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"content": "\u003cfigure id=\"attachment_18618\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro1-e1397066807510.jpg\">\u003cimg class=\"size-large wp-image-18618\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro1-640x480.jpg\" alt=\"Neurosurgeon Katherine Ko stands next to her painting "Craniotomy in G Sharp," a depiction of her drilling a skull in preparation for brain surgery. "It's kind of a self portrait," she says. (April Dembosky/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Neurosurgeon Kathryn Ko stands next to her painting \"Craniotomy in G Sharp,\" a depiction of her drilling a skull in preparation for brain surgery. \"It's kind of a self portrait,\" she says. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>SAN FRANCISCO -- Most of the Moscone Center exhibit hall is full of looming medical machines: brain scanners and brain mappers. Men in suits wait for the wandering neurosurgeon to pass by so they can pounce with their pitch for the latest, greatest technology that will change brain surgery forever.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Patterns repeat themselves over and over in nature. We see that in our work and in anatomy.” \u003c/aside>\n\u003cp>But back at exhibit booth 630, it’s a different scene. An art show. Paintings and photographs depict abstract interpretations by neurosurgeons of their work, portraits of neurosurgery patients and natural landscapes that offer a striking resemblance to the human brain.\u003c/p>\n\u003cp>“Music, art, the visual, the senses -- matches and melds with medicine,” says Dr. Kathryn Ko, a neurosurgeon from New York who curated the show. “We like to see that left brain, right brain cross over. It’s a respite where you don’t have to concentrate. You can just let your eyes roam.”\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/147635003&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\">\u003c/iframe>\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>The theme of this year’s American Association of Neurological Surgeons annual conference is “Expanding Neurosurgery” and Ko wanted to expand beyond the scientific. Throughout the exhibit space, she hung sheets of music from Modest Mussorgsky’s \"Pictures at an Exhibition.\" It was an insightful choice for a neurosurgeon. The composer wrote the piano suite after a dear friend died of a brain aneurysm, and he based the work on his experience walking through an exhibit of the friend’s drawings.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ko played on the theme further, creating installations that overlaid surgical instruments on the sheet music. She dropped medical supplies into her own paintings.\u003c/p>\n\u003cfigure id=\"attachment_18619\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro2-e1397066869933.jpg\">\u003cimg class=\"size-medium wp-image-18619 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro2-300x225.jpg\" alt=\"(April Dembosky/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The photographer-neurosurgeon who took this picture at Yellowstone National Park says it reminded her of the surface of the brain. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“One of my pieces is called 'Craniotomy in G sharp,'” she says, pointing to a canvas that closes in on a surgeon's hands opening a skull. “It’s because the drill that we use to open the brain, when it’s properly working, emits the sound that is G sharp. And because I have perfect pitch I can tell whether or not the nurses have turned the drill on properly.”\u003c/p>\n\u003cp>Another piece, displayed on a music stand, uses white and red gauze to create an impression of a needle holder, a tool used to suture skin after surgery.\u003c/p>\n\u003cp>“The needle has a little bit of glitter on it so it catches your eye as you walk by,” she says.\u003c/p>\n\u003cp>For Shelly Timmons, a trauma neurosurgeon from Pennsylvania, she sees her work in nature. She displayed two photographs she took of geysers in Yellowstone National Park.\u003c/p>\n\u003cp>“Patterns repeat themselves over and over in nature,” she says. “We see that in our work and in anatomy.”\u003c/p>\n\u003cp>One photo shows a flat sandy rock flanked by blue and clear water.\u003c/p>\n\u003cp>“This particular piece reminds me a lot of the surface of the brain,” she says. “There’s a structure in the brain called the choroid plexus, which produces spinal fluid. This piece reminds me of that, and it’s surrounded by fluid so it’s sort of thematic.”\u003c/p>\n\u003cfigure id=\"attachment_18620\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro3-e1397066910486.jpg\">\u003cimg class=\"size-medium wp-image-18620\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro3-300x252.jpg\" alt=\"A neurosurgeon's portrait of a mother and child in Mombasa, Kenya. The child was treated for hydrocephalus, a condition where spinal fluid builds up in the brain. (April Dembosky/KQED)\" width=\"300\" height=\"252\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A neurosurgeon's portrait of a mother and child in Mombasa, Kenya. The child was treated for hydrocephalus, a condition where spinal fluid builds up in the brain. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>The human side of neurosurgery comes through as well. Dr. Bob Dempsey, a professor of neurosurgery at the University of Wisconsin, displayed a portrait of a woman he took while working in Africa. She is dressed in a colorful wrap, gazing down at her child.\u003c/p>\n\u003cp>“I call this the face of hydrocephalus,” he says. “Hydrocephalus is a condition where spinal fluid in the central nervous system builds up in the brain, causing pressure. It ends in mental retardation, paralysis or death. It’s a very endemic problem in the developing world.”\u003c/p>\n\u003cp>It is reversible, though, and after he treated this woman’s child, he asked if he could take her picture.\u003c/p>\n\u003cp>“The compositor was hers, just the way she cared for the child, and all I did was try to capture that,” he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"lk38Ol9MQrIXsEdWRDQRORc9nG8qMnco\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18618\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro1-e1397066807510.jpg\">\u003cimg class=\"size-large wp-image-18618\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro1-640x480.jpg\" alt=\"Neurosurgeon Katherine Ko stands next to her painting "Craniotomy in G Sharp," a depiction of her drilling a skull in preparation for brain surgery. "It's kind of a self portrait," she says. (April Dembosky/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Neurosurgeon Kathryn Ko stands next to her painting \"Craniotomy in G Sharp,\" a depiction of her drilling a skull in preparation for brain surgery. \"It's kind of a self portrait,\" she says. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>SAN FRANCISCO -- Most of the Moscone Center exhibit hall is full of looming medical machines: brain scanners and brain mappers. Men in suits wait for the wandering neurosurgeon to pass by so they can pounce with their pitch for the latest, greatest technology that will change brain surgery forever.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Patterns repeat themselves over and over in nature. We see that in our work and in anatomy.” \u003c/aside>\n\u003cp>But back at exhibit booth 630, it’s a different scene. An art show. Paintings and photographs depict abstract interpretations by neurosurgeons of their work, portraits of neurosurgery patients and natural landscapes that offer a striking resemblance to the human brain.\u003c/p>\n\u003cp>“Music, art, the visual, the senses -- matches and melds with medicine,” says Dr. Kathryn Ko, a neurosurgeon from New York who curated the show. “We like to see that left brain, right brain cross over. It’s a respite where you don’t have to concentrate. You can just let your eyes roam.”\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/147635003&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\">\u003c/iframe>\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>The theme of this year’s American Association of Neurological Surgeons annual conference is “Expanding Neurosurgery” and Ko wanted to expand beyond the scientific. Throughout the exhibit space, she hung sheets of music from Modest Mussorgsky’s \"Pictures at an Exhibition.\" It was an insightful choice for a neurosurgeon. The composer wrote the piano suite after a dear friend died of a brain aneurysm, and he based the work on his experience walking through an exhibit of the friend’s drawings.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ko played on the theme further, creating installations that overlaid surgical instruments on the sheet music. She dropped medical supplies into her own paintings.\u003c/p>\n\u003cfigure id=\"attachment_18619\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro2-e1397066869933.jpg\">\u003cimg class=\"size-medium wp-image-18619 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro2-300x225.jpg\" alt=\"(April Dembosky/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The photographer-neurosurgeon who took this picture at Yellowstone National Park says it reminded her of the surface of the brain. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“One of my pieces is called 'Craniotomy in G sharp,'” she says, pointing to a canvas that closes in on a surgeon's hands opening a skull. “It’s because the drill that we use to open the brain, when it’s properly working, emits the sound that is G sharp. And because I have perfect pitch I can tell whether or not the nurses have turned the drill on properly.”\u003c/p>\n\u003cp>Another piece, displayed on a music stand, uses white and red gauze to create an impression of a needle holder, a tool used to suture skin after surgery.\u003c/p>\n\u003cp>“The needle has a little bit of glitter on it so it catches your eye as you walk by,” she says.\u003c/p>\n\u003cp>For Shelly Timmons, a trauma neurosurgeon from Pennsylvania, she sees her work in nature. She displayed two photographs she took of geysers in Yellowstone National Park.\u003c/p>\n\u003cp>“Patterns repeat themselves over and over in nature,” she says. “We see that in our work and in anatomy.”\u003c/p>\n\u003cp>One photo shows a flat sandy rock flanked by blue and clear water.\u003c/p>\n\u003cp>“This particular piece reminds me a lot of the surface of the brain,” she says. “There’s a structure in the brain called the choroid plexus, which produces spinal fluid. This piece reminds me of that, and it’s surrounded by fluid so it’s sort of thematic.”\u003c/p>\n\u003cfigure id=\"attachment_18620\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro3-e1397066910486.jpg\">\u003cimg class=\"size-medium wp-image-18620\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Neuro3-300x252.jpg\" alt=\"A neurosurgeon's portrait of a mother and child in Mombasa, Kenya. The child was treated for hydrocephalus, a condition where spinal fluid builds up in the brain. (April Dembosky/KQED)\" width=\"300\" height=\"252\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A neurosurgeon's portrait of a mother and child in Mombasa, Kenya. The child was treated for hydrocephalus, a condition where spinal fluid builds up in the brain. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>The human side of neurosurgery comes through as well. Dr. Bob Dempsey, a professor of neurosurgery at the University of Wisconsin, displayed a portrait of a woman he took while working in Africa. She is dressed in a colorful wrap, gazing down at her child.\u003c/p>\n\u003cp>“I call this the face of hydrocephalus,” he says. “Hydrocephalus is a condition where spinal fluid in the central nervous system builds up in the brain, causing pressure. It ends in mental retardation, paralysis or death. It’s a very endemic problem in the developing world.”\u003c/p>\n\u003cp>It is reversible, though, and after he treated this woman’s child, he asked if he could take her picture.\u003c/p>\n\u003cp>“The compositor was hers, just the way she cared for the child, and all I did was try to capture that,” he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"lk38Ol9MQrIXsEdWRDQRORc9nG8qMnco\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "School Nurses on Front Lines to Raise Vaccine Rates",
"title": "School Nurses on Front Lines to Raise Vaccine Rates",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18566\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/SchoolnurseGrassVallNo2March2014JA.jpg\">\u003cimg class=\"size-large wp-image-18566 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/SchoolnurseGrassVallNo2March2014JA-640x426.jpg\" alt=\"(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Robyn Ettl, Grass Valley Unified school nurse, gives a vision test to second grader Chase Littlejohn at the Grass Valley Charter School. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams,\u003c/strong>\u003ca href=\"http://edsource.org/2014/under-new-law-school-nurses-aim-to-stop-rise-in-vaccination-opt-outs/60044#.U0LWDf2PSDV\" target=\"_blank\"> EdSource\u003c/a>\u003c/p>\n\u003cp>In her 33 years as a school nurse, Robyn Ettl has listened, sometimes quietly, sometimes not, to parents in rural Nevada County explain why their children don’t need vaccinations against contagious and potentially fatal diseases, including polio, diphtheria, measles and pertussis.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Parents must now meet with health provider before opting-out of vaccines for their children. \u003c/aside>\n\u003cp>Now, with nearly a half a million children in California registering for kindergarten in the fall, school nurses like Ettl are more invested than ever in a delicate task: trying to change the minds of parents intent on opting out of school-entrance immunizations.\u003c/p>\n\u003cp>Under a\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120AB2109\" target=\"_blank\"> state law\u003c/a> that took effect Jan. 1, parents may no longer simply file a letter to opt-out of vaccines. Instead, they are required to consult with a health practitioner –- doctor, naturopath or credentialed school nurse –- before they’re allowed to obtain what's known as a \"personal-belief exemption\" from their child’s required immunizations.\u003c!--more-->\u003c/p>\n\u003cp>Nowhere is the impact of the law more anticipated than in Nevada County, a former gold mining haven in the Sierra foothills, northeast of Sacramento. The county had the highest opt-out rate in the state for many years and is now a close second to sparsely populated Trinity County. Here, 20 percent of kindergartners have a personal belief exemption on file.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Public Charter Schools Have Highest Opt-Out Rates\u003c/strong>\u003c/p>\n\u003cp>That exemption rate is driven by huge percentages of vaccination opt-outs at public charter schools in the county, led by Yuba River Charter School in Nevada City. In the current school year, 81 percent of kindergarteners at the school received personal-belief exemptions.\u003c/p>\n\u003cp>Caleb Buckley, director of the Yuba River Charter School, said many students’ parents steer clear of Western medicine and, by association, its core tenet that immunizations save lives. “I don’t know too many that go to see the local pediatrician group, unless they really have to,” Buckley said.\u003c/p>\n\u003cp>As Trevor Michael, president of the Nevada County Board of Education, explained, “Our county is rural. People live alternative lifestyles and have alternative beliefs.”\u003c/p>\n\u003cp>At Grass Valley Unified, Ettl hears parents state that it is better for a child’s immune system to get the disease than the vaccination, and that polio is passé. And even though a research paper alleging a link between vaccinations and autism was \u003ca href=\"http://download.thelancet.com/flatcontentassets/pdfs/S0140673610601754.pdf\" target=\"_blank\">retracted\u003c/a>, deemed a \u003ca href=\"http://www.bmj.com/content/342/bmj.c7452\" target=\"_blank\">fraud\u003c/a> by the British Medical Journal and its author \u003ca href=\"http://www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf\" target=\"_blank\">stripped of his medical license\u003c/a>, they say they’re still not sure that a vaccination won’t give their child autism.\u003c/p>\n\u003cp>“I don’t argue with them,” Ettl said. In the past, when she has refuted their claims, “They get mad and head right to Holly,” she said, referring to Holly Hermansen, superintendent of the Nevada County Office of Education.\u003c/p>\n\u003cp style=\"text-align: center\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">\u003cstrong>[Related: More California Parents Opt-Out of Vaccines -- Look Up Your School Online]\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>At some charter schools in the county, a philosophical opposition to vaccinations has become a defining feature of the culture, said Sharyn Turner, coordinator of school health services at the Nevada County Office of Education.\u003c/p>\n\u003cp>“All of a sudden it becomes socially unacceptable to be one of the few parents immunizing your child,” Turner said.\u003c/p>\n\u003cp>Public charter schools lead the state in enrolling the highest percentage of kindergarteners with personal-belief exemptions – 10.1 percent in 2013-14, according to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">new data \u003c/a>from the California Department of Public Health. At private schools, 5.6 percent of kindergarteners received personal-belief exemptions, while 2.3 percent opted out at public schools.\u003c/p>\n\u003cp>Those high rates are driving an overall increase in personal belief exemptions statewide. The percentage of exempted kindergarteners more than doubled, from 1.4 percent in 2007 to 3.1 percent in 2013-14, according to the state Department of Public Health.\u003c/p>\n\u003cp>\u003cstrong>Fading Awareness of Dire Infectious Diseases\u003c/strong>\u003c/p>\n\u003cp>If roughly 90 percent of a population is fully vaccinated, “\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>” helps keep at bay infectious diseases including measles, pertussis or rubella. But with longstanding herd immunity comes fading awareness of dire infectious diseases. “There’s no fear,” said Lindsay Dunckel, executive director of First 5 Nevada County, which funds community programs for babies and young children. “These diseases that were once so frightening have disappeared.”\u003c/p>\n\u003cp>Now some of them are coming back, and the role of unvaccinated people in spreading disease is under scrutiny. In 159 cases of measles across the country last year, 82 percent of those infected \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a2.htm\" target=\"_blank\">were unvaccinated\u003c/a> and of those, 79 percent had philosophical objections to vaccinations, according to the CDC.\u003c/p>\n\u003cp>So far in 2014, the California Department of Public Health has received reports of \u003ca href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">51 cases\u003c/a> of measles in the state, the largest number since 2000, when measles was declared eliminated in the U.S. In the decade before the introduction of a measles vaccine in 1963, the disease killed about \u003ca href=\"http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm#measles\" target=\"_blank\">450 people a year \u003c/a>in the U.S., according to the CDC.\u003c/p>\n\u003cp>Also increasing in California is the number of cases of pertussis, better known as whooping cough. Reported cases in 2013 hit more than \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Pages/PertussisSummaryReports.aspx\" target=\"_blank\">2,300\u003c/a>, including an infant who contracted the disease at 4 weeks old and died. During a 2010 California outbreak of pertussis, in which 10 infants died and more than 9,000 cases were reported, children with personal-belief exemptions \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/09/24/peds.2013-0878.abstract\" target=\"_blank\">played a role\u003c/a> in transmitting the disease. Communities with high rates of personal-belief exemptions were 2.5 times more likely to also have pertussis clusters.\u003c/p>\n\u003cp>\u003cstrong>Can the New Law Help Raise Vaccine Rates?\u003c/strong>\u003c/p>\n\u003cp>At Grass Valley Unified, Ettl met recently with a parent of an incoming kindergartener who was dead-set against immunizations. The meeting was perfunctory: The parent read the vaccination information sheet, and Ettl explained that an unvaccinated child may not attend school for 21 days if an outbreak of whooping cough or measles occurs. Then Ettl and the parent signed the new \u003ca href=\"http://eziz.org/assets/docs/CDPH-8262.pdf\" target=\"_blank\">personal belief exemption form\u003c/a>.\u003c/p>\n\u003cp>Ettl’s hopes, and the hopes of public health officials, rest largely with parents whose opposition to vaccination is not entirely locked in. “‘I’ll ask, ‘Are you against every vaccine or some of them?’” she said.\u003c/p>\n\u003cp>One mother of a kindergartener recently told Ettl that although her child had received one vaccination, she was now inclined to opt out of the rest. Ettl talked to her about the risk of tetanus, a bacterial infection that can be contracted through a wound or animal bite. “We live in a rural place and tetanus is a serious disease,” Ettl recalled telling her. “I said, ‘Why don’t you start with one?’”\u003c/p>\n\u003cp>The mother left without a personal belief exemption in hand, saying she would think about it.\u003c/p>\n\u003cp>That’s just what the law is intended to do. The state of Washington passed a similar law in 2011 and its opt-out rate has dropped about 40 percent.\u003c/p>\n\u003cp>“Some parents are never going to change their mind,” said Catherine Flores Martin, director of the California Immunization Coalition, “but there is a larger number that want to have their vaccine concerns acknowledged and answered.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"XFhbYjl34gl1ZRPLwBP1QZhMQzjUqiEo\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18566\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/SchoolnurseGrassVallNo2March2014JA.jpg\">\u003cimg class=\"size-large wp-image-18566 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/SchoolnurseGrassVallNo2March2014JA-640x426.jpg\" alt=\"(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Robyn Ettl, Grass Valley Unified school nurse, gives a vision test to second grader Chase Littlejohn at the Grass Valley Charter School. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams,\u003c/strong>\u003ca href=\"http://edsource.org/2014/under-new-law-school-nurses-aim-to-stop-rise-in-vaccination-opt-outs/60044#.U0LWDf2PSDV\" target=\"_blank\"> EdSource\u003c/a>\u003c/p>\n\u003cp>In her 33 years as a school nurse, Robyn Ettl has listened, sometimes quietly, sometimes not, to parents in rural Nevada County explain why their children don’t need vaccinations against contagious and potentially fatal diseases, including polio, diphtheria, measles and pertussis.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Parents must now meet with health provider before opting-out of vaccines for their children. \u003c/aside>\n\u003cp>Now, with nearly a half a million children in California registering for kindergarten in the fall, school nurses like Ettl are more invested than ever in a delicate task: trying to change the minds of parents intent on opting out of school-entrance immunizations.\u003c/p>\n\u003cp>Under a\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120AB2109\" target=\"_blank\"> state law\u003c/a> that took effect Jan. 1, parents may no longer simply file a letter to opt-out of vaccines. Instead, they are required to consult with a health practitioner –- doctor, naturopath or credentialed school nurse –- before they’re allowed to obtain what's known as a \"personal-belief exemption\" from their child’s required immunizations.\u003c!--more-->\u003c/p>\n\u003cp>Nowhere is the impact of the law more anticipated than in Nevada County, a former gold mining haven in the Sierra foothills, northeast of Sacramento. The county had the highest opt-out rate in the state for many years and is now a close second to sparsely populated Trinity County. Here, 20 percent of kindergartners have a personal belief exemption on file.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Public Charter Schools Have Highest Opt-Out Rates\u003c/strong>\u003c/p>\n\u003cp>That exemption rate is driven by huge percentages of vaccination opt-outs at public charter schools in the county, led by Yuba River Charter School in Nevada City. In the current school year, 81 percent of kindergarteners at the school received personal-belief exemptions.\u003c/p>\n\u003cp>Caleb Buckley, director of the Yuba River Charter School, said many students’ parents steer clear of Western medicine and, by association, its core tenet that immunizations save lives. “I don’t know too many that go to see the local pediatrician group, unless they really have to,” Buckley said.\u003c/p>\n\u003cp>As Trevor Michael, president of the Nevada County Board of Education, explained, “Our county is rural. People live alternative lifestyles and have alternative beliefs.”\u003c/p>\n\u003cp>At Grass Valley Unified, Ettl hears parents state that it is better for a child’s immune system to get the disease than the vaccination, and that polio is passé. And even though a research paper alleging a link between vaccinations and autism was \u003ca href=\"http://download.thelancet.com/flatcontentassets/pdfs/S0140673610601754.pdf\" target=\"_blank\">retracted\u003c/a>, deemed a \u003ca href=\"http://www.bmj.com/content/342/bmj.c7452\" target=\"_blank\">fraud\u003c/a> by the British Medical Journal and its author \u003ca href=\"http://www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf\" target=\"_blank\">stripped of his medical license\u003c/a>, they say they’re still not sure that a vaccination won’t give their child autism.\u003c/p>\n\u003cp>“I don’t argue with them,” Ettl said. In the past, when she has refuted their claims, “They get mad and head right to Holly,” she said, referring to Holly Hermansen, superintendent of the Nevada County Office of Education.\u003c/p>\n\u003cp style=\"text-align: center\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">\u003cstrong>[Related: More California Parents Opt-Out of Vaccines -- Look Up Your School Online]\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>At some charter schools in the county, a philosophical opposition to vaccinations has become a defining feature of the culture, said Sharyn Turner, coordinator of school health services at the Nevada County Office of Education.\u003c/p>\n\u003cp>“All of a sudden it becomes socially unacceptable to be one of the few parents immunizing your child,” Turner said.\u003c/p>\n\u003cp>Public charter schools lead the state in enrolling the highest percentage of kindergarteners with personal-belief exemptions – 10.1 percent in 2013-14, according to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">new data \u003c/a>from the California Department of Public Health. At private schools, 5.6 percent of kindergarteners received personal-belief exemptions, while 2.3 percent opted out at public schools.\u003c/p>\n\u003cp>Those high rates are driving an overall increase in personal belief exemptions statewide. The percentage of exempted kindergarteners more than doubled, from 1.4 percent in 2007 to 3.1 percent in 2013-14, according to the state Department of Public Health.\u003c/p>\n\u003cp>\u003cstrong>Fading Awareness of Dire Infectious Diseases\u003c/strong>\u003c/p>\n\u003cp>If roughly 90 percent of a population is fully vaccinated, “\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>” helps keep at bay infectious diseases including measles, pertussis or rubella. But with longstanding herd immunity comes fading awareness of dire infectious diseases. “There’s no fear,” said Lindsay Dunckel, executive director of First 5 Nevada County, which funds community programs for babies and young children. “These diseases that were once so frightening have disappeared.”\u003c/p>\n\u003cp>Now some of them are coming back, and the role of unvaccinated people in spreading disease is under scrutiny. In 159 cases of measles across the country last year, 82 percent of those infected \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a2.htm\" target=\"_blank\">were unvaccinated\u003c/a> and of those, 79 percent had philosophical objections to vaccinations, according to the CDC.\u003c/p>\n\u003cp>So far in 2014, the California Department of Public Health has received reports of \u003ca href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">51 cases\u003c/a> of measles in the state, the largest number since 2000, when measles was declared eliminated in the U.S. In the decade before the introduction of a measles vaccine in 1963, the disease killed about \u003ca href=\"http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm#measles\" target=\"_blank\">450 people a year \u003c/a>in the U.S., according to the CDC.\u003c/p>\n\u003cp>Also increasing in California is the number of cases of pertussis, better known as whooping cough. Reported cases in 2013 hit more than \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Pages/PertussisSummaryReports.aspx\" target=\"_blank\">2,300\u003c/a>, including an infant who contracted the disease at 4 weeks old and died. During a 2010 California outbreak of pertussis, in which 10 infants died and more than 9,000 cases were reported, children with personal-belief exemptions \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/09/24/peds.2013-0878.abstract\" target=\"_blank\">played a role\u003c/a> in transmitting the disease. Communities with high rates of personal-belief exemptions were 2.5 times more likely to also have pertussis clusters.\u003c/p>\n\u003cp>\u003cstrong>Can the New Law Help Raise Vaccine Rates?\u003c/strong>\u003c/p>\n\u003cp>At Grass Valley Unified, Ettl met recently with a parent of an incoming kindergartener who was dead-set against immunizations. The meeting was perfunctory: The parent read the vaccination information sheet, and Ettl explained that an unvaccinated child may not attend school for 21 days if an outbreak of whooping cough or measles occurs. Then Ettl and the parent signed the new \u003ca href=\"http://eziz.org/assets/docs/CDPH-8262.pdf\" target=\"_blank\">personal belief exemption form\u003c/a>.\u003c/p>\n\u003cp>Ettl’s hopes, and the hopes of public health officials, rest largely with parents whose opposition to vaccination is not entirely locked in. “‘I’ll ask, ‘Are you against every vaccine or some of them?’” she said.\u003c/p>\n\u003cp>One mother of a kindergartener recently told Ettl that although her child had received one vaccination, she was now inclined to opt out of the rest. Ettl talked to her about the risk of tetanus, a bacterial infection that can be contracted through a wound or animal bite. “We live in a rural place and tetanus is a serious disease,” Ettl recalled telling her. “I said, ‘Why don’t you start with one?’”\u003c/p>\n\u003cp>The mother left without a personal belief exemption in hand, saying she would think about it.\u003c/p>\n\u003cp>That’s just what the law is intended to do. The state of Washington passed a similar law in 2011 and its opt-out rate has dropped about 40 percent.\u003c/p>\n\u003cp>“Some parents are never going to change their mind,” said Catherine Flores Martin, director of the California Immunization Coalition, “but there is a larger number that want to have their vaccine concerns acknowledged and answered.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Your Doctor's Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk",
"title": "Your Doctor's Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk",
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"content": "\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-e1396647760530.jpg\">\u003cimg class=\"size-large wp-image-18548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-640x437.jpg\" alt=\"136237601\" width=\"640\" height=\"437\">\u003c/a>\u003cbr>\nIf you're going to go to the trouble of having a colonoscopy, you'd probably prefer that you get as much as you can out of the screening test. A new study this week shows that a doctor's rate of finding and removing adenomas -- these are pre-cancerous growths -- is linked to the patient's lower risk of developing colon cancer later.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For every 1 percent increase in adenoma detection there was a 3 percent decrease a person's colon cancer risk. \u003c/aside>\n\u003cp>Colonoscopy is one of the \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">recommended screening tests\u003c/a> for colon cancer. Yet doctors have differing rates at how often they find these adenomas. This is the first study in the U.S. to look at the association between finding adenomas and later cancer risk, as part of a national review funded by the National Cancer Institute. It was published in the\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1309086\" target=\"_blank\"> New England Journal of Medicine.\u003c/a>\u003c/p>\n\u003cp>In the study, researchers at Kaiser Permanente Northern California reviewed more than 300,000 colonoscopies performed by 136 gastroenterologists between 1998 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>The doctors' detection rates for adenomas ranged from 7.4 percent to 52.5 percent. The researchers found that for every 1 percent increase in detection rate there was a 3 percent decrease in colon cancer risk over the next decade.\u003c/p>\n\u003cp>Dr. Douglas Corley is research scientist with Kaiser's Department of Research and lead author of the study. \"The (doctors) who were at the higher end of the detection, their patients were actually less likely in the future to be diagnosed with a colon cancer, an advanced colon cancer and to die of colon cancer,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medicare is in the process of setting standards for doctors' groups to report their detection of adenomas as a quality measure but \"patients certainly ask their physicians if their groups measure adenoma detection rates\" now, Corley said.\u003c/p>\n\u003cp>HealthDay spoke to a gastroenterologist not involved in the study who backed up Corley's recommendation. \u003ca href=\"http://consumer.healthday.com/cancer-information-5/colon-cancer-news-96/doctor-s-skill-at-colonoscopy-affects-patient-s-colon-cancer-risk-study-686446.html\" target=\"_blank\">From HealthDay\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"Many (doctors) make quality measures available to their patients,\" said Dr. Lawrence Kim, who serves as the community private practice councilor for the American Gastroenterological Association (AGA).\u003c/p>\n\u003cp>That information may be in the written materials your doctor gives you, or even on the practice's website, Kim said.\u003c/p>\u003c/blockquote>\n\u003cp>A \"minimum threshold\" for finding adenomas is at least 15 percent for women and 25 percent for men, Corley noted. Adenomas are more common in men. Most of the doctors in the study were above 20 percent overall. Kaiser is working to develop interventions to improve adenoma detection rates among all doctors, he said. Those interventions may ultimately be applied to physicians beyond Kaiser.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eyYxSV4FoBl5SCktFpYEH8WMHNf2BlSD\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-e1396647760530.jpg\">\u003cimg class=\"size-large wp-image-18548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-640x437.jpg\" alt=\"136237601\" width=\"640\" height=\"437\">\u003c/a>\u003cbr>\nIf you're going to go to the trouble of having a colonoscopy, you'd probably prefer that you get as much as you can out of the screening test. A new study this week shows that a doctor's rate of finding and removing adenomas -- these are pre-cancerous growths -- is linked to the patient's lower risk of developing colon cancer later.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For every 1 percent increase in adenoma detection there was a 3 percent decrease a person's colon cancer risk. \u003c/aside>\n\u003cp>Colonoscopy is one of the \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">recommended screening tests\u003c/a> for colon cancer. Yet doctors have differing rates at how often they find these adenomas. This is the first study in the U.S. to look at the association between finding adenomas and later cancer risk, as part of a national review funded by the National Cancer Institute. It was published in the\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1309086\" target=\"_blank\"> New England Journal of Medicine.\u003c/a>\u003c/p>\n\u003cp>In the study, researchers at Kaiser Permanente Northern California reviewed more than 300,000 colonoscopies performed by 136 gastroenterologists between 1998 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>The doctors' detection rates for adenomas ranged from 7.4 percent to 52.5 percent. The researchers found that for every 1 percent increase in detection rate there was a 3 percent decrease in colon cancer risk over the next decade.\u003c/p>\n\u003cp>Dr. Douglas Corley is research scientist with Kaiser's Department of Research and lead author of the study. \"The (doctors) who were at the higher end of the detection, their patients were actually less likely in the future to be diagnosed with a colon cancer, an advanced colon cancer and to die of colon cancer,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medicare is in the process of setting standards for doctors' groups to report their detection of adenomas as a quality measure but \"patients certainly ask their physicians if their groups measure adenoma detection rates\" now, Corley said.\u003c/p>\n\u003cp>HealthDay spoke to a gastroenterologist not involved in the study who backed up Corley's recommendation. \u003ca href=\"http://consumer.healthday.com/cancer-information-5/colon-cancer-news-96/doctor-s-skill-at-colonoscopy-affects-patient-s-colon-cancer-risk-study-686446.html\" target=\"_blank\">From HealthDay\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"Many (doctors) make quality measures available to their patients,\" said Dr. Lawrence Kim, who serves as the community private practice councilor for the American Gastroenterological Association (AGA).\u003c/p>\n\u003cp>That information may be in the written materials your doctor gives you, or even on the practice's website, Kim said.\u003c/p>\u003c/blockquote>\n\u003cp>A \"minimum threshold\" for finding adenomas is at least 15 percent for women and 25 percent for men, Corley noted. Adenomas are more common in men. Most of the doctors in the study were above 20 percent overall. Kaiser is working to develop interventions to improve adenoma detection rates among all doctors, he said. Those interventions may ultimately be applied to physicians beyond Kaiser.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eyYxSV4FoBl5SCktFpYEH8WMHNf2BlSD\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "50-Year Review: Mammography Benefits Oversold, Harms Minimized",
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"content": "\u003cfigure id=\"attachment_18497\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-e1396421050813.jpg\">\u003cimg class=\"size-large wp-image-18497\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-640x424.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/04/01/297826238/review-finds-mammographys-benefits-overplayed-harms-dismissed\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Two months ago, a widely publicized Canadian \u003ca href=\"http://www.npr.org/blogs/health/2014/02/12/275883427/latest-evidence-against-mammograms-adds-to-womens-uncertainty\" target=\"_blank\">study\u003c/a> found that mammograms did not reduce breast cancer deaths, but that study was fiercely criticized by the nation's radiologists as \"\u003ca href=\"http://www.acr.org/News-Publications/News/News-Articles/2014/ACR/BMJ-Article-on-Breast-Cancer-Screening-Effectiveness-Incredibly-Flawed-and-Misleading\" target=\"_blank\">incredibly flawed and misleading\u003c/a>.\"\u003c/p>\n\u003cp>A few weeks earlier, an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/04/the-cost-of-mammograms-is-a-picture-worth-7-billion/\" target=\"_blank\">analysis\u003c/a> \u003ca href=\"http://www.npr.org/blogs/health/2014/02/04/271554425/are-we-paying-8-billion-too-much-for-mammograms\">f\u003c/a>ound that screening all women annually starting at age 40, as the American Cancer Society recommends, costs $6.5 billion more a year more than following the U.S. Preventive Service's Task Force recommendation that women be screened every other year starting at age 50.\u003c/p>\n\u003cp>Now, the latest entries — two studies that try to put all the previous research on mammography's harms and benefits in perspective.\u003c/p>\n\u003cp>\u003cspan>First, researchers at Harvard took a broad look at all the research on mammograms since 1960 — more than 50 years of study. They also looked at evidence on the harms of false positives and overdiagnoses, in which a woman is treated for a cancer that would never have proved deadly. And they reviewed whether current efforts to try to personalize a woman's cancer risk helped a woman figure out whether it was worth her while to get a mammogram.\u003c!--more-->\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Their conclusion: The benefits of mammography, though real, have been oversold, while the harms have been minimized.\u003c/p>\n\u003cp>Annual mammograms reduce the risk of dying from breast cancer by about 19 percent, but the benefit varies widely based on a woman's age and underlying cancer risk, the study found. For instance, about 1,904 women in their 40s would have to be screened to prevent one death, compared with just 377 women in their 60s.\u003c/p>\n\u003cp>That's because breast cancer becomes much more common as a woman ages. At age 40, a woman's risk of getting breast cancer in the next 10 years is 1.5 percent. At age 50, it's 2.3 percent. And a 60-year-old has a 3.5 percent risk in the next decade.\u003c/p>\n\u003cp>The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1853165\" target=\"_blank\">results\u003c/a> were published Tuesday in \u003cem>JAMA,\u003c/em> the journal of the American Medical Association.\u003c/p>\n\u003cp>The analysis found that about 19 percent of women who are diagnosed with breast cancer as a result of a mammogram are overdiagnosed — getting surgery, chemotherapy or radiation to treat a cancer that would never be life-threatening.\u003c/p>\n\u003cp>The bottom line, the researchers say, is that mammography is a less-than-perfect screening test, and doctors and patients need a lot more help figuring out if and when to use it.\u003c/p>\n\u003cp>\"Decisions about mammography should involve discussion of risks, benefits, uncertainties, alternatives and patient preferences,\" the authors write.\u003c/p>\n\u003cp>And women age 75 and older really need to consider whether they should be having mammograms at all, a second \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1853134\">study\u003c/a> in \u003cem>JAMA\u003c/em> reports. As the researchers point out, there are no randomized controlled trials of mammography in women in that age group. So there's no way to know how much they might extend a woman's life.\u003c/p>\n\u003cp>So the harms of screening probably outweigh any benefits in women who will live for less than 10 years, the researchers say, and women who think they will live longer than that should talk with their doctors about the benefits and risks.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"R92E2PtWb9ByYxKHc9uuHx9GMY4QWB2k\"]\u003c/p>\n\n",
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"excerpt": "Scores of women treated for cancer are over-diagnosed; their cancer would never threaten their lives.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18497\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-e1396421050813.jpg\">\u003cimg class=\"size-large wp-image-18497\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/154216755_2-640x424.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/04/01/297826238/review-finds-mammographys-benefits-overplayed-harms-dismissed\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Two months ago, a widely publicized Canadian \u003ca href=\"http://www.npr.org/blogs/health/2014/02/12/275883427/latest-evidence-against-mammograms-adds-to-womens-uncertainty\" target=\"_blank\">study\u003c/a> found that mammograms did not reduce breast cancer deaths, but that study was fiercely criticized by the nation's radiologists as \"\u003ca href=\"http://www.acr.org/News-Publications/News/News-Articles/2014/ACR/BMJ-Article-on-Breast-Cancer-Screening-Effectiveness-Incredibly-Flawed-and-Misleading\" target=\"_blank\">incredibly flawed and misleading\u003c/a>.\"\u003c/p>\n\u003cp>A few weeks earlier, an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/04/the-cost-of-mammograms-is-a-picture-worth-7-billion/\" target=\"_blank\">analysis\u003c/a> \u003ca href=\"http://www.npr.org/blogs/health/2014/02/04/271554425/are-we-paying-8-billion-too-much-for-mammograms\">f\u003c/a>ound that screening all women annually starting at age 40, as the American Cancer Society recommends, costs $6.5 billion more a year more than following the U.S. Preventive Service's Task Force recommendation that women be screened every other year starting at age 50.\u003c/p>\n\u003cp>Now, the latest entries — two studies that try to put all the previous research on mammography's harms and benefits in perspective.\u003c/p>\n\u003cp>\u003cspan>First, researchers at Harvard took a broad look at all the research on mammograms since 1960 — more than 50 years of study. They also looked at evidence on the harms of false positives and overdiagnoses, in which a woman is treated for a cancer that would never have proved deadly. And they reviewed whether current efforts to try to personalize a woman's cancer risk helped a woman figure out whether it was worth her while to get a mammogram.\u003c!--more-->\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Their conclusion: The benefits of mammography, though real, have been oversold, while the harms have been minimized.\u003c/p>\n\u003cp>Annual mammograms reduce the risk of dying from breast cancer by about 19 percent, but the benefit varies widely based on a woman's age and underlying cancer risk, the study found. For instance, about 1,904 women in their 40s would have to be screened to prevent one death, compared with just 377 women in their 60s.\u003c/p>\n\u003cp>That's because breast cancer becomes much more common as a woman ages. At age 40, a woman's risk of getting breast cancer in the next 10 years is 1.5 percent. At age 50, it's 2.3 percent. And a 60-year-old has a 3.5 percent risk in the next decade.\u003c/p>\n\u003cp>The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1853165\" target=\"_blank\">results\u003c/a> were published Tuesday in \u003cem>JAMA,\u003c/em> the journal of the American Medical Association.\u003c/p>\n\u003cp>The analysis found that about 19 percent of women who are diagnosed with breast cancer as a result of a mammogram are overdiagnosed — getting surgery, chemotherapy or radiation to treat a cancer that would never be life-threatening.\u003c/p>\n\u003cp>The bottom line, the researchers say, is that mammography is a less-than-perfect screening test, and doctors and patients need a lot more help figuring out if and when to use it.\u003c/p>\n\u003cp>\"Decisions about mammography should involve discussion of risks, benefits, uncertainties, alternatives and patient preferences,\" the authors write.\u003c/p>\n\u003cp>And women age 75 and older really need to consider whether they should be having mammograms at all, a second \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1853134\">study\u003c/a> in \u003cem>JAMA\u003c/em> reports. As the researchers point out, there are no randomized controlled trials of mammography in women in that age group. So there's no way to know how much they might extend a woman's life.\u003c/p>\n\u003cp>So the harms of screening probably outweigh any benefits in women who will live for less than 10 years, the researchers say, and women who think they will live longer than that should talk with their doctors about the benefits and risks.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"R92E2PtWb9ByYxKHc9uuHx9GMY4QWB2k\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Yes, It's A Headache. No, I Didn't Need That Brain Scan",
"title": "Yes, It's A Headache. No, I Didn't Need That Brain Scan",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18177\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/stk116189rke-e1395165944260.jpg\">\u003cimg class=\"size-large wp-image-18177\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/stk116189rke-640x425.jpg\" alt=\"Headaches are almost never caused by a tumor, say neurologists. (Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Headaches are almost never caused by a tumor, say neurologists. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Over at NPR, the Shots blog reports that Americans get $1 billion (yes, with a \"B\") worth of brain scans every year -- because they have a headache. That's according to research at the University of Michigan.\u003c/p>\n\u003cp>Headaches are one of the most common reasons people go to the doctor -- up to a quarter of all doctor visits, says Shots.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Sending a billion dollars \"down the drain.\" Annually.\u003c/aside>\n\u003cp>Presumably people are getting the scans because they're worried that headache is a sign of something much more scary -- say a brain tumor.\u003c/p>\n\u003cp>There's just one problem. Most headaches are just that -- a headache.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.npr.org/blogs/health/2014/03/18/291044766/yes-its-a-headache-no-you-dont-need-a-brain-scan\" target=\"_blank\">Shots post\u003c/a>:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>(S)ince headaches are almost never caused by a tumor or other serious brain problem, that $1 billion is money down the drain, according to Dr. Brian Callaghan, the assistant professor of neurology who led the study.\u003c/p>\n\u003cp>\"It's such a big number,\" Callaghan told Shots. \"It's just an incredible number of MRIs and CTs that people get.\"\u003c/p>\n\u003cp>From 2007 to 2010, people visited the doctor 51 million times for headache-related problems, according to a national database of outpatient visits. And 12 percent of the time, the doctors sent their patients for a brain scan. Those numbers are on the rise, the analysis found, even though \u003ca href=\"http://www.choosingwisely.org/doctor-patient-lists/imaging-tests-for-headaches/\" target=\"_blank\">guidelines \u003c/a>urge doctors to shun the scans. The \u003ca href=\"https://archinte.jamanetwork.com/article.aspx?articleid=1835347\" target=\"_blank\">results \u003c/a>were published Monday in \u003cem>JAMA Internal Medicine\u003c/em>.\u003c/p>\u003c/blockquote>\n\u003cp>I'm guilty of sending part of that billion down the drain. A few years ago, I was driving on the highway with my two children in the back seat. I glanced down, then back at the road, and suddenly was seeing double. I managed to pull over but was very shaken. I didn't know if I was having a stroke. But over a few minutes, the symptoms subsided. I won't drag you through everything I did next, but in short, I got home safely and made an appointment with the doctor.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She listened to my story, then pointed out that this episode was likely a version of the migraines I get. Migraines are often preceded by an aura, a visual effect that can include \u003ca href=\"http://www.mayoclinic.org/diseases-conditions/migraine-with-aura/basics/definition/con-20030404\" target=\"_blank\">flashing lights or blind spots\u003c/a>, according to the Mayo Clinic.\u003c/p>\n\u003cp>But I was freaked out. She referred me to an ophthalmologist with whom I had a long conversation about getting an MRI. He said he wouldn't do it.\u003c/p>\n\u003cp>I did it.\u003c/p>\n\u003cp>I was lucky -- not because the MRI came back normal (which I'm sure you expected by now) but also because it didn't turn up any false positives as can happen, often, with MRIs. If the MRI turns up something suspicious, it can \"prompt a cascade of tests and invasive procedures,\" Shots says, over things that will never cause any harm.\u003c/p>\n\u003cp>But that's not as bad as a CT scan -- in that case, you're exposing your brain to needless radiation. Personally, I like my brain not irradiated, if at all possible.\u003c/p>\n\u003cp>Patients like me certainly bear some responsibility, but doctors are guilty as well, says Callaghan. Ordering a scan both gets the patient out the door quickly and it does make the patient feel like someone is taking care of them.\u003c/p>\n\u003cp>Still, there are times you should worry. Again, from Shots:\u003c/p>\n\u003cblockquote>\u003cp>When should we worry? If a \u003ca href=\"http://www.nlm.nih.gov/medlineplus/headache.html\" target=\"_blank\">severe headache\u003c/a> strikes suddenly, the neurologists say. People also should seek medical help for \u003ca href=\"http://www.npr.org/blogs/health/2014/03/18/291044766/Different%20from%20other%20headaches%20you've%20had%20in%20the%20past,%20especially%20if%20you're%2050%20or%20older.%20Brought%20on%20by%20exertion.%20Accompanied%20by%20fever,%20seizure,%20vomiting,%20a%20loss%20of%20coordination,%20or%20a%20change%20in%20vision,%20speech,%20or%20alertness.\" target=\"_blank\">headaches \u003c/a>that are markedly different than ones in the past, are brought on by exertion, or come with fever, vomiting, loss of coordination, or a change in vision, speech or alertness.\u003c/p>\u003c/blockquote>\n\u003cp>In retrospect, my doctor was taking care of me by pointing out the correct problem: the migraine. In the weeks after that first episode, I had a few more episodes of double vision. It turns out if I stopped what I was doing, closed my eyes and took some deep breaths, my vision returned to normal.\u003c/p>\n\u003cp>That's a lot cheaper and easier than an MRI.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"JxVXk0bjis5QvOXUSNT42V5dBltPTkye\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18177\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/stk116189rke-e1395165944260.jpg\">\u003cimg class=\"size-large wp-image-18177\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/stk116189rke-640x425.jpg\" alt=\"Headaches are almost never caused by a tumor, say neurologists. (Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Headaches are almost never caused by a tumor, say neurologists. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Over at NPR, the Shots blog reports that Americans get $1 billion (yes, with a \"B\") worth of brain scans every year -- because they have a headache. That's according to research at the University of Michigan.\u003c/p>\n\u003cp>Headaches are one of the most common reasons people go to the doctor -- up to a quarter of all doctor visits, says Shots.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Sending a billion dollars \"down the drain.\" Annually.\u003c/aside>\n\u003cp>Presumably people are getting the scans because they're worried that headache is a sign of something much more scary -- say a brain tumor.\u003c/p>\n\u003cp>There's just one problem. Most headaches are just that -- a headache.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.npr.org/blogs/health/2014/03/18/291044766/yes-its-a-headache-no-you-dont-need-a-brain-scan\" target=\"_blank\">Shots post\u003c/a>:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>(S)ince headaches are almost never caused by a tumor or other serious brain problem, that $1 billion is money down the drain, according to Dr. Brian Callaghan, the assistant professor of neurology who led the study.\u003c/p>\n\u003cp>\"It's such a big number,\" Callaghan told Shots. \"It's just an incredible number of MRIs and CTs that people get.\"\u003c/p>\n\u003cp>From 2007 to 2010, people visited the doctor 51 million times for headache-related problems, according to a national database of outpatient visits. And 12 percent of the time, the doctors sent their patients for a brain scan. Those numbers are on the rise, the analysis found, even though \u003ca href=\"http://www.choosingwisely.org/doctor-patient-lists/imaging-tests-for-headaches/\" target=\"_blank\">guidelines \u003c/a>urge doctors to shun the scans. The \u003ca href=\"https://archinte.jamanetwork.com/article.aspx?articleid=1835347\" target=\"_blank\">results \u003c/a>were published Monday in \u003cem>JAMA Internal Medicine\u003c/em>.\u003c/p>\u003c/blockquote>\n\u003cp>I'm guilty of sending part of that billion down the drain. A few years ago, I was driving on the highway with my two children in the back seat. I glanced down, then back at the road, and suddenly was seeing double. I managed to pull over but was very shaken. I didn't know if I was having a stroke. But over a few minutes, the symptoms subsided. I won't drag you through everything I did next, but in short, I got home safely and made an appointment with the doctor.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She listened to my story, then pointed out that this episode was likely a version of the migraines I get. Migraines are often preceded by an aura, a visual effect that can include \u003ca href=\"http://www.mayoclinic.org/diseases-conditions/migraine-with-aura/basics/definition/con-20030404\" target=\"_blank\">flashing lights or blind spots\u003c/a>, according to the Mayo Clinic.\u003c/p>\n\u003cp>But I was freaked out. She referred me to an ophthalmologist with whom I had a long conversation about getting an MRI. He said he wouldn't do it.\u003c/p>\n\u003cp>I did it.\u003c/p>\n\u003cp>I was lucky -- not because the MRI came back normal (which I'm sure you expected by now) but also because it didn't turn up any false positives as can happen, often, with MRIs. If the MRI turns up something suspicious, it can \"prompt a cascade of tests and invasive procedures,\" Shots says, over things that will never cause any harm.\u003c/p>\n\u003cp>But that's not as bad as a CT scan -- in that case, you're exposing your brain to needless radiation. Personally, I like my brain not irradiated, if at all possible.\u003c/p>\n\u003cp>Patients like me certainly bear some responsibility, but doctors are guilty as well, says Callaghan. Ordering a scan both gets the patient out the door quickly and it does make the patient feel like someone is taking care of them.\u003c/p>\n\u003cp>Still, there are times you should worry. Again, from Shots:\u003c/p>\n\u003cblockquote>\u003cp>When should we worry? If a \u003ca href=\"http://www.nlm.nih.gov/medlineplus/headache.html\" target=\"_blank\">severe headache\u003c/a> strikes suddenly, the neurologists say. People also should seek medical help for \u003ca href=\"http://www.npr.org/blogs/health/2014/03/18/291044766/Different%20from%20other%20headaches%20you've%20had%20in%20the%20past,%20especially%20if%20you're%2050%20or%20older.%20Brought%20on%20by%20exertion.%20Accompanied%20by%20fever,%20seizure,%20vomiting,%20a%20loss%20of%20coordination,%20or%20a%20change%20in%20vision,%20speech,%20or%20alertness.\" target=\"_blank\">headaches \u003c/a>that are markedly different than ones in the past, are brought on by exertion, or come with fever, vomiting, loss of coordination, or a change in vision, speech or alertness.\u003c/p>\u003c/blockquote>\n\u003cp>In retrospect, my doctor was taking care of me by pointing out the correct problem: the migraine. In the weeks after that first episode, I had a few more episodes of double vision. It turns out if I stopped what I was doing, closed my eyes and took some deep breaths, my vision returned to normal.\u003c/p>\n\u003cp>That's a lot cheaper and easier than an MRI.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"JxVXk0bjis5QvOXUSNT42V5dBltPTkye\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Use of ADHD Drugs Increasing Fastest Among Young Women",
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"content": "\u003cfigure id=\"attachment_18141\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/177861835-e1394820572797.jpg\">\u003cimg class=\"size-large wp-image-18141\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/177861835-640x494.jpg\" alt=\"Women ages 19 to 25 have higher rates of ADHD medication use than girls ages 12 to 18. (Getty Images)\" width=\"640\" height=\"494\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Women ages 19 to 25 have higher rates of ADHD medication use than girls ages 12 to 18. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/03/14/289821414/young-women-increasingly-turn-to-adhd-drugs\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Use of ADHD drugs continues to rise in the United States, but the group whose use is increasing the most may come as a surprise: young women.\u003c/p>\n\u003cp>An \u003ca href=\"http://lab.express-scripts.com/wp-content/uploads/2014/03/ADHD_March2014_ExpressScripts.pdf\">analysis\u003c/a> of prescriptions filled from 2008 to 2012 through Express Scripts, a pharmacy benefit management company, found that use of ADHD medications rose 35.5 percent overall. The company's database includes 15 million people with private insurance.\u003c/p>\n\u003cfigure id=\"attachment_18147\" class=\"wp-caption alignleft\" style=\"max-width: 259px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/Screen-Shot-2014-03-14-at-11.20.07-AM.png\">\u003cimg class=\"size-medium wp-image-18147\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/Screen-Shot-2014-03-14-at-11.20.07-AM-300x347.png\" alt=\"Children and young adults on ADHD medications by gender. (Express Scripts)\" width=\"259\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Children and young adults on ADHD medications by gender. (Express Scripts)\u003c/figcaption>\u003c/figure>\n\u003cp>The medications, largely stimulants like Ritalin and Adderall, are still most commonly prescribed to boys ages 12 to 18. In 2012 7.8 percent of boys ages 4 to 18 were taking an ADHD medication -- that's more than twice the rate of girls (3.5 percent). But in young adulthood, ages 19 to 25, men's use plummets, while young women's rate increases. From ages 26 to 64, use of ADHD medications by women exceeds that of men.\u003c/p>\n\u003cp>To find out more about what's going on, we talked with \u003ca href=\"http://lab.express-scripts.com/author/david-muzina/\">Dr. David Muzina\u003c/a>, a psychiatrist who is the vice president and national practice leader for neuroscience at Express Scripts. This is an edited version of our conversation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>The Centers for Disease Control and Prevention and others have \u003ca href=\"http://www.npr.org/blogs/health/2013/11/22/246771526/more-children-are-being-medicated-for-adhd-than-before\">reported\u003c/a> increases in use of ADHD medications in children, but this increase in adults seems huge. What's happening there?\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>ADHD is no longer just a childhood condition. Many of the children and adolescents who were diagnosed 10 years ago are now adults, and we know that about 1 in 3 kids carry ADHD with them into adulthood. I think that's one reason why the numbers in adults are going up. And there's been progressively more attention on ADHD in the public sphere. More adults recognize the symptoms: \"Oh, I'm not concentrating, I'm not focusing. Maybe I have ADHD.\"\u003c/p>\n\u003cp>Then there's overdiagnosis, overtreatment and perhaps misuse. Frankly, many prescribers mistake a patient's objective reporting of symptoms like being forgetful for ADHD. Are there life stressors, is there a medical condition, is there depression or anxiety that explains this better?\u003c/p>\n\u003cp>\u003cstrong>You're seeing a drop-off in young men using ADHD drugs after age 18. Why?\u003c/strong>\u003c/p>\n\u003cp>Men are less likely to go to the doctor, and take the meds, and fill the meds. We're thinking about the 18-, 19-year-old who's going off to college. They're going to the doctor only once or twice a year.\u003c/p>\n\u003cp>\u003cstrong>But then why this big spike among women the same age, with 4 percent of young women taking ADHD meds in 2012?\u003c/strong>\u003c/p>\n\u003cp>It's been known for a long, long time that if girls have ADHD they are more likely to have the inattention form, not the hyperactive, aggressive, disruptive form. Perhaps that difference in how ADHD can look is why the diagnosis is missed in girls. They may be quietly suffering and having trouble in school, but they're not disruptive.\u003c/p>\n\u003cp>They move on into life, where those inattentive symptoms may reveal themselves as academic and social pressures compound. Now it's becoming more of an issue.\u003c/p>\n\u003cp>And lastly, we know that women in the United States are increasingly juggling more and more and more. Women still tend to have the majority of the responsibilities at home, particularly when families start up. That elevation of pressure and stress can either produce symptoms like ADHD, or that additional stress can express the underlying ADHD that previously had not been diagnosed.\u003c/p>\n\u003cp>\u003cstrong>Stimulant drugs like Ritalin are pretty well-known for improving energy and concentration, even if you don't have ADHD. Could that be a factor here?\u003c/strong>\u003c/p>\n\u003cp>There may be an element here of medication being prescribed off-label to help with that, as well as the desire to suppress appetite and lose weight. It's totally not approved for that. But it's popularized and perhaps glorified to some extent in popular media, including women's magazines. I've seen references to using these medications for weight loss.\u003c/p>\n\u003cp>\u003cstrong>Is this the tip of the iceberg?\u003c/strong>\u003c/p>\n\u003cp>I think we're into the iceberg. We forecast that use of ADHD medications will be 25 percent higher in five years. That's the main reason why Express Scripts decided to do this deeper analysis, to see what's driving the trend. If we see patterns from prescriptions that are coming in, we can intervene if someone shouldn't be on this medication or if we suspect fraud. We're beginning to put our brains around tightening those monitoring systems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"7WRNz7KKp9AwOEcEZQA5VRzGtVm5qH8j\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18141\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/177861835-e1394820572797.jpg\">\u003cimg class=\"size-large wp-image-18141\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/177861835-640x494.jpg\" alt=\"Women ages 19 to 25 have higher rates of ADHD medication use than girls ages 12 to 18. (Getty Images)\" width=\"640\" height=\"494\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Women ages 19 to 25 have higher rates of ADHD medication use than girls ages 12 to 18. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/03/14/289821414/young-women-increasingly-turn-to-adhd-drugs\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Use of ADHD drugs continues to rise in the United States, but the group whose use is increasing the most may come as a surprise: young women.\u003c/p>\n\u003cp>An \u003ca href=\"http://lab.express-scripts.com/wp-content/uploads/2014/03/ADHD_March2014_ExpressScripts.pdf\">analysis\u003c/a> of prescriptions filled from 2008 to 2012 through Express Scripts, a pharmacy benefit management company, found that use of ADHD medications rose 35.5 percent overall. The company's database includes 15 million people with private insurance.\u003c/p>\n\u003cfigure id=\"attachment_18147\" class=\"wp-caption alignleft\" style=\"max-width: 259px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/Screen-Shot-2014-03-14-at-11.20.07-AM.png\">\u003cimg class=\"size-medium wp-image-18147\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/Screen-Shot-2014-03-14-at-11.20.07-AM-300x347.png\" alt=\"Children and young adults on ADHD medications by gender. (Express Scripts)\" width=\"259\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Children and young adults on ADHD medications by gender. (Express Scripts)\u003c/figcaption>\u003c/figure>\n\u003cp>The medications, largely stimulants like Ritalin and Adderall, are still most commonly prescribed to boys ages 12 to 18. In 2012 7.8 percent of boys ages 4 to 18 were taking an ADHD medication -- that's more than twice the rate of girls (3.5 percent). But in young adulthood, ages 19 to 25, men's use plummets, while young women's rate increases. From ages 26 to 64, use of ADHD medications by women exceeds that of men.\u003c/p>\n\u003cp>To find out more about what's going on, we talked with \u003ca href=\"http://lab.express-scripts.com/author/david-muzina/\">Dr. David Muzina\u003c/a>, a psychiatrist who is the vice president and national practice leader for neuroscience at Express Scripts. This is an edited version of our conversation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>The Centers for Disease Control and Prevention and others have \u003ca href=\"http://www.npr.org/blogs/health/2013/11/22/246771526/more-children-are-being-medicated-for-adhd-than-before\">reported\u003c/a> increases in use of ADHD medications in children, but this increase in adults seems huge. What's happening there?\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>ADHD is no longer just a childhood condition. Many of the children and adolescents who were diagnosed 10 years ago are now adults, and we know that about 1 in 3 kids carry ADHD with them into adulthood. I think that's one reason why the numbers in adults are going up. And there's been progressively more attention on ADHD in the public sphere. More adults recognize the symptoms: \"Oh, I'm not concentrating, I'm not focusing. Maybe I have ADHD.\"\u003c/p>\n\u003cp>Then there's overdiagnosis, overtreatment and perhaps misuse. Frankly, many prescribers mistake a patient's objective reporting of symptoms like being forgetful for ADHD. Are there life stressors, is there a medical condition, is there depression or anxiety that explains this better?\u003c/p>\n\u003cp>\u003cstrong>You're seeing a drop-off in young men using ADHD drugs after age 18. Why?\u003c/strong>\u003c/p>\n\u003cp>Men are less likely to go to the doctor, and take the meds, and fill the meds. We're thinking about the 18-, 19-year-old who's going off to college. They're going to the doctor only once or twice a year.\u003c/p>\n\u003cp>\u003cstrong>But then why this big spike among women the same age, with 4 percent of young women taking ADHD meds in 2012?\u003c/strong>\u003c/p>\n\u003cp>It's been known for a long, long time that if girls have ADHD they are more likely to have the inattention form, not the hyperactive, aggressive, disruptive form. Perhaps that difference in how ADHD can look is why the diagnosis is missed in girls. They may be quietly suffering and having trouble in school, but they're not disruptive.\u003c/p>\n\u003cp>They move on into life, where those inattentive symptoms may reveal themselves as academic and social pressures compound. Now it's becoming more of an issue.\u003c/p>\n\u003cp>And lastly, we know that women in the United States are increasingly juggling more and more and more. Women still tend to have the majority of the responsibilities at home, particularly when families start up. That elevation of pressure and stress can either produce symptoms like ADHD, or that additional stress can express the underlying ADHD that previously had not been diagnosed.\u003c/p>\n\u003cp>\u003cstrong>Stimulant drugs like Ritalin are pretty well-known for improving energy and concentration, even if you don't have ADHD. Could that be a factor here?\u003c/strong>\u003c/p>\n\u003cp>There may be an element here of medication being prescribed off-label to help with that, as well as the desire to suppress appetite and lose weight. It's totally not approved for that. But it's popularized and perhaps glorified to some extent in popular media, including women's magazines. I've seen references to using these medications for weight loss.\u003c/p>\n\u003cp>\u003cstrong>Is this the tip of the iceberg?\u003c/strong>\u003c/p>\n\u003cp>I think we're into the iceberg. We forecast that use of ADHD medications will be 25 percent higher in five years. That's the main reason why Express Scripts decided to do this deeper analysis, to see what's driving the trend. If we see patterns from prescriptions that are coming in, we can intervene if someone shouldn't be on this medication or if we suspect fraud. We're beginning to put our brains around tightening those monitoring systems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"7WRNz7KKp9AwOEcEZQA5VRzGtVm5qH8j\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study: Estrogen Therapy May Help Some Older Women at Risk for Alzheimer's Disease",
"title": "Study: Estrogen Therapy May Help Some Older Women at Risk for Alzheimer's Disease",
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"content": "\u003cfigure id=\"attachment_18086\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/2380867-e1394646803472.jpg\">\u003cimg class=\"size-large wp-image-18086\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/2380867-640x341.jpg\" alt=\"Estrogen replacement patches. (Ian Waldie/Getty Images)\" width=\"640\" height=\"341\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Estrogen replacement patches. (Ian Waldie/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Postmenopausal women have heard just about everything when it comes to hormone therapy. In the 1990s, doctors routinely recommended it, believing that it helped women avoid heart attacks, thinning bones and other problems of aging. Then along came the Women's Health Initiative study, which first found hormone therapy (HT) created more risks than benefits -- \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1745676\" target=\"_blank\">then found that over time \u003c/a>some of those risks subsided, at least somewhat.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It's a very provocative finding, without a doubt.\" \u003c/aside>\n\u003cp>But one main criticism of the Women's Health Initiative study was that women were recruited to start on hormone therapy long after they had gone through menopause. The women were ages 65 or older.\u003c/p>\n\u003cp>Today, \u003ca href=\"http://www.menopause.org/for-women/menopauseflashes/news-you-can-use-about-hormone-therapy\" target=\"_blank\">many doctors believe\u003c/a> that HT started at the time of menopause -- or soon after -- can help women with hot flashes, vaginal dryness and other symptoms.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Now a small study at Stanford has looked at another area of interest with HT -- the possible effects of estrogen on the brain. Conflicting evidence has indicated that HT can help women fight dementia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In this study, instead of starting women on hormones, as the Women's Health Initiative study did, the Stanford researchers recruited women already taking them and then randomized them into two groups -- some would continue taking hormones, some would stop.\u003c/p>\n\u003cp>\"They start women on hormones, and we stopped women on hormones. Biologically it's a very different phenomenon,\" said Dr. Natalie Rasgon, director of the Stanford Center for Neuroscience in Women's Health, lead author of the study.\u003c/p>\n\u003cp>Rasgon and her team also recruited significantly younger women, ages 50-65. The researchers measured metabolic activity in specific brain regions associated with memory and executive function, using sophisticated PET scans. Rasgon said that studies have shown that these areas can show a decline before a person would notice symptoms of Alzheimer's disease.\u003c/p>\n\u003cp>\u003cstrong>One Type of Estrogen Helps, Another Doesn't\u003c/strong>\u003c/p>\n\u003cp>They found that women taking a type of synthetic estrogen called estradiol saw that their brain function was better preserved. But here's the rub: Another kind of estrogen, conjugated equine estrogen, often known by the brand name Premarin, did not confer the same benefit. The study found that women who took Premarin saw a decline in the key brain regions studied. Results were published in \u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0089095\">Plos One.\u003c/a>\u003c/p>\n\u003cp>Many women who take hormone therapy take both synthetic estrogen and progesterone, in part because estrogen therapy alone increases a woman's risk of uterine cancer. In women in the study who took both hormones, the synthetic progesterone wiped out any benefits provided by estradiol and increased the brain decline seen in women taking Premarin.\u003c/p>\n\u003cp>\"It's a very provocative finding, without a doubt,\" Rasgon said.\u003c/p>\n\u003cp>Estradiol is a \"synthetic molecule which exactly mimics the estrogen produced by the ovary,\" Rasgon said. Pfizer, which manufactures Premarin,\u003ca href=\"http://labeling.pfizer.com/showlabeling.aspx?id=131\" target=\"_blank\"> describes it\u003c/a> as \"a mixture of conjugated estrogens obtained exclusively from natural sources.\"\u003c/p>\n\u003cp>Before you rush out to take estradiol to help ward off Alzheimer's disease, Rasgon was careful to issue clear caveats. First, this is a small study, just 45 women, \"and it's a very specific population,\" she said. \"It's a population that is at risk for Azheimer's disease.\"\u003c/p>\n\u003cp>In order to be included in the study, women were required to be at increased risk for dementia, as indicated by having a first-degree relative with Alzheimer's disease, or that they were known to carry a specific variant of the \u003ca href=\"http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet\" target=\"_blank\">ApoE gene\u003c/a>, which is associated with increased risk of Alzheimer's. Women who had a personal history of major depression were also eligible.\u003c/p>\n\u003cp>In the PET scans, researchers were looking only at changes in metabolic activity in the brain -- a marker for brain preservation -- and not at direct cognition among the women. \"Metabolic changes in these brain regions presage overt symptoms of cognitive decline, sometimes by decades,\" Rasgon said. \"We're finding significant changes in women who are still cognitively intact.\"\u003c/p>\n\u003cp>\"This is a wonderful study,\" said Dr. David Rubinow, former head of the division of behavioral endocrinology at the National Institute of Mental Health and now at the University of North Carolina-Chapel Hill. He was not involved in the study. \"Dr. Rasgon was able to demonstrate that there were marked differences between conjugated equine estrogen and estradiol, and both of those observations had been suggested but were untested.\"\u003c/p>\n\u003cp>Rubinow said that more study is needed. \"Is this a study that suggests that we need to redouble our efforts to determine the effects of estradiol administered during perimenopause on cognitive function? The answer is yes.\"\u003c/p>\n\u003cp>\u003cstrong>Lack of Randomization Raises Questions\u003c/strong>\u003c/p>\n\u003cp>Dr. Rita Redberg, director of Women's Cardiovascular Services at UC San Francisco, was more skeptical. While changes in metabolic activity in the brain are a marker for disease, \"a marker is a long way from dementia,\" she noted. While people who now have Alzheimer's disease may well have started off with these changes years ago, it's likely that many people will experience these metabolic changes but never go on to develop dementia.\u003c/p>\n\u003cp>Redberg also was concerned that women came into the study already taking hormones. The study required that women already be taking them for at least one year, so this means the women were not randomly assigned estradiol or Premarin. \"There were likely differences among women who chose to take estradiol and women who chose to take (Premarin), so it wasn't randomized.\"\u003c/p>\n\u003cp>Women can slow or prevent memory loss by eating a healthy diet and getting regular exercise, Redberg said. Also, estrogen therapy increases a woman's risk for breast cancer.\u003c/p>\n\u003cp>Rasgon agreed that diet and exercise can help people reduce their risk of dementia, but she also stressed that women should assess risks and benefits of hormone therapy individually. \"Those risks and benefits have to be accounted for now for the type of hormone preparation they are taking and presence or absence of progestin,\" she said. \"Not every women taking progestin may need it. … Those factors were not part of the equation in the past and now they should be -- at least for those who are at risk for Alzheimer's disease.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"48k9vaFKqfQgzEla6UEXSIUUWAXWPjmR\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18086\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/2380867-e1394646803472.jpg\">\u003cimg class=\"size-large wp-image-18086\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/2380867-640x341.jpg\" alt=\"Estrogen replacement patches. (Ian Waldie/Getty Images)\" width=\"640\" height=\"341\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Estrogen replacement patches. (Ian Waldie/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Postmenopausal women have heard just about everything when it comes to hormone therapy. In the 1990s, doctors routinely recommended it, believing that it helped women avoid heart attacks, thinning bones and other problems of aging. Then along came the Women's Health Initiative study, which first found hormone therapy (HT) created more risks than benefits -- \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1745676\" target=\"_blank\">then found that over time \u003c/a>some of those risks subsided, at least somewhat.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It's a very provocative finding, without a doubt.\" \u003c/aside>\n\u003cp>But one main criticism of the Women's Health Initiative study was that women were recruited to start on hormone therapy long after they had gone through menopause. The women were ages 65 or older.\u003c/p>\n\u003cp>Today, \u003ca href=\"http://www.menopause.org/for-women/menopauseflashes/news-you-can-use-about-hormone-therapy\" target=\"_blank\">many doctors believe\u003c/a> that HT started at the time of menopause -- or soon after -- can help women with hot flashes, vaginal dryness and other symptoms.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Now a small study at Stanford has looked at another area of interest with HT -- the possible effects of estrogen on the brain. Conflicting evidence has indicated that HT can help women fight dementia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In this study, instead of starting women on hormones, as the Women's Health Initiative study did, the Stanford researchers recruited women already taking them and then randomized them into two groups -- some would continue taking hormones, some would stop.\u003c/p>\n\u003cp>\"They start women on hormones, and we stopped women on hormones. Biologically it's a very different phenomenon,\" said Dr. Natalie Rasgon, director of the Stanford Center for Neuroscience in Women's Health, lead author of the study.\u003c/p>\n\u003cp>Rasgon and her team also recruited significantly younger women, ages 50-65. The researchers measured metabolic activity in specific brain regions associated with memory and executive function, using sophisticated PET scans. Rasgon said that studies have shown that these areas can show a decline before a person would notice symptoms of Alzheimer's disease.\u003c/p>\n\u003cp>\u003cstrong>One Type of Estrogen Helps, Another Doesn't\u003c/strong>\u003c/p>\n\u003cp>They found that women taking a type of synthetic estrogen called estradiol saw that their brain function was better preserved. But here's the rub: Another kind of estrogen, conjugated equine estrogen, often known by the brand name Premarin, did not confer the same benefit. The study found that women who took Premarin saw a decline in the key brain regions studied. Results were published in \u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0089095\">Plos One.\u003c/a>\u003c/p>\n\u003cp>Many women who take hormone therapy take both synthetic estrogen and progesterone, in part because estrogen therapy alone increases a woman's risk of uterine cancer. In women in the study who took both hormones, the synthetic progesterone wiped out any benefits provided by estradiol and increased the brain decline seen in women taking Premarin.\u003c/p>\n\u003cp>\"It's a very provocative finding, without a doubt,\" Rasgon said.\u003c/p>\n\u003cp>Estradiol is a \"synthetic molecule which exactly mimics the estrogen produced by the ovary,\" Rasgon said. Pfizer, which manufactures Premarin,\u003ca href=\"http://labeling.pfizer.com/showlabeling.aspx?id=131\" target=\"_blank\"> describes it\u003c/a> as \"a mixture of conjugated estrogens obtained exclusively from natural sources.\"\u003c/p>\n\u003cp>Before you rush out to take estradiol to help ward off Alzheimer's disease, Rasgon was careful to issue clear caveats. First, this is a small study, just 45 women, \"and it's a very specific population,\" she said. \"It's a population that is at risk for Azheimer's disease.\"\u003c/p>\n\u003cp>In order to be included in the study, women were required to be at increased risk for dementia, as indicated by having a first-degree relative with Alzheimer's disease, or that they were known to carry a specific variant of the \u003ca href=\"http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet\" target=\"_blank\">ApoE gene\u003c/a>, which is associated with increased risk of Alzheimer's. Women who had a personal history of major depression were also eligible.\u003c/p>\n\u003cp>In the PET scans, researchers were looking only at changes in metabolic activity in the brain -- a marker for brain preservation -- and not at direct cognition among the women. \"Metabolic changes in these brain regions presage overt symptoms of cognitive decline, sometimes by decades,\" Rasgon said. \"We're finding significant changes in women who are still cognitively intact.\"\u003c/p>\n\u003cp>\"This is a wonderful study,\" said Dr. David Rubinow, former head of the division of behavioral endocrinology at the National Institute of Mental Health and now at the University of North Carolina-Chapel Hill. He was not involved in the study. \"Dr. Rasgon was able to demonstrate that there were marked differences between conjugated equine estrogen and estradiol, and both of those observations had been suggested but were untested.\"\u003c/p>\n\u003cp>Rubinow said that more study is needed. \"Is this a study that suggests that we need to redouble our efforts to determine the effects of estradiol administered during perimenopause on cognitive function? The answer is yes.\"\u003c/p>\n\u003cp>\u003cstrong>Lack of Randomization Raises Questions\u003c/strong>\u003c/p>\n\u003cp>Dr. Rita Redberg, director of Women's Cardiovascular Services at UC San Francisco, was more skeptical. While changes in metabolic activity in the brain are a marker for disease, \"a marker is a long way from dementia,\" she noted. While people who now have Alzheimer's disease may well have started off with these changes years ago, it's likely that many people will experience these metabolic changes but never go on to develop dementia.\u003c/p>\n\u003cp>Redberg also was concerned that women came into the study already taking hormones. The study required that women already be taking them for at least one year, so this means the women were not randomly assigned estradiol or Premarin. \"There were likely differences among women who chose to take estradiol and women who chose to take (Premarin), so it wasn't randomized.\"\u003c/p>\n\u003cp>Women can slow or prevent memory loss by eating a healthy diet and getting regular exercise, Redberg said. Also, estrogen therapy increases a woman's risk for breast cancer.\u003c/p>\n\u003cp>Rasgon agreed that diet and exercise can help people reduce their risk of dementia, but she also stressed that women should assess risks and benefits of hormone therapy individually. \"Those risks and benefits have to be accounted for now for the type of hormone preparation they are taking and presence or absence of progestin,\" she said. \"Not every women taking progestin may need it. … Those factors were not part of the equation in the past and now they should be -- at least for those who are at risk for Alzheimer's disease.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Contra Costa County Maps Schools by Vaccination Rates: Find Yours ",
"title": "Contra Costa County Maps Schools by Vaccination Rates: Find Yours ",
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"content": "\u003cfigure id=\"attachment_17972\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://cchealth.org/immunization/school-iz-levels.php\" target=\"_blank\">\u003cimg class=\"size-large wp-image-17972 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/Screen-Shot-2014-03-04-at-3.29.21-PM-640x292.png\" alt=\"The red dots mark a school or childcare facility where the vaccine opt-out rate is 10 percent or more. \" width=\"640\" height=\"292\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The red dots mark a school or child care facility where the vaccine opt-out rate is above 9.9 percent. The statewide average is 3 percent. (Contra Costa Health Department)\u003c/figcaption>\u003c/figure>\n\u003cp>In response to the troubling number of children whose parents opt out of vaccines for them, Contra Costa Health Services (CCHS) has published an \u003ca href=\"http://cchealth.org/immunization/school-iz-levels.php\" target=\"_blank\">interactive online map of vaccine rates\u003c/a> for schools and licensed child-care facilities with at least 15 children at each site across the county.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"There's not much wiggle room. We need about 90 percent of our community to be immune.\"\u003c/aside>\n\u003cp>The screen shot above shows the map. When you visit the site you can click on any of the dots, and a box appears to show you the name of the school, its address and rate of \"personal belief exemptions.\" While state law requires that every child be fully vaccinated to enter kindergarten, parents can opt out by filing a personal belief exemption (PBE), a signed statement that vaccines are against a parent's beliefs.\u003c/p>\n\u003cp>Paul Leung, immunization program manager for Contra Costa Public Health, said the goal of producing the map was to increases awareness. \"Many community members may not realize this dangerous, disturbing trend of parents choosing to skip vaccines for their children,\" he said. \"It not only puts these kids at greater risk of serious, dangerous diseases like measles and polio,\" but it also puts others at risk, he said, including those who cannot be vaccinated, such as babies, and children or adults too sick to be vaccinated. \u003c!--more-->\u003c/p>\n\u003cp>The map color-codes schools by PBE rates -- green is a PBE rate of 2.9 percent of less; yellow is 3-9.9 percent; red is greater than 9.9 percent.\u003c/p>\n\u003cp>\"There's not much wiggle room,\" Leung said. \"We need about 90 percent of our community to be immune. What we've done with our maps is highlight schools where 10 percent or more of their incoming kids have exempted from vaccines, so these schools are more vulnerable to vaccine-preventable outbreaks.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"644a949393a3957ed06ca92570f1ee94\"]\u003c/p>\n\u003cp>Contra Costa Health Department says the kindergartens at five elementary schools and students at 22 child-care facilities had PBE rates above 9.9 percent. The schools are both public and private. East Bay Waldorf School, a private school in El Sobrante, has the highest PBE rate in the county, 50 percent, CCHD says. In 2008, county health officials briefly closed the school due to a whooping cough outbreak.\u003c/p>\n\u003cp>The statewide average for personal belief exemptions is 3 percent.\u003c/p>\n\u003cp>In January, a new state law went into effect, requiring parents seeking a personal belief exemption to first meet with a health care provider to discuss the risks and benefits of vaccines and to learn more about vaccine-preventable illnesses. Washington passed a similar law in 2011, and its personal belief exemption rate has dropped by 40 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Contra Costa's data are for the current school year -- schools are all required to report vaccination rates and PBE rates to the state after school starts in September. The state has not released its data for all counties for this school year as yet, but if you live in one of California's other 57 counties, you can \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">look up your school's vaccination rates\u003c/a> for 2012-2013.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17972\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://cchealth.org/immunization/school-iz-levels.php\" target=\"_blank\">\u003cimg class=\"size-large wp-image-17972 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/Screen-Shot-2014-03-04-at-3.29.21-PM-640x292.png\" alt=\"The red dots mark a school or childcare facility where the vaccine opt-out rate is 10 percent or more. \" width=\"640\" height=\"292\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The red dots mark a school or child care facility where the vaccine opt-out rate is above 9.9 percent. The statewide average is 3 percent. (Contra Costa Health Department)\u003c/figcaption>\u003c/figure>\n\u003cp>In response to the troubling number of children whose parents opt out of vaccines for them, Contra Costa Health Services (CCHS) has published an \u003ca href=\"http://cchealth.org/immunization/school-iz-levels.php\" target=\"_blank\">interactive online map of vaccine rates\u003c/a> for schools and licensed child-care facilities with at least 15 children at each site across the county.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"There's not much wiggle room. We need about 90 percent of our community to be immune.\"\u003c/aside>\n\u003cp>The screen shot above shows the map. When you visit the site you can click on any of the dots, and a box appears to show you the name of the school, its address and rate of \"personal belief exemptions.\" While state law requires that every child be fully vaccinated to enter kindergarten, parents can opt out by filing a personal belief exemption (PBE), a signed statement that vaccines are against a parent's beliefs.\u003c/p>\n\u003cp>Paul Leung, immunization program manager for Contra Costa Public Health, said the goal of producing the map was to increases awareness. \"Many community members may not realize this dangerous, disturbing trend of parents choosing to skip vaccines for their children,\" he said. \"It not only puts these kids at greater risk of serious, dangerous diseases like measles and polio,\" but it also puts others at risk, he said, including those who cannot be vaccinated, such as babies, and children or adults too sick to be vaccinated. \u003c!--more-->\u003c/p>\n\u003cp>The map color-codes schools by PBE rates -- green is a PBE rate of 2.9 percent of less; yellow is 3-9.9 percent; red is greater than 9.9 percent.\u003c/p>\n\u003cp>\"There's not much wiggle room,\" Leung said. \"We need about 90 percent of our community to be immune. What we've done with our maps is highlight schools where 10 percent or more of their incoming kids have exempted from vaccines, so these schools are more vulnerable to vaccine-preventable outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Contra Costa Health Department says the kindergartens at five elementary schools and students at 22 child-care facilities had PBE rates above 9.9 percent. The schools are both public and private. East Bay Waldorf School, a private school in El Sobrante, has the highest PBE rate in the county, 50 percent, CCHD says. In 2008, county health officials briefly closed the school due to a whooping cough outbreak.\u003c/p>\n\u003cp>The statewide average for personal belief exemptions is 3 percent.\u003c/p>\n\u003cp>In January, a new state law went into effect, requiring parents seeking a personal belief exemption to first meet with a health care provider to discuss the risks and benefits of vaccines and to learn more about vaccine-preventable illnesses. Washington passed a similar law in 2011, and its personal belief exemption rate has dropped by 40 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Contra Costa's data are for the current school year -- schools are all required to report vaccination rates and PBE rates to the state after school starts in September. The state has not released its data for all counties for this school year as yet, but if you live in one of California's other 57 counties, you can \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">look up your school's vaccination rates\u003c/a> for 2012-2013.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Just One Dose of Many Common Medicines Can Kill a Child",
"title": "Just One Dose of Many Common Medicines Can Kill a Child",
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"content": "\u003cfigure id=\"attachment_17955\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/56492598-e1393869663329.jpg\">\u003cimg class=\"size-large wp-image-17955\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/56492598-640x426.jpg\" alt=\"Many over-the-counter products contain acetaminophen. One dose is usually not a problem, but it's easy to lose track of how much your child is taking. An overdose can cause liver failure or death. (Scott Olson/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many over-the-counter products contain acetaminophen. One dose is usually not a problem, but it's easy to lose track of how much your child is taking. An overdose can cause liver failure or death. (Scott Olson/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Scott Hensley,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/02/28/283933166/just-one-dose-of-many-common-medicines-can-kill-a-child\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Concerns about drug risks have led 28 state attorneys general to ask the Food and Drug Administration to reverse its approval of Zohydro, a long-acting narcotic painkiller, before the medicine is even \u003ca href=\"http://www.reuters.com/article/2014/02/27/us-usa-fda-zohydro-idUSBREA1Q1VT20140227\" target=\"_blank\">put on the market\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People often underestimate the risks of individual drugs and combinations of drugs for young children.\u003c/aside>\n\u003cp>The risks for addiction and overdose from the potent opioid outweigh the benefits of pain relief, critics say. Some point to the risk for children, in particular. A single capsule of Zohydro \u003ca href=\"https://www.zohydroerrems.com/Portal/Content%20Library/ZO0024.1213%20-%20Zohydro%20ISI.pdf\" target=\"_blank\">could kill a kid\u003c/a>, the medicine's instructions warn.\u003c/p>\n\u003cp>Other opioid painkillers, such as Vicodin and Percocet, are already fixtures in America's medicine cabinets. And as the prescriptions for drugs like these have surged, so have the reports of overdoses and deaths — for children and adults.\u003c/p>\n\u003cp>But opioids are just one kind of risky medicine. Doctors \u003ca href=\"http://webapps.acep.org/sa/Syllabi/SU-161.pdf\" target=\"_blank\">have a disturbingly long list of drugs\u003c/a> that can lead to the death of a child after just one or two doses.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There are lots of pills that kill,\" says Dr. Cathleen Clancy, associate medical director for the National Capital Poison Center in Washington, D.C. People often underestimate the risks of individual drugs and combinations of drugs for young children, she says.\u003c/p>\n\u003cp>\u003cstrong>Pain Relievers Top List of Drugs that Can Poison Kids\u003c/strong>\u003c/p>\n\u003cp>Pain relievers, or analgesics, are at the top of the list of drugs that poison kids. And a single dose of codeine, morphine or methadone can end a toddler's life.\u003c/p>\n\u003cp>Acetaminophen, sold generically and under the brand name Tylenol, is a popular pain reliever for children. A single dose isn't usually a problem. But an overdose can cause liver failure and death. The drug is an ingredient in many over-the-counter remedies, so it's easy to lose track of how much a child is taking.\u003c/p>\n\u003cp>\"Acetaminophen is probably the most common ingestion of analgesics that we get called about,\" Clancy says. \"It's just overwhelmingly available. Parents will give it to their kids maybe not respecting the dosage limitations.\"\u003c/p>\n\u003cp>One or two pills of blood pressure medicines known as calcium channel blockers can be lethal for kids. These drugs are usually generics. Diltiazem, nifedipine and verapamil are some of the common ones.\u003c/p>\n\u003cp>Several different medicines to control irregular heartbeats can also be deadly. They include quinidine and procainamide.\u003c/p>\n\u003cp>Clancy says a recent poisoning case involved a 12-month-old boy who ate a \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684030.html\" target=\"_blank\">verapamil\u003c/a> tablet he found in his father's wallet. The boy was treated in the emergency room and later put in the pediatric intensive care unit. He responded well to treatment and survived.\u003c/p>\n\u003cp>\u003cstrong>Some Diabetes Drugs Dangerous for Kids, Too\u003c/strong>\u003c/p>\n\u003cp>Some pills adults take to manage diabetes can be extremely hazardous, too, including Glucotrol, or glipizide, and chlorpropamide. Clancy noted three recent cases that involved young children getting ill after taking small doses of medicines like these. After treatment, all three children survived.\u003c/p>\n\u003cp>Pills aren't the only form of medicine that can be lethal for children, Clancy says. \"One patch can kill, too,\" she says. Patches containing \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a608049.html\" target=\"_blank\">clonidine\u003c/a>, a blood pressure medicine, can be deadly. Pain patches made with fentanyl can be, too. Even nicotine patches can be hazardous, Clancy says.\u003c/p>\n\u003cp>Be careful about disposing of patches where children might come across them. Used patches can still contain enough drug to do harm, if a small child sucks on them or swallows them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"9sGBsEJfkjmAX6nTXs3XIdIAJoRdDxRW\"]\u003c/p>\n\n",
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"excerpt": "\"There are lots of pills that kill,\" says Dr. Cathleen Clancy, associate medical director for the National Capital Poison Center in Washington, D.C. People often underestimate the risks of individual drugs and combinations of drugs for young children, she says.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17955\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/56492598-e1393869663329.jpg\">\u003cimg class=\"size-large wp-image-17955\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/56492598-640x426.jpg\" alt=\"Many over-the-counter products contain acetaminophen. One dose is usually not a problem, but it's easy to lose track of how much your child is taking. An overdose can cause liver failure or death. (Scott Olson/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many over-the-counter products contain acetaminophen. One dose is usually not a problem, but it's easy to lose track of how much your child is taking. An overdose can cause liver failure or death. (Scott Olson/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Scott Hensley,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/02/28/283933166/just-one-dose-of-many-common-medicines-can-kill-a-child\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Concerns about drug risks have led 28 state attorneys general to ask the Food and Drug Administration to reverse its approval of Zohydro, a long-acting narcotic painkiller, before the medicine is even \u003ca href=\"http://www.reuters.com/article/2014/02/27/us-usa-fda-zohydro-idUSBREA1Q1VT20140227\" target=\"_blank\">put on the market\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People often underestimate the risks of individual drugs and combinations of drugs for young children.\u003c/aside>\n\u003cp>The risks for addiction and overdose from the potent opioid outweigh the benefits of pain relief, critics say. Some point to the risk for children, in particular. A single capsule of Zohydro \u003ca href=\"https://www.zohydroerrems.com/Portal/Content%20Library/ZO0024.1213%20-%20Zohydro%20ISI.pdf\" target=\"_blank\">could kill a kid\u003c/a>, the medicine's instructions warn.\u003c/p>\n\u003cp>Other opioid painkillers, such as Vicodin and Percocet, are already fixtures in America's medicine cabinets. And as the prescriptions for drugs like these have surged, so have the reports of overdoses and deaths — for children and adults.\u003c/p>\n\u003cp>But opioids are just one kind of risky medicine. Doctors \u003ca href=\"http://webapps.acep.org/sa/Syllabi/SU-161.pdf\" target=\"_blank\">have a disturbingly long list of drugs\u003c/a> that can lead to the death of a child after just one or two doses.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There are lots of pills that kill,\" says Dr. Cathleen Clancy, associate medical director for the National Capital Poison Center in Washington, D.C. People often underestimate the risks of individual drugs and combinations of drugs for young children, she says.\u003c/p>\n\u003cp>\u003cstrong>Pain Relievers Top List of Drugs that Can Poison Kids\u003c/strong>\u003c/p>\n\u003cp>Pain relievers, or analgesics, are at the top of the list of drugs that poison kids. And a single dose of codeine, morphine or methadone can end a toddler's life.\u003c/p>\n\u003cp>Acetaminophen, sold generically and under the brand name Tylenol, is a popular pain reliever for children. A single dose isn't usually a problem. But an overdose can cause liver failure and death. The drug is an ingredient in many over-the-counter remedies, so it's easy to lose track of how much a child is taking.\u003c/p>\n\u003cp>\"Acetaminophen is probably the most common ingestion of analgesics that we get called about,\" Clancy says. \"It's just overwhelmingly available. Parents will give it to their kids maybe not respecting the dosage limitations.\"\u003c/p>\n\u003cp>One or two pills of blood pressure medicines known as calcium channel blockers can be lethal for kids. These drugs are usually generics. Diltiazem, nifedipine and verapamil are some of the common ones.\u003c/p>\n\u003cp>Several different medicines to control irregular heartbeats can also be deadly. They include quinidine and procainamide.\u003c/p>\n\u003cp>Clancy says a recent poisoning case involved a 12-month-old boy who ate a \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684030.html\" target=\"_blank\">verapamil\u003c/a> tablet he found in his father's wallet. The boy was treated in the emergency room and later put in the pediatric intensive care unit. He responded well to treatment and survived.\u003c/p>\n\u003cp>\u003cstrong>Some Diabetes Drugs Dangerous for Kids, Too\u003c/strong>\u003c/p>\n\u003cp>Some pills adults take to manage diabetes can be extremely hazardous, too, including Glucotrol, or glipizide, and chlorpropamide. Clancy noted three recent cases that involved young children getting ill after taking small doses of medicines like these. After treatment, all three children survived.\u003c/p>\n\u003cp>Pills aren't the only form of medicine that can be lethal for children, Clancy says. \"One patch can kill, too,\" she says. Patches containing \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a608049.html\" target=\"_blank\">clonidine\u003c/a>, a blood pressure medicine, can be deadly. Pain patches made with fentanyl can be, too. Even nicotine patches can be hazardous, Clancy says.\u003c/p>\n\u003cp>Be careful about disposing of patches where children might come across them. Used patches can still contain enough drug to do harm, if a small child sucks on them or swallows them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"9sGBsEJfkjmAX6nTXs3XIdIAJoRdDxRW\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Food Labels to Focus on Calories, Sugar",
"title": "New Food Labels to Focus on Calories, Sugar",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_17920\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/dannynic/8407037563/sizes/l/\">\u003cimg class=\"size-large wp-image-17920\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/8407037563_11bbebbee2_b-640x470.jpg\" alt=\"Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\" width=\"640\" height=\"470\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/02/27/283055089/first-look-the-fdas-nutrition-label-gets-a-makeover\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ready for a reality check about how many calories you're eating or drinking?\u003c/p>\n\u003cp>The proposed new nutrition facts panel may help.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I've been hoping for years that the FDA would list added sugars,\" -- Marion Nestle, NYU Nutrition Professor \u003c/aside>\n\u003cp>The Obama administration Thursday released its proposed tweaks to the iconic black and white panel that we're all accustomed to seeing on food packages.\u003c/p>\n\u003cp>The most visible change is that calorie counts are bigger and bolder — to give them greater emphasis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, serving sizes start to reflect the way most of us really eat. Take, for example, ice cream. The current serving size is a half-cup. But who eats that little?\u003c/p>\n\u003cp>Under the proposed new label, the serving size would become 1 cup. So, when you scoop a bowl of mint chocolate chip, the calorie count that you see on the label will probably be much closer to what you're actually eating.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Another example: A 20-ounce bottle of soda would be labeled as one serving. And with that, the calorie count at the top would come closer to reality.\u003c/p>\n\u003cp>Another significant change: The new panel will include a separate line for added sugars.\u003c/p>\n\u003cp>This is aimed at helping consumers distinguish between the sugars that are naturally found in foods (such as the sugar in raisins found in cereal) from the refined sugars that \u003ca href=\"http://www.webmd.com/food-recipes/features/sugar-shockers-foods-surprisingly-high-in-sugar\" target=\"_blank\">food manufacturers add to their products\u003c/a>.\u003c/p>\n\u003cp>\"I've been hoping for years that the FDA would list added sugars,\" Marion Nestle, a professor of nutrition at New York University, tells us. \"I definitely think it's helpful.\"\u003c/p>\n\u003cp>As we've reported, there's a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/04/sugar-is-a-risk-for-heart-disease-too/\" target=\"_blank\">solid body of evidence\u003c/a> linking excessive sugar consumption to an increased risk of heart disease and other ailments.\u003c/p>\n\u003cp>And the intent here, senior administration officials say, is to help cue Americans to consume less of it. Despite industry opposition to the listing of added sugars, officials say they're confident the science is strong enough to justify adding it to the label.\u003c/p>\n\u003cfigure id=\"attachment_17917\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM.png\">\u003cimg class=\"size-large wp-image-17917\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM-640x553.png\" alt=\"Proposed new food label from the Food and Drug Administration. \" width=\"640\" height=\"553\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposed new food label from the Food and Drug Administration.\u003c/figcaption>\u003c/figure>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"xMOBk5ALaPzOtje43iBVRVTPGrSv2FkY\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17920\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/dannynic/8407037563/sizes/l/\">\u003cimg class=\"size-large wp-image-17920\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/8407037563_11bbebbee2_b-640x470.jpg\" alt=\"Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\" width=\"640\" height=\"470\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/02/27/283055089/first-look-the-fdas-nutrition-label-gets-a-makeover\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ready for a reality check about how many calories you're eating or drinking?\u003c/p>\n\u003cp>The proposed new nutrition facts panel may help.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I've been hoping for years that the FDA would list added sugars,\" -- Marion Nestle, NYU Nutrition Professor \u003c/aside>\n\u003cp>The Obama administration Thursday released its proposed tweaks to the iconic black and white panel that we're all accustomed to seeing on food packages.\u003c/p>\n\u003cp>The most visible change is that calorie counts are bigger and bolder — to give them greater emphasis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition, serving sizes start to reflect the way most of us really eat. Take, for example, ice cream. The current serving size is a half-cup. But who eats that little?\u003c/p>\n\u003cp>Under the proposed new label, the serving size would become 1 cup. So, when you scoop a bowl of mint chocolate chip, the calorie count that you see on the label will probably be much closer to what you're actually eating.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Another example: A 20-ounce bottle of soda would be labeled as one serving. And with that, the calorie count at the top would come closer to reality.\u003c/p>\n\u003cp>Another significant change: The new panel will include a separate line for added sugars.\u003c/p>\n\u003cp>This is aimed at helping consumers distinguish between the sugars that are naturally found in foods (such as the sugar in raisins found in cereal) from the refined sugars that \u003ca href=\"http://www.webmd.com/food-recipes/features/sugar-shockers-foods-surprisingly-high-in-sugar\" target=\"_blank\">food manufacturers add to their products\u003c/a>.\u003c/p>\n\u003cp>\"I've been hoping for years that the FDA would list added sugars,\" Marion Nestle, a professor of nutrition at New York University, tells us. \"I definitely think it's helpful.\"\u003c/p>\n\u003cp>As we've reported, there's a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/04/sugar-is-a-risk-for-heart-disease-too/\" target=\"_blank\">solid body of evidence\u003c/a> linking excessive sugar consumption to an increased risk of heart disease and other ailments.\u003c/p>\n\u003cp>And the intent here, senior administration officials say, is to help cue Americans to consume less of it. Despite industry opposition to the listing of added sugars, officials say they're confident the science is strong enough to justify adding it to the label.\u003c/p>\n\u003cfigure id=\"attachment_17917\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM.png\">\u003cimg class=\"size-large wp-image-17917\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM-640x553.png\" alt=\"Proposed new food label from the Food and Drug Administration. \" width=\"640\" height=\"553\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposed new food label from the Food and Drug Administration.\u003c/figcaption>\u003c/figure>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"xMOBk5ALaPzOtje43iBVRVTPGrSv2FkY\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "'Insufficient Evidence' That Vitamins Prevent Heart Disease, Cancer",
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"content": "\u003cfigure id=\"attachment_16791\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/146873360-e1387392461923.jpg\">\u003cimg class=\"size-large wp-image-16791\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/146873360-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brittany Patterson\u003c/strong>\u003c/p>\n\u003cp>Toss those vitamin bottles and instead opt for a well-balanced diet if you’re looking to prevent heart disease or cancer.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force released\u003ca href=\"http://annals.org/article.aspx?articleid=1832969\" target=\"_blank\"> new recommendations\u003c/a> Monday regarding both multivitamins and certain supplements -- and their potential to help prevent heart disease and cancer. The task force \"concludes that the current evidence is insufficient to assess the balance of benefits and harms\" of the use of multivitamins, vitamins, minerals and other dietary supplements to prevent heart disease or cancer.\u003c/p>\n\u003cp>The task force is, however, recommending against use of beta-carotene and vitamin E supplements.\u003c!--more-->\u003c/p>\n\u003cp>“It’s essential to know that science has told us something — vitamin E and beta-carotene, they don’t work and sometimes cause harm,” said Dr. Kirsten Bibbins-Domingo, a cardiovascular epidemiologist at UC San Francisco and member of the task force.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The recommendations apply to healthy adults ages 50 and older who do not have any special nutritional needs.\u003c/p>\n\u003cp>The task force, a 16-member volunteer panel of national experts in prevention that makes evidence-based recommendations about preventive services -- including screenings and medications -- examined recent studies and found mostly inconclusive evidence.\u003c/p>\n\u003cp>For vitamin E they found no net preventive benefit, but for beta-carotene the research showed increased risk for lung cancer in some people, including those who smoke or are exposed to asbestos.\u003c/p>\n\u003cp>According to the Centers for Disease Control and Prevention, about 600,000 people die of heart disease in the United States every year. Nearly as many people die of all forms of cancer combined.\u003c/p>\n\u003cp>Vitamin and supplement use has been on the rise in the United States. In 2011, the CDC reported that more than half of adult Americans take at least one dietary supplement, such as multivitamins, minerals and herbs.\u003c/p>\n\u003cp>According to Bibbins-Domingo, some vitamins are essential for certain biological processes in the body, and researchers are examining how some of them, such as antioxidants, might have protective qualities. But, she said, the research hasn’t shown these nutrients work when people take them as individual supplements.\u003c/p>\n\u003cp>This new recommendation is an update to one the task force \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsvita.htm\" target=\"_blank\">initially made in 200\u003c/a>3. The panel has the option to revisit its stance on issues every five years if new evidence is available, Bibbins-Domingo said. In this case new studies had been done, but the evidence was still not enough to make a recommendation either way for most supplements.\u003c/p>\n\u003cp>A diet with fruits, vegetables, whole grains, fat-free and low-fat dairy products and seafood has been associated with a reduced risk of heart disease and cancer.\u003c/p>\n\u003cp>“If you’re taking supplements because you want to prevent heart disease and cancer, there’s just not enough evidence,” she said. “If your goal is to prevent heart disease and cancer, a healthy, balanced diet is the way to go.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"VNNUDz7ewE2xWSLBN7AcBnOBBgYIQjUU\"]\u003c/p>\n\n",
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"excerpt": "The U.S. Preventive Services Task Force released new recommendations Monday regarding both multivitamins and certain supplements -- and their potential to help prevent heart disease and cancer. The Task Force \"concludes that the current evidence is insufficient to assess the balance of benefits and harms\" of the use of multivitamins, vitamins, minerals and other dietary supplements to prevent heart disease or cancer.\r\n\r\nThe task force is, however, recommending against use of beta-carotene and vitamin E supplements.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16791\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/146873360-e1387392461923.jpg\">\u003cimg class=\"size-large wp-image-16791\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/146873360-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brittany Patterson\u003c/strong>\u003c/p>\n\u003cp>Toss those vitamin bottles and instead opt for a well-balanced diet if you’re looking to prevent heart disease or cancer.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force released\u003ca href=\"http://annals.org/article.aspx?articleid=1832969\" target=\"_blank\"> new recommendations\u003c/a> Monday regarding both multivitamins and certain supplements -- and their potential to help prevent heart disease and cancer. The task force \"concludes that the current evidence is insufficient to assess the balance of benefits and harms\" of the use of multivitamins, vitamins, minerals and other dietary supplements to prevent heart disease or cancer.\u003c/p>\n\u003cp>The task force is, however, recommending against use of beta-carotene and vitamin E supplements.\u003c!--more-->\u003c/p>\n\u003cp>“It’s essential to know that science has told us something — vitamin E and beta-carotene, they don’t work and sometimes cause harm,” said Dr. Kirsten Bibbins-Domingo, a cardiovascular epidemiologist at UC San Francisco and member of the task force.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The recommendations apply to healthy adults ages 50 and older who do not have any special nutritional needs.\u003c/p>\n\u003cp>The task force, a 16-member volunteer panel of national experts in prevention that makes evidence-based recommendations about preventive services -- including screenings and medications -- examined recent studies and found mostly inconclusive evidence.\u003c/p>\n\u003cp>For vitamin E they found no net preventive benefit, but for beta-carotene the research showed increased risk for lung cancer in some people, including those who smoke or are exposed to asbestos.\u003c/p>\n\u003cp>According to the Centers for Disease Control and Prevention, about 600,000 people die of heart disease in the United States every year. Nearly as many people die of all forms of cancer combined.\u003c/p>\n\u003cp>Vitamin and supplement use has been on the rise in the United States. In 2011, the CDC reported that more than half of adult Americans take at least one dietary supplement, such as multivitamins, minerals and herbs.\u003c/p>\n\u003cp>According to Bibbins-Domingo, some vitamins are essential for certain biological processes in the body, and researchers are examining how some of them, such as antioxidants, might have protective qualities. But, she said, the research hasn’t shown these nutrients work when people take them as individual supplements.\u003c/p>\n\u003cp>This new recommendation is an update to one the task force \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsvita.htm\" target=\"_blank\">initially made in 200\u003c/a>3. The panel has the option to revisit its stance on issues every five years if new evidence is available, Bibbins-Domingo said. In this case new studies had been done, but the evidence was still not enough to make a recommendation either way for most supplements.\u003c/p>\n\u003cp>A diet with fruits, vegetables, whole grains, fat-free and low-fat dairy products and seafood has been associated with a reduced risk of heart disease and cancer.\u003c/p>\n\u003cp>“If you’re taking supplements because you want to prevent heart disease and cancer, there’s just not enough evidence,” she said. “If your goal is to prevent heart disease and cancer, a healthy, balanced diet is the way to go.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"VNNUDz7ewE2xWSLBN7AcBnOBBgYIQjUU\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "HPV Vaccine Prevents Cancer, Yet Parents Slow To Make Sure Kids Get It",
"title": "HPV Vaccine Prevents Cancer, Yet Parents Slow To Make Sure Kids Get It",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_17815\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/vcucns/6792819478/sizes/l/\">\u003cimg class=\"size-large wp-image-17815 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/6792819478_ce19ec1b85_b-640x425.jpg\" alt=\"Studies show the HPV vaccine is highly protective, but as many as two-thirds of 11 and 12-year-old girls don't get it. (Art Writ/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Studies show the HPV vaccine is highly protective, but as many as two-thirds of 11 and 12-year-old girls don't get it. (Art Writ/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/02/19/279609708/parents-and-teens-arent-up-to-speed-on-hpv-risks-doctors-say\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>You would think that a vaccine that could prevent cancer would be an easy sell, but that's hasn't proven to be true so far with the vaccine to prevent cervical cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This is a vaccine that protects against cancer; what could be better than that?\" \u003c/aside>\n\u003cp>Just 33 percent of girls and less than 7 percent of boys in the U.S. have gotten all three recommended doses of the vaccine to protect against the \u003ca href=\"http://www.cdc.gov/std/hpv/stdfact-hpv.htm\" target=\"_blank\">human papillomavirus\u003c/a>, which causes cervical and other cancers. Compare that to the tiny African nation of Rwanda, where \u003ca href=\"www.who.int/bulletin/volumes/90/8/BLT-11-097253-table-T1.html\" target=\"_blank\">more than 90 percent\u003c/a> of sixth-grade girls were vaccinated in 2011, or Australia, where \u003ca href=\"http://www.bmj.com/content/346/bmj.f2032\" target=\"_blank\">73 percent \u003c/a>of 12- and 13-year-old girls have gotten all three vaccines.\u003c/p>\n\u003cp>\"This is a vaccine that protects against cancer; what could be better than that?\" asks Shannon Stokley, an epidemiologist with the Centers for Disease Control and Prevention. She and other public health officials are trying to figure out the best ways to persuade American teenagers and preteens to get the HPV vaccine.\u003c!--more-->\u003c/p>\n\u003cp>The argument for it is simple: HPV is the \u003ca href=\"http://www.cdc.gov/hpv/whatishpv.html\" target=\"_blank\">most common\u003c/a> sexually transmitted infection. Most HPV viruses are harmless. But a few types can cause cervical, anal and penile cancer, as well as genital warts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We don't know who is going to develop cancer or who will clear infection,\" Stokley says, \"which is why it's so critical to protect adolescents with the vaccine long before they're ever exposed to the virus.\"\u003c/p>\n\u003cp>The federal government \u003ca href=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil.html\">recommends\u003c/a> that the first of three HPV vaccine doses be given to children when they turn 11 or 12. A second dose is given about one month later, with a third and final dose within six months. HPV vaccine has been recommended for routine vaccination for girls since 2006 and for boys since 2011.\u003c/p>\n\u003cp>A recent \u003ca href=\"http://www.idsociety.org/2013_HPV_Vaccine/\">CDC study\u003c/a> found HPV prevalence was reduced by 56 percent among teenage girls between the ages of 14 and 19 who were vaccinated, suggesting the vaccine is highly protective. But as many as two thirds of 11- and 12-year-old girls don't get the HPV vaccine when they are at the doctor getting other vaccines.\u003c/p>\n\u003cp>About one quarter of parents say they don't plan on getting their daughters vaccinated in the next year, according to a \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6229a4.htm\">survey\u003c/a> published in July 2013 by the CDC. The most common reasons parents gave were thinking that the vaccine wasn't necessary (19.1 percent); the doctor didn't recommend it (14.2 percent); and safety concerns (13.1 percent).\u003c/p>\n\u003cp>Studies to date have shown no significant safety problems.\u003c/p>\n\u003cp>Then there are logistical issues. In countries like Australia and Rwanda with high rates of coverage, children are vaccinated at school. In the U.S., parents have to take children to a doctor or clinic three times to get all three shots.\u003c/p>\n\u003cp>Younger kids routinely go to a doctor for well child visits, but teenagers typically don't see a doctor regularly. And Stokley says \"doctors may feel uncomfortable\" talking about a vaccine that protects against sexually transmitted disease with teens or with parents of kids as young as 11.\u003c/p>\n\u003cp>The fact that one-fifth of parents think the vaccine isn't necessary shows that doctors have to be more vigilant in recommending the HPV vaccine, says Dr. Jeffrey Duchin. He is chief of the Communicable Disease Epidemiology & Immunization Section at the Seattle & King County Department of Public Health. \"Our research showed that parents did not have a lot of knowledge about how widespread HPV was, how readily it was transmitted, how easy it is to acquire and also about the severity of illness it can cause,\" he says.\u003c/p>\n\u003cp>People often mistakenly think the vaccine is targeted at teens who are sexually active, which Duchin says is simply not true. \"Once you become sexually active, you can acquire HPV infection quite readily. The entire strategy is based on protecting kids before they get infected, just like it is with all our other vaccine preventable diseases.\"\u003c/p>\n\u003cp>Earlier in February, the \u003ca href=\"http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/ExecutiveSummary.htm#sthash.acdO8QX4.3kLUVmTo.dpbs\">President's Cancer Panel\u003c/a> said that more need to be done to get the public educated about HPV and cancer. The panel also called for more efforts by health care providers to recommend and give vaccines, and to make sure the vaccines are available where teenagers get their health care.\u003c/p>\n\u003cp>Convenience is key, Duchin says. And that may include offering the HPV vaccine in school-based health clinics, or at pharmacies, similar to the flu vaccine.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"YKhgJlz1h9Hz9yGeIIPqNu1SOz9EU5SN\"]\u003c/p>\n\n",
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"excerpt": "You would think that a vaccine that could prevent cancer would be an easy sell, but that's hasn't proven to be true so far with the vaccine to prevent cervical cancer.\r\n\r\nJust 33 percent of girls and less than 7 percent of boys in the U.S. have gotten all three recommended doses of the vaccine to protect against the human papillomavirus, which causes cervical and other cancers. Compare that to the tiny African nation of Rwanda, where more than 90 percent of sixth-grade girls were vaccinated in 2011.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17815\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/vcucns/6792819478/sizes/l/\">\u003cimg class=\"size-large wp-image-17815 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/6792819478_ce19ec1b85_b-640x425.jpg\" alt=\"Studies show the HPV vaccine is highly protective, but as many as two-thirds of 11 and 12-year-old girls don't get it. (Art Writ/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Studies show the HPV vaccine is highly protective, but as many as two-thirds of 11 and 12-year-old girls don't get it. (Art Writ/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/02/19/279609708/parents-and-teens-arent-up-to-speed-on-hpv-risks-doctors-say\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>You would think that a vaccine that could prevent cancer would be an easy sell, but that's hasn't proven to be true so far with the vaccine to prevent cervical cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This is a vaccine that protects against cancer; what could be better than that?\" \u003c/aside>\n\u003cp>Just 33 percent of girls and less than 7 percent of boys in the U.S. have gotten all three recommended doses of the vaccine to protect against the \u003ca href=\"http://www.cdc.gov/std/hpv/stdfact-hpv.htm\" target=\"_blank\">human papillomavirus\u003c/a>, which causes cervical and other cancers. Compare that to the tiny African nation of Rwanda, where \u003ca href=\"www.who.int/bulletin/volumes/90/8/BLT-11-097253-table-T1.html\" target=\"_blank\">more than 90 percent\u003c/a> of sixth-grade girls were vaccinated in 2011, or Australia, where \u003ca href=\"http://www.bmj.com/content/346/bmj.f2032\" target=\"_blank\">73 percent \u003c/a>of 12- and 13-year-old girls have gotten all three vaccines.\u003c/p>\n\u003cp>\"This is a vaccine that protects against cancer; what could be better than that?\" asks Shannon Stokley, an epidemiologist with the Centers for Disease Control and Prevention. She and other public health officials are trying to figure out the best ways to persuade American teenagers and preteens to get the HPV vaccine.\u003c!--more-->\u003c/p>\n\u003cp>The argument for it is simple: HPV is the \u003ca href=\"http://www.cdc.gov/hpv/whatishpv.html\" target=\"_blank\">most common\u003c/a> sexually transmitted infection. Most HPV viruses are harmless. But a few types can cause cervical, anal and penile cancer, as well as genital warts.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We don't know who is going to develop cancer or who will clear infection,\" Stokley says, \"which is why it's so critical to protect adolescents with the vaccine long before they're ever exposed to the virus.\"\u003c/p>\n\u003cp>The federal government \u003ca href=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil.html\">recommends\u003c/a> that the first of three HPV vaccine doses be given to children when they turn 11 or 12. A second dose is given about one month later, with a third and final dose within six months. HPV vaccine has been recommended for routine vaccination for girls since 2006 and for boys since 2011.\u003c/p>\n\u003cp>A recent \u003ca href=\"http://www.idsociety.org/2013_HPV_Vaccine/\">CDC study\u003c/a> found HPV prevalence was reduced by 56 percent among teenage girls between the ages of 14 and 19 who were vaccinated, suggesting the vaccine is highly protective. But as many as two thirds of 11- and 12-year-old girls don't get the HPV vaccine when they are at the doctor getting other vaccines.\u003c/p>\n\u003cp>About one quarter of parents say they don't plan on getting their daughters vaccinated in the next year, according to a \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6229a4.htm\">survey\u003c/a> published in July 2013 by the CDC. The most common reasons parents gave were thinking that the vaccine wasn't necessary (19.1 percent); the doctor didn't recommend it (14.2 percent); and safety concerns (13.1 percent).\u003c/p>\n\u003cp>Studies to date have shown no significant safety problems.\u003c/p>\n\u003cp>Then there are logistical issues. In countries like Australia and Rwanda with high rates of coverage, children are vaccinated at school. In the U.S., parents have to take children to a doctor or clinic three times to get all three shots.\u003c/p>\n\u003cp>Younger kids routinely go to a doctor for well child visits, but teenagers typically don't see a doctor regularly. And Stokley says \"doctors may feel uncomfortable\" talking about a vaccine that protects against sexually transmitted disease with teens or with parents of kids as young as 11.\u003c/p>\n\u003cp>The fact that one-fifth of parents think the vaccine isn't necessary shows that doctors have to be more vigilant in recommending the HPV vaccine, says Dr. Jeffrey Duchin. He is chief of the Communicable Disease Epidemiology & Immunization Section at the Seattle & King County Department of Public Health. \"Our research showed that parents did not have a lot of knowledge about how widespread HPV was, how readily it was transmitted, how easy it is to acquire and also about the severity of illness it can cause,\" he says.\u003c/p>\n\u003cp>People often mistakenly think the vaccine is targeted at teens who are sexually active, which Duchin says is simply not true. \"Once you become sexually active, you can acquire HPV infection quite readily. The entire strategy is based on protecting kids before they get infected, just like it is with all our other vaccine preventable diseases.\"\u003c/p>\n\u003cp>Earlier in February, the \u003ca href=\"http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/ExecutiveSummary.htm#sthash.acdO8QX4.3kLUVmTo.dpbs\">President's Cancer Panel\u003c/a> said that more need to be done to get the public educated about HPV and cancer. The panel also called for more efforts by health care providers to recommend and give vaccines, and to make sure the vaccines are available where teenagers get their health care.\u003c/p>\n\u003cp>Convenience is key, Duchin says. And that may include offering the HPV vaccine in school-based health clinics, or at pharmacies, similar to the flu vaccine.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"YKhgJlz1h9Hz9yGeIIPqNu1SOz9EU5SN\"]\u003c/p>\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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