003c/a> and among the highest in the state. Last school year, 6.45 percent of Marin’s kindergartners went unvaccinated by invoking it.\u003c/p>\n\u003cp>One Marin family who had no choice but to leave their child unvaccinated during the measles scare is the Krawitts. Their 6-year-old son, Rhett, was in remission from leukemia, but his immune system was still too weak to tolerate vaccination; he had to rely on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>, a state of protection for even unvaccinated individuals resulting from immunization by enough of the surrounding population. After Carl Krawitt spoke out against those who voluntarily opt out of vaccination, Rhett became a sort of poster child for people with compromised immune systems put at greater risk from a decrease in the vaccination rate.\u003c/p>\n\u003cp>Yesterday in Sacramento, Rhett \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/23/boy-leukemia-patient-weighs-in-as-vote-on-vaccine-bill-nears/\" target=\"_blank\">delivered a petition to the governor\u003c/a>, with more than 32,000 signatures, in support of SB277.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>April Dembosky and Lisa Aliferis contributed to this post.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state Assembly Thursday voted 46-30 to end California's personal belief exemption for vaccinating schoolchildren. The bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a>, now goes back to the Senate for a vote before it can be sent to the governor.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The law would allows kids with existing personal belief exemptions to continue in school until their next \"grade span.\" That means those families can still rely on their exemptions until either entering preschool, kindergarten or seventh grade. Medical exemptions would also still be allowed.\u003c/p>\n\u003cp>The law, if signed, would go into effect Jan. 1, 2016. Starting July 1, 2016, students would need vaccinations to attend school.\u003c/p>\n\u003cp>Gov. Jerry Brown has not taken a position on the bill, but as noted on \u003ca href=\"http://ww2.kqed.org/news/2015/06/19/california-budget-deal-explained-kqed-politics-podcast/\" target=\"_blank\">KQED’s California Politics Podcast last week\u003c/a>, some Capitol observers think the fact that his cabinet secretary, Dana Williamson, testified in support of SB277 at the Assembly’s Health Committee hearing was an indication of which way the wind is blowing, even though Williamson emphasized she was speaking on her own behalf.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/health-shots/2015/06/25/417489013/california-law-to-curtail-vaccine-exemptions-clears-hurdle\" target=\"_blank\">NPR is reporting\u003c/a> that a spokesman for Brown said via email that the governor \"believes that vaccinations are profoundly important and a major public health benefit and any bill that reaches his desk will be closely considered.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One option for those opposing the bill, if it's signed, would be to try to undo it through a referendum. But that's easier said than done ...\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>State Sen. Richard Pan (D-Sacramento), a physician and co-author of the bill, lauded its passage. \"Many of my colleagues have been under a lot of pressure because of the vociferousness of the opposition,\" he told KQED's April Dembosky. \"But when you look at the science and the facts, it's very clear this bill is what we need to do to make sure we protect our communities, protect our children from communicable disease.\"\u003c/p>\n\u003cp>The debate over the bill became a major battleground in the ongoing conflict between those who urge everyone to get vaccinated -- a group that includes the scientific and medical community -- and those who think the decision should remain personal. Many in that category believe vaccines are responsible for the rising autism rate, a proposition that has never been proved but remains an article of faith among some in the anti-vaccine movement.\u003c/p>\n\u003cp>The legislation gained steam in the wake of the measles outbreak that started in Disneyland last December and spread to at least half a dozen additional states. A total of \u003ca href=\"http://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\">117 cases\u003c/a> were associated with the outbreak, which was declared over on April 17 of this year.\u003c/p>\n\u003cp>Ninety percent of parents in California vaccinate their children, but there are pockets in the state where the rate of opting out is high. Marin County, for example, has the \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">highest rate of personal belief exemptions in the Bay Area\u003c/a> and among the highest in the state. Last school year, 6.45 percent of Marin’s kindergartners went unvaccinated by invoking it.\u003c/p>\n\u003cp>One Marin family who had no choice but to leave their child unvaccinated during the measles scare is the Krawitts. Their 6-year-old son, Rhett, was in remission from leukemia, but his immune system was still too weak to tolerate vaccination; he had to rely on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>, a state of protection for even unvaccinated individuals resulting from immunization by enough of the surrounding population. After Carl Krawitt spoke out against those who voluntarily opt out of vaccination, Rhett became a sort of poster child for people with compromised immune systems put at greater risk from a decrease in the vaccination rate.\u003c/p>\n\u003cp>Yesterday in Sacramento, Rhett \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/23/boy-leukemia-patient-weighs-in-as-vote-on-vaccine-bill-nears/\" target=\"_blank\">delivered a petition to the governor\u003c/a>, with more than 32,000 signatures, in support of SB277.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>April Dembosky and Lisa Aliferis contributed to this post.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Why get tested for HIV? Here's what amfAR, The Foundation for AIDS Research, has to say:\u003c/p>\n\u003cblockquote>\u003cp>Early diagnosis is crucial in preventing life-threatening health conditions and combating the spread of HIV. Knowing your status will allow you to take steps to protect your health and the health of others. If you know you are HIV-positive and pregnant, you can take medications and other precautions -— such as refraining from breast-feeding -- to significantly reduce the risk of infecting your child.\u003c/p>\u003c/blockquote>\n\u003cp>So if you've been putting off getting an HIV test, now's the time. June 27 is National HIV Testing Day, but you don't have to wait until then to get going.\u003c/p>\n\u003cp>AIDS.gov has a \u003ca href=\"https://locator.aids.gov/\" target=\"_blank\">\u003cstrong>locator tool\u003c/strong>\u003c/a> to find testing sites near you, and Walgreens, in partnership with \u003ca href=\"http://www.greaterthan.org/\" target=\"_blank\">Greater Than AIDS\u003c/a>, is providing free testing at select store locations around the country. Show up at the following times:\u003c/p>\n\u003cul>\n\u003cli>Thursday, June 25, from 3 p.m. to 7 p.m.\u003c/li>\n\u003cli>Friday, June 26, from 3 p.m. to 7 p.m.\u003c/li>\n\u003cli>Saturday, June 27, from 10 a.m. to 2 p.m.\u003c/li>\n\u003c/ul>\n\u003cp>You can find the Walgreens testing sites using \u003ca href=\"http://www.greaterthan.org/get-tested-with-walgreens-and-greater-than-aids/\" target=\"_blank\">this map\u003c/a> or on \u003ca href=\"http://www.greaterthan.org/wp-content/uploads/2015/06/2015_0617_-Content-for-PDF-of-Walgreens-Locations-for-GTA-Website-_-FORMATTED.pdf\" target=\"_blank\">this list\u003c/a>, arranged by state. There are 23 locations in California, including nine in the Los Angeles area and eight in the San Francisco Bay Area. (And if you happen to live in Contra Costa County, the county is providing \u003ca href=\"http://cchealth.org/press-releases/2015/0619-HIV-Testing-Day.php\" target=\"_blank\">free testing on Friday in Richmond\u003c/a>.)\u003c/p>\n\u003cp>You can check out amfAR's \u003ca href=\"http://www.amfar.org/about-hiv-and-aids/hiv-testing/a-practical-guide-to-getting-tested-for-hiv/\" target=\"_blank\">A Practical Guide to Getting Tested for HIV\u003c/a> here.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Why get tested for HIV? Here's what amfAR, The Foundation for AIDS Research, has to say:\u003c/p>\n\u003cblockquote>\u003cp>Early diagnosis is crucial in preventing life-threatening health conditions and combating the spread of HIV. Knowing your status will allow you to take steps to protect your health and the health of others. If you know you are HIV-positive and pregnant, you can take medications and other precautions -— such as refraining from breast-feeding -- to significantly reduce the risk of infecting your child.\u003c/p>\u003c/blockquote>\n\u003cp>So if you've been putting off getting an HIV test, now's the time. June 27 is National HIV Testing Day, but you don't have to wait until then to get going.\u003c/p>\n\u003cp>AIDS.gov has a \u003ca href=\"https://locator.aids.gov/\" target=\"_blank\">\u003cstrong>locator tool\u003c/strong>\u003c/a> to find testing sites near you, and Walgreens, in partnership with \u003ca href=\"http://www.greaterthan.org/\" target=\"_blank\">Greater Than AIDS\u003c/a>, is providing free testing at select store locations around the country. Show up at the following times:\u003c/p>\n\u003cul>\n\u003cli>Thursday, June 25, from 3 p.m. to 7 p.m.\u003c/li>\n\u003cli>Friday, June 26, from 3 p.m. to 7 p.m.\u003c/li>\n\u003cli>Saturday, June 27, from 10 a.m. to 2 p.m.\u003c/li>\n\u003c/ul>\n\u003cp>You can find the Walgreens testing sites using \u003ca href=\"http://www.greaterthan.org/get-tested-with-walgreens-and-greater-than-aids/\" target=\"_blank\">this map\u003c/a> or on \u003ca href=\"http://www.greaterthan.org/wp-content/uploads/2015/06/2015_0617_-Content-for-PDF-of-Walgreens-Locations-for-GTA-Website-_-FORMATTED.pdf\" target=\"_blank\">this list\u003c/a>, arranged by state. There are 23 locations in California, including nine in the Los Angeles area and eight in the San Francisco Bay Area. (And if you happen to live in Contra Costa County, the county is providing \u003ca href=\"http://cchealth.org/press-releases/2015/0619-HIV-Testing-Day.php\" target=\"_blank\">free testing on Friday in Richmond\u003c/a>.)\u003c/p>\n\u003cp>You can check out amfAR's \u003ca href=\"http://www.amfar.org/about-hiv-and-aids/hiv-testing/a-practical-guide-to-getting-tested-for-hiv/\" target=\"_blank\">A Practical Guide to Getting Tested for HIV\u003c/a> here.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Medical Marijuana Often Less Potent Than Advertised, Ineffective for Many Conditions",
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"content": "\u003cp>People who buy medical marijuana products might not be getting what they paid for, a study finds. And evidence remains elusive on benefits for most medical conditions, even though almost half the states have \u003ca href=\"http://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq/#link/_80\">legalized\u003c/a> medical marijuana.\u003c/p>\n\u003cp>The majority of edible cannabis products sold for medicinal purposes have labels that do not accurately reflect the amount of delta-9-tetrahydrocannabinol, THC for short, infused in them. THC is the component that's responsible for the marijuana high. But it's also known as \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a607054.html\">dronabinol\u003c/a>, a prescribed medication used to treat nausea and vomiting caused by chemotherapy.\u003c/p>\n\u003caside class=\"pullquote alignright\">The rush to legalize medical marijuana tends to obscure the fact that it's not clear if medical marijuana has any therapeutic benefits at all.\u003c/aside>\n\u003cp>THC and cannabidiol (CBD), another chemical component of cannabis, are believed to be primarily responsible for therapeutic benefits, especially when the THC: CBD ratio is close to 1:1, according to the study.\u003c/p>\n\u003cp>Of 75 products legally purchased in three cities, only 17 percent were correctly labeled, according to the \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2338239\">report\u003c/a>, which was published Tuesday in \u003cem>JAMA\u003c/em>, the American Medical Association's journal. Accuracy for labeling was defined as the product having THC content within 10 percent of what's printed on the label.\u003c/p>\n\u003cp>Twenty-three percent were under-labeled, meaning there's more THC than advertised. Sixty percent were over-labeled, where customers were not getting the bang for their buck.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"A couple of products were supposed to contain 100 milligrams of THC but had only two to three [milligrams],\" says lead author \u003ca href=\"http://www.hopkinsmedicine.org/profiles/results/directory/profile/0656049/ryan-vandrey\">Ryan Vandrey\u003c/a>, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University. \"That was striking -- these were not cheap products and were being sold as medicine.\"\u003c/p>\n\u003cp>Currently, 23 states and Washington, D.C., have \u003ca href=\"https://www.mpp.org/states/\">laws\u003c/a> legalizing marijuana for medical purposes. Four states and D.C. allow legal recreational use of cannabis. Some laws are broader than others, and qualifications for medical marijuana vary as well.\u003c/p>\n\u003cp>The rush to legalize medical marijuana tends to obscure the fact that it's not clear if medical marijuana has any therapeutic benefits at all. A \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2338251\">review\u003c/a> of studies on the topic, also published in Tuesday's \u003cem>JAMA\u003c/em>, found \"moderate\" evidence that cannabinoids help with chronic pain and spasticity. But the researchers found little evidence that they help with nausea and vomiting due to chemotherapy, weight gain in people with HIV, sleep disorders and Tourette syndrome. About one third of people in the studies reported side effects ranging from probably OK (euphoria) to distressing (vomiting, dizziness, hallucinations.)\u003c/p>\n\u003cp>Does this mean all the cannabis-infused tea that you've been drinking doesn't help your anxiety disorder at all? It's really impossible to say. There's just not enough scientific evidence to prove that it does work, or to tell us how much THC is needed to treat a certain condition.\u003c/p>\n\u003cp>For the people who are using medical marijuana to treat illnesses, the population affected by mislabeling is not small: An estimated 16 to 23 percent of medical cannabis patients consume edible products, according to the Vandrey study. Losing out on potential benefits is one thing, but potential overdosing poses a much bigger threat, especially when it comes to edibles. Undesirable \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/000952.htm\">side effects\u003c/a> such as decreased short-term memory, panic, paranoia and even acute psychosis are possible, and the risk increases with higher dosages.\u003c/p>\n\u003cp>In the natural cannabis plant there is a ceiling amount of THC, but edibles can contain much more. A pot-infused brownie with over 1,200 milligrams of THC can look the same as the brownie with only 50 milligrams of THC.\u003c/p>\n\u003cp>Marijuana product testing, as Shots has \u003ca href=\"http://www.npr.org/sections/health-shots/2015/03/24/395065699/quality-testing-legal-marijuana-strong-but-not-always-clean\">previously reported\u003c/a>, is a fairly new phenomenon. Oversight and regulations for testing medicinal cannabis \u003ca href=\"https://www.mpp.org/states/\">vary \u003c/a>from state to state.\u003c/p>\n\u003cp>Colorado \u003ca href=\"http://www.denverpost.com/news/ci_25680313/colorado-begins-mandatory-testing-edible-marijuana-potency\">mandated\u003c/a> potency testing for marijuana edibles last May, but the rule applies only to edibles for recreational purposes.\u003c/p>\n\u003cp>As a result, labels for recreational marijuana are getting better at accurately stating THC content, according to Ian Barringer, owner of \u003ca href=\"http://www.rm3.us/science.html#research\">RM3 Labs\u003c/a> in Denver, Colo. Products for both medicinal and recreational uses came in much weaker than labeled in earlier years, Barringer says, but most of the products the lab tests now fall within the acceptable range of 20 percent plus or minus the labeled THC content displayed on the label.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And starting in July 2016, Colorado will require independent testing and certification for medical marijuana and infused products containing medical marijuana, according to a \u003ca href=\"http://www.statebillinfo.com/bills/bills/15/260_enr.pdf\">bill\u003c/a> approved and \u003ca href=\"https://www.colorado.gov/pacific/governor/news/gov-hickenlooper-signs-several-bills-law-18\">signed\u003c/a> by Gov. John Hickenlooper on May 29. The state of Washington \u003ca href=\"http://www.doh.wa.gov/YouandYourFamily/Marijuana/MedicalMarijuana\">followed\u003c/a> suit, requiring testing for THC and CBD levels, accurate labels and child-resistant packaging specifically for medical marijuana.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Medical+Marijuana+Is+Often+Less+Potent+Than+Advertised&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People who buy medical marijuana products might not be getting what they paid for, a study finds. And evidence remains elusive on benefits for most medical conditions, even though almost half the states have \u003ca href=\"http://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq/#link/_80\">legalized\u003c/a> medical marijuana.\u003c/p>\n\u003cp>The majority of edible cannabis products sold for medicinal purposes have labels that do not accurately reflect the amount of delta-9-tetrahydrocannabinol, THC for short, infused in them. THC is the component that's responsible for the marijuana high. But it's also known as \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a607054.html\">dronabinol\u003c/a>, a prescribed medication used to treat nausea and vomiting caused by chemotherapy.\u003c/p>\n\u003caside class=\"pullquote alignright\">The rush to legalize medical marijuana tends to obscure the fact that it's not clear if medical marijuana has any therapeutic benefits at all.\u003c/aside>\n\u003cp>THC and cannabidiol (CBD), another chemical component of cannabis, are believed to be primarily responsible for therapeutic benefits, especially when the THC: CBD ratio is close to 1:1, according to the study.\u003c/p>\n\u003cp>Of 75 products legally purchased in three cities, only 17 percent were correctly labeled, according to the \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2338239\">report\u003c/a>, which was published Tuesday in \u003cem>JAMA\u003c/em>, the American Medical Association's journal. Accuracy for labeling was defined as the product having THC content within 10 percent of what's printed on the label.\u003c/p>\n\u003cp>Twenty-three percent were under-labeled, meaning there's more THC than advertised. Sixty percent were over-labeled, where customers were not getting the bang for their buck.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A couple of products were supposed to contain 100 milligrams of THC but had only two to three [milligrams],\" says lead author \u003ca href=\"http://www.hopkinsmedicine.org/profiles/results/directory/profile/0656049/ryan-vandrey\">Ryan Vandrey\u003c/a>, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University. \"That was striking -- these were not cheap products and were being sold as medicine.\"\u003c/p>\n\u003cp>Currently, 23 states and Washington, D.C., have \u003ca href=\"https://www.mpp.org/states/\">laws\u003c/a> legalizing marijuana for medical purposes. Four states and D.C. allow legal recreational use of cannabis. Some laws are broader than others, and qualifications for medical marijuana vary as well.\u003c/p>\n\u003cp>The rush to legalize medical marijuana tends to obscure the fact that it's not clear if medical marijuana has any therapeutic benefits at all. A \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2338251\">review\u003c/a> of studies on the topic, also published in Tuesday's \u003cem>JAMA\u003c/em>, found \"moderate\" evidence that cannabinoids help with chronic pain and spasticity. But the researchers found little evidence that they help with nausea and vomiting due to chemotherapy, weight gain in people with HIV, sleep disorders and Tourette syndrome. About one third of people in the studies reported side effects ranging from probably OK (euphoria) to distressing (vomiting, dizziness, hallucinations.)\u003c/p>\n\u003cp>Does this mean all the cannabis-infused tea that you've been drinking doesn't help your anxiety disorder at all? It's really impossible to say. There's just not enough scientific evidence to prove that it does work, or to tell us how much THC is needed to treat a certain condition.\u003c/p>\n\u003cp>For the people who are using medical marijuana to treat illnesses, the population affected by mislabeling is not small: An estimated 16 to 23 percent of medical cannabis patients consume edible products, according to the Vandrey study. Losing out on potential benefits is one thing, but potential overdosing poses a much bigger threat, especially when it comes to edibles. Undesirable \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/000952.htm\">side effects\u003c/a> such as decreased short-term memory, panic, paranoia and even acute psychosis are possible, and the risk increases with higher dosages.\u003c/p>\n\u003cp>In the natural cannabis plant there is a ceiling amount of THC, but edibles can contain much more. A pot-infused brownie with over 1,200 milligrams of THC can look the same as the brownie with only 50 milligrams of THC.\u003c/p>\n\u003cp>Marijuana product testing, as Shots has \u003ca href=\"http://www.npr.org/sections/health-shots/2015/03/24/395065699/quality-testing-legal-marijuana-strong-but-not-always-clean\">previously reported\u003c/a>, is a fairly new phenomenon. Oversight and regulations for testing medicinal cannabis \u003ca href=\"https://www.mpp.org/states/\">vary \u003c/a>from state to state.\u003c/p>\n\u003cp>Colorado \u003ca href=\"http://www.denverpost.com/news/ci_25680313/colorado-begins-mandatory-testing-edible-marijuana-potency\">mandated\u003c/a> potency testing for marijuana edibles last May, but the rule applies only to edibles for recreational purposes.\u003c/p>\n\u003cp>As a result, labels for recreational marijuana are getting better at accurately stating THC content, according to Ian Barringer, owner of \u003ca href=\"http://www.rm3.us/science.html#research\">RM3 Labs\u003c/a> in Denver, Colo. Products for both medicinal and recreational uses came in much weaker than labeled in earlier years, Barringer says, but most of the products the lab tests now fall within the acceptable range of 20 percent plus or minus the labeled THC content displayed on the label.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And starting in July 2016, Colorado will require independent testing and certification for medical marijuana and infused products containing medical marijuana, according to a \u003ca href=\"http://www.statebillinfo.com/bills/bills/15/260_enr.pdf\">bill\u003c/a> approved and \u003ca href=\"https://www.colorado.gov/pacific/governor/news/gov-hickenlooper-signs-several-bills-law-18\">signed\u003c/a> by Gov. John Hickenlooper on May 29. The state of Washington \u003ca href=\"http://www.doh.wa.gov/YouandYourFamily/Marijuana/MedicalMarijuana\">followed\u003c/a> suit, requiring testing for THC and CBD levels, accurate labels and child-resistant packaging specifically for medical marijuana.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Medical+Marijuana+Is+Often+Less+Potent+Than+Advertised&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"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. ",
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"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. ",
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"marketplace": {
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"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",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
"id": "snap-judgment",
"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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},
"soldout": {
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