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Excerpts of Key Health News Stories in Major Media

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In a development that consumer groups say raises privacy issues, a growing number of hospitals are mining patients' personal financial information to figure out how likely they are to pay their bills. Some hospitals are peering into patients' credit reports, which contain information on people's lines of credit, debts and payment histories. Other hospitals are contracting with outside services that predict a patient's income and whether he or she is likely to walk away from a medical bill. Hospitals often use these services when patients are uninsured or have big out-of-pocket costs despite having health insurance. Consumer advocates say the practice creates the potential for hospitals to misuse the information by denying or cutting back on patients' care if they can't pay. What's more, hospitals could scour a patient's financial records for credit lines and encourage the patient to tap them, despite high interest rates or other costs. "It has the potential to put people at risk financially," says Mark Rukavina, executive director of the Access Project, a research and advocacy group that focuses on medical debt. The Health Insurance Portability and Accountability Act, or Hipaa, a federal law that has patient-privacy provisions, doesn't bar hospitals from providing patient payment histories to consumer reporting agencies. It's unclear how much latitude hospitals have to legally check a patient's financial information. Under the Fair Credit Reporting Act, hospitals are allowed to obtain patients' credit reports if they get their permission, says Rebecca Kuehn, an assistant director in the Federal Trade Commission's division of privacy and identity protection.

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The Environmental Protection Agency weakened one part of its new limits on smog-forming ozone after an unusual last-minute intervention by President Bush, according to documents released by the EPA. EPA officials initially tried to set a lower seasonal limit on ozone to protect wildlife, parks and farmland, as required under the law. Bush overruled EPA officials and on Tuesday ordered the agency to increase the limit, according to the documents. "It is unprecedented and an unlawful act of political interference for the president personally to override a decision that the Clean Air Act leaves exclusively to EPA's expert scientific judgment," said John Walke, clean-air director for the Natural Resources Defense Council. The president's order prompted a scramble by administration officials to rewrite the regulations to avoid a conflict with past EPA statements on the harm caused by ozone. Solicitor General Paul D. Clement warned administration officials ... that the rules contradicted the EPA's past submissions to the Supreme Court, according to sources familiar with the conversation. As a consequence, administration lawyers hustled to craft new legal justifications for the weakened standard. The dispute involved one of two distinct parts of the EPA's ozone restrictions: the "public welfare" standard, which is designed to protect against long-term harm from high ozone levels. The other part is known as the "public health" standard, which sets a legal limit on how high ozone levels can be at any one time. The two standards were set at the same level Wednesday, but until Bush asked for a change, the EPA had planned to set the "public welfare" standard at a lower level.

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A vast array of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in the drinking water supplies of at least 41 million Americans, an Associated Press investigation shows. To be sure, the concentrations of these pharmaceuticals are tiny, measured in quantities of parts per billion or trillion, far below the levels of a medical dose. But the presence of so many prescription drugs ... in so much of our drinking water is heightening worries among scientists of long-term consequences to human health. In the course of a five-month inquiry, the AP discovered that drugs have been detected in the drinking water supplies of 24 major metropolitan areas — from Southern California to Northern New Jersey, from Detroit to Louisville, Ky. Water providers rarely disclose results of pharmaceutical screenings, unless pressed, the AP found. How do the drugs get into the water? People take pills. Their bodies absorb some of the medication, but the rest of it passes through and is flushed down the toilet. The wastewater is treated before it is discharged into reservoirs, rivers or lakes. Then, some of the water is cleansed again at drinking water treatment plants and piped to consumers. But most treatments do not remove all drug residue. And while researchers do not yet understand the exact risks from decades of persistent exposure to random combinations of low levels of pharmaceuticals, recent studies — which have gone virtually unnoticed by the general public — have found alarming effects on human cells and wildlife. "We recognize it is a growing concern and we're taking it very seriously," said Benjamin H. Grumbles, assistant administrator for water at the U.S. Environmental Protection Agency.

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Government health officials have conceded that childhood vaccines worsened a rare, underlying disorder that ultimately led to autism-like symptoms in a Georgia girl, and that she should be paid from a federal vaccine-injury fund. Thousands of families are seeking compensation for disabilities they attribute to vaccines and a preservative. Medical and legal experts say the narrow wording and circumstances probably make the case an exception -- not a precedent for thousands of other pending claims. However, parents and advocates for autistic children see the case as a victory that may help certain others. Although the science on this is very limited, the girl's disorder may be more common in children with autism than in healthy ones. "It's a beginning," said Kevin Conway, a Boston, Massachusetts, lawyer representing more than 1,200 families with vaccine injury claims. "Each case is going to have to be proved on its individual merits. But it shows to me that the government has conceded that it's biologically plausible for a vaccine to cause these injuries. They've never done it before." Nearly 5,000 families are seeking compensation for autism or other developmental disabilities they say are caused by vaccines and a mercury-based preservative, thimerosal. It once was commonly used to prevent bacterial contamination but since 2001 has been used only in certain flu shots. Some cases contend that the cumulative effect of many shots given at once may have caused injuries. The cases are before a special "vaccine court" that doles out cash from a fund Congress set up to pay people injured by vaccines and to protect makers from damages as a way to help ensure an adequate vaccine supply.

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Under pressure from the chemical industry, the Environmental Protection Agency has dismissed an outspoken scientist who chaired a federal panel responsible for helping the agency determine the dangers of a flame retardant widely used in electronic equipment. Toxicologist Deborah Rice was appointed chair of an EPA scientific panel reviewing the chemical a year ago. Federal records show that she was removed from the panel in August after the American Chemistry Council, the lobbying group for chemical manufacturers, complained to a top-ranking EPA official that she was biased. The chemical, a brominated compound known as deca, is [commonly] used in the plastic housings of television sets. Rice, an award-winning former EPA scientist ... has studied low doses of deca and reported neurological effects in lab animals. The EPA is in the process of deciding how much daily exposure to deca is safe - a decision, expected next month, that could determine whether it can still be used in consumer products. The role of the expert panel was to review and comment on the scientific evidence. Sonya Lunder, a senior analyst at the Environmental Working Group, an advocacy group in Washington, said it was unprecedented for the EPA to remove an expert for expressing concerns about the potential dangers of a chemical. "It's a scary world if we create a precedent that says scientists involved in decision-making are perceived to be too biased," she said. In 2004, the EPA gave Rice and four colleagues an award for what it called "exceptionally high-quality research" for a study that linked lead exposure to premature puberty in girls.

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It's been dubbed a Noah's Ark for plant life and built to withstand an earthquake or a nuclear attack. Dug deep into the permafrost of a remote Arctic mountain, the "doomsday" vault is designed by Norway to protect the world's seeds from global catastrophe. The Svalbard Global Seed Vault, a backup to the world's 1,400 other seed banks, was to be officially inaugurated in a ceremony Tuesday on the northern rim of civilization attended by about 150 guests from 33 countries. The frozen vault has the capacity to store 4.5 million seed samples from around the globe, shielding them from climate change, war, natural disasters and other threats. Norway's government owns the vault in Svalbard, a frigid archipelago 620 miles from the North Pole. The Nordic country paid $9.1 million for construction, which took less than a year. Other countries can deposit seeds for free and reserve the right to withdraw them upon need. Giant air conditioning units have chilled the vault to just below zero, a temperature at which experts say many seeds could survive for 1,000 years. Inside the concrete entrance ... a roughly 400-foot-long tunnel of steel and concrete leads to three separate 32-by-88-foot chambers where the seeds will be stored. The first 600 boxes with 12 tons of seeds already have arrived from 20 seed banks around the world, Norwegian Agriculture Minister Terje Riis-Johansen said. Each chamber can hold 1.5 million packets holding all types of crop seeds, from carrots to wheat.

Despite living on a commune in rural Tennessee, Ina May Gaskin has had the kind of career success most people only dream about. Gaskin has helped to bring home birth and lay midwifery back from the brink of extinction in the United States. An obstetrical maneuver she learned from the indigenous Mayans of Guatemala has made it into scientific journals and medical textbooks, and her insistence on the rights of a birthing mother empowered a generation of women to demand changes from doctors and hospitals. In 1975, Gaskin published Spiritual Midwifery, which included birth stories and a primer on delivering babies. Her book has sold around 750,000 copies, has been translated into four languages and has inspired a generation of women to become midwives. She promoted the idea that a woman's state of mind will influence how easy her birth is and encouraged unorthodox ways to improve the woman's experience, like encouraging her to make out with her husband during labor. She has tried to widen the reach of her message by airing natural birth videos ... on television. "The women are so beautiful giving birth," she said. TV stations rarely have run them, calling them too graphic. "I started to think I should put them on YouTube," Gaskin said. Now, Gaskin has a film in the works that is in keeping with her anti-establishment, freewheeling nature. "We're doing a movie called The Orgasmic Birth," she said. That's not a metaphor. Gaskin says that under the right circumstances women experience a sort of birth ecstasy. "I mean, it's not a guarantee," she said, shrugging her shoulders and smiling, "but it's a possibility. It's the only way I can think to market it to (this) generation."

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Dozens of environmental health organizations in the United States and Canada are calling for an immediate moratorium on the use of a chemical, bisphenol A — or BPA — in food and beverage containers, including baby bottles. They say a new study found that, when exposed to heat, baby bottles release a chemical that, researchers say, has been linked to obesity, diabetes and developmental problems in lab animals. "When bottles are used extensively over time, and when they're heated, higher levels of this chemical leach out, exposing young infants to elevated levels of this unnecessary toxic chemical," says Mike Shaade at the Center for Health Environment and Justice. BPA is used to make plastic in 95 percent of baby bottles now on the market. But it is up for debate whether it is harmful or not. BPA is already in most of us: the Centers for Disease Control and Prevention found BPA in the urine of 95 percent of people it tested. Dr. Maida Galvez is a pediatrician at Mount Sinai Hospital in New York City, who studies whether traces of BPA found in children's urine is harmful to them. "We know the animal studies raise concerns, but there aren't human studies showing effects yet ... so, when we don't have the evidence, what we recommend is that parents try to err on the side of caution," she says.

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Lawmakers and watchdog groups had harsh words Monday for the U.S. Department of Agriculture after the agency ordered a recall of 143 million pounds of beef from a Southern California slaughterhouse. Beef products dating to Feb. 1, 2006, that came from Westland/Hallmark Meat Co. of Chino (San Bernardino County) are subject to the recall, which is the largest such action in U.S. history. The notice came after the Humane Society of the United States shot undercover video showing crippled and sick animals being shoved with forklifts - treatment that has also triggered an animal-abuse investigation. A congresswoman who chairs a House subcommittee that determines funding levels for the USDA sent a letter ... to the agency's undersecretary for food safety demanding an explanation of the Westland case before a March 5 budgetary review hearing. Rep. Rosa DeLauro, D-Conn., chairwoman of the House Agriculture, Food and Drug Administration Appropriations Subcommittee, called the scenes in the video inhumane and said the video "demonstrates just how far our food safety system has collapsed." DeLauro has called for an investigation into the government's ability to secure the safety of meat in the nation's schools. Westland was a major supplier of beef for the National School Lunch Program. She also asked how the agency is addressing staff shortages among slaughterhouse inspectors - an issue also raised by several food safety experts and watchdog groups. According to Felicia Nestor, a senior policy analyst with Food and Water Watch, a consumer advocacy group based in Washington, anywhere from 7 to 21 percent of slaughterhouse inspector positions have been left vacant by the USDA, depending on the district. "They just don't fill vacancies," Nestor said.

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Today, some scientists think [that] germs can teach our bodies how to fight back against tumors. Dr. John Timmerman, a cancer immunotherapy expert at UCLA's Jonsson Cancer Center, says this revolution has produced "the most exciting sets of compounds in cancer immunology." New studies are revealing that certain cancers may be reduced by exposure to disease-causing bacteria and viruses. The studies also imply that our cleaner, infection-free lifestyles may be contributing to the rise in certain cancers over the last 50 years, scientists say, because they make the immune system weaker or less mature. Germs cause disease but may also fortify the body, a notion summed up in a 2006 report by a team of Canadian researchers as "whatever does not kill me makes me stronger." In the 1980s, dermatologists began noticing that patients with severe acne, which is caused by another type of bacterium, have reduced rates of skin cancer, lymphoma and leukemia. According to a paper by Dr. Mohammad Namazi at the Shiraz University of Medical Sciences in Iran, studies showed that these bacteria, when injected into animals, appear to stimulate the immune system and shrink tumors. In reports published in the last two years, Harvey Checkoway, a University of Washington epidemiologist, has found that female cotton workers in Shanghai have a 40% to 60% lower risk of lung, breast, and pancreas cancer than other factory workers. Other recent studies by Giuseppe Mastrangelo at the University of Padua in Italy found that dairy farmers exposed to high levels of manure dust are up to five times less likely to develop lung cancer than their colleagues who work in open fields.

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As a U.S. taxpayer, you may be contributing to fewer cheap drugs on international shelves. Public dollars support the Office of the U.S. Trade Representative, the trade agency with authority to pressure foreign governments to change their domestic intellectual property laws. As such, the agency actively presses for laws that would keep generic drugs out of markets worldwide. Congress is considering legislation to create a separate executive branch office dedicated to using government resources for lobbying other countries to change their laws, sometimes exclusively to benefit certain U.S. companies. That's a bad idea for patients here and abroad, because it would give the U.S. government more power in an area where it should instead have less. The trade agency's interpretation of what other countries' domestic laws need to cover expands beyond the broadest definitions within U.S. law. To give one example, data gathered during clinical trials of new drugs are not protected by copyright, patent or trademark in the United States. The Food and Drug Administration restricts use of test results finding that a brand-name drug is safe when considering the safety of identical generic drugs. The trade representative is using its authority to press for comparable rules restricting the approval process for generic drugs in other countries. It doesn't take much sleuthing to follow the money back to the U.S. pharmaceutical manufacturers on the trade agency's advisory panel, who can maintain monopolist profits while a generic drug is blocked from the market in Guatemala, Malaysia or any of the dozen other countries that the trade agency is pressuring to adopt U.S.-style restrictions on generic drug approval.

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As they seek to document and demystify one of life's great thrills, scientists have run across some real head-scratchers. How, for example, can they explain the fact that some men and women who are paralyzed and numb below the waist are able to have orgasms? How to explain the "orgasmic auras" that can descend at the onset of epileptic seizures -- sensations so pleasurable they prompt some patients to refuse antiseizure medication? And how on Earth to explain the case of the amputee who felt his orgasms centered in that missing foot? No one -- no sexologist, no neuroscientist -- really knows. For a subject with so many armchair experts, the human orgasm is remarkably mysterious. But today, a few scientists are making real progress -- in part because they're changing their focus. To uncover the orgasm's secrets, researchers are looking ... to the place behind the scenes where the true magic happens. They're examining the central nervous system: the network of electrical impulses that zip to and fro through the brain and spinal cord. In an orgasm orchestra, the genitalia may be the instruments, but the central nervous system is the conductor. Armed with new lab tools and fearless volunteers, scientists are getting first-ever glimpses of how the brain lights up (and, in places, shuts down) when the orgasmic fireworks go off. They're tracing nerves and finding new pathways for pleasure that help explain how people with shattered spinal cords can defy sexual expectations.

A sea change in the consumption of a resource that Americans take for granted may be in store — something cheap, plentiful, widely enjoyed and a part of daily life. And it isn’t oil. It’s meat. Global demand for meat has multiplied in recent years, encouraged by growing affluence and nourished by the proliferation of huge, confined animal feeding operations. These assembly-line meat factories consume enormous amounts of energy, pollute water supplies, generate significant greenhouse gases and require ever-increasing amounts of corn, soy and other grains, a dependency that has led to the destruction of vast swaths of the world’s tropical rain forests. The world’s total meat supply was 71 million tons in 1961. In 2007, it was estimated to be 284 million tons. Per capita consumption has more than doubled over that period. (In the developing world, it rose twice as fast, doubling in the last 20 years.) At about 5 percent of the world’s population, [Americans] “process” (that is, grow and kill) nearly 10 billion animals a year, more than 15 percent of the world’s total. Growing meat (it’s hard to use the word “raising” when applied to animals in factory farms) uses so many resources that it’s a challenge to enumerate them all. An estimated 30 percent of the earth’s ice-free land is directly or indirectly involved in livestock production. Livestock production generates nearly a fifth of the world’s greenhouse gases — more than transportation. Though some 800 million people on the planet now suffer from hunger or malnutrition, the majority of corn and soy grown in the world feeds cattle, pigs and chickens.

"Some recent studies suggest that over-consumption of fluoride can raise the risks of disorders affecting teeth, bones, the brain and the thyroid gland," reports Scientific American [magazine]. "Scientific attitudes toward fluoridation may be starting to shift," writes author Dan Fagin. "Fluoride, the most consumed drug in the USA, is deliberately added to [two-thirds] of public water supplies theoretically to reduce tooth decay, but with no scientifically-valid evidence proving safety or effectiveness," says lawyer Paul Beeber [of the] New York State Coalition Opposed to Fluoridation. Fagin, Director of New York University's Science, Health and Environmental Reporting Program, writes, "There is no universally accepted optimal level for daily intake of fluoride." After [three] years of scrutinizing hundreds of studies, a National Research Council committee "concluded that fluoride can subtly alter endocrine function, especially in the thyroid -- the gland that produces hormones regulating growth and metabolism," reports Fagin. Fluoride in foods, beverages, medicines and dental products can result in fluoride over-consumption, visible in young children as dental fluorosis -- white spotted, yellow, brown and/or pitted teeth. Reports Fagin, "a series of epidemiological studies in China have associated high fluoride exposures with lower IQ. Epidemiological studies and tests on lab animals suggest that high fluoride exposure increases the risk of bone fracture, especially in vulnerable populations such as the elderly and diabetics."

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Scientists at a California company reported yesterday that they had created the first mature cloned human embryos from single skin cells taken from adults, a significant advance toward the goal of growing personalized stem cells for patients suffering from various diseases. Creation of the embryos -- grown from cells taken from the company's chief executive and one of its investors -- also offered sobering evidence that few, if any, technical barriers may remain to the creation of cloned babies. The study leader, who is also the medical director of a fertility clinic ... emphasized that he has no interest in cloning people. "It's unethical and it's illegal, and we hope no one else does it either," said Samuel H. Wood, chief executive of Stemagen in La Jolla, whose skin cells were cloned and who led the study. The closely held company hopes to make embryos that are clones, or genetic twins, of patients, then harvest stem cells from those embryos and grow them into replacement tissues. Opponents of research on human embryos lashed out at the approach. "This study seems to confirm that human cloning ... is technically possible," said Richard Doerflinger of the U.S. Conference of Catholic Bishops. "It does not answer the ethical or social questions about the mass-production of developing human lives in order to destroy them. It only tells us that these questions are more urgent than ever." Other critics noted that scientists in Japan and Wisconsin recently discovered a way to "reprogram" stem cells directly from skin cells, without having to make embryos as a middle step. "In light of the recent cell reprogramming developments, cloning-based stem cell research is less justified than ever," said Marcy Darnovsky of the Center for Genetics and Society.

[Robyn O’Brien's] story is one of several in a new book, Healthy Child, Healthy World. About two years ago, she fed her youngest child scrambled eggs. The baby’s face quickly swelled into a grotesque mask. Little Tory had a severe food allergy, and Ms. O’Brien’s journey had begun. Her theory — that the food supply is being manipulated with additives, genetic modification, hormones and herbicides, causing increases in allergies, autism and other disorders in children — is not supported by leading researchers or the largest allergy advocacy groups. [But] record numbers of parents are heading to doctors concerned that their children are allergic to a long list of foods. States are passing laws requiring schools to have policies protecting children with food allergies. No one knows why the number of allergies seems to be on the rise. Ms. O’Brien and leading allergy researchers agree that few reliable studies on food allergies exist. The best estimates suggest that 4 to 8 percent of young children suffer from them. Many health professionals, though, agree that something is changing. The hygiene hypothesis intrigues many researchers. It holds that children are being exposed to fewer micro-organisms and, as a result, have weaker immune systems. “But this alone cannot account for the massive relative increase in food allergy compared with other allergic disease such as asthma,” said Dr. Marc E. Rothenberg, the director of allergy and immunology at Cincinnati Children’s Hospital Medical Center. [Ms. O'Brien] chides top allergy doctors who are connected to Monsanto, the producer of herbicides and genetically modified seeds. She asserts that the Food Allergy and Anaphylaxis Network, the nation’s leading food allergy advocacy group, is tainted by the money it receives from food manufacturers and peanut growers.

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Bristol-Myers Squibb Co. and a former subsidiary have agreed to pay more than $515 million to settle federal and state investigations into their drug marketing and pricing practices. The civil settlement ... resolves a broad array of allegations against Bristol-Myers Squibb, dating from 1994 through 2005. Among them was a charge that the ... company illegally promoted the sale of Abilify, an anti-psychotic drug, for pediatric use and to treat dementia-related psychoses. Neither use is approved by the U.S. [FDA]. Although physicians are permitted to prescribe drugs for off-label uses, drug companies are prohibited from marketing them for uses that have not been approved by the FDA. U.S. Attorney Michael Sullivan said when pharmaceutical companies market drugs for unapproved uses, there is a potential risk that patients could be harmed, because the drugs have not been tested as rigorously as they are during the FDA approval process. The government also alleged the company paid illegal inducements in the form of consulting fees and trips to luxury resorts to influence doctors and other health care providers to buy and prescribe the company's drugs. The company's former generic drug subsidiary, Apothecon Inc., also was accused of giving illegal enticements to induce retail pharmacy and wholesale customers to buy its products. Bristol-Myers Squibb misreported its best price for the anti-depression drug Serzone, violating a law that requires drug companies to report their lowest price to Medicaid, prosecutors said. The company was selling Serzone to a larger commercial purchaser at a lower price, prosecutors said. Bristol-Myers Squibb and Apothecon also inflated prices for an assortment of oncology and generic drugs knowing that federal health care programs established reimbursement rates based on those prices, Sullivan said.

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Bay Area researchers are beginning the first major U.S. study into a mystery disease known for its frightening symptoms - among them, open sores and unidentifiable objects poking out of the skin - that doctors have long suspected is all in patients' heads. The study into Morgellons will start immediately. The research will be funded by the U.S. Centers for Disease Control and Prevention [and conducted by Kaiser Permanente]. Researchers are hoping to come up with a more specific definition of Morgellons and how prevalent it is in the Bay Area, which has one of the largest concentrations of ... cases of the disease in the country. The CDC is not yet agreeing that Morgellons is a medical condition. Many doctors believe that Morgellons is actually a psychiatric condition called delusional parasitosis. They say the filaments that patients report growing out of their skin are actually lint or threads from clothing, and the open sores are caused by patients scratching at skin when they perceive a crawling sensation. San Francisco resident Pat Miller has been to more than a dozen doctors since he first developed symptoms several years ago. He's been diagnosed with a wide variety of skin conditions, as well as delusional parasitosis, and few doctors have been willing to consider Morgellons. "I've developed this lack of love for doctors and health care systems. You pretty much have to become your own doctor." The nonprofit Morgellons Research Foundation says that more than 10,000 families in the United States have registered with the Web site, claiming at least one family member has the disease. About 24 percent of registered families are in California, and the Bay Area is one of several hot spots in the country. The research foundation estimates that 150 to 500 people in Northern California have Morgellons.

Note: Though mainstream science initially claimed Morgellons disease was purely psychological, much information is challenging this stance. For many revealing health stories from reliable sources, click here.

The U.S. Department of Agriculture yesterday asked U.S. farmers to keep their cloned animals off the market indefinitely even as Food and Drug Administration officials announced that food from cloned livestock is safe to eat. Bruce I. Knight, the USDA's undersecretary for marketing and regulatory programs, requested an ongoing "voluntary moratorium" to buy time for "an acceptance process" that Knight said consumers in the United States and abroad will need, "given the emotional nature of this issue." Yet even as the two agencies sought a unified message -- that food from clones is safe for people but perhaps dangerous to U.S. markets and trade relations -- evidence surfaced suggesting that Americans and others are probably already eating meat from the offspring of clones. Executives from the nation's major cattle cloning companies conceded yesterday that they have not been able to keep track of how many offspring of clones have entered the food supply, despite a years-old request by the FDA to keep them off the market pending completion of the agency's safety report. At least one Kansas cattle producer also disclosed yesterday that he has openly sold semen from prize-winning clones to many U.S. meat producers in the past few years, and that he is certain he is not alone. "This is a fairy tale that this technology is not being used and is not already in the food chain," said Donald Coover, a Galesburg cattleman and veterinarian who has a specialty cattle semen business. "Anyone who tells you otherwise either doesn't know what they're talking about, or they're not being honest." Last year, [only] 22 percent of Americans who responded to a major survey said they had a favorable impression of food from clones.

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Things did not exactly go as planned when Ricki Lake and Abby Epstein conceived the idea of working together on an expose of America's delivery rooms. Called "The Business of Being Born," the documentary examines the politics, economics and history of how and where most Americans take their first breaths. This includes the births of Epstein's and Lake's own babies - Lake delivered at home aided by a midwife. Although they were longtime friends, Epstein had written off Lake's interest in home birth and midwifery as a "reckless" crusade that she admits she "totally didn't get." That all changed in 2004 when Lake showed Epstein a home video of [Lake] giving birth to her second son in a bathtub in 2001. "Ricki's video was so inspiring. I didn't know you could have a baby like that - with no blood, in her own home," Epstein says. "It was clean. It was beautiful. She looked so powerful and so in control." While "The Business of Being Born" clearly takes a stance in defending the craft of midwifery, Epstein and Lake insist that their mission is more about empowering women with knowledge and reminding them that they may have more choices than they realize. "The film is not advocating anything but choice. I'm not at all telling people to have a home birth like me," says Lake, who after reading a book called Spiritual Midwifery decided she wanted to give birth to her second child at home. Citing statistics that show home-birthing rates declining from 95 percent in 1900 to less than 1 percent by 1955, the film questions whether American women today have been convinced that they are not responsible for the births of their children or simply don't know how to give birth on their own.

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