Does cannabis cost, or pay? CCU study claims marijuana costs $4.50 for every $1 it generates

Coloradans spend $4.57 to mitigate marijuana’s effects for every tax dollar it generates, claims a recently released study.

Colorado Christian University’s Centennial Institute scoured 2017 data to try to understand the economic and social costs of legal marijuana, said Jeff Hunt, CCU’s vice president of public policy and director of the Centennial Institute.

“No matter where you stand in the marijuana legalization debate, having more information is critical to making the best decisions for the future of Colorado and our nation,” Hunt said in a statement.

The tab taxpayers pick up will likely increase as commercial marijuana’s long-term health consequences become more clear, Hunt said.

“Like tobacco, commercial marijuana is likely to have health consequences that we won’t be able to determine for decades,” Hunt said, adding that those costs are not configured in the report. “The economic and social costs in this report are intentionally low and the comprehensive costs are likely much higher.”

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Stocks drop 4 percent in rocky week on trade, growth worries

Wall Street capped a turbulent week of trading Friday with the biggest weekly loss since March as traders fret over rising trade tensions between Washington and Beijing and signals of slower economic growth.

The latest wave of selling erased more than 550 points from the Dow Jones Industrial Average, bringing its three-day loss to more than 1,400. For the week, major indexes are down more than 4 percent.

Worries that the testy U.S.-China trade dispute and higher interest rates will slow the economy has made investors uneasy, leading to volatile swings in the market from one day to the next.

On Monday, news that the U.S. and China had agreed to a 90-day truce in their escalating trade conflict drove stocks sharply higher, adding to strong gains the week before. The next day, as doubts mounted over the likelihood of a swift resolution to the trade dispute, stocks sank. On Friday, another early rally faded into another sharp drop.

“We’re in a market where investors just want to sell any upside that they see,” said Lindsey Bell, investment strategist at CFRA. “The volatility we’ve seen the last couple of weeks has been pretty extreme in both directions.”

The S&P 500 index fell 62.87 points, or 2.3 percent, to 2,633.08. The index has ended lower three out of the last four weeks. The Dow dropped 558.72 points, or 2.2 percent, to 24,388.95.

The Nasdaq composite slid 219.01 points, or 3 percent, to 6,969.25. The Russell 2000 index of small-company stocks gave up 29.32 points, or 2 percent, to 1,448.09.

The S&P 500 and Dow are now in the red for the year again. The Nasdaq was holding on to a modest gain.

Volatility has gripped the market since early October, reflecting investors’ worries that the Federal Reserve might overshoot with its campaign of rate increases and hurt U.S. economic growth.

Traders also fear that a prolonged trade dispute between the U.S. and China could crimp corporate profits and that tariffs will raises costs for businesses and consumers. Uncertainty over those issues helped drive the market’s sell-off this week.

“The Fed has taken the punch bowl away in getting back to rates where they are today,” said Doug Cote, chief market strategist for Voya Investment Management. “We’re also going to get back to more normal volatility.”

At the same time, traders are also worried about a sharp drop in long-term bond yields as investors plow money into Treasurys, which tends to happen when investors expect slower economic growth.

Technology stocks accounted for much of the market’s broad slide Friday. Chipmaker Advanced Micro Devices slid 8.6 percent to $19.46.

Health care sector stocks, the biggest gainer in the S&P 500 this year, took some of the heaviest losses. Medical device company Cooper lost 12.3 percent to $243.01.

Utilities, which investors favor when they’re fearful, eked out a slight gain. PPL Corp. gained 2.8 percent to $31.09.

Oil prices rose after OPEC countries agreed to reduce global oil production by 1.2 million barrels a day for six months, beginning in January. The move would include a reduction of 800,000 barrels per day from OPEC countries and 400,000 barrels per day from Russia and other non-OPEC nations.

The news, which had been widely anticipated, pushed crude oil prices higher. U.S. benchmark crude rose 2.2 percent to $52.61 a barrel in New York. Brent crude, used to price international oils, gained 2.7 percent to $61.67 a barrel in London.

The Labor Department said U.S. employers added 155,000 jobs in November, a slowdown from recent months but enough to suggest that the economy is expanding at a solid pace despite sharp gyrations in the stock market. The unemployment rate remained at 3.7 percent, nearly a five-decade low, for the third straight month.

Bond prices rose, sending yields slightly lower. The yield on the 10-year Treasury fell to 2.86 percent from 2.87 percent late Thursday.

The decline in bond yields, which affect interest rates on mortgages and other consumer loans, weighed on banks, which make more money when rates are rising. Morgan Stanley slid 3 percent to $41.32.

The dollar rose to 112.66 yen from 112.65 yen late Thursday. The euro strengthened to $1.1418 from $1.1373.

Gold gained 0.7 percent to $1,252.60 an ounce. Silver climbed 1.3 percent to $14.70 an ounce. Copper added 0.6 percent to $2.76 a pound.

In other commodities trading, wholesale gasoline climbed 3.7 percent to $1.49 a gallon. Heating oil rose 1.5 percent to $1.89 a gallon. Natural gas gained 3.7 percent to $4.49 per 1,000 cubic feet.

In Europe, Germany’s DAX dipped 0.2 percent while the CAC 40 in France rose 0.7 percent. Britain’s FTSE 100 jumped 1.1 percent. Major indexes in Asia finished mostly higher.

Japan’s benchmark Nikkei 225 added 0.8 percent and Australia’s S&P/ASX 200 gained 0.4 percent. South Korea’s Kospi rose 0.3 percent. Hong Kong’s Hang Seng gave up 0.3 percent.

A recent CU study shows that good gut bacteria can have a positive effect on the brain

Gut Check

By Emily O’Brien

Could your gut impact your brain health? A new study conducted by CU Boulder researchers recently found that beneficial bacteria in your gut, aka gut microbiome, when used as an immunization, can have long-lasting anti-inflammatory effects on the brain, making it more resilient to the physical and mental effects of stress.

The study, which will be replicated in future clinical trials, could eventually lead to new probiotic-based immunizations that would protect against post-traumatic stress disorder (PTSD) and anxiety. It could also be used as a new way to treat depression.

The study was a CU Boulder collaboration between distinguished professor Steven Maier, senior research associate Matt Frank in the Department of Psychology and Neuroscience and associate professor Christopher A. Lowry, and orchestrated in the Department of Integrative Physiology laboratory.

Probiotics may have the potential to ward off mood disorders.


In short, the findings show that mice inoculated with a particular strain of soil-derived microbe showed signs of reduced stress among other positive benefits. Lowry explained that numerous studies have suggested there is a connection between the gut microbiome and mental health. This could mean that your gut health can be tied to your mood. And eventually, probiotics may have the potential to ward off mood disorders.

“Although we are still trying to understand how the gut microbiome impacts mental health, one likely mechanism is through interactions between the gut microbiome and our immune system,” Lowry said.

Your gut health can have a positive or negative impact on your immune system, depending on what strains of bacteria are present. The negative effect can create exaggerated inflammation, which puts you at risk for developing stress-related psychiatric disorders like PTSD, anxiety disorders and depression.

This new work suggests that, this specific strain of bacteria, and probiotics with similar immune effects could be used to reduce the risk of developing these types of disorders. Although recent studies involved injecting the strain, trials are also on the horizon to see if swallowing them will have the same outcome.

This is also exciting because of the effects on the peripheral immune system. “For example, this strain can prevent allergic airway inflammation and control the balance between inflammatory and anti-inflammatory responses,” Lowry said.

There’s still work to do, but it’s possible that other strains of beneficial bacteria or probiotics may have similar effects on the brain. If true, then specific strains of probiotics could be used to help keep things in balance.

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Longmont United Hospital offering nitrous oxide for pain relief during labor

Expecting mothers are often only given three options for pain relief during labor — intravenous narcotics, an epidural or nothing at all — but there is another option: nitrous oxide.

Most people know nitrous oxide as the laughing gas administered in their dentist’s office, but other countries such as Great Britain, Canada, Australia, and Finland have used it as an analgesic during labor for over a century.

While a few university hospitals in the United States have offered nitrous as a form of pain relief for some time now, only recently has it become a more widespread option. Longmont United Hospital , for example, just started to offer it on Monday.

Non-addictive laughing gas can effectively dull the pain of giving birth and leaves a person’s system so fast it doesn’t have any effect on the mother’s or child’s health, according to the American College of Nurse-Midwives.

“It’s a very nice adjuvant between going completely natural and using an epidural,” said Dr. Jennifer Blattner, an OB/GYN for Boulder Medical Center. “I’ve seen a lot of women get through the whole labor course with just nitrous. You can also use it after the baby comes out and there’s a drop in adrenaline, but you still have to deliver the placenta or have a complicated vaginal repair, it’s nice to use for extra pain relief.”


This Denver woman has donated 70 gallons of blood — and she’s loved every second that drips by

The blood donation center has become Chris Orr’s neighborhood social club.

Twice a month, Orr is there giving pep talks to fellow donors who are squeamish around needles. She takes naps in a chair after a long night of work, and she chats amiably with employees, who are all on a first-name basis.

On Wednesday, the Denver native gave her 70th gallon of blood. That’s right — 70 gallons. Since 1976, she has donated a barrel drum’s worth of blood…with three five-gallon paint cans stacked on top.

Sitting in a comfy blue medical chair, with friends in the room and a wide grin on her face, Orr joined a rarefied club. She became the first woman in Colorado to hit the 70-gallon mark at a Vitalant donation center. Ten other state residents have done it before her.

“I love doing this,” Orr said as nurses readied her for the blood drawing. “It’s such a simple thing to do, but it makes such an impact.”

As she waited for nurses to assemble the equipment, Orr, 64, comforted herself with a quilt made by a close friend when she joined the 50-gallon club in 2009. The quilt was decorated with pictures of Orr and her best friends, pictures of her smiling brightly as she celebrated another milestone.

Nearby, her second grade teacher, Pat Kehl, beamed with pride.

“Her personality is exactly the same as it was back then,” Kehl, who came to support her former student, said. “Very outgoing, smart, athletic. I wished every kid was like Chris.”

“Nice stick!” Orr exclaimed when a nurse pricked her left arm. The blood began to surge through the tube. “Woo hoo! It’s so exciting when this happens.”

Hyoung Chang, The Denver Post
Chris Orr, 64, donates blood to break the 70-gallon mark on Dec. 5, 2018.

This lifetime practice began when Orr was 21. Her cousin got sick with leukemia and Orr desperately wanted to help, but didn’t know how. Orr’s mother, a nurse, suggested giving blood.

The cousin died three months later, but the act of donating blood sparked something inside Orr.

Nearly every other week for more than 40 years, Orr has come to Vitalant — formerly Bonfils Blood Center — to donate blood. She literally has donated a piece of herself 560 times.

The hours add up. With each visit lasting two to three hours, Orr has spent nearly 50 full days giving blood.

“It’s been worth every minute,” she said.

“Her dedication is incredible,” Liz Lambert, spokeswoman for Vitalant, said. “It takes a selflessness to make sure that someone you don’t know gets what they need.”

Through these donations, Orr has saved up to 1,680 lives, Vitalant said. Since the late 1980s, Orr, a customer service representative for United Airlines, has donated platelets. These donations, which can be done every other week, are essential for cancer therapy, open-heart surgery, blood disorders and organ transplants.

Platelet donations are particularly needed because they have a much shorter shelf life than other blood donations. Platelets last only five days, where whole blood donations last 42 days and plasma donations can keep for a year, Lambert said.

As she watched her blood make its way through the machine, Orr couldn’t stop grinning.

“Every time I walk out of here,” she said, “I feel like I’ve helped somebody.”

81 migrant children separated from families since June

WASHINGTON — The Trump administration separated 81 migrant children from their families at the U.S.-Mexico border since the June executive order that stopped the general practice amid a crackdown on illegal crossings, according to government data obtained by The Associated Press.

Despite the order and a federal judge’s later ruling, immigration officials are allowed to separate a child from a parent in certain cases — serious criminal charges against a parent, concerns over the health and welfare of a child or medical concerns. Those caveats were in place before the zero-tolerance policy that prompted the earlier separations at the border.

The government decides whether a child fits into the areas of concern, worrying advocates of the families and immigrant rights groups that are afraid parents are being falsely labeled as criminals.

From June 21, the day after President Donald Trump’s order, through Tuesday, 76 adults were separated from the children, according to the data. Of those, 51 were criminally prosecuted — 31 with criminal histories and 20 for other, unspecified reasons, according to the data. Nine were hospitalized, 10 had gang affiliations and four had extraditable warrants, according to the immigration data. Two were separated because of prior immigration violations and orders of removal, according to the data.

“The welfare of children in our custody is paramount,” said Katie Waldman, a spokeswoman for the Department of Homeland Security, which oversees U.S. immigration enforcement. “As we have already said — and the numbers show: Separations are rare. While there was a brief increase during zero tolerance as more adults were prosecuted, the numbers have returned to their prior levels.”

At its height over the summer, more than 2,400 children were separated. The practice sparked global outrage from politicians, humanitarians and religious groups who called it cruel and callous. Images of weeping children and anguished, confused parents were splashed across newspapers and television.

A federal judge hearing a lawsuit brought by a mother who had been separated from her child barred further separations and ordered the government to reunite the families.

But the judge, Dana Sabraw, left the caveats in place and gave the option to challenge further separations on an individual basis. American Civil Liberties Union attorney Lee Gelernt, who sued on behalf of the mother, said he hoped the judge would order the government to alert them to any new separations, because right now the attorneys don’t know about them and therefore can’t challenge them.

“We are very concerned the government may be separating families based on vague allegations of criminal history,” Gelernt said.

According to the government data, from April 19 through Sept. 30, 170 family units were separated because they were found to not be related — that included 197 adults and 139 minors. That could also include grandparents or other relatives if there was no proof of relationship. Many people fleeing poverty or violence leave their homes in a rush and don’t have birth certificates or formal documents with them.

Other separations were because the children were not minors, the data showed.

During the budget year 2017, which began in October 2016 and ended in September 2017, 1,065 family units were separated, which usually means a child and a parent — 46 due to fraud and 1,019 due to medical or security concerns, according to data.

Waldman said the data showed “unequivocally that smugglers, human traffickers, and nefarious actors are attempting to use hundreds of children to exploit our immigration laws in hopes of gaining entry to the United States.”

Thousands of migrants have come up from Central America in recent weeks as part of caravans. Trump, a Republican, used his national security powers to put in place regulations that denied asylum to anyone caught crossing illegally, but a judge has halted that change as a lawsuit progresses.

The zero-tolerance policy over the summer was meant in part to deter families from illegally crossing the border. Trump administration officials say the large increase in the number of Central American families coming between ports of entry has vastly strained the system.

But the policy — and what it would mean for parents — caught some federal agencies off guard. There was no system in place to track parents along with their children, in part because after 72 hours children are turned over to a different agency, the Department of Health and Human Services, which has been tasked with caring for them.

An October report by Homeland Security’s watchdog found immigration officials were not prepared to manage the consequences of the policy. The resulting confusion along the border led to misinformation among separated parents who did not know why they had been taken from their children or how to reach them, longer detention for children at border facilities meant for short-term stays and difficulty in identifying and reuniting families.

Backlogs at ports of entry may have pushed some into illegally crossing the U.S-Mexico border, the report found.

Canada’s pot industry so hot it’s importing workers

It was mid-summer, fewer than three months before Canada legalized recreational marijuana, and Vic Neufeld had a problem.

The chief executive officer of Aphria had just hired 50 people to work in the pot producer’s greenhouse in Leamington, Ontario, and by the end of the first week all but eight had quit.

“Those are really hot, humid months and working in a greenhouse, as much cooling and airflow as we can provide, is still pretty darn hot in July and August,” Neufeld said in a phone interview.

A lack of qualified local labor forced Aphria to dispose of almost 14,000 cannabis plants in the quarter ended Aug. 31 after they weren’t harvested in time, costing it nearly ($750,000 (C$1 million ). Since then, the company has doubled the staff at its Aphria One greenhouse thanks in part to Canada’s Seasonal Agriculture Worker Program, which has allowed it to hire about 50 temporary workers from the Caribbean and Guatemala with plans to bring in up to 100 more.

Aphria’s experience underscores the swelling demand for labor in Canada’s five-year-old cannabis sector, where openings have tripled in the past year to 34 out of every 10,000 job postings, according to employment search engine Indeed.

Canada’s licensed producers employed about 2,400 workers at the end of 2017, according to Statistics Canada, and BMO Capital Markets estimated that industry employment was around 3,500 people when legalization took effect in mid-October.

Between them, eight of Canada’s largest cannabis companies are now actively recruiting for approximately 1,700 positions, according to data compiled by Bloomberg. Many companies say they expect that number to grow as they expand production facilities after Canada legalized recreational marijuana in October.

There’s been a spike in postings for jobs at cannabis growers and retailers. Next year will see even more demand for labor as Canada expands the number of legal cannabis products to include edibles and concentrates, said Alison McMahon, founder and CEO of Cannabis At Work, a recruitment and training site.

“We’re going to see a lot of R&D positions and a lot of science-based positions around extraction and formulations,” said McMahon, estimating that the industry could create around 125,000 jobs in the first year after legalization.

Increasing automation will also likely accelerate the shift toward more high-tech jobs in the industry away from more manual jobs. That would follow the pattern of traditional sectors such as the auto industry, where blue-collar manufacturing jobs have been disappearing as companies ramp up spending on research and engineering.

Canopy Growth Corp., Canada’s largest licensed producer by market value, needs to fill about 1,200 positions. Recent postings on the company’s recruitment site range from a “destruction lead hand” in Langley, British Columbia, to a “soft gel encapsulation manager” in Smiths Falls, Ontario. With operations in 12 countries, Canopy is also recruiting for a few international jobs, including a regional manager for natural health products in Frankfurt and a manager of medical affairs in Cape Town.

Most of Canopy’s hiring is happening in Canada, however, as the country is the global center of the legal cannabis industry, said CEO Bruce Linton.

“It’s kind of like a burden for the globe, but it’s being borne in Canada because it has the most medical patients and it’s the best place to hire the people to do the research,” Linton said in an interview.

Aurora Cannabis has grown to 1,700 employees worldwide from 35 when COO Cam Battley joined the company in March 2016, Battley said in an interview. The Edmonton, Alberta-based company currently has about 140 openings and is bringing 60 new employees on board each month.

There’s plenty of interested candidates, with Aurora getting between 200 to thousands of applications for each posting. Competition for workers is fierce, with Canada’s jobless rate at a four-decades low of 5.8 percent.

“We’re bringing in people from mature industries who probably wouldn’t have considered a career in the cannabis business two years ago,” Battley said. “We’ve got people coming in from the logistics business, we’ve got people coming in from agriculture and different sciences, we’ve got people coming in from oil and gas.”

The latter industry, largely based in Aurora’s home province of Alberta, is suffering from the slump in Canadian crude prices, which fell to a record low in November.

“There’s no question that we’ve been one of the bright lights in the Alberta economy,” Battley said.

Colorado flu season picking up steam, but it’s too early to say if it will match 2017 in severity

Health experts are not sure if the new flu season will be like last year’s record-breaking outbreak. But they are sure Coloradans can no longer delay getting their flu shots.

“We would not recommend waiting any longer,” said Rachel Herlihy, the state’s communicable disease epidemiologist. “Now is the right time to do it because it takes two weeks for the vaccine to get to its full strength. It’s not advisable to wait much longer.”

Last year, Colorado had its worst flu season on record, with 4,650 Coloradans hospitalized with the flu. There were also 183 outbreaks in the state’s nursing homes last season.

This flu season is off to a slower start than in 2017-18, which peaked in late December and early January. So far this year, 57 people have been hospitalized due to flu and only one outbreak has been reported, according to the Colorado Department of Public Health and Environment.

But conditions can change quickly, Herlihy said. “This season’s peak could be a little later. But you have to remember flu season is unpredictable. It’s really impossible to tell yet how it’s going to go.”

This season’s vaccine is also standing up well to the latest flu virus strain, she said. “There have been no concerns as far as we know.”

Why Colorado’s health insurance sign-up numbers look strong, even as the rest of the country struggles

The conventional wisdom about how health insurance enrollment across the country would go this year went something like this: B-R-U-T-A-L.

Major Trump administration changes took effect that were likely to diminish people’s interest in buying plans through an insurance exchange. High prices continued to bedevil consumers. And national numbers so far bear these fears out: About 350,000 fewer people have signed up for insurance through the federal portal this year compared to the same period last year.

That’s what makes Colorado’s sign-up totals so surprising. They’re up. Not by a lot, but not by a little, either.

So why has Colorado thus far escaped the national slump? There’s at least one big reason worth understanding.

Just looking for open enrollment deadlines and other how-to info? Skip to the “What’s next” section.

The basics

First thing, we’re only talking about a small subset of the health insurance market here — people who don’t get insurance through an employer or through Medicare or Medicaid. This is the “individual” health insurance market, the people who buy plans on their own. It makes up about 8 percent of the total market in Colorado.

People in the individual market buy plans either through a health insurance broker or an online exchange. Most of the country uses the exchange, run by the federal government. Colorado is one of 12 states that runs its own exchange, free and clear of federal involvement. It’s called Connect for Health Colorado.

This all was created as a result of the Affordable Care Act, which also contained a mighty big hammer to drive health insurance sign-ups: It imposed a penalty on people without insurance. Last year, the penalty was $695 or 2.5 percent of your income, whichever was greater.

What Trump changed

The Trump Administration has been steadily whittling away at the Affordable Care Act — the law also known as Obamacare. It slashed funding for marketing and for organizations that help people sign up for coverage. It encouraged the use of short-term plans and other types of coverage not sold on the exchanges.

And, along with Republicans in Congress, it did away with the penalty for not having insurance. Starting in 2019, the fine is $0.

That last one could have been potentially significant for Colorado, where sky-high costs in some parts of the state provide ample incentive to skip coverage. But the penalty does appear to have been somewhat successful in nudging people to sign up, according to a recent Colorado Health Institute report. The report found that fewer Coloradans skipped having insurance as the penalty increased.

Why Colorado is different

Through November, consumers made 46,332 medical plan selections on Connect for Health Colorado — one plan selection, of course, can cover multiple people, such as a family. That’s nearly 6 percent more than the 43,881 plan selections made during November last year.

It’s too early to say whether it’s just an earlier crowd this year or if this represents real growth. But 15 percent of those signing up so far are new — not returning — customers.

Structurally, the main difference between Colorado and much of the rest of the country is that Colorado’s control over its own insurance exchange means it can largely opt out of the federal turmoil.

Connect for Health Colorado controls its own marketing and outreach budget, which it has been using for radio and social media ads and to support sign-up assistance centers. It made technical improvements to the website in the hopes of streamlining the sign-up process. It also found some extra money to help local organizations better serve their areas.

Kevin Patterson, Connect for Health’s CEO, gave an example of a health district in Larimer County. Because of its autonomy, Connect for Health was able to chip in some money to help the district reach out to consumers who live in the county but outside the health district’s boundaries — people who might otherwise not have gotten that kind of attention.

“I think it’s fair to say we’re able to target and market in a way that connects with our citizenry,” Patterson said.


What’s next

Open enrollment runs through Jan. 15. But to have insurance that starts on Jan. 1, 2019, you must sign up by Dec. 15.

If you don’t sign up during open enrollment, you’ll have to wait until open enrollment starts again next fall. The only exceptions are if you have a major life event — such as you lose your job or you have a baby. Then you get a special enrollment window to buy coverage.

Colorado insurance officials this year used a regulatory technique that resulted in the lowest price increases for health insurance on the individual market in years. If you are eligible to receive a tax credit to help pay for premiums (go to to figure out if you are), Patterson said it’s likely you will be able to find plans for $50 a month or less. But, since those plans could come with high deductibles, it’s best to shop around.

If you’re not eligible for a tax credit, using an insurance broker may help you make the best choice. Connect for Health can help you find one.

Need in-person help? You can call Connect for Health at 1-855-752-6749. (Connect for Health styles that as 1-855-PLANS-4-YOU.) You can also use a live chat feature on the website. Connect for Health can also connect you with an enrollment center or a person certified to provide enrollment assistance.

Rising Sun

Xcel Energy wants carbon-free electricity by 2050

Xcel Energy, Colorado’s largest electric utility, is upping its renewables game with the announcement Tuesday that it has a goal of being 100-percent carbon free by 2050.

The Minneapolis-based company that serves eight states has been a leader in the quest to increase the use of renewable energy sources, said Ben Fowke, the utility’s chairman, president and CEO.

“This isn’t new to us. We’ve been leading the clean-energy transition at Xcel for quite a while now. Investing in renewables has really been part of our DNA for over 20 years now,” Fowke said at a news conference for the announcement Tuesday at the Denver Museum of Nature and Science.

The move to more wind, solar and other renewable energy sources is not only good for the environment but also good for the bottom line of both the company and its customers, Fowke added.

“That has allowed us to reduce our carbon footprint by 35 percent across all our eight states since 2005,” Fowke said.

Xcel Energy already had a goal of reducing carbon dioxide emissions by nearly 60 percent and increasing its use of renewable energy sources to 55 percent of its mix by 2026 as part of its Colorado Energy Plan, which was approved by state regulators in August. The new plan includes a goal of reducing carbon emissions by 80 percent by 2030 across eight states and getting to zero emissions of the greenhouse gas by 2050.

Fowke and Alice Jackson, president of Xcel’s Colorado operation, said they don’t know of any other utility in the country that has set a goal and timeline for producing no carbon emissions.

Colorado Gov.-elect Jared Polis, who has a goal of getting 100 percent of the state’s electricity from renewable sources by 2040, said he is excited about “Xcel having the most aggressive goal of any utility in the country.”

Polis, speaking at the Xcel Energy news conference, said he would like to see Colorado achieve the zero-carbon goal even earlier and wants to work with municipal utilities and rural electric cooperatives to achieve the goal.

“Colorado has always been a very innovative state and I think it’s great that we’re showing the country the way to keep rates low, have cleaner air and to do our part for our climate and embrace the future of clean energy and make it work for Colorado businesses and individuals,” he said.

Fowke and Jackson conceded in a media briefing before the news conference that some of the technology required to meet the new goal might not currently exist.

“I’m betting on the technology,” said Fowke, referring to the many advances that have made wind and solar energy comparable to or less expensive than fossil fuels.

Jackson said state policies, including laws and regulations, might have to be changed to make it easier for utilities to invest in the research and development of new technology. She and Fowke also acknowledged that attaining zero emissions of carbon dioxide might involve the use of nuclear power and capture and sequestration of emissions from fossil fuels.

Fowke stressed that providing affordable and reliable power across Xcel’s territory is the priority. Stemming the effects of climate change, fueled by heat-trapping carbon dioxide emissions, is also of concern he said. The latest National Climate Assessment by the federal government shows that the effects of climate change are getting worse, he noted.

“I think it drives home the sense of urgency,” Fowke said of the report.

“An ugly scenario:” For-profit health corporation to shut down midwifery practices in Denver, Aurora

Two Denver-area midwifery practices that have delivered thousands of babies in the past two decades, many born to low-income, inner-city mothers and refugee families, are closing their doors.

Midwives, social workers and other employees at the practices linked to Rose Medical Center and Aurora Medical Center were informed Friday by the for-profit parent company of the hospitals and the midwifery clinics, Hospital Corporation of America or HCA. Hundreds of pregnant women who are current patients at the two practices will receive letters from the hospitals this week.

Rose Midwifery, next to Rose Medical Center, has about 700 pregnant patients and typically delivers 50 to 100 babies per month. The 22-year-old practice includes nine midwives, several medical assistants and three social workers who work with new mothers whose babies are at risk of growing up in unsafe environments.

Employees at the clinic were told not to give media interviews about its closure but said their jobs will last two more months. HealthOne, which runs multiple hospitals in the metro area under the HCA parent company, confirmed the closures Monday night but did not provide any interviews.

Rose Midwifery and Colorado Nurse Midwives in Aurora will close Jan. 31. The clinics will help any patients whose due dates fall after that date transition to other care, HCA Healthcare spokeswoman Angie Anania said in an emailed statement. She did not provide any reason for the closures or say how many patients will have to find other care.

“We are extremely proud of the clinical care provided by the Rose Midwifery clinic and the Colorado Nurse Midwives clinic,” she said. “Our patients remain our top priority.”

Midwives are often nurses trained in labor and delivery for patients with normal, low-risk pregnancies. Women who seek out midwifery typically are looking for a more holistic approach to birth, with the possibility of having their baby at home.

The midwifery practices at Rose and Aurora Medical Center are not providing the “boutique” care offered by some private practices that cater to women with private insurance, however. Instead, they serve mainly patients who have Medicaid, which is government insurance for the poor.

Dr. Kent Heyborne, chief of obstetrics for Denver Health and an expert in maternal-fetal medicine, called the news “very disconcerting and very upsetting.”

He noted that black women in the United States are two to four times more likely to die in pregnancy compared with white women. Minority and poorer women, the same population served by the clinics at Rose and Aurora Medical Center, are more likely to have complications including preeclampsia, hypertension and high-blood pressure, as well as more likely to die by suicide and overdose during pregnancy.

“The underserved are the ones who need the care most and often are the ones who have the hardest time getting the care,” he said. “It’s just going to make their fight worse and put their lives and their health in graver danger. It’s not what you would like to see happening in the United States in 2018.”

Denver Health, which delivers about 3,400 babies per year, mostly to underserved women, likely will make up for some of the community loss of the clinics, he said. At Denver Health, midwives typically handle the prenatal care and appointments for women with normal, healthy pregnancies, while doctors take the high-risk cases. Patients can choose whether they want a physician or midwife to attend their delivery, and midwives handle about one-third of all births.

The model is less expensive than having doctors handle all prenatal care and delivery, and it has good health outcomes, Heyborne said.

“Most women don’t need much besides some tender-loving care and support,” he said. “The midwives are better at keeping their hands off of patients during delivery. They don’t intervene unnecessarily.”

Several private obstetrics practices in the Denver area employ midwives, but typically take only a small percentage of Medicaid patients, Heyborne said.

The closure of the midwifery clinics is a “huge loss to the community,” he said. “It will be very hard for them to get care anywhere else. The danger is that it will put these women at risk and they will be left without health care. It’s an ugly scenario.”

Dana Nitchke had her first child, a now 2-year-old girl, with Rose Midwifery and is now seven months pregnant with her second. Her due date is Jan. 24, one week before the clinic will shut its doors.

She was waiting for her husband to get home from work Monday night so they could decide whether to find a new clinic now or stick with Rose and hope their second baby girl comes in time. “Babies come when babies come,” said Nitchke, who worked as a nurse at Rose several years ago. “If I don’t have the baby before Jan. 31, you are basically walking into the hospital with people you don’t know and have never met before.”

Even though Nitchke moved from Denver to the south suburb of Centennial since her first daughter was born, she is driving up to Rose for medical appointments and planned to have her baby there because she loved the midwifery experience that much.

“It’s horrible,” she said of the news the practice is shutting down. “They were very knowledgeable, open and kind. I just felt comfortable with them.”

Nitchke felt more comfortable at the midwifery clinic, she said, in part because her midwife was a woman, but mostly because she never felt pressured about inducing delivery or any other medical procedures. She led the way, and they were there to support her.

“They are not trying to push you into anything,” she said.

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Colorado’s care of the intellectually and developmentally disabled is flawed, state audit finds

Colorado’s care of the intellectually and developmentally disabled is riddled with oversight problems that are wasting taxpayer dollars and leaving individuals in jeopardy, a state audit released Monday found.

The audit reviewed care and spending at the state’s 20 Community Centered Boards. The Colorado Department of Health Care Policy and Financing, which administers the state’s Medicaid program, contracts with those boards to provide services.

In fiscal year 2017, the community boards received about $200 million in public aid. That year, the boards provided services to about 13,000 adults and children in Colorado through three Medicaid programs. The programs are meant to serve recipients in their community so they remain independent and outside of an institution.

The audit by the office of State Auditor Dianne Ray followed an investigation by The Denver Post in 2016 that found the state’s treatment of the disabled struggled with conflicts of interests and other issues. The entire disabilities system has come under scrutiny since the Denver auditor found in 2015 that the city’s local board had grossly mismanaged mill levy funds, paid its former director nearly $500,000 in salary and benefits, and provided employee perks that included free internet for their homes. Rocky Mountain Human Services is now operating under new leadership.

The state audit released Monday found that problems in the state’s treatment of the disabled continue to persist.

When auditors looked at one part of the state program meant to help the disabled live independently, they found that 19 of the 20 CCBs did not meet basic state requirements for case management, according to a press release from Stelios Pavlou, spokesman for Ray’s office.

“This included not monitoring the services that were being provided to recipients, not updating their service plans and not documenting case management activities,” according to the press release. “Auditors also found instances where some program recipients were not receiving the services outlined in their service plans, which could put their health, safety, and ability to remain independent at risk.”

Foothills Gateway Inc. of Fort Collins was the only community board that did not have case management issues in that program, according to the audit. Still, Foothills had issues in other programs and failed to hold required face-to-face meetings with individuals as much as 17 percent of the time.

The audit reviewed case management services by community boards throughout the state for 96 disabled clients enrolled in a program meant to help them live independently and found “issues” existed for 61 of those clients, or 64 percent of those receiving treatment. Case managers often were not conducting periodic reviews to make sure services were being provided and whether those services were adequate.

The audit also reviewed services provided to 71 individuals in the program and found that 29 of those weren’t receiving all of the services they were supposed to receive. In one case, a disabled person hadn’t received any of the 600 hours of day habilitation services the individual was supposed to receive.  Habilitation services are supposed to teach an individual how to eat on their own, go to the bathroom and do other activities.

Similar problems were found in other programs administered by the Community Centered Boards, the audit found.

The Colorado Department of Health Care Policy and Financing has not established policies for properly overseeing how community boards provide case management, the audit found. During the audit, HCPF staffers “were inconsistent” regarding their expectations for such oversight, according to the findings.

HCPF’s response to the audit noted that the department had provided additional training to community board officials in August and in September had made changes to a database on how the community boards are tracking the services they provide.

“The department will continue to monitor the effectiveness of the reports and gather input from CCBs on any suggested improvements,” the audit report stated. It also noted that the community boards had agreed to improve monitoring.

Auditors found multiple instances where CCBs billed, and the department paid, for claims that did not have supporting documents, as required by federal law, or that exceeded department caps. The auditors found more than $790,000 billed by the community boards to the state that did not follow federal and state requirements.

In addition, auditors found 202 instances in which CCB billing for case management services to the state totaled 24 hours or more in a single day, which auditors determined was was not only unfeasible but unreasonable. State officials have not set a limit on the daily amount of hours that can be billed, the audit found.

Here’s Jared Polis’ initial to-do list, courtesy of current Gov. John Hickenlooper

Gov. John Hickenlooper is leaving his successor Jared Polis with a lengthy to-do list.

In one of its final acts, the Hickenlooper administration set preliminary performance goals through June 2020 for the Polis team in the areas of economic development, environment, health, education and government services.

The incoming Democratic administration is not beholden to the benchmarks — and even suggested plans to rewrite them. But the document offers guidelines for Polis to build on the current administration’s work, which he pledged to do in his campaign. How much energy Polis puts into the effort also will indicate whether public accountability and transparency will be a priority.

“We felt like you couldn’t just end the conversation, as if we can walk away at the end of 2018,” said Lt. Gov. Donna Lynne, who leads the current administration’s effort as the state’s chief operating officer. “We wanted the agencies to continue to do the work which they are doing to get to improvement across all of those areas in 2019.”

A look at the goals set for Polis administration

The two dozen goals outlined for the Polis administration are incremental in many cases, but others would result in real-life impacts if achieved, according to documents shared with The Colorado Sun.

The targets to meet by the end of June 2020 include:

  • Improve broadband coverage in rural parts of the state from the current 81 percent rate to 95 percent, and reach 97 percent statewide in the same time frame.
  • Reduce traffic congestion on Interstates 70 and 25 by a few minutes and reduce crash fatalities.
  • Cut 1.5 million tons of carbon dioxide emissions from the current level as part of a goal to lower emissions nearly 20 percent by 2025.
  • Increase the acreage restored for wildlife habitat each year to about 21,000 acres from 11,095
  • Lower the state’s suicide rate to 18.5 per 100,000 residents from the latest figure of 20.2.
  • Increase the immunization rate among kindergartners to 95 percent from the current 88.7 percent.

Lynne, who serves on the Polis transition team for customer service, said the governor-elect may want to accelerate certain goals or find new areas of focus. Either way, she added, “we feel pretty passionate about continuing the work.”

Mara Sheldon, a spokeswoman for Polis, said in a statement that the transition team is gathering information and plans to present modified goals in April.

But she declined to answer questions or elaborate on whether Polis will continue to prioritize the government accountability process once he takes office Jan. 8. The question of whether Polis would champion transparency is one that remains unanswered from the campaign.

Polis urged to embrace accountability and transparency dashboard

Much of the work is required by state law as part of the State Measurement for Accountable, Responsive and Transparent Government Act passed in 2010. But Lynne said it takes much more — a desire to build “a whole culture that supports it.”

The Hickenlooper administration embraced the SMART Act to increase government accountability and transparency, designating a chief performance officer in each state agency and building a public dashboard that allows the public to track progress toward the goals.

Gov. John Hickenlooper’s administration published a dashboard that showed progress toward its goals in different key areas.

“The one-page colorful dashboard is just like a car dashboard,” said Lynne, who has talked to the Polis team about the importance of what she considers a good-government initiative.

Even if they don’t fill her job as the state’s chief operating officer, Lynne said she implored them to have “the accountability to say where you are going, put the resources to it and then report it out.”

State Rep. Bob Rankin, a Carbondale Republican and budget writer, also wants to see the Polis administration continue the dashboard to help shed light on the agency priorities.

“It condenses rather wordy documents into some very concise measurements that the average legislator can identify with and think about it,” he said in an interview.

In essence, it holds the administration’s “feet to fire and makes it visible to both the public and the legislature.”

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Could anyone have stopped gene-edited babies experiment?

HONG KONG — Early last year, a little-known Chinese researcher turned up at an elite meeting in Berkeley, California, where scientists and ethicists were discussing a technology that had shaken the field to its core — an emerging tool for “editing” genes, the strings of DNA that form the blueprint of life.

The young scientist, He Jiankui, saw the power of this tool, called CRISPR, to transform not only genes, but also his own career.

In visits to the United States, he sought out CRISPR pioneers such as Jennifer Doudna of the University of California, Berkeley, and Stanford University’s Dr. Matthew Porteus, and big thinkers on its use, like Stanford ethicist Dr. William Hurlbut.

Last week, those shocked researchers watched as He hijacked an international conference they helped organize with an astonishing claim: He said he helped make the world’s first gene-edited babies , despite clear scientific consensus that making genetic changes that could be passed to future generations should not be attempted at this point .

U.S. National Institutes of Health Director Francis Collins called He’s experiment “a misadventure of a major sort” — starring “a scientist who apparently believed that he was a hero. In fact, he crossed every line, scientifically and ethically.”

But nobody stopped him. How can that be?

To be fair, scientists say there’s no certain way to stop someone intent on monkeying with DNA, no matter what laws or standards are in place. CRISPR is cheap and easy to use — which is why scientists began to worry almost as soon as the technology was invented that something like this would happen.

And there is a long history in science and medicine of researchers launching experiments prematurely that were met with scorn or horror — some of which led to what are now common practices, such as in-vitro fertilization.

Gene-editing for reproductive purposes is effectively banned in the U.S. and most of Europe. In China, ministerial guidelines prohibit embryo research that “violates ethical or moral principles.”

It turns out He wasn’t exactly tight-lipped about his goals . He pursued international experts at Stanford and Rice Universities, where he had done graduate studies work, and elsewhere, seeking advice before and during the experiment.

Should scientists who knew of He’s plans have spoken up? Could they have dissuaded him?

The answers aren’t clear.

“It doesn’t fall into the category of legal responsibility, but ethical responsibility,” said Collins. He said that not speaking up “doesn’t seem like a scientist taking responsibility.”

China’s National Commission of Health, Chinese Academy of Sciences and He’s own university have said they were in dark and have since condemned him .

But three Stanford scientists — Hurlbut, Porteus and He’s former fellowship adviser, Stephen Quake — had extensive contact with him over the last few years. They and other scientists knew or strongly suspected that He intended to try to make genetically edited babies.

Some confidantes didn’t think He would follow through; others raised concerns that were never heeded.

Stanford has not responded to an interview request.

Quake, a bioengineering professor, was one of the first to know about He’s ambition. Quake said he had met with He through the years whenever his former student was in town, and that He confided his interest a few years ago in editing embryos for live births to try to make them resistant to the AIDS virus.

Quake said he gave He only general advice and encouraged him to talk with mainstream scientists, to choose situations where there’s consensus that the risks are justified, to meet the highest ethics standards and to publish his results in a peer-reviewed journal.

“My advice was very broad,” Quake said.

Hurlbut thinks he first met He in early 2017, when he and Doudna, co-inventor of CRISPR, held the first of three meetings with leading scientists and ethicists to discuss the technology.

“Somehow, he ended up at our meeting,” Hurlbut said.

Since then, He returned several times to Stanford, and Hurlbut said he “spent many hours” talking with He about situations where gene editing might be appropriate.

Four or five weeks ago, Hurlbut said He came to see him again and discussed embryo gene editing to try to prevent HIV. Hurlbut said he suspected He had tried to implant a modified embryo in a woman’s womb.

“I admonished him,” he said. “I didn’t green-light his work. I challenged him on it. I didn’t approve of what he was doing.”

Porteus said he knew that He had been talking with Hurlbut and assumed Hurlbut discouraged the Chinese scientist. In February, He asked to meet with Porteus and told him he had gotten approval from a hospital ethics board to move forward.

“I think he was expecting me to be more receptive, and I was very negative,” Porteus said. “I was angry at his naivete, I was angry at his recklessness.”

Porteus said he urged He “to go talk to your senior Chinese colleagues.”

After that meeting, “I didn’t hear from him and assumed he would not proceed,” Porteus said. “In retrospect, I could have raised a hue and cry.”

In a draft article about the gene-edited twin girls, which He planned to submit to journals, he thanked UC Berkeley biophysicist Mark DeWitt for “editing the manuscript.” DeWitt said he tried to dissuade He and disputed that he edited the paper. He said he saw the paper, but the feedback he offered was “pretty general.”

He’s claims, including that his work has resulted in a second pregnancy , cannot be independently confirmed and his work has not been published. He defended his actions last week at a gene editing summit in Hong Kong.

In contrast, another U.S. scientist said he not only encouraged He but played a large role in the project.

Michael Deem, a bioengineering professor at Rice University and He’s doctoral degree adviser, said he had worked with He since the scientist returned to China around 2012, and that he sits on the advisory boards and holds “a small stake” in He’s two genetics companies in Shenzhen. Deem defended He’s actions, saying the research team did earlier experiments on animals.

“We have multiple generations of animals that were genetically edited and produced viable offspring,” and a lot of research on unintended effects on other genes, Deem said. Deem also said he was present in China when some study participants gave their consent to try embryo gene editing.

Rice said it had no knowledge of Deem’s involvement and is now investigating.

So far most of the attention has focused on regulatory gaps in China.

But that’s not the whole story, said Rosario Isasi, an expert on genomics law in the U.S. and China at the University of Miami.

“Let’s focus on how it happened and why it happened, and the way it happened,” said Isasi. “How can we establish a system that has better transparency?”

There’s no international governing body to enforce bioethics rules, but scientific bodies and universities can use other tools.

“If someone breaks those rules, scientists can ostracize, journals can refuse to publish, employers can refuse to employ, funders can refuse to fund,” said Hank Greely, a professor of law and genetics at Stanford.

Greely expects He’s experiment will have ripple effects in academia, whether or not regulators act. “Universities are going to take a harder look at what’s going on. This incident will put everyone on alert about any related research.”

Of course, sometimes bad beginnings can turn into better endings.

In 1980, University of California, Los Angeles, professor Martin Cline was sanctioned for performing the first gene therapy on two women in Israel and Italy because he hadn’t gotten approval to try it at UCLA.

Cline announced his work rather than publishing it in a scientific journal, and faced criticism for trying “genetic engineering” on people when its safety and effectiveness hadn’t yet been established in animals. Now gene therapy is an established, although still fairly novel, treatment method.

Two years earlier, in 1978, Dr. Robert Edwards was similarly denounced when he announced through the press the world’s first “test tube baby,” Louise Brown. The work later earned a Nobel Prize, and IFV has helped millions to have a child.

And this year, Louise Brown — mother of two sons, conceived in the old-fashioned way — turned 40.

Larson reported from Washington, D.C.

This Associated Press series was produced in partnership with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

State grant to help Durango hospital document increased sexual assaults

DURANGO — A hospital in Colorado plans to use a state grant to help victims of sexual assault.

Mercy Regional Medical Center in Durango says it will expand staff hours for nurse examiners who respond to reports of sexual assault.

The $75,000 grant will also help pay for new equipment and education. The funding is part of almost $1 million to be split between 10 hospitals in the Centura Health system.

Hospital officials tell the Durango Herald the number of sexual assault survivors going to the emergency room has increased from 15 in 2014 to 56 so far this year.

An estimated 3,750 sexual assaults will be reported throughout Colorado this year.

“People need to know”: West Nile virus remains a concern in Colorado

Two months before Chuck Clark-Martin died, he was exercising six days a week.

A sergeant with the Denver Sheriff Department for 35 years, Clark-Martin maintained an active lifestyle into his 60s and showed no signs of slowing down.

Until he suddenly got sick. Doctors were stumped. On October 28th, Clark-Martin died at the age of 63. The cause? West Nile encephalitis, a rare form of the virus that attacks the brain. There is no cure.

Research for West Nile has drawn protests from the People for the Ethical Treatment of Animals. But Clark-Martin’s family is fighting back, insisting this work is more necessary than ever as the virus takes root in the state.

“People don’t know this is occurring,” Katelyn Lucero, Clark-Martin’s daughter, said. “They need to know there’s no treatment.”

With last month’s hard freeze, the West Nile virus season in Colorado has reached its end. But after two deaths and nearly 100 infections to date in 2018, experts said the virus is here to stay — and it’s a cause for concern.

Since West Nile first came to Colorado in 2002, only four states have a higher average incidence rate than the Centennial State’s rate of 1.35 incidents per 100,000 people, according to the Centers for Disease Control and Prevention.

In 2018, there have been 94 reported human cases in Colorado, according to data compiled by the state’s Department of Public Health and Environment. Last year, there were 68 human cases in the state, including four deaths.

Nationally, there have been more than 2,300 West Nile cases this year, leading to 110 deaths, according to CDC data.

West Nile season typically runs from June through the beginning of October, when mosquitoes are active, according to the CDC.

The virus most often spreads to people via mosquito bites, but a vast majority of those infected feel no symptoms. For those that do, symptoms include fever, headache, body aches, vomiting and diarrhea. In rarer instances, like in Clark-Martin’s case, individuals can develop serious illness that affects the central nervous system, the CDC said.

A confluence of factors make Colorado more hospitable to the virus, including the climate and species of mosquito, said Dr. Jennifer House, an infectious disease expert with the Colorado Department of Public Health and Environment.

“We have enough of the virus for it to be a concern to people,” House said.

There are no vaccines or medications to prevent or treat West Nile virus.

The virus’ victims this year were Clark-Martin and longtime Colorado journalist Ed Marston.

“This is not just a little thing”

As state experts attempt to learn more about the virus, there has been some pushback from animal rights groups on how it is researched.

PETA sent a letter to Colorado State University in mid-November asking the school to end experiments that involve infecting wild birds with the West Nile virus. In its letter, PETA argued that experiments on birds have “little relevance to West Nile virus infection in human populations.”

CSU countered that the research is vital to saving human and animal lives.

Lucero read about PETA’s protests and felt compelled to speak out. She watched firsthand as the virus debilitated her once-active father. She saw doctors identify the cause of his ailment, and not be able to do anything to stop it. West Nile is personal.

“I emailed the head of research (at CSU) and said it’s a good idea to continue testing,” Lucero said. “I think it’s really important to do that research.”

West Nile is a disease that flies under the radar, she said. It’s time to change that.

“This is not just a little thing,” she said, “that shouldn’t be taken care of.”

“A Perfect Storm”

The West Nile virus is a relatively new concern for Americans. In fact, the first reported case in the U.S. wasn’t detected until 1999, and Colorado saw no sign of the virus until 2002, according to CSU.

Then, in 2003, the virus attacked the state like no place else. Since Colorado had no prior history with West Nile, birds, people and other wildlife had no immunity, and the results were catastrophic.

“It was kind of like this perfect storm,” House said.

Nearly 3,000 people were infected that year. Sixty-three died. It was the worst epidemic in the United States, and no state has reached those numbers in any year since, CDC data showed.

Since 2003, outbreaks of the virus have varied from year to year in the state, with a low of seven cases reported in 2011. Whereas 2003 was an epidemic, House explains, West Nile has now become endemic.

“The virus is here and will never go away,” she said. “We would never expect it to be as bad as 2003, but we expect it never goes away.”

Fortnite addiction is forcing kids into video-game rehab

By Jef Feeley and Christopher Palmeri

Debbie Vitany is fighting a losing battle against Fortnite.

Her 17-year-old son, Carson, has been logging 12 hours a day on the video game, searching for weapons and resources in a post-apocalyptic world where the goal is being the last person standing. Teachers complain he falls asleep in class and his grades have plummeted.

“We’d made some progress in getting him to cut down his Fortnite hours and get better sleep, but he’s slipped back into his old habits,” Vitany, who lives near Saginaw, Michigan, said in an interview. “I’ve never seen a game that has such control over kids’ minds.”

Vitany’s anguish is echoed by an army of other parents, teachers and bosses around the world grappling with a game that sucks up hours of players’ time — sometimes to the detriment of other activities. More than 200 million people have registered to play Fortnite, which has become a billion-dollar business for its creator, Epic Games Inc. Some desperate parents have sent their kids to rehab.

“This game is like heroin,” said Lorrine Marer, a British behavioral specialist who works with kids battling game addiction. “Once you are hooked, it’s hard to get unhooked.”

Epic has issued past warnings about avoiding Fortnite scammers, but it declined to comment on the addiction issue.

Video-game addiction isn’t new: Parents and teachers have been carping about distracted children — and their joystick-addled hands — since the days of Atari consoles. But the ubiquity of Fortnite has created a more widespread menace. And it’s happening against the backdrop of broader concerns about social-media and smartphone overuse.

Fortnite, first released in its popular “battle royale” mode in September 2017, isn’t just causing problems for kids. An online U.K. divorce service says 200 petitions cited Fortnite and other video games this year as the reason for the breakup of marriages.

Professional athletes are getting hooked, too. The National Hockey League’s Vancouver Canucks had so much trouble getting players to meetings and dinners they banned Fortnite on the road. David Price, star pitcher for Major League Baseball’s World Series-winning Boston Red Sox, was scratched from a May start against the archrival New York Yankees because of wrist problems that may have been exacerbated by Fortnite playing.

Some pro-baseball players are so Fortnite-obsessed that they’ve hooked the game up to their stadium’s Jumbotron video system to play it while waiting to take batting practice.

Randy Kulman, a child psychologist in Wakefield, Rhode Island, has seen a surge in parents taking their kids to counseling because of video-game addictions.

“I had a 13-year-old in my office who said he had 300 Fortnite wins,” Kulman said. “I had to stop for a minute and calculate what he had to invest just to get those.”

Michael Jacobus, who runs the Reset Summer Camp for kids with addictions, said about 60 percent of the 120 children he counseled at camps in Santa Barbara, California, and Asheville, North Carolina, last summer were playing Fortnite excessively. Treatment involves a technology detox — their devices are taken away — combined with healthy eating, sleep and group therapy. Next summer, he plans to enroll more than twice as many kids, with additional locations in Texas, Indiana and New York.

Fortnite is particularly compelling because the battle-royale version is free to play and available on a range of devices from phones to gaming consoles, notes Cam Adair, who dropped out of high school at age 15 due to his own video-game addiction and now speaks on the subject to schools and others groups. Fortnite players compete in 100-person fights until the last one is standing — matches that make it difficult to quit once they’re started.

“It’s World War III if a parent asks their son to come to dinner because if they leave they lose,” Adair said.

While the game is free, Epic has created opportunities to sell hundreds of dollars of add-ons — including exotic weapons and “skins,” such as Dark Voyager, a black space suit with reflective striping — on credit cards. The company recently partnered with the National Football League to sell jerseys based on players’ favorite teams.

“Parents have lost substantial amounts of money by not paying attention to whether their credit card is tied to the game console,” said Marer, the behavioral specialist.

In October, Epic capitalized on Fortnite’s popularity by raising $1.25 billion from an investor group that included KKR & Co., Vulcan Capital and Kleiner Perkins. The deal values the closely held company at $15 billion.

Video games have generated a backlash before. The Grand Theft Auto series, made by Take-Two Interactive Software Inc., has at times been banned in countries around the globe for its extreme violence and sexual content. The industry has also drawn criticism following mass shootings that involved individuals linked to video games.

In April, Dutch gaming regulators released a study stating that “loot boxes,” where players purchase merchandise in a game without knowing exactly what they are getting, amounted to gambling and can be addictive.

For now, Fortnite is the game of choice. On a recent afternoon, the game was the most-viewed on Inc.’s Twitch streaming service, with 250,000 people watching others play.

The World Health Organization designated “gaming disorder” as a disease for the first time in June, a move that could make it easier for parents to seek reimbursement for treatment from insurers, according Paul Weigle, a psychiatrist in Mansfield Center, Connecticut.

Weigle, who’s seeing about 20 compulsive Fortnite players, recommends that parents keep kids under 10 from playing video games. And parents need to set limits when they do play. As games get more sophisticated in their ability to hook fans, he sees the issue of addiction only growing.

“It’s going to be more of a problem than it is now,” Weigle said.


– – –


Bloomberg’s John Lauerman contributed.

Optometrist Dr. Richard Cross has a vision for Jamaica

High demand for care and a commitment to his maternal heritage drives this optometrist toward a lofty goal for the island country

By Amanda Miller

The first year optometrist Dr. Richard Cross and a team of three staffed a free eye clinic in Jamaica, they saw 100 patients a day, while 100 more had to go home without care. The volunteers went back later, meaning to treat only those they had turned away, but the same thing happened.

Dr. Richard Cross examines a patient at a free eye clinic in Jamaica. (photo courtesy Dr. Richard Cross)

That first trip was in 1996. Cross cofounded the nonprofit Eye Health Institute in 2000 to continue staffing eye clinics on the island, where, as a child, the Michigan native often spent summers with his grandparents. His mother’s family is from Jamaica.

Today Cross is president of the Boulder-based nonprofit that sends teams to the island a couple times a year—volunteers who pay for their own travel—to perform eye exams, glaucoma screenings, cataract surgeries and to provide medications and glasses at no cost.

A laminated map of the island is tacked up over Cross’ desk at Boulder Vision Associates. He traces the Eye Health Institute’s movements into progressively remote outposts over the years. The organization now coordinates with the country’s health ministry to operate in a mountainous area where the people have no other access to eye care.

The Eye Health Institute has expanded its reach more recently, partnering with optometry and ophthalmology schools to recruit interns and surgical residents from around the U.S. to volunteer. The students get what Cross describes as an intense clinical experience for the one week that they’re there.

He’d like to extend the clinical rotations to six or even 12 weeks. Meanwhile, the organization has also helped design a mobile eye clinic made from a shipping container, and its doctors performed the country’s first corneal transplant in the public health system.

But, as with most small nonprofits, the year-to-year task of funding is still tough. At the same time, a long-term goal isn’t getting much closer.

The Eye Health Institute’s mobile eye clinic was made from a shipping container. (photo courtesy Dr. Richard Cross)

Cross estimates that it would cost only $100,000—land and all—to build a permanent, concrete, climate-controlled clinic powered by solar panels to preserve the delicate medical equipment that’s either bought, donated or transported back and forth each visit.
“Throughout the entire Caribbean, the salt air just destroys the electronics,” Cross said. While the life expectancy of a piece of equipment might be 20 years at an office in the U.S., “down there you’re lucky if you can even get to five on something as simple as a chair that goes up and down.”

In the Eye Health Institute’s one room inside a primitive aid station, Cross says the equipment is on its last leg. Ideally, he would like to see a new six-room building and eventually a local person to come in when volunteers aren’t present to perform periodic tests. He would also like to start using telemedicine to check on distant patients.
“There’s no shortage of patients, and the demand is great,” he said. “The hope is these communities we serve will continue to have optometry and ophthalmology care in the decades to come.”

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Colorado professor weighs in on how a scientist says he made a gene-edited baby

(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)

By George Seidel, Colorado State University

On Nov. 28, He Jiankui claimed to a packed conference room at the Second International Summit on Human Genome Editing in Hong Kong to have edited the genomes of two twin girls, Lulu and Nana, who were born in China.

Scientists at Southern University of Science and Technology in Guangdong, China, condemned He’s research asserting he “has seriously violated academic ethics and codes of conduct,” and philosophers and bioethicists were quick dive into the morass of editing human genomes. So I’m not going to cover that territory. What I want to address is what we learned: how He made these babies.

I am theoretically a retired professor in the Department of Biomedical Sciences at Colorado State University. For more than 50 years, I have researched numerous aspects of assisted reproductive technology including cloning and making genetic changes to mammalian embryos, so I am interested in most any research concerning “designer babies” and the health problems they may suffer.

A first?

At the conference He gave a general overview of the science. While research like this would typically be presented to the scientific community by publishing in a peer-reviewed journal, which he claims that he intends to do, we can get a rough sense of how he created these modified babies. This is something that has been successfully done in other species and just last year in human embryos – but the latter were not implanted into a woman. He says he spent three years testing the procedure on mice and monkeys before he moved to working on human embryos.

There is no doubt that precise genetic modifications can be made to human sperm, eggs, embryos and even some cells in adults. Such modifications have been done ad nauseum in mice, pigs and several other mammals. Thus, it is obvious to scientists like myself that these same genetic modifications can, and will, be made in humans. The easiest way to make genetic changes begins with the embryo.

The toolbox

The trendiest strategy to modify DNA these days involves the CRISPR/Cas-9 gene editing tool, which can make precise genetic modifications in living cells. Although other tools have been available for years, the CRISPR/Cas-9 approach is simpler, easier, more accurate and less expensive.

The way it works is simple in concept. The Cas-9 component is a molecular scissors that cuts the DNA at the location specified by a small piece of DNA called the “CRISPR template.” Once the DNA is cut, a gene can be modified at that location. The cut is then repaired by enzymes already present in cells.

In this case, He targeted a gene which produces a protein on the surface of cells called CCR5. The HIV virus uses this protein to attach to and infect the cell. He’s idea was to genetically change CCR5 so that HIV can no longer infect cells, making the girls resistant to the virus.

At this point He has not provided a clear explanation of exactly how he disabled the CCR5 and the nature of the genetic modification. But this kind of “disabling” is routinely used in research.

How he did it

From the diagram He presented, it appears that He injected the CRISPR/Cas-9 system into an egg at the same time as he injected a sperm to fertilize it. After this, the egg divided and formed a ball of dozens of cells – the embryo. At this stage, He removed a few cells from each embryo to determine if the desired genetic change was made. Based on my experience, the embryos were probably frozen at this point. When the analysis was complete, He probably thawed the modified embryos and transferred the best ones back into the mother’s uterus for gestation to term. Embryos without the edits or incorrect edits would either be discarded or used for research.

For many applications, it is ideal to make any changes to the genes at the one-cell stage. Then, when the embryo duplicates its DNA and divides to make a two-cell embryo, the genetic modification is also duplicated. This continues so that every cell in the resulting baby has the genetic change.

However, it appears that the genetic modification in this case did not occur until the two-cell stage or later, because some cells in the babies had the modification, while others did not. This situation is called mosaicism because the child is a mosaic of normal and edited cells.

Hazards of embryo editing?

What could go wrong in a gene-edited embryo? Plenty.

The first glitch is that no modification was made, which occurs frequently. A variation is that the change occurs in some cells of the embryo, but not in all the cells, as occurred in these babies.

The most common worry is so-called non-target effects, in which the genetic modification is made, but other unintended edit(s) occur in other locations in the genome. Having a modification at the wrong place can cause all kinds of developmental problems, such as abnormal organ development, miscarriage and even cancers.

From his slide it appears that He sequenced the genomes – the complete genetic blueprint for each child – at multiple stages of the pregnancy to determine whether there were any undesirable modifications, though these aren’t always easy to find. But until independent scientists can examine the DNA of these two baby girls, we won’t know the results. It is also not clear from the results He has shared so far whether this genetic change can be transmitted to the next generation.

Another common problem already alluded to is mosaicism, which appears to have happened in one of these twins. If some cells are edited, and some not, the baby might have liver cells that contain the edited gene and heart cells that have the normal version, for instance. This may or may not lead to serious issues.

Another issue is that manipulating embryos in vitro – outside their normal environment in the reproductive tract – where we can’t precisely duplicate the normal nutrition, oxygen levels, hormones and growth factors – could lead to developmental abnormalities including oversize fetuses, metabolic problems, and so on. This sometimes occurs with routine procedures such as in vitro fertilization when there is no attempt to make genetic modifications.

Fortunately, nature is quite good at weeding out abnormal embryos via embryonic death and spontaneous abortion. Even in healthy human populations reproducing normally, nearly half of embryos die before the woman even knows that she was pregnant.

We already design babies – and there are benefits

While I have emphasized what can go wrong, I believe that the science will evolve such that genetically modified babies will be healthier than unmodified ones. And these improvements will be passed on to future generations. Severely debilitating genetic abnormalities such as Tay-Sachs syndrome could be removed from a family by genetic modification.

Arguably, designer babies are already being born using a technique called pre-implantation genetic diagnoses (PGD). A few cells from embryos are screened for dozens, and potentially hundreds, of genetic abnormalities such as Down syndrome, cystic fibrosis and Tay-Sachs syndrome, to name a few. Parents are also able to choose those embryos of the desired sex. In my view, choosing which embryos to implant is clearly making designer babies.

Going a step further, PGD isn’t restricted to just eliminating disease. A prospective parent can also choose other traits. When one of the prospective parents in infertile, there are catalogs that provide the race, height and weight, and even the educational level of a sperm or egg donor, who is also determined to be free of major genetic defects, and free of AIDS and other venereal diseases.

In my opinion, if the procedures are deemed ethically and morally acceptable, most genetic modifications likely to be made editing embryos as He says he has done, will involve removal of harmful traits rather than adding desirable ones. Because the changes will be targeted, they will be more precise and less harmful than the mutations that occur randomly in DNA of essentially all sperm and eggs naturally.

With all of this reproductive technology, there is one other consideration: the huge costs of the procedures described. To what extent should society invest scarce medical resources in applying such techniques, especially since any benefits likely will accrue mostly to wealthier families?

These perspectives need to be kept in mind when evaluating potential genetic manipulations of humans.

This article is republished from The Conversation under a Creative Commons license. Read the original article here.

North Range expects to take a big financial hit as the result of a statewide change to mental health services

Natalie Dyer, Greeley Tribune
A North Range Behavioral Health worker takes a call Tuesday as part of the system’s 24/7 crisis line, operated out of Greeley’s crisis walk-in center, 928 12th St.

A therapy room at North Range Behavioral Health’s walk-in crisis center in downtown Greeley was dark and calm, decorated with paintings of trees and lit only with lamps.

“Think of a mom who might be concerned for her son about suicide,” said Joanna Sinnwell, business development and marketing director for North Range, as she looked at two chairs set up in the room across from a therapist’s desk.

Across the way, another therapy room was set up with games and puzzles so entire families could talk. In another room, North Range workers answered phone calls through the service’s 24/7 crisis hotline. Other workers were out on calls in the community, meeting people with the center’s mobile van to address crises.

It’s a calm environment where people can feel comfortable to work through a mental health crisis or their struggles with substance abuse, Sinnwell said, and it’s different from an emergency room or jail — the places where some people ended up before North Range and other providers across the state implemented Colorado Crisis Services, a network of mental health providers, in 2014.

Officials at North Range are worried that environment, which was developed over four years and has served nearly 8,000 people in Weld County this year, could be in jeopardy as officials with the Colorado Department of Human Services and Office of Behavioral Health consider a new way to manage the state’s crisis services. North Range officials worry the change would effectively shift resources out of crisis services and into administration.

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Nearly 48,000 Colorado children could lose health insurance if Trump administration’s proposed change goes into effect, experts say

The number of children in Colorado with health insurance has increased for almost a decade, but now the decline in the state’s youth uninsured rate is stagnating — and advocates fear more children could lose coverage due to a rule change proposed by the Trump administration.

The number of uninsured children in Colorado remained unchanged in 2017, with about 57,000 individuals under 19 without coverage, according to a new report by Georgetown University Health Policy Institute’s Center for Children and Families.

That stagnation comes after Colorado saw the percentage of children without health insurance drop from 14 percent in 2008 to 4.3 percent in 2016, according to Colorado Children’s Campaign, a nonprofit group advocating for children’s health and education.

“Holding steady over the last year is as good as about any state in the country did,” said Erin Miller, vice president of health initiatives at the Colorado Children’s Campaign.

Overall, the number of uninsured children in the U.S. jumped by roughly 276,000 to more than 3.9 million in 2017. It’s the first time in almost a decade that the number of uninsured children increased across the nation, according to the report. The numbers from 2017 are the most recent data available.

“We saw all 50 states either go backwards or stagnate,” said Joan Alker, executive director of the Center for Children and Families. “We’ve never seen that kind of uniformity in states.”

Washington, D.C., was the only place to see improvements in health insurance coverage for children.

Political events on the national stage attributed to a notion that public coverage was at risk, leading to the jump in uninsured children. For example, Congress spent much of the year debating a repeal of the Affordable Care Act and funding for the Children’s Health Insurance Program, or CHIP, lapsed for a period, Alker said.

“It is a product of some of these federal changes that have been made,” Miller added.

It’s expected that the number of uninsured children could increase nationwide under the “public charge” rule proposed by the Trump administration. The rule change would allow the government to consider the use of public health services when deciding to permit an immigrant into the U.S. or whether to issue a green card.

Such public services include Medicaid, the government health care program for low-income adults and children, and CHIP, which provides health coverage to kids and pregnant women in families that don’t qualify for Medicaid.

Advocates argue that the rule would deter members of the immigration community from seeking health care.

In Colorado, it’s projected that about 75,000 people could lose health insurance under the rule change, which would increase the state’s overall uninsured rate from 6.5 percent to 7.9 percent. About two-thirds, or 48,000, of those who would lose coverage are children, according to a report by the Colorado Health Institute.

“Even families who would not be impacted by the rule, who are not immigrant families, might pull their kids out of coverage programs,” Miller said.

Norovirus outbreak at Loveland assisted living center prompts quarantine

A norovirus outbreak at a Loveland assisted living center this week has prompted a quarantine to stop the spread, according to its executive director.

Kristen Vasquez said she could not share the number of affected residents but that they were being confined to their rooms. Park Regency Assisted Living also has employed additional sanitization, visitation and staff procedures per policy.

Larimer County Health and Environment spokeswoman Katie O’Donnell said that she did not know how many residents showed symptoms, but that Park Regency contacted the health department to report an outbreak, meaning at least two non-related people have shown symptoms. She added that test results for one resident came back positive for the disease.

“It’s not a fun thing for anyone to go through, and it’s very contagious,” Vasquez said Wednesday afternoon, noting that the disease causes vomiting and diarrhea. “We don’t want visitors coming in and bringing it home to their families. But we’re still providing activities for those confined to their apartments, and they can call other residents.”

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Exposure to racism made undergraduate Latino students internalize self-hatred, CU Denver study finds

A Colorado professor wondered how racist rhetoric stoked by the 2016 presidential election was impacting Latino students, so he conducted academic research that found exposure to racism often led to self-hatred and acceptance of the offensive cultural beliefs lobbed at young Latinos from politicians, the media and their community.

“Although most people might intuitively know that racism negatively affects Latino undergraduates, the findings of this study provide empirical evidence of racism’s impacts,” said Carlos P. Hipolito-Delgado, an associate professor of counseling at the University of Colorado Denver. “Little by little, it begins to chip away at that sense of self.”

Hipolito-Delgado’s interest in studying the subject piqued during the lead up to the 2016 presidential election and after Donald Trump referred to Mexicans as rapists, drug dealers and criminals. In Colorado, white supremacist and other extremist organizations have been more emboldened now than in past years, data show, and the incidents of hate and bias in the state is rising dramatically, experts said. 

The study’s participants, 350 first-generation Latino undergraduate students from colleges across the country, took a survey designed to determine whether exposure to racism and encouragement to accept and assimilate to racist notions were predictive of internalized racism.

Questions included whether participants believed certain racist stereotypes, how much they felt like an American and whether or not they’d endured racist experiences like a clerk following them around a store, expecting them to steal.

The survey’s results indicated that participants did internalize hatred directed at them in a way that was statistically significant.

The study defines racial internalization as the conscious or unconscious acceptance of a racial hierarchy that values white people above people of color. Internalized racism has been linked to marital dissatisfaction, increased depressive symptoms, increased stress, decreased self-esteem and decreased life satisfaction, the study said.

Luis Estrada, an electrical engineering student at Metropolitan State University of Denver, was joined by about a dozen undocumented and refugee college students earlier this month at downtown Denver’s Auraria Higher Education Center to share stories and insights with the Colorado Department of Higher Education.

Estrada pulled up an internet meme of a Spongebob Squarepants character on fire who appeared unbothered by the flames.

“This climate we’re in feels like this,” the first-generation college student said. “You just get used to it. I’ve made peace with the fact that I can’t control anything. I can’t control Congress. I can’t control the president’s mood. I am just trying to find internships for myself and work hard.”

Dan Baer, executive director of the state’s higher education department, acknowledged the difficulties marginalized students face.

“We’re living through a really unsettling political environment that’s not welcoming or comfortable, and it’s especially important we have conversations like this because the people around this table don’t have direct power to change what’s going on in Washington, but we do have the ability to support each other,” Baer said to the group of students and members of his staff.

Hipolito-Delgado hopes the study will encourage counselors to intervene by helping Latino undergraduate students talk through discrimination they face.

Saira Galindo, a senior at MSU and an undocumented student, said counseling and access to mental health care was crucial as she worked through the stresses of the political atmosphere and everyday life of being a Mexican immigrant living in the United States.

“It’s been life-saving and life-changing to attend the free counseling services MSU offers because of our lack of access to health insurance,” Galindo said. “We don’t always have to be strong. It feels like it because we’re so busy taking care of our families and working so hard against all this, but there are resources out there.”

Hipolito-Delgado plans on further studying the impacts of racism and bias on academic achievements and the pursuit of college.

“My hope is for the student to realize that racism is not the student’s fault,” Hipolito-Delgado said. “It is not a reflection of the student’s culture or heritage, but instead is the product of a biased perpetrator and a racist society.”

Colorado health systems look for ways to address gender identity in medical records

From medical records to wristbands, Colorado hospitals and health systems are finding new ways to change how they record patients’ gender identities.

The changes come as the Trump administration is considering limiting the definition of gender, a move that would pull back on the recognition and protections of transgender people under federal law.

This year, Kaiser Permanente changed its electronic medical record system so physicians can note patients’ gender identity and preferred pronouns alongside their legal names and other information typically included in medical records.

“We know that we’re telling that member we accept who they are,” said Dr. Brian Bost, medical director of transgender services at Kaiser Permanente. “We want them at ease.”

Children’s Hospital Colorado still uses “male” and “female” gender designations in medical records, but it has removed them from patients’ wristbands.

“We also are committed to offering culturally responsive care for the diverse populations we serve so that we can create a welcoming, supporting and safe environment that is so important for all of our patients and families,” spokesperson Elizabeth Whitehead said in an email.

Roughly 20,850 individuals in Colorado identify as transgender, an umbrella term for people whose gender identity, expression or behavior does not conform to the sex they were assigned at birth, according to a 2016 study by the Williams Institute at UCLA School of Law.

One of the barriers transgender people face in accessing health care is that they fear discrimination and the possibility that a provider will use the wrong name and pronouns, said Daniel Ramos, executive director of One Colorado.

Addressing transgender patients by their proper names and pronouns is “incredibly important,” Ramos said. “And ensuring that transgender folks can access affirming care.”

The New York Times reported last month that the Department of Health and Human Services is heading an effort to adopt a definition of gender as either male or female, as determined by a person’s genitals at birth.

Kaiser Permanente responded to the report by saying it has joined more than 50 other companies and organizations in signing a statement “in support of transgender equality.”

“Regardless of any change to the (Affordable Care Act) nondiscrimination provision, Kaiser Permanente will maintain our current services and protections for our transgender members,” said chief executive officer Bernard J. Tyson in a statement.

While some health systems haven’t altered how they record gender identity, they say a change is in the works.

As of now, UCHealth is able to print a patient’s preferred and legal names and legal gender on wristbands, but is working to “incorporate additional functionality” within its electronic medical record system, said Dr. Micol Rothman, an endocrinologist and co-founder of the system’s Integrated Transgender Program.

Patients also are asked their preferred name and gender identity when they check in to see a doctor.

“It’s becoming more clear that there’s more of a interest in developing this,” Rothman said. “The (electronic medical record) is going to allow us to do this in a way that was previously more challenging with paper charts.”

Centura Health has just updated its electronic medical record system, which it said will give physicians greater flexibility when it comes to recording gender identity. Previously, the system only had a field for documenting a patient’s “sex.” Centura Health said it is able to put a patient’s preferred name under a field called “alias.”

Officials at Centura Health have held preliminary conversations on how the system will respond to the medical record changes, spokesperson Wendy Forbes said in an email.

“At this time, Centura Health is evaluating all the important considerations to address gender identification before we finalize a position longer term,” she said.

One in eight Denver residents is clinically depressed and most aren’t getting treatment, new study says

Depression is so pervasive in Denver that it’s hard to wrap the mind around how many people in the city are chronically sad.

Think about it this way. Imagine every person in Denver’s four largest neighborhoods — Montbello, Hampden, Westwood and Capitol Hill. That’s about 76,000 people, near the same number of Denver residents who reported signs of clinical depression at least eight days out of the prior month.

At any given time, one in eight Denver residents is depressed, according to a first-of-its-kind study from Denver Public Health that relied on electronic medical records and surveys to gauge the mental-health status of Denver.

“It’s common. It’s serious. It affects people throughout their lifespan,” said Dr. Bill Burman, the director at Denver Public Health.

The study, released this month, found that three in 10 students at Denver middle and high schools feel “persistently sad and hopeless” for more than two weeks at a time during the course of a year. And results showed one in four pregnant women who had a medical appointment at Denver Health was depressed.

To compound all that news, almost 70 percent of Denver residents who are depressed are not getting treatment.

The findings align with national statistics on depression, but until this report, there was a shortage of data regarding the scope of depression at a local level.

Knowing the numbers is important, Burman said, in order to improve treatment options and allocate funding. The report was released about a week after Denver voters approved a new sales tax that will raise $45 million each year for mental-health services, suicide-prevention programs and substance-abuse treatment. The tax, which amounts to 25 cents on a $100 purchase, begins Jan. 1.

Public-health officials hope the report will advance progress toward “integrated care,” a health care model that incorporates mental-health and substance-abuse treatment at the same place patients go for medical care.

MORE: Read the Denver Health study

Psychologists embedded in Denver Health clinics add mental health to other care

That integrated setup is already in place at several Denver Health clinics, including one for pregnant women.

KC Lomonaco, a clinical psychologist who specializes in pregnancy-related depression, works in the same office as the obstetricians, nurse practitioners and other medical staff at the Denver Health Women’s Care Clinic. The clinic, which sees about 200 women each day, has two “integrated” psychologists who are available to talk to patients who are feeling anxious and depressed.

“I like to say we are embedded in the clinic, like a reporter embedded with troops,” Lomonaco said.

She sees patients in her office, which is just down the hall from the gynecological exam room, and sometimes in the exam room before or after their medical appointment. The visits might happen once or might occur regularly throughout a woman’s pregnancy and into postpartum.

The clinic began screening women for mental-health issues in 2014 at three specific points — their first visit, the midpoint of the pregnancy and postpartum. The screening, which comes in 30 languages, asks how often a woman is “able to laugh and see the funny side of things,” whether she has been “so unhappy” that she has been crying, as well as other questions.

The questions are designed to determine whether a pregnant woman or new mother has clinical depression or is losing sleep and feeling overwhelmed simply because she is too uncomfortable to sleep or is up taking care of a newborn overnight.

The integrated-care approach is becoming more common, but it’s still much more common at federally qualified health centers, which serve a lower-income population, than it is in private ob-gyn practices, which are more likely to have patients with insurance, Lomonaco said.

The model is effective because, according to Lomonaco’s previous research, patients are four times more likely to see a mental-health professional if one is in the office than if they are handed a piece of paper referring them elsewhere.

Denver Health patients, on average, are at higher risk of pregnancy-related depression because of other “psycho-social” factors, including worries about money and housing, but depression affects one in five pregnant women nationwide. “Depression is not a disease of just the poor,” Lomonaco said. “It can strike almost anyone.”

3 in 10 Denver kids are clinically depressed overall with nearly 60 percent of gay students meeting criteria

The report tracked clinical depression, which is often chronic and has long-term physical effects such as headaches, aches and pains, and digestive problems. The symptoms of chronic depression include persistent sadness, hopelessness and low self-worth.

It’s different than situational depression, which is time-limited and typically the result of a specific life event such as a breakup, a death, or problems at work or school.

When surveying kids, the key question was to find out whether they felt “so sad or hopeless” for two consecutive weeks that they stopped participating in their usual activities. Three in 10 said they had. Among them, girls were more likely than boys to meet that definition of clinical depression, and youths who identified as gay or bisexual were far more likely to answer yes than heterosexual youths.

While 26 percent of heterosexual youths said they had been that sad or hopeless, 58 percent of gay students said the same.

Among Denver adults, 15 percent studied from 2012-16 said they had eight or more days of severe stress, depression and emotional problems within the prior month. That definition typically warrants a diagnosis of clinical depression, researchers said. Women and African-Americans were more likely to say yes to the question.

To get more people in treatment, “culture shift” around mental health must take place 

Matthias Darricarrere, a 26-year-old psychology resident at Denver Health, saw himself reflected in the report “in a number of ways.”  

As a teenager, he had depression but never received treatment. Instead, he heard the “classic messages,” including “Put a smile on,” “Don’t look so sad” and “Why can’t you brighten up?”

“There is a chunk of my memories where everything was in shades of gray,” said Darricarrere, who believes his depression was part of the reason he is working on a doctorate in clinical psychology. “I could not see color anymore in my life.

“I was pretty aware that something was wrong. For me, what I experienced was that there are so many occasions where these pieces of ourselves are kind of punished for being present. My own feelings of sadness and anger didn’t really have a space to live publicly.”

More than anything else, Darricarrere said, the country needs a “culture shift” to reduce stigma and “carve out space so that people can talk” about depression and mental health. “I think that’s where depression really becomes insidious, when it’s left to fester silently,” he said.

Improving depression occurs either through addressing biological markers, often with medication, or through environmental factors. For Darricarrere, his life and the people in it expanded to include “more richness,” and he poured his pain into running.

Now, as a student at the University of Denver, he works alongside doctors at the Peña Southwest Family Health Center, an integrated behavioral health clinic that has physicians, dentists, psychiatrists and other professionals in one building. Darricarrere is there to talk a patient through a cancer diagnosis — or help him figure out whether it’s the diagnosis, the recent divorce or the job loss, or some combination of them, that is causing mental-health problems.

Mental health is embedded in the entire practice, beginning with the physician asking patients not just about physical sensations, but also about thoughts and emotions. If a patient is feeling anxious or depressed, the doctor tells them, “There is someone here who can help you with that.”

“One of our really big benefits is that we can come in and slow things down,” Darricarrere said. “This is a way that once they are in the door, they can receive care for what they are needing in their lives.”

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It’s OK to eat some romaine, look for labels, U.S. officials say

NEW YORK — It’s OK to eat some romaine lettuce again, U.S. health officials said. Just check the label.

The Food and Drug Administration narrowed its blanket warning from last week, when it said people shouldn’t eat any romaine because of an E. coli outbreak. The agency said Monday the romaine linked to the outbreak appears to be from the California’s Central Coast region. It said romaine from elsewhere should soon be labeled with harvest dates and regions, so people know it’s OK to eat.

People shouldn’t eat romaine that doesn’t have the label information, the FDA said. For romaine that doesn’t come in packaging, grocers and retailers are being asked to post the information by the register.

Romaine harvesting recently began shifting from California’s Central Coast to winter growing areas, primarily Arizona, Florida, Mexico and California’s Imperial Valley. Those winter regions weren’t yet shipping when the illnesses began. The FDA also noted hydroponically grown romaine and romaine grown in greenhouses aren’t implicated in the outbreak.

The labeling arrangement was worked out as the produce industry called on the FDA to quickly narrow the scope of its warning so it wouldn’t have to waste freshly harvested romaine. An industry group said people can expect to start seeing labels as early as this week. It noted the labels are voluntary, and that it will monitor whether to expand the measure to other leafy greens and produce.

The FDA said the industry committed to making the labeling standard for romaine and to consider longer-term labeling options for other leafy greens.

Robert Whitaker, chief science officer of the Produce Marketing Association, said labeling for romaine could help limit the scope of future alerts and rebuild public trust after other outbreaks.

“Romaine as a category has had a year that’s been unfortunate,” Whitaker said.

The FDA still hasn’t identified a source of contamination in the latest outbreak. There have been no reported deaths, but health officials say 43 people in 12 states have been sickened. Twenty-two people in Canada were also sickened.

Even though romaine from the Yuma, Arizona, region is not implicated in the current outbreak, it was blamed for an E. coli outbreak this spring that sickened more than 200 people and killed five. Contaminated irrigation water near a cattle lot was later identified as the likely source.

Leafy greens were also blamed for an E. coli outbreak last year. U.S. investigators never specified which salad green might be to blame for those illnesses, which happened around the same time of year as the current outbreak. But officials in Canada identified romaine as a common source of illnesses there.

The produce industry is aware the problem is recurring, said Jennifer McEntire of the United Fresh Produce Association.

“To have something repeat in this way, there simply must be some environmental source that persisted,” she said. “The question now is, can we find it?”

Growers and handlers in the region tightened food safety measures after the outbreak this spring, the industry says. Steps include expanding buffer zones between cattle lots and produce fields. But McEntire said it’s not known for sure how the romaine became contaminated in the Yuma outbreak. Another possibility, she said, is that winds blew dust from the cattle lot onto produce.

McEntire said the industry is considering multiple theories, including whether there is something about romaine that makes it more susceptible to contamination. Compared with iceberg lettuce, she noted its leaves are more open, thus exposing more surface area.

Since romaine has a shelf life of about 21 days, health officials said last week they believed contaminated romaine could still be on the market or in people’s homes.

Food poisoning outbreaks from leafy greens are not unusual. But after a 2006 outbreak linked to spinach, the produce industry took steps it believed would limit large scale outbreaks, said Timothy Lytton, a Georgia State University law professor. The outbreak linked to romaine earlier this year cast doubt on how effective the measures have been, he said.

But Lytton also noted the inherent risk of produce, which is grown in open fields and eaten raw.


The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Denver moves forward with plan for supervised injection site for IV-drug users

Denver City Council approved plans Monday night to open a supervised injection site where IV-drug users could inject heroin near staff standing by with the life-saving antidote to opioid overdose.

The two-year pilot program is contingent on state legislation that would create criminal immunity for those using drugs at the site, a sterile clinic containing private booths.

No American city has such a site, though several — including New York, Philadelphia, San Francisco and Seattle — are moving forward on plans to open one. Supervised injection sites, which have opened in more than 60 international cities, are illegal under federal law.

“There is a national health crisis in front of us and cities are on the front line,” Councilman Albus Brooks said just before a 12-1 vote on his bill. “Tonight we act to save lives and repair families.

“When we view people simply as addicts, we rob them of their humanity. This ordinance is not about addicts. This is about our neighbors.”

MORE: Denver city councilman, state lawmaker revive plans for safe injection site, in spite of federal law

Only Councilman Kevin Flynn voted against the measure. Other city leaders said a supervised injection site would become another tool for the city to deal with addiction, and a way to prevent overdose deaths happening on the city’s streets, public parks, alleys and restaurant bathrooms.

The measure requires Mayor Michael Hancock’s signature but he has indicated he will support it.

More than 200 people died of drug overdoses in Denver last year, more deaths than were caused by firearms.

“You’ve got to remove your fear,” Councilman Paul Lopez said. “Look at this person as a human being and the end goal is saving their life. Get out of this mindset that, ‘Oh, this is scary,’ that this is a bunch of folks shooting up and we’re enabling them.’”

The staff who would run the site would not enable drug-users, but act as supervisors to “make sure they’re not killing themselves,” Lopez said.

City and state officials tried to pass similar measures last year, but the idea failed out of concern that it would condone illegal activity, create an area of heavy drug sales and defy federal law.

The legislation was killed by a Republican-controlled Senate committee in February. This time around, Democrats will control both the House and Senate, and the proposal — along with a list of other ideas to mitigate the opioid epidemic — is more likely to pass than it was last session.

At supervised injection sites in other cities, drug-users inject heroin or methamphetamine in curtained booths containing sterile needles, clean water and testing strips to make sure their drugs don’t contain fentanyl, a synthetic opioid that is more potent than heroin. They shoot up, wait about 20 minutes to make sure they are OK, and then leave.

City leaders have avoided discussion about where they would locate the proposed site. The Harm Reduction Action Center, which runs a needle-exchange program across East Colfax Avenue from the state Capitol, has offered to host the site.

Rising Sun

More from The Colorado Sun

Company pays $4.25M to settle suit over Colorado inmate’s death

COLORADO SPRINGS — A correctional health care company has agreed to pay $4.25 million to settle a lawsuit brought by the family of a man who died in a Colorado jail after being cut off from a prescription medication.

The Gazette reports attorneys for the estate of John Patrick Walter disclosed the settlement Monday with Correctional Healthcare Companies Inc., which had provided medical care to inmates at the time of Walter’s death.

The 53-year-old inmate died in the Fremont County jail in July 2014.

An autopsy later determined he died of benzodiazepine withdrawal after being deprived from a prescribed anti-anxiety medication.

Correctional Healthcare Companies was acquired by Correct Care Solutions Inc. in 2014. The company is now known as WellPath, which did not return the newspaper’s email Monday.

Aurora receives nearly $500,000 in housing vouchers to help people with disabilities

The Aurora housing authority has been awarded federal vouchers designed to help people with disabilities live independently.

In a statement Monday, the Housing Authority of the City of Aurora said it collaborated with Atlantis Community Inc. and Developmental Pathways, which work with people with disabilities, and the Aurora Mental Health Center to apply for the U.S. Department of Housing and Urban Development’s Section 811 Mainstream Housing Choice Voucher Program. It received 40 rental assistance vouchers worth a total of $492,106 a year. Recipients will be able to use the vouchers for as long as needed.

Six other Colorado housing agencies, including the state Division of Housing, also received vouchers in the national program.

Section 811 supports low-income, non-elderly people with disabilities who are leaving institutional or similar settings and are homeless or at risk of institutionalization or homelessness. The vouchers can be used by people who are eligible and their families. Public housing authorities administer the vouchers and local health and human services agencies provide support services.

Craig A. Maraschky, executive director of Aurora’s housing authority, said in the statement that the demand for any type of affordable housing in his Denver suburb was “huge.

“Consequently, we are very pleased to offer assistance to these very needy individuals.”

The vouchers will not be released until early 2019. The statement urged those interested to check the authority’s website and the Aurora Sentinel in early 2019 for announcements on how to apply for vouchers.

Get Cooking: Mindful cooking and drinking around the holidays

A disaster looms for the Good Ship Health.

On the map ahead, the shoals are marked Holiday Gathering, Christmas Dinner, Feast of the Seven Fishes, New Year’s Eve and the particularly insidious triplets Secret Santa, Sing-along and Just Another Small One.

Navigating the Thanksgiving dinner buffet was calm waters compared to what’s on the horizon.

You’ll hear that the best ways to keep weight off and your head on are to “not” do things. That’s one way to ennoble negative space.

But I say just slow everything down — in the kitchen at the table, with the belly up to the bar. If the pace gets glacial, that’s fine. When time isn’t moving, that’s a lot of not doing, too.

The present-day word for “slow” is “mindfulness.” When we attend to the moment, and lose thought of the past or future, we effect the pause. We savor one bite instead of shovel two; we sip instead of gulp.

My favorite time cooking is stuff like this: standing over a carrot and staring at it, figuring out how to slice or dice this hard orange thing that is about to roll away from me; stirring a fluid in a figure-eight slowly and splashlessly so that the eddies and waves take on their own shiny life; watching onions go from ghostly to golden to amber then auburn, losing their sulfuric sting, becoming honeyed.

All these things take time. Each moment enriches my senses, in turn, one sense, then another: color, sound, smell, taste, touch.

I can sense them altogether, if I like, at eating, but I can’t even do that well if I don’t spend time on the forkful or don’t linger on the bite, letting the flavors and textures come slowly to, onto, and into me.

I learned one of the great lessons of my life —  not merely my cooking life, but my overall life —  watching my maternal grandmother make mayonnaise. She made it every day.

Each morning, she placed a plate on her lap, smashed an egg yolk on it with the back of a fork, and swept it up into a cream. Oil went in drip by drip until the new mayonnaise could accept a wee stream of oil and then it was done. A few drops of lemon juice, salt, white pepper. Today’s mayonnaise.

Cooking, eating, and drinking mindfully the next few weeks:

  •  One of the great gifts to the kitchen from France is the concept of “mise en place.” The phrase pretty much means “everything put in its place” and stands for the preparing ahead and laying out of all the constituents that will go into a particular dish or recipe.

The idea is to chop, peel, dice, measure, squeeze, apportion and individualize the ingredients that make up a recipe, place them in small bowls, ramekins or cups, and have them ready and willing when it comes time to finally cook.

  •  Your fork is not a shovel. Like a Henry Moore sculpture, it allows you to see the world on the other side of it — if you take the time to look.
  •  Eating food and drinking good wine or beer are not merely about taste. Use all of your senses to savor color and shape, texture and touch, and all the perfumes and aromas that float there.
  •  As for taste, let it stick around. Tastes tend to unfold in waves of flavor. Smoosh that tongue, smack those lips.

My Grandmother’s Homemade Mayonnaise

Makes 1/2 to 3/4 cup


  • 1 large egg yolk, at room temperature
  • 1 teaspoon freshly squeezed lemon juice
  • 3/4 cup canola, safflower or pure olive oil (not extra virgin cold-pressed oil)


On a room temperature plate, smash and stir the egg with a fork until creamed. Add a tiny amount of oil at a time and blend. Season with lemon juice, salt and pepper.

Tuna or swordfish with onion confit

From Mark Bittman, The New York Times; serves 4


  • 3 tablespoons extra virgin olive oil
  • 3 large or 4-5 medium onions, peeled and thinly sliced
  • Salt and freshly ground black pepper
  • 1 large thyme sprig or 1 bay leaf
  • 2 medium tomatoes, cored
  • 1 1/2 to 2 pounds tuna or swordfish, cut into steaks or left whole
  • About 1/2 cup pitted and roughly chopped black olives


Put olive oil in a 10- or 12-inch skillet, and turn heat to medium. Add onions, a good pinch of salt, pepper and bay leaf or thyme. Cook, stirring, until mixture starts to sizzle, a minute or two. Adjust heat so you need to stir at most only every 5 minutes to keep onions from browning as they soften. Do not allow to brown. Cook at least 30 minutes.

Meanwhile, cut tomatoes in half and shake out seeds, then cut into 1/2-inch dice. Heat a grill until moderately hot. When onions are very soft, almost a shapeless mass, season fish and grill it, turning once, for a total of about 6 minutes for tuna, 8-10 minutes for swordfish. Check for doneness by making a small cut in center to peek inside.

While fish is grilling, stir olives and tomatoes into onions, and raise heat; cook, stirring occasionally, until tomatoes liquefy and mixture becomes juicy. Taste, and adjust seasoning. Serve fish on a bed of onion confit, whole fish cut into serving portions.

Reach Bill St John at