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June 23, 2014

Host: Ted Simons

Custom Drug Treatments for Children

  |   Video
  • Researchers from Phoenix Children’s Hospital, TGen, and the University of Arizona College of Medicine are working on developing individualized drugs for children with cancer and other diseases, with the drugs based on their genetics. Dr. Robert Arceci is the Division Chief of Oncology at Phoenix Children’s Hospital, and he will talk about the research.
  • Dr. Robert Arceci - Division Chief of Oncology, Phoenix Children’s Hospital
Category: Medical/Health   |   Keywords: medical, health, custom, drug, treatments, children, research, phoenix, cancer, diseases,

View Transcript
Ted Simons: Local researchers are working on using genetic information to develop individualized drugs for children with cancer and other diseases. Dr. Robert Arceci is the division chief of oncology at Phoenix children's hospital. He joins us now with more on this, very good to have you here.

Dr. Robert Arceci: Thank you.

Ted Simons: This is, this is -- it's always -- you get filled with hope when you talk about this, and what we're talking about, it sounds like what genetic-based treatments for kids.

Dr. Robert Arceci: Exactly right, what we're trying to do is to change the way that we treat patients, in the past, we have for instance, taken 100 patients with a certain type of leukemia, and given them the same three drugs, and half respond, and that is their disease response, and half of them don't respond and, and they all end up in the hospital for a month and, and literally, about 2% or 3% of them will die from the treatments. And it seems barbaric at so many levels, and yet, that has led us to, to many cures, but still, many patients are not being cured, so we're trying to do now is to capture the secrets in the genome, which is in our genes, and to really try to make the cancer much more susceptible by identifying the Achilles heels.

Ted Simons: Can you find that in there or is it still -- in other words, can you do a sniper action or is it a bit of an elephant gun?

Dr. Robert Arceci: It's getting far more precise, and we like to call it precision medicine because we can take, you know, about $2.3 billion base that is comprise our genomes, and actually, sequence all of that. It's like, taking a tale for two cities and cutting it up into individual letters and throwing it in the waste basket and having someone say can you reassemble that? That's what we are trying to do but with the help of smart people and a lot of computer power, we can do that, and actually, identify single changes.

Ted Simons: I was going to ask, what can the genetic makeup of a patient tell you about that patient?

Dr. Robert Arceci: So, it's an amazing amount of information, of course, and this is where you get into some of the ethical issues, so, if we do a genetic sequencing and try to identify key drivers of leukemia, and that we can target, and, and we also need to compare that to the normal DNA, and in that normal DNA, we find sometimes things that, that are, are, for instance, a susceptible to other cancers, or maybe a susceptibility to a disease that could affect other people in the family. So, there are real implications of doing this work.

Ted Simons: What do you do when you find those susceptibilities?

Dr. Robert Arceci: There is a protocol that, that we, and many, and many investigators and the Government and, and ethical bodies have put together, and an approach to, to up front getting consent, telling people what, what to expect, and we, we tell them that, that we will inform them of things that, that we, we can do something about, or that, that are going to be relevant.

Ted Simons: Ted Simons: It sounds like these are clinical trials on kids, for kids, as opposed to the adult component in there, and, and am I wrong? And, and is that, is that different than the way that things have been done?

Dr. Robert Arceci: We have had a problem, in pediatrics and, and in general, but in pediatric oncology, and that is getting new drugs to be tested and to be used in children. There have been several Government acts that have encouraged companies to do that, and they have been partially successful, so, so what we're doing here is to, is to really take children with the worst cancers that we have and, and, and to, to, to try to find those new drugs, and we've been working with the pharmaceutical industry, as well as the Government to try to bring those new drugs earlier to the children.

Ted Simons: And I would imagine because, because you are children focused, that would speed the development of the drugs?

Dr. Robert Arceci: It would, because often, children will respond to, to those, those drugs, much more quickly, much more effectively than adults because of the complexity of the tumors.

Ted Simons: I have heard and, and read on this, that r&d for pediatric diseases has fallen off in recent years. First of all, is that accurate? And secondly, if it is, why?

Dr. Robert Arceci: Well, it's a complicated scenario. We, we do believe that, that children somewhere, have often gotten the short end of, of funding and support, although people do continue, including the Government and, and philanthropists continue to help. But in many ways children don't vote and, and their parents do. But, the children don't vote, and it's a very difficult thing to, to, to bring extra money to the table for the 2% or 3% of patients with cancer, and even though if we cure it every child with cancer, it would have an effect as if we cured every patient with breast cancer.

Ted Simons: And you certainly would say the development, as well, because you have got someone who is young and you can see how far along things might go. And I think that that would be valuable.

Dr. Robert Arceci: And we save a three-year-old's life. It might be the next precedent.

Ted Simons: There you go. And so, how far along are these drugs and what's going on? -- so, we are taking drugs some pharmaceutical industries have developed, and we're also going back and repurposing older drugs to find out if they could work like the newer drugs, which sometimes we cannot get for children, but those other drugs were out there for a long time. So, if we can get those and create a, a way to, to make them for children, that's another way that we can do this.

Dr. Robert Arceci: We had a story last week, regarding with men with advanced prostate cancer, that some of these generic – that no one is testing anymore, they are bringing these things back and showing more promise than the newer drugs.

Dr. Robert Arceci: Sometimes we get lucky on the screening we are doing on pediatric cancers, they are identifying some of these older drugs, so, we have to, of course, manufacture them, and get fda approval to use them in people, but nevertheless, they are sitting there.

Ted Simons: So what is next? What do we look at from the study and the research? What can we expect to see in the headline shortly?

Dr. Robert Arceci: I hope that what we will do is to be able to increase the, the ability to predict responses of cancers to various drugs. Right now, our, -- we do about five to 10% of patients will respond to a drug, and we don't know which 5% or 10%. We would love to utilize the approach to, to bring -- if I could tell a family, or a drug company, that you have an 85%, 90% chance of responding, that would be fantastic.

Ted Simons: It would, and we all wish you and your research the best of luck.
Thank you very much for being here.

Dr. Robert Arceci: Thanks, Ted, appreciate it.

Maricopa County Update

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  • Maricopa County supervisors are working on a new budget. Board Chairman Denny Barney will discuss that and other county issues.
  • Denny Barney - Board Chairman, Maricopa County Board of Supervisors
Category: Government   |   Keywords: government, maricopa, county, update, budget, issues,

View Transcript
Ted Simons: And Maricopa County passed a new budget today, the $2.2 billion spending plan is slightly less than last year's budget. Joining us now is the chairman of the Maricopa County board of supervisors, Denny Barney. Good to have you here. Thanks for joining us.

Denny Barney: Thank you for the invitation.

Ted Simons: $2.2 billion compared to last year’s budget, what are we seeing?

Denny Barney: The budget overall is about the same at last year, actually slightly less about $8.6 million less. What we really focused on this year was the criminal Justice components of our budget, the public safety piece, which represents a significant portion of the budget, about %51 of our overall budget, so really, that's, that was our emphasis this year.

Ted Simons: And I want to get to that emphasis in a second but I want to start with the idea of zero-based budgeting. It sounds like you went in there and said we're going to start over with this?

Denny Barney: In a way we did. It was a little scary at first because we felt like this was something that we traditionally wanted to explore and really see if we could make happen, it's not the way that we budget it at the county, and we started with our county attorney, Bill Montgomery, and said can you do this? And, and from there, pick three or four other strategic departments that we could, we could send down this kind of tandem track with the other budgets that we were working on, and frankly, it turned out to be very effective, we were able to, from the bottom up, discern what the needs were based on a mandate study, and what resources do we need based on service ratios and all of that stuff.

Ted Simons: So past spending, we talk about -- basically you start from zero, the past spending was not much of a factor, no factor, how much of a factor?

What, what -- the starting point is really looking at the ratios based on service demands, if we take the County Attorney's Office, or public defense services, for example, we can look at the flows and the volumes that we have on cases and is trials and different inputs that go into that, for that service lineup, and so we, we took those ratios from past budgets, and matched those up against other, other similar departments in the country, and started at the bottom and said, if we were building from the base, from zero, what would we need to deliver service based on these -- on this, these demands in the system?

Ted Simons: You mentioned the overall budget, is slightly less than last year, however, the operating budget was an increase of $64 million. Talk to us about this. You refer to public safety and these sorts of things as being an emphasis. Why?

Denny Barney: Well, our focus has been the mandates, and if you look at the mandates that we have under the statutes from the legislature, it really is public safety and criminal Justice, so this year, while we saw an increase in the operating budget, what we did was reduced the overall budget by $8.6 million, by redirecting where we put those dollars. We saw an increase on the operating side, that decrease came from strategically looking across the board, or can we pull resources while trying to keep the, the taxes very, very flat, if you will.

Ted Simons: Sounds like capital, the capital budget got hit?

Denny Barney: It did. The capital budget came down and, and frankly, a lot of areas came down, but when you look at where we spend the money and what we're mandated to do, we felt a huge priority as a board of supervisors to put that into the, the public safety.

Ted Simons: When we talk about the capital budget, excuse me, construction, I.T., maintenance, these things.

Denny Barney: Yeah. It is a big piece. IT is a big piece. We did put some resources into IT, especially into cyber security which is an important piece we felt we needed to keep in the budget. We’ve got a number of projects that are kind of in the queue, that were, we're working on, but really, took through kind of a strategic planning initiative that, that involved all of the other elected officials, and took, took a step back and said what is it that we're supposed to be doing, and reset our mission, and really, the budget is built around kind of that whole strategic planning idea, and that initiative.

Ted Simons: And how much of a pushback did you get?

Ted Simons: Ironically, we did not get any pushback. I think what, what -- what made this year different, is that we, we met from the beginning with, with every department both elected and non-elected, and recognizing that, that those elected officials are constitutional officers, and, and then we went through the needs and kind of did the, the analysis together, and we went through the strategic planning process, and so when we got to the, to the kind of later in the process to the actual budget conversations, we had kind of came together in terms of what the needs were going to be.

Denny Barney: And indeed, 51% of the budgets, give or take a percentage point there, and seems to be with the public safety, new superior court divisions, it also looks like --

Denny Barney: Three.

Ted Simons: Three? Okay. And salary hikes for MCSO, for Sherriff’s department per say. Talk to us about that.

Denny Barney: And, and well, it's not just for the deputies, or the correctional officers, but for the probation officers, and other people that were kind of in the criminal Justice side. The thing that is most important to us, is that we don't lose good people, anybody that, that owns and operates a business knows how important it is to keep the right people, and as the market is healing, and coming back, albeit slowly, and we were seeing that, that our, our -- we were losing good people to other departments in the market, so this was really an attempt for us to shore up kind of the base of people that we need to help move us forward as the service demands continue to increase the population.

Ted Simons: So, there was a threat, and there was an actual loss of personnel because of salary?

Denny Barney: In an organization the size of the county you are going to have attrition and, and as the market was starting to heat up, if you will, we saw those numbers edge up, and so really we went through kind of a holistic market study, if you will, and determined strategically where do we need the additional resources to keep the right people?

Ted Simons: As far as the things in the queue, as you mentioned earlier, anything that you want to discuss? What are we looking at that we might be talking about next year at this time?

Denny Barney: We have the radio system, that, that, that's been approved, that will allow enhanced serviceability for the county. The county is 9,200 square miles, and we don't have a radio system that supports public safety, emergency service across the county, so that's coming, and we have additional work that's happening with the Justice courts and trying to figure out the best way to, to bring that to the market, so we have got some good things that we're working on, but we put other things on hold, so we can really focus on, on what are the immediate needs today.

Ted Simons: Were these court divisions and the operations and buildings and stuff, were they put on hold or were they things that were in the pipeline and, and going and just, you had to find the money for?

Denny Barney: Well, of the three court divisions, we had two that were juvenile divisions, and one is a criminal one, so as we looked at the volumes that were coming through the system, we felt like we had to find the money because as we, we slow the process down, that means we put more people in jail for a longer period of time, which has, has significant costs associated with it, so working with, with judge Davis, who is the presiding judge, and others in the, on the criminal Justice side, we really kind of drilled down what do we need today, and frankly there is not enough money to go around. That was what was really exciting about this time, is that everybody came together and, and said, we recognize the constraints and, and we also recognized the needs and, and here we go, and we kind of came together in a unique way this year.

Ted Simons: Do you think that zero-based, the zero-based method will be used the next go around?

Denny Barney: We're working on, on who is going to be the lucky department to engage. But yeah, we'll, we'll invite a number of departments to do it, and frankly, I think we'll get in a cycle of every three or four years doing that, so that we can take a reset view of where do we start?

Ted Simons: Last question, so we got the 73, something around there cut, 64 added, and I think what most folks want to know is everything that is supposed to be funded and should be funded, adequately funded?

Denny Barney: And it's a great question, and I think the answer is yes, but, one thing that we did this year was we're starting to anticipate even as we're coming out of this recession, what is the next recession, what does it look like? So we put in place the plan for our reserves and, and that, that over a period of time, four or five years, we can -- little by little prepare and anticipate that. We have got a plan now that lets us anticipate some of the other needs that are going to come both on the capital, the operating side, so the good news is, I think that, that together with the board and the elected officials, we kind of took a really, a different view on the budget, and it's been very, very, I think very rewarding for everybody involved.

Ted Simons: All right. It's good to have you here. Thanks for joining us.

Thanks for the invitation.

Sustainability: Natural Resources Value

  |   Video
  • An Arizona State University scientist and a colleague have developed a first-of-its-kind equation to estimate the monetary value of natural resources such as fish stock, groundwater or forests. The formula can be used to create markets for natural resources, helping to encourage sustainable practices. Josh Abbott, an associate professor in ASU’s School of Sustainability, will discuss his report.
  • Josh Abbott - Associate Professor, School of Sustainability at Arizona State University
Category: Sustainability   |   Keywords: sustainability, natural, resources, value, equation, asu, report,

View Transcript
Ted Simons: Tonight's focus on sustainability looks at an attempt to develop a first of its kind method to estimate the monetary value of natural resources. The idea is to create markets that would encourage sustainable practices. Here now is Josh Abbott, an associate professor at ASU's school of sustainability. And you are kind of the guy behind this whole thing, aren't you?

Josh Abbott: Yes, I am, along with the elected official.

Ted Simons: We're measuring the monetary value of natural resources. Explain, please.

Josh Abbott: So, when I talked, when we say the monetary value of natural resources, we're not thinking about the value of using them, so, you know, if you wanted to find the value of a fish and, and use, you could go to the supermarket, right and find the price of a filet of cod or something. What we're looking at is the value of the resources in preservation, the value of a fish in the water, the value of groundwater in the aquifer, so this is the value of the, the sort of streams of benefits that, that, that natural capital, if you will, could provide to, to us and to future generations.

Ted Simons: Which would lead to what, asset markets for, for natural capital? Is that what we're talking about here?

Josh Abbott: It could lead to asset markets, but, one of the fundamental differences between natural capital and, and the other kinds of capital that we often think about in society, like your house, or, or a stock, is, is that, that, that most natural capital does not have a market. AND so, what we're trying to do with this research is to step in when there is not a market, not a natural price, so, like, you know, you know that there is a price for, for the house, and you can go on zillow and find that, or, you know, some other resource and, and go to the Dow Jones Industrial Average and look at the stock price, and there is not that sort of resource for capital, so what we're trying to do, is, is to sort of step in and provide a price that is, that is like, like the prices that we see for other kinds of assets, and so that we can put natural capital on even par and other forms of capital.

Ted Simons: So, define, define natural resource, I have got the fish in there, and what else is included?

Josh Abbott: So, this, this really includes any sort of feature of, of the, of an eco-system, the natural world around us that, that has this long lived property, not just provides benefits today, but, also, can provide benefits for tomorrow. So, this could include all kinds of renewable resources like groundwater are renewable and this could include, you know, the fish example that I gave, could include the forest but also could include the atmosphere, and so the amount of carbon that is out there in the atmosphere is, actually, sort of not an asset, but also, a liability, but it's still a capital asset in a way, right.

Ted Simons: And indeed, but, how do you measure the monetary value or the, the capital, how do you measure the value of this stuff? It sounds like, there is -- you have changing metrics, ecology and human behavior and moving goalposts all over the place.

Josh Abbott: And no one said it was easy, and the, the basic idea is to take principles that are there for asset pricing that are well-known and recognized to anyone in finance and, and to, to modify them a bit, to, to account for the unique properties of natural capital, so, usually when we think about a, a financial asset, we would think about the value of being a function of the dividends that we expect it to pay out over time, or the capital gains it might have over time and, and we would, you know, discount that back in some way, and that would be the way that we would think about it. Here, with natural capital, we have to think about an added dimension, which is that, if it's a renewable resource, it, actually, can physically grow, if we leave it in place. So, we can, actually, we actually need to account for the ecology, the sort of rate of growth, and it's like nature is giving us a rate of interest on top of, of the usual rate of interest, so we built that into the formula, and we also have to think about how the resources are managed through time. The kinds of management that are applied. So, is, is, in the case of the fishery, is it well managed or poorly managed, and that's going to influence the trajectory of the value of capital over time.

Ted Simons: And this value of the capital, is it different for you than it might be for me than it might be for them? And, and a factor, factor that into an equation that seems, seems like it's moving a bit there.

Josh Abbott: Right, so, definitely in society, we have different values. Now, the idea here in this formula is that we would sort of bring the different values together into, into the evaluation. And people might all value a different stock, differently, too, but the fact is that there remains a price for that stock, the market agrees on, so we are trying to resolve all those sort of different evaluations here in a similar way through the pricing, but there are different values held by different members of society.

Ted Simons: It would be very interesting to see who values and how much. Implications for policy-makers, and implications for stakeholders, what are you seeing?

Josh Abbott: So I think that there is two levels of, of applications. One is that, that, for a very particular asset, so for a particular aquifer or, or for a particular fishery, we can, basically, do a cost benefit analysis of what's the value of, of, you know, using the resource now, and withdrawing the water now, versus keeping it in the ground, so preservation versus conservation, and so our, our metric, our, our equation is providing that conservation value, and this would be the same in a fishery, the context, as well and, and the other sort of context where we might use, use the values is to, is to develop indicators for sustainability, so, sort of big scale indicators that are called Green accounting measures. And, and where we try to sort of get a sense, or, or from one generation to the next, are we, we enhancing the value of the natural resources or making them go down? And, and in order to do that, you have to have values on them. So, we can supply the values that would go into that sort of accounting exercise to sort of let us know, are we more sustainable than the previous generation or less?

Ted Simons: Last question, what is next for this idea?

Josh Abbott: Yeah, so we're looking at a few different Avenues and, and we want to, to extend the application in this paper, which was to one particular fish stock in the Gulf of Mexico to valuing fish stocks in a variety of different places, and particularly, and try to fill out all the values for, for the, the U.S. fish stocks, and then we're also looking at applications, specifically, in groundwater and forestry. And, and looking to, to, to sort of broaden the base of, you know, of the types of capital that we have applied this formula to.

Ted Simons: So basically, emerging markets for stuff that's been there for a long time?

Josh Abbott: Right, and trying to acknowledge the value of it.

Josh Abbott: Very good. Very interesting. Good to have you here, thanks for joining us.

Ted Simons: Thank you.