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"content": "\u003cp>Gov. Jerry Brown rejected legislation on Sunday that would have allowed San Francisco to open what would’ve been the nation’s first supervised drug injection site under a pilot program.\u003c/p>\n\u003cp>Advocates of “safe injection” sites say the locations would save lives by preventing drug overdoses and providing access to counseling. But the U.S. government and other critics say taxpayers should not be helping users shoot up heroin, methamphetamine or other illegal drugs.\u003c/p>\n\u003cp>“Fundamentally I do not believe that enabling illegal drug use in government sponsored injection centers — with no corresponding requirement that the use undergo treatment — will reduce drug addiction,” Brown said in his \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2018/09/AB-186-veto-9.30.pdf\" rel=\"noopener\" target=\"_blank\">announcement of the veto\u003c/a>.\u003c/p>\n\u003cp>San Francisco Mayor London Breed has vowed to \u003ca href=\"https://www.kqed.org/news/11690409/s-f-safe-injection-site-supporters-urge-gov-brown-to-sign-bill\" rel=\"noopener\" target=\"_blank\">open a supervised injection site\u003c/a>, saying the status quo is not acceptable in a city known for rampant drug use. It’s not uncommon to see people injecting drugs in public, and used needles are a major source of trash.\u003c/p>\n\u003cp>“Safe injection sites save lives,” she said Sunday. “If we are going to prevent overdoses and connect people to services and treatment that they badly need to stop using drugs in the first place, we need safe injection sites.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The country is struggling with an opioid epidemic that has led to rising overdose deaths. The increase has been attributed to the painkiller fentanyl and similar drugs that are powerful but relatively cheap and cut into street drugs without buyers’ knowledge.\u003c/p>\n\u003cp>San Francisco has reported about 200 overdose deaths annually in recent years, largely from opioids. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB186\" rel=\"noopener\" target=\"_blank\">AB 186\u003c/a> would have protected staff and participants from state prosecution related to illegal narcotics. But it gave no legal cover from federal laws, including a “crack house” statute that makes it a felony to knowingly maintain a place for using a controlled substance.\u003c/p>\n\u003cp>San Francisco has not shied away from confronting the U.S. government and has repeatedly sued the Trump administration, including one lawsuit over sanctuary protections for people in the country illegally. The issue of drug injection sites would likely wind up before a federal judge if San Francisco opens a clinic, legal experts say.\u003c/p>\n\u003cp>Robert Mikos, who teaches federalism and drug law at Vanderbilt Law School, said a quasi-medical facility where the goal is to reduce harm sounds well-intentioned but appears to violate a statute used to go after people who run drug dens.\u003c/p>\n\u003cp>“It would depend on whether federal prosecutors are willing to prosecute this violation,” he said. “Federal prosecutors always have some discretion, and they have some independence from Washington, D.C., and the attorney general, but this is a tricky situation.”\u003c/p>\n\u003cp>Leo Beletsky, an associate professor of law and health sciences at Northeastern University, said a federal judge might find in San Francisco’s favor.\u003c/p>\n\u003cp>“If you got it before a judge, it’s anyone’s guess,” he said. “You can make a very reasonable argument that a health care facility of this sort is not something that was ever intended to be covered under the crack house statute.”\u003c/p>\n\u003cp>There are supervised injection sites in Canada and Europe, but none in the United States.\u003c/p>\n\u003cp>Days after California lawmakers sent the legislation to the governor in August, U.S. Deputy Attorney General Rod Rosenstein \u003ca href=\"https://www.nytimes.com/2018/08/27/opinion/opioids-heroin-injection-sites.html\" rel=\"noopener\" target=\"_blank\">wrote in The New York Times\u003c/a> that the federal government would take aggressive action against any supervised injection sites.\u003c/p>\n\u003cp>“Americans struggling with addiction need treatment and reduced access to deadly drugs. They do not need a taxpayer-sponsored haven to shoot up,” he wrote.\u003c/p>\n\u003cp>State Sen. Scott Wiener (D-San Francisco) who co-authored the legislation, says the city has no qualms about taking on the federal government over what he calls a failed war on drugs. He noted that the city has long led the country on health and safety policy as well as on challenging the federal government.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We implemented needle exchange before it was legal. We implemented medical cannabis before it was legal, and we have always been on the forefront of the sanctuary city movement,” he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Jerry Brown rejected legislation on Sunday that would have allowed San Francisco to open what would’ve been the nation’s first supervised drug injection site under a pilot program.\u003c/p>\n\u003cp>Advocates of “safe injection” sites say the locations would save lives by preventing drug overdoses and providing access to counseling. But the U.S. government and other critics say taxpayers should not be helping users shoot up heroin, methamphetamine or other illegal drugs.\u003c/p>\n\u003cp>“Fundamentally I do not believe that enabling illegal drug use in government sponsored injection centers — with no corresponding requirement that the use undergo treatment — will reduce drug addiction,” Brown said in his \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2018/09/AB-186-veto-9.30.pdf\" rel=\"noopener\" target=\"_blank\">announcement of the veto\u003c/a>.\u003c/p>\n\u003cp>San Francisco Mayor London Breed has vowed to \u003ca href=\"https://www.kqed.org/news/11690409/s-f-safe-injection-site-supporters-urge-gov-brown-to-sign-bill\" rel=\"noopener\" target=\"_blank\">open a supervised injection site\u003c/a>, saying the status quo is not acceptable in a city known for rampant drug use. It’s not uncommon to see people injecting drugs in public, and used needles are a major source of trash.\u003c/p>\n\u003cp>“Safe injection sites save lives,” she said Sunday. “If we are going to prevent overdoses and connect people to services and treatment that they badly need to stop using drugs in the first place, we need safe injection sites.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The country is struggling with an opioid epidemic that has led to rising overdose deaths. The increase has been attributed to the painkiller fentanyl and similar drugs that are powerful but relatively cheap and cut into street drugs without buyers’ knowledge.\u003c/p>\n\u003cp>San Francisco has reported about 200 overdose deaths annually in recent years, largely from opioids. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB186\" rel=\"noopener\" target=\"_blank\">AB 186\u003c/a> would have protected staff and participants from state prosecution related to illegal narcotics. But it gave no legal cover from federal laws, including a “crack house” statute that makes it a felony to knowingly maintain a place for using a controlled substance.\u003c/p>\n\u003cp>San Francisco has not shied away from confronting the U.S. government and has repeatedly sued the Trump administration, including one lawsuit over sanctuary protections for people in the country illegally. The issue of drug injection sites would likely wind up before a federal judge if San Francisco opens a clinic, legal experts say.\u003c/p>\n\u003cp>Robert Mikos, who teaches federalism and drug law at Vanderbilt Law School, said a quasi-medical facility where the goal is to reduce harm sounds well-intentioned but appears to violate a statute used to go after people who run drug dens.\u003c/p>\n\u003cp>“It would depend on whether federal prosecutors are willing to prosecute this violation,” he said. “Federal prosecutors always have some discretion, and they have some independence from Washington, D.C., and the attorney general, but this is a tricky situation.”\u003c/p>\n\u003cp>Leo Beletsky, an associate professor of law and health sciences at Northeastern University, said a federal judge might find in San Francisco’s favor.\u003c/p>\n\u003cp>“If you got it before a judge, it’s anyone’s guess,” he said. “You can make a very reasonable argument that a health care facility of this sort is not something that was ever intended to be covered under the crack house statute.”\u003c/p>\n\u003cp>There are supervised injection sites in Canada and Europe, but none in the United States.\u003c/p>\n\u003cp>Days after California lawmakers sent the legislation to the governor in August, U.S. Deputy Attorney General Rod Rosenstein \u003ca href=\"https://www.nytimes.com/2018/08/27/opinion/opioids-heroin-injection-sites.html\" rel=\"noopener\" target=\"_blank\">wrote in The New York Times\u003c/a> that the federal government would take aggressive action against any supervised injection sites.\u003c/p>\n\u003cp>“Americans struggling with addiction need treatment and reduced access to deadly drugs. They do not need a taxpayer-sponsored haven to shoot up,” he wrote.\u003c/p>\n\u003cp>State Sen. Scott Wiener (D-San Francisco) who co-authored the legislation, says the city has no qualms about taking on the federal government over what he calls a failed war on drugs. He noted that the city has long led the country on health and safety policy as well as on challenging the federal government.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We implemented needle exchange before it was legal. We implemented medical cannabis before it was legal, and we have always been on the forefront of the sanctuary city movement,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "state-fines-psychiatric-hospital-in-attack-on-nurse-amid-renewed-staffing-concerns",
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"content": "\u003cp>David McElveen recently had a stroke. The 59-year-old Vallejo resident and John George Psychiatric Hospital nurse has short-term memory problems and has been out of work for more than a year. The stroke may be linked to an attack he suffered last summer.\u003c/p>\n\u003cp>He was working the morning shift on Sept. 13, 2017 at the Alameda County mental health care facility in San Leandro when a patient punched him the face.\u003c/p>\n\u003cp>“I heard somebody running and that’s the last thing I remembered,” McElveen said in an interview on Monday.\u003c/p>\n\u003cp>He fell to the floor. The patient kept hitting him, slamming his head against the ground.\u003c/p>\n\u003cp>“The injured was unconscious and had a seizure while bleeding from his face and head area,” an investigator with California’s Division of Occupational Safety and Health (Cal/OSHA) wrote in the agency’s investigation into the attack, obtained through a California Public Records Act Request.\u003c/p>\n\u003cp>McElveen’s facial bones were fractured.\u003c/p>\n\u003cp>“The left side of my skull was busted open. My right eye was closed for more than 10 days. My jaw was broken in two different places. And, I lost a tooth,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11694380\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11694380\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258.jpg\" alt=\"\" width=\"480\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258.jpg 480w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258-240x320.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258-375x500.jpg 375w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">David McElveen, a John George Psychiatric Hospital nurse, was attacked by a patient in September 2017. \u003ccite>(Courtesy David McElveen)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>McElveen was hospitalized and underwent surgery. Doctors wired his jaw shut. He also says the morning he was attacked, the hospital was short-staffed.\u003c/p>\n\u003cp>“We didn’t have enough mental health workers. We didn’t have enough nurses,” he said. “Everyone was just overwhelmed.”\u003c/p>\n\u003cp>Union officials who represent McElveen and other John George workers say the attack is the result of low staffing at the facility’s emergency room (known as “emergency services”) and poor security protocols at a hospital that has repeatedly come under scrutiny for dangers posed to employees and patients.\u003c/p>\n\u003cp>Now, dozens of Service Employees International Union Local 1021 members plan to hold an informational picket in Oakland on Tuesday afternoon to draw attention to staffing issues there and two other Alameda County medical facilities.\u003c/p>\n\u003cp>Two months after McElveen was attacked, \u003ca href=\"https://www.sfgate.com/crime/article/Runaway-psych-patient-hit-by-car-in-San-Leandro-12417473.php\" target=\"_blank\" rel=\"noopener\">another patient\u003c/a> fled from the hospital, tried to carjack two vehicles, assaulted a teenage boy and bit an elderly man.\u003c/p>\n\u003cp>In 2016, the \u003ca href=\"https://www.eastbayexpress.com/oakland/overwhelmed/Content?oid=4705660\" target=\"_blank\" rel=\"noopener\">East Bay Express\u003c/a> and \u003ca href=\"http://www.ktvu.com/news/2-investigates/2-investigates-patients-say-conditions-at-john-george-mental-hospital-were-hell\" target=\"_blank\" rel=\"noopener\">KTVU\u003c/a> reported on severe overcrowding at the hospital where workers described the facility’s emergency room as dangerous and inhumane, with patients sleeping and eating on the floor — some moaning and crying for help.\u003c/p>\n\u003cp>Despite that media scrutiny and probes by government agencies, not much has changed, according to the SEIU Local 1021 field supervisor Ann Schuyler.\u003c/p>\n\u003cp>“The number of injuries is not abating and the severity of these injuries, caused while at work, is heartbreaking,” Schuyler said in an interview.\u003c/p>\n\u003cp>\u003cstrong>Investigation Into the Attack\u003c/strong>\u003c/p>\n\u003cp>The Alameda County Sheriff’s Office has identified 51-year-old Michael Lindsay of Fairfield as the patient who allegedly assaulted McElveen.\u003c/p>\n\u003cp>Lindsay was on the third day of his stay at John George and “was extremely agitated” during the two-and-a-half hours before the attack, state workplace regulators said.\u003c/p>\n\u003cp>The patient “expressed that he wanted to leave the facility” and was “verbally abusive to staff,” Cal/OSHA’s report states.\u003c/p>\n\u003cp>McElveen and another hospital worker tried to redirect Lindsay’s attention and de-escalate his behavior. Hospital staff gave him medication but said it was unclear if he faked digesting the pill.\u003c/p>\n\u003cp>Minutes later Lindsay went behind McElveen and punched him in the face and continued attacking him, according to the report.\u003c/p>\n\u003cp>Other staff members subdued the patient, called 911 and administered CPR to McElveen.\u003c/p>\n\u003cp>When an Alameda County Sheriff’s deputy arrived, Lindsay was being held down by staff and was yelling. The deputy placed handcuffs on Lindsay and put his knee on his back while other law enforcement officers arrived.\u003c/p>\n\u003cp>“McElveen was bleeding from a large wound on his head and was complaining of pain to his jaw,” wrote deputy Jeriah Gurley in a report on the incident, noting that the victim had blood on his clothes and there was blood on the floor next to him. Witnesses told the deputy McElveen was gasping for air.\u003c/p>\n\u003cp>McElveen was taken to Eden Medical Center in Castro Valley where he was treated for the next three days.\u003c/p>\n\u003cp>Lindsay was taken to San Leandro Hospital and eventually arrested.\u003c/p>\n\u003cp>Prosecutors later filed felony battery charges against Lindsay.\u003c/p>\n\u003cp>He has pleaded not guilty and his case is expected to go to trial in November, according to Alameda County District Attorney spokeswoman Teresa Drenick.\u003c/p>\n\u003cp>The deputy’s report also found that there were no surveillance cameras in the area where the attack took place.\u003c/p>\n\u003cp>Cal/OSHA concluded that Lindsay arrived at the hospital using a different name and that John George did not have policies in place to handle patients who use aliases. Without those procedures, the hospital failed to identify Lindsay as a patient who had a violent history at the facility.\u003c/p>\n\u003cp>\u003cstrong>Safety and Staffing Issues at the Hospital\u003c/strong>\u003c/p>\n\u003cp>In March, Cal/OSHA cited the Alameda Health System (AHS), which runs the hospital. It issued a $11,250 fine against AHS for a “serious” violation for having an injury and illness prevention program that was ineffective.\u003c/p>\n\u003cp>AHS officials did not appeal the penalty, and in June they paid the fine.\u003c/p>\n\u003cp>But hospital leaders emphasize that the facility correctly followed protocol before, during and after the incident.\u003c/p>\n\u003cp>Luis Fonseca, AHS’s chief operating officer, told Cal/OSHA that Linsday did not show signs of violence beforehand.\u003c/p>\n\u003cp>“We initiated safe practices and processes,” Fonseca said. The hospital immediately contacted law enforcement, helped McElveen press charges and provided him with emotional support, he said.\u003c/p>\n\u003cp>Sandra Williams, director of the hospital system’s environmental health and safety department, told a Cal/OSHA inspector “our actions were reasonable and responsible” on the day of the attack.\u003c/p>\n\u003cp>Lorna Fernandes, an AHS spokeswoman, emphasized that creating and maintaining a safe environment for its workers, patients and visitors is a top priority.\u003c/p>\n\u003cp>“AHS self-reported this incident to Cal/OSHA and then took immediate action and actively engaged all appropriate protocols to address the situation. Further, AHS cooperated with Cal/OSHA over the course of a thorough investigation,” Fernandes said in an statement emailed to KQED.\u003c/p>\n\u003cp>“Alameda Health System realizes that keeping our employees safe from harm so they can provide quality patient care is of the utmost importance. We continue to proactively address and adjust protocols to ensure we are adhering to best practices for maximum protection for AHS employees, patients, visitors and the community we serve,” Fernandes said.\u003c/p>\n\u003cp>Currently, the nurses’ contract with AHS at John George calls for one nurse for for every six patients at the emergency room, according to SEIU.\u003c/p>\n\u003cp>But the union’s Schuyler says with 40 to 60 patients in the ER, the hospital often goes over that ratio.\u003c/p>\n\u003cp>She says SEIU has pushed for years for more staffing.\u003c/p>\n\u003cp>“Patients keep arriving,” Schuyler said. “There is still an enormous need. It’s a constant struggle.”\u003c/p>\n\u003cp>AHS officials have yet to respond to questions about staffing at John George.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>David McElveen recently had a stroke. The 59-year-old Vallejo resident and John George Psychiatric Hospital nurse has short-term memory problems and has been out of work for more than a year. The stroke may be linked to an attack he suffered last summer.\u003c/p>\n\u003cp>He was working the morning shift on Sept. 13, 2017 at the Alameda County mental health care facility in San Leandro when a patient punched him the face.\u003c/p>\n\u003cp>“I heard somebody running and that’s the last thing I remembered,” McElveen said in an interview on Monday.\u003c/p>\n\u003cp>He fell to the floor. The patient kept hitting him, slamming his head against the ground.\u003c/p>\n\u003cp>“The injured was unconscious and had a seizure while bleeding from his face and head area,” an investigator with California’s Division of Occupational Safety and Health (Cal/OSHA) wrote in the agency’s investigation into the attack, obtained through a California Public Records Act Request.\u003c/p>\n\u003cp>McElveen’s facial bones were fractured.\u003c/p>\n\u003cp>“The left side of my skull was busted open. My right eye was closed for more than 10 days. My jaw was broken in two different places. And, I lost a tooth,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11694380\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11694380\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258.jpg\" alt=\"\" width=\"480\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258.jpg 480w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258-240x320.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/09/mcelveen-e1537822957258-375x500.jpg 375w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">David McElveen, a John George Psychiatric Hospital nurse, was attacked by a patient in September 2017. \u003ccite>(Courtesy David McElveen)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>McElveen was hospitalized and underwent surgery. Doctors wired his jaw shut. He also says the morning he was attacked, the hospital was short-staffed.\u003c/p>\n\u003cp>“We didn’t have enough mental health workers. We didn’t have enough nurses,” he said. “Everyone was just overwhelmed.”\u003c/p>\n\u003cp>Union officials who represent McElveen and other John George workers say the attack is the result of low staffing at the facility’s emergency room (known as “emergency services”) and poor security protocols at a hospital that has repeatedly come under scrutiny for dangers posed to employees and patients.\u003c/p>\n\u003cp>Now, dozens of Service Employees International Union Local 1021 members plan to hold an informational picket in Oakland on Tuesday afternoon to draw attention to staffing issues there and two other Alameda County medical facilities.\u003c/p>\n\u003cp>Two months after McElveen was attacked, \u003ca href=\"https://www.sfgate.com/crime/article/Runaway-psych-patient-hit-by-car-in-San-Leandro-12417473.php\" target=\"_blank\" rel=\"noopener\">another patient\u003c/a> fled from the hospital, tried to carjack two vehicles, assaulted a teenage boy and bit an elderly man.\u003c/p>\n\u003cp>In 2016, the \u003ca href=\"https://www.eastbayexpress.com/oakland/overwhelmed/Content?oid=4705660\" target=\"_blank\" rel=\"noopener\">East Bay Express\u003c/a> and \u003ca href=\"http://www.ktvu.com/news/2-investigates/2-investigates-patients-say-conditions-at-john-george-mental-hospital-were-hell\" target=\"_blank\" rel=\"noopener\">KTVU\u003c/a> reported on severe overcrowding at the hospital where workers described the facility’s emergency room as dangerous and inhumane, with patients sleeping and eating on the floor — some moaning and crying for help.\u003c/p>\n\u003cp>Despite that media scrutiny and probes by government agencies, not much has changed, according to the SEIU Local 1021 field supervisor Ann Schuyler.\u003c/p>\n\u003cp>“The number of injuries is not abating and the severity of these injuries, caused while at work, is heartbreaking,” Schuyler said in an interview.\u003c/p>\n\u003cp>\u003cstrong>Investigation Into the Attack\u003c/strong>\u003c/p>\n\u003cp>The Alameda County Sheriff’s Office has identified 51-year-old Michael Lindsay of Fairfield as the patient who allegedly assaulted McElveen.\u003c/p>\n\u003cp>Lindsay was on the third day of his stay at John George and “was extremely agitated” during the two-and-a-half hours before the attack, state workplace regulators said.\u003c/p>\n\u003cp>The patient “expressed that he wanted to leave the facility” and was “verbally abusive to staff,” Cal/OSHA’s report states.\u003c/p>\n\u003cp>McElveen and another hospital worker tried to redirect Lindsay’s attention and de-escalate his behavior. Hospital staff gave him medication but said it was unclear if he faked digesting the pill.\u003c/p>\n\u003cp>Minutes later Lindsay went behind McElveen and punched him in the face and continued attacking him, according to the report.\u003c/p>\n\u003cp>Other staff members subdued the patient, called 911 and administered CPR to McElveen.\u003c/p>\n\u003cp>When an Alameda County Sheriff’s deputy arrived, Lindsay was being held down by staff and was yelling. The deputy placed handcuffs on Lindsay and put his knee on his back while other law enforcement officers arrived.\u003c/p>\n\u003cp>“McElveen was bleeding from a large wound on his head and was complaining of pain to his jaw,” wrote deputy Jeriah Gurley in a report on the incident, noting that the victim had blood on his clothes and there was blood on the floor next to him. Witnesses told the deputy McElveen was gasping for air.\u003c/p>\n\u003cp>McElveen was taken to Eden Medical Center in Castro Valley where he was treated for the next three days.\u003c/p>\n\u003cp>Lindsay was taken to San Leandro Hospital and eventually arrested.\u003c/p>\n\u003cp>Prosecutors later filed felony battery charges against Lindsay.\u003c/p>\n\u003cp>He has pleaded not guilty and his case is expected to go to trial in November, according to Alameda County District Attorney spokeswoman Teresa Drenick.\u003c/p>\n\u003cp>The deputy’s report also found that there were no surveillance cameras in the area where the attack took place.\u003c/p>\n\u003cp>Cal/OSHA concluded that Lindsay arrived at the hospital using a different name and that John George did not have policies in place to handle patients who use aliases. Without those procedures, the hospital failed to identify Lindsay as a patient who had a violent history at the facility.\u003c/p>\n\u003cp>\u003cstrong>Safety and Staffing Issues at the Hospital\u003c/strong>\u003c/p>\n\u003cp>In March, Cal/OSHA cited the Alameda Health System (AHS), which runs the hospital. It issued a $11,250 fine against AHS for a “serious” violation for having an injury and illness prevention program that was ineffective.\u003c/p>\n\u003cp>AHS officials did not appeal the penalty, and in June they paid the fine.\u003c/p>\n\u003cp>But hospital leaders emphasize that the facility correctly followed protocol before, during and after the incident.\u003c/p>\n\u003cp>Luis Fonseca, AHS’s chief operating officer, told Cal/OSHA that Linsday did not show signs of violence beforehand.\u003c/p>\n\u003cp>“We initiated safe practices and processes,” Fonseca said. The hospital immediately contacted law enforcement, helped McElveen press charges and provided him with emotional support, he said.\u003c/p>\n\u003cp>Sandra Williams, director of the hospital system’s environmental health and safety department, told a Cal/OSHA inspector “our actions were reasonable and responsible” on the day of the attack.\u003c/p>\n\u003cp>Lorna Fernandes, an AHS spokeswoman, emphasized that creating and maintaining a safe environment for its workers, patients and visitors is a top priority.\u003c/p>\n\u003cp>“AHS self-reported this incident to Cal/OSHA and then took immediate action and actively engaged all appropriate protocols to address the situation. Further, AHS cooperated with Cal/OSHA over the course of a thorough investigation,” Fernandes said in an statement emailed to KQED.\u003c/p>\n\u003cp>“Alameda Health System realizes that keeping our employees safe from harm so they can provide quality patient care is of the utmost importance. We continue to proactively address and adjust protocols to ensure we are adhering to best practices for maximum protection for AHS employees, patients, visitors and the community we serve,” Fernandes said.\u003c/p>\n\u003cp>Currently, the nurses’ contract with AHS at John George calls for one nurse for for every six patients at the emergency room, according to SEIU.\u003c/p>\n\u003cp>But the union’s Schuyler says with 40 to 60 patients in the ER, the hospital often goes over that ratio.\u003c/p>\n\u003cp>She says SEIU has pushed for years for more staffing.\u003c/p>\n\u003cp>“Patients keep arriving,” Schuyler said. “There is still an enormous need. It’s a constant struggle.”\u003c/p>\n\u003cp>AHS officials have yet to respond to questions about staffing at John George.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>At the children’s dental clinic that Dr. John Blake runs in Long Beach, toddlers come in all the time with problems so severe they need root canals.\u003c/p>\n\u003cp>Children as young as 2 or 3 show up with blackened teeth and swollen faces, unable to eat because of the pain and in need of whole mouth restorations.\u003c/p>\n\u003cp>“It’s rampant,” Blake said, “and it’s really a disaster to see.”\u003c/p>\n\u003cp>In California, the state with the highest \u003ca href=\"https://www.census.gov/data/tables/2018/demo/income-poverty/p60-263.html\" target=\"_blank\" rel=\"noopener\">poverty\u003c/a> rate, tooth decay in children outpaces the national average. Hoping to save both teeth and money, the state is addressing the problem with an overhaul of Denti-Cal, part of the Medi-Cal health system for low-income Californians.\u003c/p>\n\u003cp>Pilot programs are underway to get more kids into a dentist’s chair, and the state plans to kick off an educational campaign next month. Officials have also reduced red tape, streamlined billing, raised payments to dentists and offered cash to those willing to accept more state patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The moves fit into a larger state \u003ca href=\"https://calmatters.org/articles/category/california/health/wellness/\" target=\"_blank\" rel=\"noopener\">focus\u003c/a> on prevention as a way to reduce chronic conditions, emergency care, surgeries and the high related treatment costs. Medi-Cal covers about a third of Californians and consumes more than $100 billion annually in state and federal money. Denti-Cal accounts for about 2 percent of that, or just under $2 billion.\u003c/p>\n\u003cp>Not long ago, Blake said, he was exasperated by the state program; some of its payment rates were “almost comically low.” His nonprofit clinic had mostly Denti-Cal patients, and he needed private donations to fund about half of his operating expenses. The system was a constant hassle, with unnecessary paperwork and delayed payments.\u003c/p>\n\u003cp>“I was one of the fiercest critics of Denti-Cal,” Blake said. “I can remember sitting before the Legislature and telling them, ‘This is not a functional program.'”\u003c/p>\n\u003cp>But in the past few years, the state has aside money for rate increases — $210 million in the current budget. It has also signed up hundreds more dentists, expanded the number of patients seen by individual providers and placed new emphasis on prevention, according to the California Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>“Now I have to give them some praise,” Blake said. Almost all of the problems and possible solutions he testified about years ago have been addressed or implemented, he said — although he’ll continue fundraising because the increases still don’t meet his costs.\u003c/p>\n\u003cp>“These changes at Denti-Cal are great … And I can tell you,” he said with a little chuckle, “I don’t think I’ve ever used ‘great’ and ‘Denti-Cal’ in the same sentence before.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/2a4c428a-2547-4669-98e0-b381186e5d66?src=embed\" title=\"Cavities in California's children\" width=\"800\" height=\"850\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The Little Hoover Commission, a state oversight panel, has also pushed for change.\u003c/p>\n\u003cp>It initiated public hearings in 2015 to examine Denti-Cal’s rock-bottom utilization rates — at the time, only a third of enrolled children ages 3 and younger had seen a dentist in the previous year. The commission issued a damning \u003ca href=\"http://www.lhc.ca.gov/sites/lhc.ca.gov/files/Reports/230/Report230.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> in 2016 that called the system “broken” and one of the state’s “greatest deficiencies.”\u003c/p>\n\u003cp>“It’s not there still,” Blake said, adding that payments now are about 30 percent of what he’d get from private insurance — better than the 25 percent or so he used to get, but not enough. And “paperwork is still a factor,” he said.\u003c/p>\n\u003cp>Signing up dentists with a negative view of Denti-Cal has been a big challenge for the department. But the latest data shows a turn. A recent \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Medi-Cal2020DY13-Q3ProgressReport.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the Department of Health Care Services says that, from July 2017 to March 2018, 360 new providers joined Denti-Cal, bringing the participant total to nearly 10,000.\u003c/p>\n\u003cp>And from 2014 to 2016, the department \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/DTIPY1FinalReport.pdf\" target=\"_blank\" rel=\"noopener\">reported\u003c/a>, the number of dentists seeing 10 or more Denti-Cal children rose by more than 6 percent, which means roughly 400 more dentists across the state have expanded their practices to include more low-income kids. Cash bonuses go to those who expand their Denti-Cal load by 2 percent, a target that will grow to 10 percent over five years.\u003c/p>\n\u003cp>In addition, the state has:\u003c/p>\n\u003cul>\n\u003cli>Expanded teledentistry efforts, allowing providers to supervise some care remotely, increasing their availability to underserved areas.\u003c/li>\n\u003cli>Switched to electronic billing and trimmed paperwork requirements.\u003c/li>\n\u003cli>Begun testing ways to reach more patients and offer better preventive services, through the pilot programs across California. In Sonoma County, for instance, the goal is to eliminate new cavities in 75 percent of children within five years.\u003c/li>\n\u003cli>Appointed a state dental director, Jayanth Kumar, charged with reducing oral-health disparities in California and developing a statewide oral-health plan in coordination with multiple government agencies.\u003c/li>\n\u003c/ul>\n\u003cp>Harvey Lee is chief dental officer for the nonprofit Healthy Smiles for Kids, which provides care to low-income children in Orange County. He said the Denti-Cal changes helped convince him to treat low-income youngsters, outside of his fee-for-service practice in Irvine.\u003c/p>\n\u003cp>He had heard “the nightmare stories of waiting for six months to get approval” as a provider, … and the red tape, … submission of X-rays and so forth just to get pennies on the dollar.”\u003c/p>\n\u003cp>But he was approved in a week. A Denti-Cal representative even came to his office to help with his application. Lee said the payments aren’t as high as what he gets in private practice, but “the increase helps.”\u003c/p>\n\u003cp>“Most dentists just know the old Denti-Cal, but they don’t know the little nuances in how it was improved,” Lee said. He’s treating a high volume of Denti-Cal patients through teledentistry.\u003c/p>\n\u003cp>With that kind of innovation, said Alani Jackson, chief of dental services at the Department of Health Care Services, “it’s like we’re riding the right wave of change.”\u003c/p>\n\u003cp>The main goal of the system overhaul is to establish a dental “home” for patients, where one dentist coordinates care for an individual or family. That can help lead to a lifetime of better oral health, Jackson said. And lower costs for the state.\u003c/p>\n\u003cp>In particular, the department is focusing on children 6 and younger. Jackson said the pilot program in Orange County includes presentations at schools. “We’re going to where the kids are,” she said.\u003c/p>\n\u003cp>There’s still work to do, Jackson and her staff acknowledge. And their successes must be maintained for the long term. Katie Andrew, oral health senior associate at Children Now, a nonprofit health advocacy group in Sacramento, agreed.\u003c/p>\n\u003cp>“For patients,” Andrew said, “this hasn’t been a dramatic change. Many still don’t know about Denti-Cal benefits, and in the rural counties especially, there just aren’t enough providers.”\u003c/p>\n\u003cp>Blake said it will take “many years to rebuild that system of care and earn back the trust of California’s dentists … Many dentists are waiting in the wings to see if this can be sustained.”\u003c/p>\n\u003cp>Meanwhile, Lee expressed surprise at how much it means to him to care for low-income, high-need patients.\u003c/p>\n\u003cp>“I never really thought I’d enjoy this part of being a dentist,” Lee said. “But it’s wonderful. I mean, you’re not doing it to make money, you do it because there’s a need.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://calmatters.org/\">\u003cem>CALmatters.org\u003c/em>\u003c/a>\u003cem> is a nonprofit, nonpartisan media venture explaining California policies and politics. This is the fifth article in a series on state efforts to foster healthy living as a way to reduce chronic illness.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At the children’s dental clinic that Dr. John Blake runs in Long Beach, toddlers come in all the time with problems so severe they need root canals.\u003c/p>\n\u003cp>Children as young as 2 or 3 show up with blackened teeth and swollen faces, unable to eat because of the pain and in need of whole mouth restorations.\u003c/p>\n\u003cp>“It’s rampant,” Blake said, “and it’s really a disaster to see.”\u003c/p>\n\u003cp>In California, the state with the highest \u003ca href=\"https://www.census.gov/data/tables/2018/demo/income-poverty/p60-263.html\" target=\"_blank\" rel=\"noopener\">poverty\u003c/a> rate, tooth decay in children outpaces the national average. Hoping to save both teeth and money, the state is addressing the problem with an overhaul of Denti-Cal, part of the Medi-Cal health system for low-income Californians.\u003c/p>\n\u003cp>Pilot programs are underway to get more kids into a dentist’s chair, and the state plans to kick off an educational campaign next month. Officials have also reduced red tape, streamlined billing, raised payments to dentists and offered cash to those willing to accept more state patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The moves fit into a larger state \u003ca href=\"https://calmatters.org/articles/category/california/health/wellness/\" target=\"_blank\" rel=\"noopener\">focus\u003c/a> on prevention as a way to reduce chronic conditions, emergency care, surgeries and the high related treatment costs. Medi-Cal covers about a third of Californians and consumes more than $100 billion annually in state and federal money. Denti-Cal accounts for about 2 percent of that, or just under $2 billion.\u003c/p>\n\u003cp>Not long ago, Blake said, he was exasperated by the state program; some of its payment rates were “almost comically low.” His nonprofit clinic had mostly Denti-Cal patients, and he needed private donations to fund about half of his operating expenses. The system was a constant hassle, with unnecessary paperwork and delayed payments.\u003c/p>\n\u003cp>“I was one of the fiercest critics of Denti-Cal,” Blake said. “I can remember sitting before the Legislature and telling them, ‘This is not a functional program.'”\u003c/p>\n\u003cp>But in the past few years, the state has aside money for rate increases — $210 million in the current budget. It has also signed up hundreds more dentists, expanded the number of patients seen by individual providers and placed new emphasis on prevention, according to the California Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>“Now I have to give them some praise,” Blake said. Almost all of the problems and possible solutions he testified about years ago have been addressed or implemented, he said — although he’ll continue fundraising because the increases still don’t meet his costs.\u003c/p>\n\u003cp>“These changes at Denti-Cal are great … And I can tell you,” he said with a little chuckle, “I don’t think I’ve ever used ‘great’ and ‘Denti-Cal’ in the same sentence before.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/2a4c428a-2547-4669-98e0-b381186e5d66?src=embed\" title=\"Cavities in California's children\" width=\"800\" height=\"850\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The Little Hoover Commission, a state oversight panel, has also pushed for change.\u003c/p>\n\u003cp>It initiated public hearings in 2015 to examine Denti-Cal’s rock-bottom utilization rates — at the time, only a third of enrolled children ages 3 and younger had seen a dentist in the previous year. The commission issued a damning \u003ca href=\"http://www.lhc.ca.gov/sites/lhc.ca.gov/files/Reports/230/Report230.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> in 2016 that called the system “broken” and one of the state’s “greatest deficiencies.”\u003c/p>\n\u003cp>“It’s not there still,” Blake said, adding that payments now are about 30 percent of what he’d get from private insurance — better than the 25 percent or so he used to get, but not enough. And “paperwork is still a factor,” he said.\u003c/p>\n\u003cp>Signing up dentists with a negative view of Denti-Cal has been a big challenge for the department. But the latest data shows a turn. A recent \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Medi-Cal2020DY13-Q3ProgressReport.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the Department of Health Care Services says that, from July 2017 to March 2018, 360 new providers joined Denti-Cal, bringing the participant total to nearly 10,000.\u003c/p>\n\u003cp>And from 2014 to 2016, the department \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/DTIPY1FinalReport.pdf\" target=\"_blank\" rel=\"noopener\">reported\u003c/a>, the number of dentists seeing 10 or more Denti-Cal children rose by more than 6 percent, which means roughly 400 more dentists across the state have expanded their practices to include more low-income kids. Cash bonuses go to those who expand their Denti-Cal load by 2 percent, a target that will grow to 10 percent over five years.\u003c/p>\n\u003cp>In addition, the state has:\u003c/p>\n\u003cul>\n\u003cli>Expanded teledentistry efforts, allowing providers to supervise some care remotely, increasing their availability to underserved areas.\u003c/li>\n\u003cli>Switched to electronic billing and trimmed paperwork requirements.\u003c/li>\n\u003cli>Begun testing ways to reach more patients and offer better preventive services, through the pilot programs across California. In Sonoma County, for instance, the goal is to eliminate new cavities in 75 percent of children within five years.\u003c/li>\n\u003cli>Appointed a state dental director, Jayanth Kumar, charged with reducing oral-health disparities in California and developing a statewide oral-health plan in coordination with multiple government agencies.\u003c/li>\n\u003c/ul>\n\u003cp>Harvey Lee is chief dental officer for the nonprofit Healthy Smiles for Kids, which provides care to low-income children in Orange County. He said the Denti-Cal changes helped convince him to treat low-income youngsters, outside of his fee-for-service practice in Irvine.\u003c/p>\n\u003cp>He had heard “the nightmare stories of waiting for six months to get approval” as a provider, … and the red tape, … submission of X-rays and so forth just to get pennies on the dollar.”\u003c/p>\n\u003cp>But he was approved in a week. A Denti-Cal representative even came to his office to help with his application. Lee said the payments aren’t as high as what he gets in private practice, but “the increase helps.”\u003c/p>\n\u003cp>“Most dentists just know the old Denti-Cal, but they don’t know the little nuances in how it was improved,” Lee said. He’s treating a high volume of Denti-Cal patients through teledentistry.\u003c/p>\n\u003cp>With that kind of innovation, said Alani Jackson, chief of dental services at the Department of Health Care Services, “it’s like we’re riding the right wave of change.”\u003c/p>\n\u003cp>The main goal of the system overhaul is to establish a dental “home” for patients, where one dentist coordinates care for an individual or family. That can help lead to a lifetime of better oral health, Jackson said. And lower costs for the state.\u003c/p>\n\u003cp>In particular, the department is focusing on children 6 and younger. Jackson said the pilot program in Orange County includes presentations at schools. “We’re going to where the kids are,” she said.\u003c/p>\n\u003cp>There’s still work to do, Jackson and her staff acknowledge. And their successes must be maintained for the long term. Katie Andrew, oral health senior associate at Children Now, a nonprofit health advocacy group in Sacramento, agreed.\u003c/p>\n\u003cp>“For patients,” Andrew said, “this hasn’t been a dramatic change. Many still don’t know about Denti-Cal benefits, and in the rural counties especially, there just aren’t enough providers.”\u003c/p>\n\u003cp>Blake said it will take “many years to rebuild that system of care and earn back the trust of California’s dentists … Many dentists are waiting in the wings to see if this can be sustained.”\u003c/p>\n\u003cp>Meanwhile, Lee expressed surprise at how much it means to him to care for low-income, high-need patients.\u003c/p>\n\u003cp>“I never really thought I’d enjoy this part of being a dentist,” Lee said. “But it’s wonderful. I mean, you’re not doing it to make money, you do it because there’s a need.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://calmatters.org/\">\u003cem>CALmatters.org\u003c/em>\u003c/a>\u003cem> is a nonprofit, nonpartisan media venture explaining California policies and politics. This is the fifth article in a series on state efforts to foster healthy living as a way to reduce chronic illness.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "childhood-trauma-can-mean-early-death-this-california-mom-wants-to-beat-the-odds",
"title": "Childhood Trauma Can Mean Early Death. This California Mom Wants to Beat the Odds",
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"headTitle": "Childhood Trauma Can Mean Early Death. This California Mom Wants to Beat the Odds | KQED",
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"content": "\u003cp>[dropcap]E[/dropcap]motional neglect, physical abuse, divorce, a household riven by addiction — science shows that traumas like these in childhood cause poorer health later in life, both mentally and physically.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/9635069\" target=\"_blank\" rel=\"noopener noreferrer\">The first research\u003c/a> was conducted in the late 1990s and recently popularized by San Francisco pediatrician and author \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime\" target=\"_blank\" rel=\"noopener noreferrer\">Nadine Burke Harris\u003c/a>. Doctors behind the first study dubbed these childhood traumas “adverse childhood experiences,” or ACEs, and devised a measurement scale: For each negative experience a person had, his or her “ACE score” would go up by 1 point.\u003c/p>\n\u003cp>The full range of the ACEs scale goes from zero (no ACEs) to 10 (a person who has experienced all 10 categories of adversity). You can find out your own ACE score by completing the \u003ca href=\"https://www.ncjfcj.org/sites/default/files/Finding%20Your%20ACE%20Score.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">ACEs questionnaire\u003c/a>.\u003c/p>\n\u003cp>A person with four or more ACEs has more than five times the risk of depression, four times the risk for chronic lung disease and double the risk for cancer. An ACE score of six or more shortens life expectancy by \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19840693\" target=\"_blank\" rel=\"noopener noreferrer\">20 years\u003c/a> on average.\u003c/p>\n\u003cfigure id=\"attachment_11687836\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687836 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-800x533.jpg\" alt=\"Sabrina Hanes is just 33, but has the medical record of someone twice her age. She recently learned these issues may be linked to the trauma she went through as a kid. To prevent further health issues, she's built a routine focused on education, exercise, and building community.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina Hanes is just 33, but has the medical record of someone twice her age. She recently learned these issues may be linked to the trauma she went through as a kid. To prevent further health issues, she’s built a routine focused on education, exercise and building community. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So what does someone do if they learn they have a high ACE score? Doctors say there are several ways to intervene, and while it’s more effective to intervene when people are young, adults can still work to heal the wounds of their past.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There are specific therapies that can help, such as \u003ca href=\"https://childtrauma.ucsf.edu/child-parent-psychotherapy-resources\" target=\"_blank\" rel=\"noopener noreferrer\">Child Parent Psychotherapy\u003c/a> and \u003ca href=\"https://pcit.ucdavis.edu/\" target=\"_blank\" rel=\"noopener noreferrer\">Parent-Child Interaction Therapy\u003c/a>.\u003c/p>\n\u003cp>They’re aimed at parents who have high ACE scores and want to make sure their children have a fulfilling childhood. There are \u003ca href=\"https://www.acesconnection.com/\" target=\"_blank\" rel=\"noopener noreferrer\">online communities\u003c/a> for practitioners and people looking for resources. Doctors also recommend other stress-relieving activities: better sleep, regular exercise, meditation, good nutrition and a focus on building healthy relationships.\u003c/p>\n\u003cp>Sabrina Hanes lives with her 4-year-old daughter, Aroara, in Paradise, California, a small Butte County town set among pine and oak trees. Sabrina is 33 now, but her youth was rife with pain, and her ACE score is 8 out of 10.\u003c/p>\n\u003cp>She got involved in drugs in her early adulthood and was in and out of jail, but 10 years ago she committed to changing her life. She’s been sober since she was 23.\u003c/p>\n\u003cp>These days, she looks at life as “something amazing and beautiful.” Health reporter Laura Klivans and photographer Anne Wernikoff both spent time following Sabrina and her daughter, Aroara, through their day, to see how Sabrina maintains a hopeful and resilient attitude despite the legacy of her painful past.\u003c/p>\n\u003cfigure id=\"attachment_11687832\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687832 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-800x533.jpg\" alt=\"Sabrina and Aroara in their two-bedroom home in Paradise, CA.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara in their two-bedroom home in Paradise, California. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina plays with her 4-year-old daughter, Aroara, in their home. Sabrina is working toward a bachelor’s degree in child development at Chico State. She carefully chooses toys and games she feels will challenge her daughter.\u003c/p>\n\u003cfigure id=\"attachment_11687837\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687837 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-800x533.jpg\" alt=\"Sabrina had always wanted to be a mom, but she was scared to repeat the behavior of her own parents. Her experience with her daughter Aroara, however, has allayed those fears. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina had always wanted to be a mom, but she was scared to repeat the behavior of her own parents. Her experience with her daughter, Aroara, however, has allayed those fears. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina’s refrigerator is decorated with photos of Aroara at various ages.\u003c/p>\n\u003cp>Emotionally neglected as a child, Sabrina reminds Aroara regularly how much she cares for and loves her. Her daughter’s name means “dawn,” but is spelled atypically to include “roar,” which Sabrina says is very fitting for her outgoing daughter.\u003c/p>\n\u003cfigure id=\"attachment_11687897\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687897 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-800x529.jpg\" alt=\"Mother and daughter head out for the day.\" width=\"800\" height=\"529\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-800x529.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-1020x674.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-1200x793.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-1180x780.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-960x635.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-375x248.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-520x344.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Mother and daughter head out for the day. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina and Aroara buckle up before driving to the nonprofit \u003ca href=\"http://www.youth4change.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Youth for Change\u003c/a>, where Sabrina works as a volunteer teacher.\u003c/p>\n\u003cp>Sabrina first connected with the nonprofit when she was pregnant with Aroara. She was reluctant at first, but now says the staff members are “like family.” The consistent relationships she has developed with them have helped turn her life around.\u003c/p>\n\u003cfigure id=\"attachment_11687899\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687899 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-800x533.jpg\" alt=\"Sabrina runs a science project with toddlers. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina runs a science project with toddlers. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Youth for Change, Sabrina leads the same class she used to take.\u003c/p>\n\u003cp>Toddlers and their caregivers gather each Monday for activities that build social and emotional skills. Sabrina has added school-readiness activities to the curriculum that is otherwise focused on social and emotional growth.\u003c/p>\n\u003cfigure id=\"attachment_11687840\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687840 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-800x533.jpg\" alt=\"Sabrina and Aroara outside their home.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara outside their home. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After class and a walk to a nearby pond, Sabrina and Aroara head home.\u003c/p>\n\u003cp>They moved into this house just before Aroara’s first birthday. Although the home needs some repairs, Sabrina loves having a consistent refuge so close to nature. In her own childhood, Sabrina moved several times, bouncing between her mother and father, who’d gone through an acrimonious divorce.\u003c/p>\n\u003cfigure id=\"attachment_11687838\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687838 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-800x533.jpg\" alt=\"Midday down-time for Sabrina and Aroara.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Midday downtime for Sabrina and Aroara. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina eats a lunch of leftover rice, quinoa and tortilla chips while she and Aroara take a break at midday to watch “The Emoji Movie,” Aroara’s current favorite. Because of her multiple health issues, Sabrina has many dietary restrictions, and she has trouble affording food she can eat on a fixed income.\u003c/p>\n\u003cp>“I usually go without, to make sure Aroara is taken care of,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11687841\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687841 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-800x530.jpg\" alt=\"Sabrina and Aroara love spending time outside on hikes and in Paradise's parks.\" width=\"800\" height=\"530\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-800x530.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-1020x676.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-1200x796.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-1180x782.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-960x637.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-375x249.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-520x345.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara love spending time outside on hikes and in Paradise’s parks. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina and Aroara hit their favorite playground after lunch. Sabrina spends all her time with her daughter, except when she’s taking classes at Chico State.\u003c/p>\n\u003cp>When she was that age, Sabrina often had to fend for herself, which left her vulnerable to abuse. She is committed to giving Aroara a different experience.\u003c/p>\n\u003cfigure id=\"attachment_11687842\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687842 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-800x553.jpg\" alt=\"Regular exercise helps Sabrina maintain a calm mind despite the mental health problem she had in the past. She was diagnosed with bipolar disorder as a teenager and once took medications. Now, however, she manages her mood through diet and exercise. \" width=\"800\" height=\"553\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-800x553.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-160x111.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-1020x704.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-1200x829.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-1180x815.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-960x663.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-240x166.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-375x259.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-520x359.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Regular exercise helps Sabrina maintain a calm mind despite the mental health problem she had in the past. She was diagnosed with bipolar disorder as a teenager and once took medications. Now, however, she manages her mood through diet and exercise.\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina and Aroara spend the afternoon and early evening at Positive-I, a dance and circus arts studio. Sabrina practices on the aerial hoop with her dance partner, Storrie Morrow.\u003c/p>\n\u003cp>“I’ve made a lot of really strong connections with women that are very empowering and uplifting,” Sabrina said. Aroara attends classes for kids, and afterward plays near her mom and other dancers.\u003c/p>\n\u003cfigure id=\"attachment_11687905\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687905 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-800x510.jpg\" alt='Sabrina in an upside-down \"Lady in the Moon\" pose on her aerial hoop. ' width=\"800\" height=\"510\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-800x510.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-1020x650.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-1200x765.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-1180x752.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-960x612.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-240x153.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-375x239.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-520x332.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina in an upside-down “Lady in the Moon” pose on her aerial hoop. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since she began studying aerial hoop last year, Sabrina has become a dedicated practitioner, and she works out at the studio several times a week.\u003c/p>\n\u003cp>She had her first solo performance a few months ago, and chose a song called “Conqueror” to accompany her routine. She felt the lyrics resonated with her own life experiences: “I’d rather stand tall than live on my knees.”\u003c/p>\n\u003cfigure id=\"attachment_11687907\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687907 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-800x533.jpg\" alt=\"Sabrina and friends at Positive-I.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and friends at Positive-I. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina practices fire dancing with Marlo Moor, left, and Tiffany Ridenour, center, outside of \u003ca href=\"http://www.positiveiparadise.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Positive-I\u003c/a>.\u003c/p>\n\u003cp>They keep in step with ease, and joke: “Can you tell we dance together?” Sabrina never imagined she’d do anything like fire dancing, and loves how this community of mostly women pushes her to try new things.\u003c/p>\n\u003cfigure id=\"attachment_11687844\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687844 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-800x533.jpg\" alt=\"Sabrina and Aroara share a moment at the park. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara share a moment at the park. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While Sabrina was already on a path to change her life for the better, getting pregnant with Aroara in 2013 pushed her to achieve her goals faster.\u003c/p>\n\u003cp>“I wanted to just be there for her and show her what I didn’t get as a child,” she said.\u003c/p>\n\u003cp>\u003cem>This story was produced as a project for the \u003ca href=\"https://www.centerforhealthjournalism.org/\" target=\"_blank\" rel=\"noopener noreferrer\">USC Center for Health Journalism\u003c/a>’s California Fellowship.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" target=\"_blank\" rel=\"noopener noreferrer\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"excerpt": "Science shows childhood trauma leads to poorer health later in life, mentally and physically. But there are ways to intervene that can heal the wounds of the past for a parent, and safeguard a daughter’s future.",
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"title": "Childhood Trauma Can Mean Early Death. This California Mom Wants to Beat the Odds | KQED",
"description": "Science shows childhood trauma leads to poorer health later in life, mentally and physically. But there are ways to intervene that can heal the wounds of the past for a parent, and safeguard a daughter’s future.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">E\u003c/span>\u003c/p>\u003cp>motional neglect, physical abuse, divorce, a household riven by addiction — science shows that traumas like these in childhood cause poorer health later in life, both mentally and physically.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/9635069\" target=\"_blank\" rel=\"noopener noreferrer\">The first research\u003c/a> was conducted in the late 1990s and recently popularized by San Francisco pediatrician and author \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime\" target=\"_blank\" rel=\"noopener noreferrer\">Nadine Burke Harris\u003c/a>. Doctors behind the first study dubbed these childhood traumas “adverse childhood experiences,” or ACEs, and devised a measurement scale: For each negative experience a person had, his or her “ACE score” would go up by 1 point.\u003c/p>\n\u003cp>The full range of the ACEs scale goes from zero (no ACEs) to 10 (a person who has experienced all 10 categories of adversity). You can find out your own ACE score by completing the \u003ca href=\"https://www.ncjfcj.org/sites/default/files/Finding%20Your%20ACE%20Score.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">ACEs questionnaire\u003c/a>.\u003c/p>\n\u003cp>A person with four or more ACEs has more than five times the risk of depression, four times the risk for chronic lung disease and double the risk for cancer. An ACE score of six or more shortens life expectancy by \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19840693\" target=\"_blank\" rel=\"noopener noreferrer\">20 years\u003c/a> on average.\u003c/p>\n\u003cfigure id=\"attachment_11687836\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687836 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-800x533.jpg\" alt=\"Sabrina Hanes is just 33, but has the medical record of someone twice her age. She recently learned these issues may be linked to the trauma she went through as a kid. To prevent further health issues, she's built a routine focused on education, exercise, and building community.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32343_ACEs_AW_40-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina Hanes is just 33, but has the medical record of someone twice her age. She recently learned these issues may be linked to the trauma she went through as a kid. To prevent further health issues, she’s built a routine focused on education, exercise and building community. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So what does someone do if they learn they have a high ACE score? Doctors say there are several ways to intervene, and while it’s more effective to intervene when people are young, adults can still work to heal the wounds of their past.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There are specific therapies that can help, such as \u003ca href=\"https://childtrauma.ucsf.edu/child-parent-psychotherapy-resources\" target=\"_blank\" rel=\"noopener noreferrer\">Child Parent Psychotherapy\u003c/a> and \u003ca href=\"https://pcit.ucdavis.edu/\" target=\"_blank\" rel=\"noopener noreferrer\">Parent-Child Interaction Therapy\u003c/a>.\u003c/p>\n\u003cp>They’re aimed at parents who have high ACE scores and want to make sure their children have a fulfilling childhood. There are \u003ca href=\"https://www.acesconnection.com/\" target=\"_blank\" rel=\"noopener noreferrer\">online communities\u003c/a> for practitioners and people looking for resources. Doctors also recommend other stress-relieving activities: better sleep, regular exercise, meditation, good nutrition and a focus on building healthy relationships.\u003c/p>\n\u003cp>Sabrina Hanes lives with her 4-year-old daughter, Aroara, in Paradise, California, a small Butte County town set among pine and oak trees. Sabrina is 33 now, but her youth was rife with pain, and her ACE score is 8 out of 10.\u003c/p>\n\u003cp>She got involved in drugs in her early adulthood and was in and out of jail, but 10 years ago she committed to changing her life. She’s been sober since she was 23.\u003c/p>\n\u003cp>These days, she looks at life as “something amazing and beautiful.” Health reporter Laura Klivans and photographer Anne Wernikoff both spent time following Sabrina and her daughter, Aroara, through their day, to see how Sabrina maintains a hopeful and resilient attitude despite the legacy of her painful past.\u003c/p>\n\u003cfigure id=\"attachment_11687832\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687832 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-800x533.jpg\" alt=\"Sabrina and Aroara in their two-bedroom home in Paradise, CA.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32310_ACEs_AW_07-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara in their two-bedroom home in Paradise, California. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina plays with her 4-year-old daughter, Aroara, in their home. Sabrina is working toward a bachelor’s degree in child development at Chico State. She carefully chooses toys and games she feels will challenge her daughter.\u003c/p>\n\u003cfigure id=\"attachment_11687837\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687837 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-800x533.jpg\" alt=\"Sabrina had always wanted to be a mom, but she was scared to repeat the behavior of her own parents. Her experience with her daughter Aroara, however, has allayed those fears. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32347_ACEs_AW_44-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina had always wanted to be a mom, but she was scared to repeat the behavior of her own parents. Her experience with her daughter, Aroara, however, has allayed those fears. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina’s refrigerator is decorated with photos of Aroara at various ages.\u003c/p>\n\u003cp>Emotionally neglected as a child, Sabrina reminds Aroara regularly how much she cares for and loves her. Her daughter’s name means “dawn,” but is spelled atypically to include “roar,” which Sabrina says is very fitting for her outgoing daughter.\u003c/p>\n\u003cfigure id=\"attachment_11687897\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687897 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-800x529.jpg\" alt=\"Mother and daughter head out for the day.\" width=\"800\" height=\"529\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-800x529.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-1020x674.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-1200x793.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-1180x780.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-960x635.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-375x248.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32496_ACEs_AW_85-qut-520x344.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Mother and daughter head out for the day. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina and Aroara buckle up before driving to the nonprofit \u003ca href=\"http://www.youth4change.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Youth for Change\u003c/a>, where Sabrina works as a volunteer teacher.\u003c/p>\n\u003cp>Sabrina first connected with the nonprofit when she was pregnant with Aroara. She was reluctant at first, but now says the staff members are “like family.” The consistent relationships she has developed with them have helped turn her life around.\u003c/p>\n\u003cfigure id=\"attachment_11687899\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687899 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-800x533.jpg\" alt=\"Sabrina runs a science project with toddlers. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32337_ACEs_AW_34-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina runs a science project with toddlers. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Youth for Change, Sabrina leads the same class she used to take.\u003c/p>\n\u003cp>Toddlers and their caregivers gather each Monday for activities that build social and emotional skills. Sabrina has added school-readiness activities to the curriculum that is otherwise focused on social and emotional growth.\u003c/p>\n\u003cfigure id=\"attachment_11687840\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687840 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-800x533.jpg\" alt=\"Sabrina and Aroara outside their home.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32363_ACEs_AW_58-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara outside their home. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After class and a walk to a nearby pond, Sabrina and Aroara head home.\u003c/p>\n\u003cp>They moved into this house just before Aroara’s first birthday. Although the home needs some repairs, Sabrina loves having a consistent refuge so close to nature. In her own childhood, Sabrina moved several times, bouncing between her mother and father, who’d gone through an acrimonious divorce.\u003c/p>\n\u003cfigure id=\"attachment_11687838\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687838 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-800x533.jpg\" alt=\"Midday down-time for Sabrina and Aroara.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32354_ACEs_AW_49-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Midday downtime for Sabrina and Aroara. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina eats a lunch of leftover rice, quinoa and tortilla chips while she and Aroara take a break at midday to watch “The Emoji Movie,” Aroara’s current favorite. Because of her multiple health issues, Sabrina has many dietary restrictions, and she has trouble affording food she can eat on a fixed income.\u003c/p>\n\u003cp>“I usually go without, to make sure Aroara is taken care of,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11687841\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687841 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-800x530.jpg\" alt=\"Sabrina and Aroara love spending time outside on hikes and in Paradise's parks.\" width=\"800\" height=\"530\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-800x530.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-1020x676.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-1200x796.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-1180x782.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-960x637.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-375x249.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32368_ACEs_AW_63-qut-520x345.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara love spending time outside on hikes and in Paradise’s parks. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina and Aroara hit their favorite playground after lunch. Sabrina spends all her time with her daughter, except when she’s taking classes at Chico State.\u003c/p>\n\u003cp>When she was that age, Sabrina often had to fend for herself, which left her vulnerable to abuse. She is committed to giving Aroara a different experience.\u003c/p>\n\u003cfigure id=\"attachment_11687842\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687842 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-800x553.jpg\" alt=\"Regular exercise helps Sabrina maintain a calm mind despite the mental health problem she had in the past. She was diagnosed with bipolar disorder as a teenager and once took medications. Now, however, she manages her mood through diet and exercise. \" width=\"800\" height=\"553\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-800x553.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-160x111.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-1020x704.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-1200x829.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-1180x815.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-960x663.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-240x166.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-375x259.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32381_ACEs_AW_76-qut-520x359.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Regular exercise helps Sabrina maintain a calm mind despite the mental health problem she had in the past. She was diagnosed with bipolar disorder as a teenager and once took medications. Now, however, she manages her mood through diet and exercise.\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina and Aroara spend the afternoon and early evening at Positive-I, a dance and circus arts studio. Sabrina practices on the aerial hoop with her dance partner, Storrie Morrow.\u003c/p>\n\u003cp>“I’ve made a lot of really strong connections with women that are very empowering and uplifting,” Sabrina said. Aroara attends classes for kids, and afterward plays near her mom and other dancers.\u003c/p>\n\u003cfigure id=\"attachment_11687905\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687905 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-800x510.jpg\" alt='Sabrina in an upside-down \"Lady in the Moon\" pose on her aerial hoop. ' width=\"800\" height=\"510\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-800x510.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-1020x650.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-1200x765.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-1180x752.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-960x612.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-240x153.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-375x239.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/ACEs_AW_86-520x332.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina in an upside-down “Lady in the Moon” pose on her aerial hoop. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since she began studying aerial hoop last year, Sabrina has become a dedicated practitioner, and she works out at the studio several times a week.\u003c/p>\n\u003cp>She had her first solo performance a few months ago, and chose a song called “Conqueror” to accompany her routine. She felt the lyrics resonated with her own life experiences: “I’d rather stand tall than live on my knees.”\u003c/p>\n\u003cfigure id=\"attachment_11687907\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687907 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-800x533.jpg\" alt=\"Sabrina and friends at Positive-I.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32386_ACEs_AW_81-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and friends at Positive-I. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sabrina practices fire dancing with Marlo Moor, left, and Tiffany Ridenour, center, outside of \u003ca href=\"http://www.positiveiparadise.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Positive-I\u003c/a>.\u003c/p>\n\u003cp>They keep in step with ease, and joke: “Can you tell we dance together?” Sabrina never imagined she’d do anything like fire dancing, and loves how this community of mostly women pushes her to try new things.\u003c/p>\n\u003cfigure id=\"attachment_11687844\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11687844 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-800x533.jpg\" alt=\"Sabrina and Aroara share a moment at the park. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/08/RS32490_ACEs_AW_54b-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara share a moment at the park. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While Sabrina was already on a path to change her life for the better, getting pregnant with Aroara in 2013 pushed her to achieve her goals faster.\u003c/p>\n\u003cp>“I wanted to just be there for her and show her what I didn’t get as a child,” she said.\u003c/p>\n\u003cp>\u003cem>This story was produced as a project for the \u003ca href=\"https://www.centerforhealthjournalism.org/\" target=\"_blank\" rel=\"noopener noreferrer\">USC Center for Health Journalism\u003c/a>’s California Fellowship.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" target=\"_blank\" rel=\"noopener noreferrer\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Hoping to Save Limbs and Toes, California Moves to Curtail Diabetes",
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"content": "\u003cp>The word “amputation” threw a chill down Michael Rubenstein’s spine.\u003c/p>\n\u003cp>The 67-year-old diabetic from San Mateo still winces at the thought. “They told me I’d need to cut it off right about here,” he said, sawing his hand across his left shin.\u003c/p>\n\u003cp>Two months after that diagnosis, he’s on an exam table at the Center for Limb Preservation at UCSF, his leg still whole, the threat of gangrene and amputation gone and his mood a lot less bleak and fearful. “Yeah, it turns out I didn’t need that,” he said.\u003c/p>\n\u003cp>Many others are not so lucky. More than 12,000 Californians lost limbs or toes to diabetes in 2016, state \u003ca href=\"https://data.inewsource.org/interactives/diabetes-related-amputations-2010-2016/\">data\u003c/a> show. More than \u003ca href=\"http://newsroom.ucla.edu/releases/majority-of-california-adults-have-prediabetes-or-diabetes\">2.5 million\u003c/a> people in the state have been diagnosed with adult diabetes, or Type 2, and risk a similar fate if it goes unchecked. That’s especially true for low-income patients, who may lack regular preventive medical services. They’re 10 times as likely as their wealthier counterparts to lose a toe, foot or leg, according to one \u003ca href=\"https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.0148\">study\u003c/a>.\u003c/p>\n\u003cp>That disparity is part of the impetus for a new diabetes prevention program for patients in Medi-Cal, the state’s version of the federal Medicaid health program for low-income residents. The rate of diabetes in California grew from 8.7% of the population in 2010 to 10.2% in 2016, while amputations increased by almost a third.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Most of those amputations are unnecessary,” said Alexander Reyzelman, co-director of the UCSF clinic that saved Rubenstein’s left leg with procedures to increase blood flow.\u003c/p>\n\u003cp>The state has \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB97\">set aside\u003c/a> $5 million annually for five years to help Medi-Cal patients at risk for \u003ca href=\"https://calmatters.org/articles/diabetes-hits-hard-california-spends-billions-treatment-little-prevention/\">diabetes,\u003c/a> a chronic condition that can lead to blindness, heart disease and stroke, among other ills. The money will fund a program, beginning in January, intended to improve their diets, lower their blood sugar and make them aware of such potentially dire consequences as amputation.\u003c/p>\n\u003cp>Preventing or curtailing the progress of the disease could save taxpayers an estimated \u003ca href=\"https://phadvocates.org/wp-content/uploads/2017/07/Medi-Cal-Coverage-of-DPP-2017.pdf\">$45 million\u003c/a> a year in treatment costs, according to the Davis-based nonprofit Public Health Advocates, which urged lawmakers to create the program.\u003c/p>\n\u003cp>Participants will have a year’s access to trained peer coaches, who’ll teach them to eat less sugar and fewer other carbohydrates and increase fiber with more fruit and vegetables. The coaches will also help foster other lifestyle changes, such as giving up smoking and exercising more. The regimen is based on a federal \u003ca href=\"https://www.cdc.gov/diabetes/prevention/prediabetes-type2/preventing.html\">program\u003c/a> that the Center for Disease Prevention and Control says can cut the risk of diabetes by more than half.\u003c/p>\n\u003cp>The effort is part of an overall state \u003ca href=\"https://calmatters.org/articles/californias-push-to-make-people-healthy-and-save-taxpayers-money/\">approach\u003c/a> that goes \u003ca href=\"https://calmatters.org/articles/food-for-the-heart-in-a-new-california-health-program/\">beyond medication\u003c/a>, aimed at producing a healthier population that requires less expensive public care. About a third of Californians receive their care through Medi-Cal.\u003c/p>\n\u003cp>About 25,000 people a year are expected to join the program.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/3da13a7e-46d7-4fbd-8239-6ce16bac1762?src=embed\" title=\"Diabetes-Related Amputation\" width=\"550\" height=\"700\" scrolling=\"yes\" align=\"alignright\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“This gives us the opportunity to intervene before they become really sick,” said Flojaune Cofer, director of state policy and research at Public Health Advocates.\u003c/p>\n\u003cp>“Once they have the disease, that’s when it gets expensive,” with added medications and significantly more tests, she said. “We think this model can be duplicated in many ways. It could be useful for asthma, it could be useful for hypertension.”\u003c/p>\n\u003cp>People with diabetes can develop poor blood flow to their extremities and suffer nerve damage and lack of feeling, most often in their legs and feet. In some cases, the result is gangrene. In some of those instances, amputation may be the only way to save a life.\u003c/p>\n\u003cp>The increase in diabetes and the threat of amputation are “a silent, sinister crisis,” said David Armstrong, a podiatric surgeon teaching at the University of Southern California’s Keck School of Medicine. “The problem is getting bigger and bigger, and you can’t fight it by just chopping off a leg.”\u003c/p>\n\u003cp>Amputation can cause as many health problems as it solves, according to Reyzelman: “When you lose a leg to amputation, 50 to 70% of patients will die within five years. You don’t want to lose a leg.”\u003c/p>\n\u003cp>Experts say a multidisciplinary approach can bring patients back from the brink of amputation. Vascular surgeons, podiatrists and reconstructive microsurgeons have joined forces to treat diabetes at medical centers across the state, including those at UCSF, UCLA, UC San Diego, UC Davis and USC.\u003c/p>\n\u003cp>The hope is that more patients can walk away like Rubenstein: intact.\u003c/p>\n\u003cp>“If I needed to get an amputation, I was willing to do that,” Rubenstein said. “But I certainly didn’t want that. Who would want that? Absolutely no one, that’s who.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>CALmatters.org\u003c/em>\u003cem> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em> \u003cem>This is the third article in a series on state efforts to foster healthy living as a way to reduce chronic illness.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The word “amputation” threw a chill down Michael Rubenstein’s spine.\u003c/p>\n\u003cp>The 67-year-old diabetic from San Mateo still winces at the thought. “They told me I’d need to cut it off right about here,” he said, sawing his hand across his left shin.\u003c/p>\n\u003cp>Two months after that diagnosis, he’s on an exam table at the Center for Limb Preservation at UCSF, his leg still whole, the threat of gangrene and amputation gone and his mood a lot less bleak and fearful. “Yeah, it turns out I didn’t need that,” he said.\u003c/p>\n\u003cp>Many others are not so lucky. More than 12,000 Californians lost limbs or toes to diabetes in 2016, state \u003ca href=\"https://data.inewsource.org/interactives/diabetes-related-amputations-2010-2016/\">data\u003c/a> show. More than \u003ca href=\"http://newsroom.ucla.edu/releases/majority-of-california-adults-have-prediabetes-or-diabetes\">2.5 million\u003c/a> people in the state have been diagnosed with adult diabetes, or Type 2, and risk a similar fate if it goes unchecked. That’s especially true for low-income patients, who may lack regular preventive medical services. They’re 10 times as likely as their wealthier counterparts to lose a toe, foot or leg, according to one \u003ca href=\"https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.0148\">study\u003c/a>.\u003c/p>\n\u003cp>That disparity is part of the impetus for a new diabetes prevention program for patients in Medi-Cal, the state’s version of the federal Medicaid health program for low-income residents. The rate of diabetes in California grew from 8.7% of the population in 2010 to 10.2% in 2016, while amputations increased by almost a third.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Most of those amputations are unnecessary,” said Alexander Reyzelman, co-director of the UCSF clinic that saved Rubenstein’s left leg with procedures to increase blood flow.\u003c/p>\n\u003cp>The state has \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB97\">set aside\u003c/a> $5 million annually for five years to help Medi-Cal patients at risk for \u003ca href=\"https://calmatters.org/articles/diabetes-hits-hard-california-spends-billions-treatment-little-prevention/\">diabetes,\u003c/a> a chronic condition that can lead to blindness, heart disease and stroke, among other ills. The money will fund a program, beginning in January, intended to improve their diets, lower their blood sugar and make them aware of such potentially dire consequences as amputation.\u003c/p>\n\u003cp>Preventing or curtailing the progress of the disease could save taxpayers an estimated \u003ca href=\"https://phadvocates.org/wp-content/uploads/2017/07/Medi-Cal-Coverage-of-DPP-2017.pdf\">$45 million\u003c/a> a year in treatment costs, according to the Davis-based nonprofit Public Health Advocates, which urged lawmakers to create the program.\u003c/p>\n\u003cp>Participants will have a year’s access to trained peer coaches, who’ll teach them to eat less sugar and fewer other carbohydrates and increase fiber with more fruit and vegetables. The coaches will also help foster other lifestyle changes, such as giving up smoking and exercising more. The regimen is based on a federal \u003ca href=\"https://www.cdc.gov/diabetes/prevention/prediabetes-type2/preventing.html\">program\u003c/a> that the Center for Disease Prevention and Control says can cut the risk of diabetes by more than half.\u003c/p>\n\u003cp>The effort is part of an overall state \u003ca href=\"https://calmatters.org/articles/californias-push-to-make-people-healthy-and-save-taxpayers-money/\">approach\u003c/a> that goes \u003ca href=\"https://calmatters.org/articles/food-for-the-heart-in-a-new-california-health-program/\">beyond medication\u003c/a>, aimed at producing a healthier population that requires less expensive public care. About a third of Californians receive their care through Medi-Cal.\u003c/p>\n\u003cp>About 25,000 people a year are expected to join the program.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/3da13a7e-46d7-4fbd-8239-6ce16bac1762?src=embed\" title=\"Diabetes-Related Amputation\" width=\"550\" height=\"700\" scrolling=\"yes\" align=\"alignright\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“This gives us the opportunity to intervene before they become really sick,” said Flojaune Cofer, director of state policy and research at Public Health Advocates.\u003c/p>\n\u003cp>“Once they have the disease, that’s when it gets expensive,” with added medications and significantly more tests, she said. “We think this model can be duplicated in many ways. It could be useful for asthma, it could be useful for hypertension.”\u003c/p>\n\u003cp>People with diabetes can develop poor blood flow to their extremities and suffer nerve damage and lack of feeling, most often in their legs and feet. In some cases, the result is gangrene. In some of those instances, amputation may be the only way to save a life.\u003c/p>\n\u003cp>The increase in diabetes and the threat of amputation are “a silent, sinister crisis,” said David Armstrong, a podiatric surgeon teaching at the University of Southern California’s Keck School of Medicine. “The problem is getting bigger and bigger, and you can’t fight it by just chopping off a leg.”\u003c/p>\n\u003cp>Amputation can cause as many health problems as it solves, according to Reyzelman: “When you lose a leg to amputation, 50 to 70% of patients will die within five years. You don’t want to lose a leg.”\u003c/p>\n\u003cp>Experts say a multidisciplinary approach can bring patients back from the brink of amputation. Vascular surgeons, podiatrists and reconstructive microsurgeons have joined forces to treat diabetes at medical centers across the state, including those at UCSF, UCLA, UC San Diego, UC Davis and USC.\u003c/p>\n\u003cp>The hope is that more patients can walk away like Rubenstein: intact.\u003c/p>\n\u003cp>“If I needed to get an amputation, I was willing to do that,” Rubenstein said. “But I certainly didn’t want that. Who would want that? Absolutely no one, that’s who.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>CALmatters.org\u003c/em>\u003cem> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em> \u003cem>This is the third article in a series on state efforts to foster healthy living as a way to reduce chronic illness.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "To Keep Women From Dying In Childbirth, Look To California",
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"content": "\u003cp>When Cayti Kane delivered a baby boy via cesarean section last year, her team of doctors was prepared.\u003c/p>\n\u003cp>Kane had been diagnosed with placenta accreta, a condition that increased the likelihood of a dangerous hemorrhage during delivery. When that happened, she had an emergency hysterectomy. Kane and her son went home healthy.\u003c/p>\n\u003cp>Complicated, high-risk deliveries in the United States often end tragically. An American woman is three times as likely to die from childbirth as a woman in Canada, and six times as likely as a woman in Scandinavia. It’s a story \u003ca href=\"https://www.npr.org/series/543928389/lost-mothers\" target=\"_blank\" rel=\"noopener\">NPR and ProPublica\u003c/a> have heard repeatedly over the last year while investigating the startling rate of maternal death in America.\u003c/p>\n\u003cp>But despite her risk factors, Kane had something going for her that made her delivery less likely to go wrong: She lived – and gave birth – in California.\u003c/p>\n\u003cp>The state is leading the charge to reverse the nationwide trend: Since 2006, California has cut its rate of women dying in childbirth by \u003ca href=\"https://www.cmqcc.org/research/ca-pamr-maternal-mortality-review\" target=\"_blank\" rel=\"noopener\">more than half\u003c/a>. And it’s a state whose impact could make a big difference: \u003ca href=\"https://www.kff.org/other/state-indicator/number-of-births/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\" target=\"_blank\" rel=\"noopener\">One in eight\u003c/a> infants born in the United States is born there.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It wasn’t always that way.\u003c/p>\n\u003cp>Debra Bingham, a nurse then working toward a doctorate in public health, was in a meeting with state public health officials in 2006, when a startling statistic was unveiled: The rate of California women dying from childbirth had recently doubled.\u003c/p>\n\u003cp>“It was unexpected and disturbing, very disturbing,” recalls Bingham, now the executive director of the Institute for Perinatal Quality Improvement. “We needed to understand and really dig into why.”\u003c/p>\n\u003cp>Soon Bingham was tasked with bringing together key players to dig in: nurses, doctors, midwives, hospital administrators and other officials. Together, they launched a massive, statewide effort to keep as many mothers as possible alive – and to understand why so many were dying in the first place. To understand that, you’ve got to go back more than sixty years.\u003c/p>\n\u003cfigure id=\"attachment_11683726\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683726\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health1-1020x679.jpg\" alt=\"Pomona Valley Hospital Medical Center, a member of the California Maternal Quality Care Collaborative, is one of the state's largest birthing centers, delivering over 7,000 babies a year.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-1200x798.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-1180x785.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-960x639.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-520x346.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1.jpg 1300w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Pomona Valley Hospital Medical Center, a member of the California Maternal Quality Care Collaborative, is one of the state’s largest birthing centers, delivering over 7,000 babies a year. \u003ccite>(Bethany Mollenkof/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>An ‘Apparently Irreducible’ Death Rate\u003c/h3>\n\u003cp>In 1950, the Journal of the American Medical Association, a beacon of medical research, made a dramatic claim: The battle to stop women from dying in childbirth had finally been won.\u003c/p>\n\u003cp>“The Journal takes pride in announcing that for the first time in history the maternal mortality rate for a large nation – the United States of America – has been pushed slightly below the apparently irreducible minimum of one maternal death per 1,000 live births,” an \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/298109\" target=\"_blank\" rel=\"noopener\">editorial proclaimed\u003c/a> in an issue that year.\u003c/p>\n\u003cp>Only a few other nations, it continued, could reach such stellar numbers: Sweden, Norway, Denmark, the Netherlands and New Zealand. In subsequent years, the rate of maternal death in the U.S., thought to be irreducible, \u003ca href=\"https://www.cdc.gov/nchs/data/series/sr_03/sr03_033.pdf\" target=\"_blank\" rel=\"noopener\">fell even further\u003c/a>.\u003c/p>\n\u003cp>But then it stopped.\u003c/p>\n\u003cp>“There was this premature declaration of victory,” says obstetrician William Callaghan, chief of the Maternal and Infant Health Branch in the Division of Reproductive Health at the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Callaghan says that after the medical community declared that victory, there was a shift in focus.\u003c/p>\n\u003cp>“Into the late ’60s and really through the ’70s, the technology of being able to care for the fetus became huge,” Callaghan says. “People became really enchanted with the ability to do ultrasound, and then high-resolution ultrasound, to do invasive procedures, to stick needles in the amniotic cavity, and everything did revolve around the baby.”\u003c/p>\n\u003cp>As the focus turned from mothers to babies, the trend lines for both diverged. Infant mortality is now at a \u003ca href=\"https://www.cdc.gov/nchs/data/databriefs/db229.htm\" target=\"_blank\" rel=\"noopener\">“historic low,”\u003c/a> while the maternal mortality rate has \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001799/\" target=\"_blank\" rel=\"noopener\">continued to rise\u003c/a> in recent years.\u003c/p>\n\u003cp>Of the 700 to 900 maternal deaths each year in America, the \u003ca href=\"https://www.cdcfoundation.org/building-us-capacity-review-and-prevent-maternal-deaths\" target=\"_blank\" rel=\"noopener\">CDC Foundation\u003c/a> estimates that 60 percent are preventable.\u003c/p>\n\u003cp>That’s because, as \u003ca href=\"https://www.npr.org/series/543928389/lost-mothers\" target=\"_blank\" rel=\"noopener\">NPR and ProPublica\u003c/a> have reported, the American medical system still prioritizes infant survival over maternal care. It approaches childbirth with the assumption that most women who give birth will be fine.\u003c/p>\n\u003ch3>‘Practice It And Practice It’\u003c/h3>\n\u003cp>For the minority of women who won’t be fine, there needs to be a plan in place, says Debra Bingham. She, along with obstetrician Elliott Main and others, sought to create one.\u003c/p>\n\u003cp>They helped found the \u003ca href=\"https://www.cmqcc.org/who-we-are\" target=\"_blank\" rel=\"noopener\">California Maternal Quality Care Collaborative\u003c/a> in 2006, where Main says a newly formed maternal mortality review committee was able to access details – for the first time – on how every mother had died over the previous five years.\u003c/p>\n\u003cfigure id=\"attachment_11683725\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11683725\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health2.gif\" alt=\"Pomona Valley Hospital Medical Center staff run through a hemorrhage drill with a mannequin.\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">Pomona Valley Hospital Medical Center staff run through a hemorrhage drill with a mannequin. \u003ccite>(Bethany Mollenkof for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It became very clear that there were cases in which, if care had been performed differently, there would have been a high likelihood of better outcomes,” says Main, who is the medical director of the collaborative and a clinical professor of Obstetrics and Gynecology at Stanford University.\u003c/p>\n\u003cp>In particular, the committee found two well-known complications offered the best chance for survival if treated properly: hemorrhage and the pregnancy-induced high blood pressure called preeclampsia.\u003c/p>\n\u003cp>Main estimated that the vast majority of the deaths from those two complications could have been prevented through early recognition, teamwork and a list of well-rehearsed treatments.\u003c/p>\n\u003cp>“The analogy would be if you had a cardiac arrest and everyone had their own way of doing CPR,” Main says. “We’ve made big advances in emergency care by having some basic standardized approaches to emergencies. That’s what we’re bringing to maternity care now.”\u003c/p>\n\u003cp>At Pomona Valley Hospital Medical Center, a member of the collaborative, doctors and nurses are doing just that.\u003c/p>\n\u003cfigure id=\"attachment_11683724\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683724\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health3-1020x679.jpg\" alt='Maria Hellen Rodriguez runs drills at Pomona Valley Hospital Medical Center to simulate real obstetric emergencies, so standard approaches become \"muscle memory\" to hospital staff, she says.' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-1200x798.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-1180x785.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-960x639.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-520x346.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3.jpg 1300w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Maria Hellen Rodriguez runs drills at Pomona Valley Hospital Medical Center to simulate real obstetric emergencies, so standard approaches become “muscle memory” to hospital staff, she says. \u003ccite>(Bethany Mollenkof/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>An hour east of Los Angeles, the hospital is one of the state’s largest birthing centers, delivering more than 7,000 babies a year.\u003c/p>\n\u003cp>Maria Hellen Rodriguez, the medical director of maternal-fetal medicine at the hospital, recently led a training drill for nurses and doctors on how to improve outcomes for women who hemorrhage during or after giving birth. Using a medical mannequin, a team practices a simulated hemorrhage.\u003c/p>\n\u003cp>“Every single woman is at risk for hemorrhage if they are going to deliver,” Rodriguez explains.\u003c/p>\n\u003cp>That idea – that every woman is at risk – is a new thought in the world of obstetrics. Preparing for the worst case scenario, Rodriguez says, is key to saving mothers.\u003c/p>\n\u003cp>“You need to make sure that you can work [it] into your muscle memory. So it happens every time you take care of a patient,” Rodriguez says.\u003c/p>\n\u003cfigure id=\"attachment_11683723\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683723\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health4-1020x765.jpg\" alt=\"Hospital staff at Pomona Valley Hospital Medical Center review video footage of an emergency drill performed on a medical mannequin.\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">Hospital staff at Pomona Valley Hospital Medical Center review video footage of an emergency drill performed on a medical mannequin. \u003ccite>(Bethany Mollenkof/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That starts with one early innovation of the California collaborative: toolkits that contain everything needed to tackle an emergency complication, from checklists to equipment to medications.\u003c/p>\n\u003cp>For an obstetrical hemorrhage, that toolkit is a cart – not unlike a crash cart used for cardiac arrest. Red, with five drawers on wheels, the hemorrhage cart is filled with every kind of equipment a team of doctors and nurses may need in an emergency: things like a checklist, an IV line, oxygen masks, a special speculum, and a Bakri balloon, which, when inserted into the uterus, puts pressure on blood vessels.\u003c/p>\n\u003cp>And, for measuring blood that is lost: sponges and pads. Traditionally – and in many hospitals still – nurses and doctors estimate the amount of blood lost by sight.\u003c/p>\n\u003cp>The team working in Rodriguez’ drill gathers the sponges and pads collecting blood and weighs them on a scale. They know how much these items weigh when dry. Once they subtract the dry weight, they can more accurately gauge how much blood has been lost.\u003c/p>\n\u003cp>The lesson, delivered over and over again, is that each team member – doctor or nurse – has the power to change the outcome.\u003c/p>\n\u003cfigure id=\"attachment_11683722\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683722\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health5-1020x679.jpg\" alt=\"Hospital staff at Pomona Valley Hospital Medical Center practice strategies that can improve outcomes for women who hemorrhage during or after giving birth.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-1200x798.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-1180x785.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-960x639.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-520x346.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5.jpg 1300w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Hospital staff at Pomona Valley Hospital Medical Center practice strategies that can improve outcomes for women who hemorrhage during or after giving birth. \u003ccite>(Bethany Mollenkof for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>An ‘Extremely Good Decision’\u003c/h3>\n\u003cp>Even though she’d had five previous C-sections, Cayti Kane had never heard of placenta accreta before she was diagnosed.\u003c/p>\n\u003cp>She also didn’t know that each repeat C-section increased the chance that she’d develop the condition. In placenta accreta, scar tissue on the uterus from previous surgeries can allow a placenta from a new pregnancy to grow through the uterine wall, which can lead to hemorrhage.\u003c/p>\n\u003cp>The disorder used to be exceedingly rare in the U.S. In the 1950s, it appeared in \u003ca href=\"https://elischolar.library.yale.edu/cgi/viewcontent.cgi?article=1702&context=ymtdl\" target=\"_blank\" rel=\"noopener\">one in every 30,000 births\u003c/a>. Today, placenta accreta appears in \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916820/\" target=\"_blank\" rel=\"noopener\">one in every 500 births\u003c/a>. Its rise has coincided with the rise in C-sections, the rate of which is \u003ca href=\"https://www.nlm.nih.gov/exhibition/cesarean/part3.html\" target=\"_blank\" rel=\"noopener\">six times\u003c/a> what it was fifty years ago. Today, \u003ca href=\"https://www.cdc.gov/nchs/fastats/delivery.htm\" target=\"_blank\" rel=\"noopener\">one in three babies\u003c/a> is born via C-section.\u003c/p>\n\u003cp>A woman having her sixth C-section – like Kane – has a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16738145\" target=\"_blank\" rel=\"noopener\">much higher chance\u003c/a> of developing placenta accreta.\u003c/p>\n\u003cp>“If I had known that this was a possibility, there’s no way I would have ever done this,” Kane says. “There’s no way I would have put my life at risk and risk my children losing their mom.”\u003c/p>\n\u003cp>It was by chance that Kane ended up at Pomona Valley Hospital Medical Center. She lives in Apple Valley, Calif., in the high desert and more than an hour’s drive away.\u003c/p>\n\u003cfigure id=\"attachment_11683720\" class=\"wp-caption alignright\" style=\"max-width: 500px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11683720\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health6.jpeg\" alt=\"\" width=\"500\" height=\"374\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6.jpeg 500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6-160x120.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6-240x180.jpeg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6-375x281.jpeg 375w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003cfigcaption class=\"wp-caption-text\">Cayti Kane was diagnosed with placenta accreta, a dangerous complication. But Pomona Valley Hospital Medical Center was prepared and two weeks later, Kane delivered a healthy boy via C-section. \u003ccite>(Courtesy of Pomona Valley Hospital Medical Center)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At 30 weeks pregnant, she went into pre-term labor and when she arrived at her local hospital, her regular doctor was out of town. In what Kane calls an “extremely good decision,” the on-call doctor transferred her to Pomona Valley, because of the risks associated with her five previous C-sections.\u003c/p>\n\u003cp>Pomona Valley was prepared for her delivery. But just as important, the small, rural hospital where Kane delivered previously – also a member of the statewide collaborative – was quick to identify a problem it was not prepared for and send her to one that was.\u003c/p>\n\u003cp>At Pomona Valley, Dr. Rodriguez immediately diagnosed Kane with placenta accreta. Two weeks later, Kane delivered a healthy boy via C-section. When, as expected, she hemorrhaged, she was surrounded by a team able to handle it.\u003c/p>\n\u003cp>From 2006 to 2013, the maternal death rate in California \u003ca href=\"https://www.cmqcc.org/research/ca-pamr-maternal-mortality-review\" target=\"_blank\" rel=\"noopener\">fell 55 percent\u003c/a>. These protocols – the checklists, carts, drills and teamwork – have not only saved women from dying, they have also dramatically reduced the rate of women who nearly died.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.cmqcc.org/sites/default/files/Main%20etal%20SMM%20HEM%20at%20SMFM%20copy.pdf\" target=\"_blank\" rel=\"noopener\">study\u003c/a> in The American Journal of Obstetrics and Gynecology found hospitals that signed up to implement the toolkits lowered the rate of severe maternal morbidity due to hemorrhage by nearly 21 percent. In hospitals not participating, that rate dropped by just over one percent.\u003c/p>\n\u003cp>As of June 2018, \u003ca href=\"https://www.cmqcc.org/news/cmqcc-releases-online-version-first-annual-report\" target=\"_blank\" rel=\"noopener\">88 percent\u003c/a> of California’s birthing hospitals have joined, accounting for 95 percent of all the births in the state.\u003c/p>\n\u003cp>\u003cem>NPR’s Meg Anderson and Barbara Van Woerkom and ProPublica’s Nina Martin contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Cayti Kane delivered a baby boy via cesarean section last year, her team of doctors was prepared.\u003c/p>\n\u003cp>Kane had been diagnosed with placenta accreta, a condition that increased the likelihood of a dangerous hemorrhage during delivery. When that happened, she had an emergency hysterectomy. Kane and her son went home healthy.\u003c/p>\n\u003cp>Complicated, high-risk deliveries in the United States often end tragically. An American woman is three times as likely to die from childbirth as a woman in Canada, and six times as likely as a woman in Scandinavia. It’s a story \u003ca href=\"https://www.npr.org/series/543928389/lost-mothers\" target=\"_blank\" rel=\"noopener\">NPR and ProPublica\u003c/a> have heard repeatedly over the last year while investigating the startling rate of maternal death in America.\u003c/p>\n\u003cp>But despite her risk factors, Kane had something going for her that made her delivery less likely to go wrong: She lived – and gave birth – in California.\u003c/p>\n\u003cp>The state is leading the charge to reverse the nationwide trend: Since 2006, California has cut its rate of women dying in childbirth by \u003ca href=\"https://www.cmqcc.org/research/ca-pamr-maternal-mortality-review\" target=\"_blank\" rel=\"noopener\">more than half\u003c/a>. And it’s a state whose impact could make a big difference: \u003ca href=\"https://www.kff.org/other/state-indicator/number-of-births/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\" target=\"_blank\" rel=\"noopener\">One in eight\u003c/a> infants born in the United States is born there.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It wasn’t always that way.\u003c/p>\n\u003cp>Debra Bingham, a nurse then working toward a doctorate in public health, was in a meeting with state public health officials in 2006, when a startling statistic was unveiled: The rate of California women dying from childbirth had recently doubled.\u003c/p>\n\u003cp>“It was unexpected and disturbing, very disturbing,” recalls Bingham, now the executive director of the Institute for Perinatal Quality Improvement. “We needed to understand and really dig into why.”\u003c/p>\n\u003cp>Soon Bingham was tasked with bringing together key players to dig in: nurses, doctors, midwives, hospital administrators and other officials. Together, they launched a massive, statewide effort to keep as many mothers as possible alive – and to understand why so many were dying in the first place. To understand that, you’ve got to go back more than sixty years.\u003c/p>\n\u003cfigure id=\"attachment_11683726\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683726\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health1-1020x679.jpg\" alt=\"Pomona Valley Hospital Medical Center, a member of the California Maternal Quality Care Collaborative, is one of the state's largest birthing centers, delivering over 7,000 babies a year.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-1200x798.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-1180x785.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-960x639.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1-520x346.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health1.jpg 1300w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Pomona Valley Hospital Medical Center, a member of the California Maternal Quality Care Collaborative, is one of the state’s largest birthing centers, delivering over 7,000 babies a year. \u003ccite>(Bethany Mollenkof/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>An ‘Apparently Irreducible’ Death Rate\u003c/h3>\n\u003cp>In 1950, the Journal of the American Medical Association, a beacon of medical research, made a dramatic claim: The battle to stop women from dying in childbirth had finally been won.\u003c/p>\n\u003cp>“The Journal takes pride in announcing that for the first time in history the maternal mortality rate for a large nation – the United States of America – has been pushed slightly below the apparently irreducible minimum of one maternal death per 1,000 live births,” an \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/298109\" target=\"_blank\" rel=\"noopener\">editorial proclaimed\u003c/a> in an issue that year.\u003c/p>\n\u003cp>Only a few other nations, it continued, could reach such stellar numbers: Sweden, Norway, Denmark, the Netherlands and New Zealand. In subsequent years, the rate of maternal death in the U.S., thought to be irreducible, \u003ca href=\"https://www.cdc.gov/nchs/data/series/sr_03/sr03_033.pdf\" target=\"_blank\" rel=\"noopener\">fell even further\u003c/a>.\u003c/p>\n\u003cp>But then it stopped.\u003c/p>\n\u003cp>“There was this premature declaration of victory,” says obstetrician William Callaghan, chief of the Maternal and Infant Health Branch in the Division of Reproductive Health at the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Callaghan says that after the medical community declared that victory, there was a shift in focus.\u003c/p>\n\u003cp>“Into the late ’60s and really through the ’70s, the technology of being able to care for the fetus became huge,” Callaghan says. “People became really enchanted with the ability to do ultrasound, and then high-resolution ultrasound, to do invasive procedures, to stick needles in the amniotic cavity, and everything did revolve around the baby.”\u003c/p>\n\u003cp>As the focus turned from mothers to babies, the trend lines for both diverged. Infant mortality is now at a \u003ca href=\"https://www.cdc.gov/nchs/data/databriefs/db229.htm\" target=\"_blank\" rel=\"noopener\">“historic low,”\u003c/a> while the maternal mortality rate has \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001799/\" target=\"_blank\" rel=\"noopener\">continued to rise\u003c/a> in recent years.\u003c/p>\n\u003cp>Of the 700 to 900 maternal deaths each year in America, the \u003ca href=\"https://www.cdcfoundation.org/building-us-capacity-review-and-prevent-maternal-deaths\" target=\"_blank\" rel=\"noopener\">CDC Foundation\u003c/a> estimates that 60 percent are preventable.\u003c/p>\n\u003cp>That’s because, as \u003ca href=\"https://www.npr.org/series/543928389/lost-mothers\" target=\"_blank\" rel=\"noopener\">NPR and ProPublica\u003c/a> have reported, the American medical system still prioritizes infant survival over maternal care. It approaches childbirth with the assumption that most women who give birth will be fine.\u003c/p>\n\u003ch3>‘Practice It And Practice It’\u003c/h3>\n\u003cp>For the minority of women who won’t be fine, there needs to be a plan in place, says Debra Bingham. She, along with obstetrician Elliott Main and others, sought to create one.\u003c/p>\n\u003cp>They helped found the \u003ca href=\"https://www.cmqcc.org/who-we-are\" target=\"_blank\" rel=\"noopener\">California Maternal Quality Care Collaborative\u003c/a> in 2006, where Main says a newly formed maternal mortality review committee was able to access details – for the first time – on how every mother had died over the previous five years.\u003c/p>\n\u003cfigure id=\"attachment_11683725\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11683725\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health2.gif\" alt=\"Pomona Valley Hospital Medical Center staff run through a hemorrhage drill with a mannequin.\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">Pomona Valley Hospital Medical Center staff run through a hemorrhage drill with a mannequin. \u003ccite>(Bethany Mollenkof for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It became very clear that there were cases in which, if care had been performed differently, there would have been a high likelihood of better outcomes,” says Main, who is the medical director of the collaborative and a clinical professor of Obstetrics and Gynecology at Stanford University.\u003c/p>\n\u003cp>In particular, the committee found two well-known complications offered the best chance for survival if treated properly: hemorrhage and the pregnancy-induced high blood pressure called preeclampsia.\u003c/p>\n\u003cp>Main estimated that the vast majority of the deaths from those two complications could have been prevented through early recognition, teamwork and a list of well-rehearsed treatments.\u003c/p>\n\u003cp>“The analogy would be if you had a cardiac arrest and everyone had their own way of doing CPR,” Main says. “We’ve made big advances in emergency care by having some basic standardized approaches to emergencies. That’s what we’re bringing to maternity care now.”\u003c/p>\n\u003cp>At Pomona Valley Hospital Medical Center, a member of the collaborative, doctors and nurses are doing just that.\u003c/p>\n\u003cfigure id=\"attachment_11683724\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683724\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health3-1020x679.jpg\" alt='Maria Hellen Rodriguez runs drills at Pomona Valley Hospital Medical Center to simulate real obstetric emergencies, so standard approaches become \"muscle memory\" to hospital staff, she says.' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-1200x798.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-1180x785.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-960x639.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3-520x346.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health3.jpg 1300w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Maria Hellen Rodriguez runs drills at Pomona Valley Hospital Medical Center to simulate real obstetric emergencies, so standard approaches become “muscle memory” to hospital staff, she says. \u003ccite>(Bethany Mollenkof/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>An hour east of Los Angeles, the hospital is one of the state’s largest birthing centers, delivering more than 7,000 babies a year.\u003c/p>\n\u003cp>Maria Hellen Rodriguez, the medical director of maternal-fetal medicine at the hospital, recently led a training drill for nurses and doctors on how to improve outcomes for women who hemorrhage during or after giving birth. Using a medical mannequin, a team practices a simulated hemorrhage.\u003c/p>\n\u003cp>“Every single woman is at risk for hemorrhage if they are going to deliver,” Rodriguez explains.\u003c/p>\n\u003cp>That idea – that every woman is at risk – is a new thought in the world of obstetrics. Preparing for the worst case scenario, Rodriguez says, is key to saving mothers.\u003c/p>\n\u003cp>“You need to make sure that you can work [it] into your muscle memory. So it happens every time you take care of a patient,” Rodriguez says.\u003c/p>\n\u003cfigure id=\"attachment_11683723\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683723\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health4-1020x765.jpg\" alt=\"Hospital staff at Pomona Valley Hospital Medical Center review video footage of an emergency drill performed on a medical mannequin.\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">Hospital staff at Pomona Valley Hospital Medical Center review video footage of an emergency drill performed on a medical mannequin. \u003ccite>(Bethany Mollenkof/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That starts with one early innovation of the California collaborative: toolkits that contain everything needed to tackle an emergency complication, from checklists to equipment to medications.\u003c/p>\n\u003cp>For an obstetrical hemorrhage, that toolkit is a cart – not unlike a crash cart used for cardiac arrest. Red, with five drawers on wheels, the hemorrhage cart is filled with every kind of equipment a team of doctors and nurses may need in an emergency: things like a checklist, an IV line, oxygen masks, a special speculum, and a Bakri balloon, which, when inserted into the uterus, puts pressure on blood vessels.\u003c/p>\n\u003cp>And, for measuring blood that is lost: sponges and pads. Traditionally – and in many hospitals still – nurses and doctors estimate the amount of blood lost by sight.\u003c/p>\n\u003cp>The team working in Rodriguez’ drill gathers the sponges and pads collecting blood and weighs them on a scale. They know how much these items weigh when dry. Once they subtract the dry weight, they can more accurately gauge how much blood has been lost.\u003c/p>\n\u003cp>The lesson, delivered over and over again, is that each team member – doctor or nurse – has the power to change the outcome.\u003c/p>\n\u003cfigure id=\"attachment_11683722\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11683722\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health5-1020x679.jpg\" alt=\"Hospital staff at Pomona Valley Hospital Medical Center practice strategies that can improve outcomes for women who hemorrhage during or after giving birth.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-1200x798.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-1180x785.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-960x639.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5-520x346.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health5.jpg 1300w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Hospital staff at Pomona Valley Hospital Medical Center practice strategies that can improve outcomes for women who hemorrhage during or after giving birth. \u003ccite>(Bethany Mollenkof for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>An ‘Extremely Good Decision’\u003c/h3>\n\u003cp>Even though she’d had five previous C-sections, Cayti Kane had never heard of placenta accreta before she was diagnosed.\u003c/p>\n\u003cp>She also didn’t know that each repeat C-section increased the chance that she’d develop the condition. In placenta accreta, scar tissue on the uterus from previous surgeries can allow a placenta from a new pregnancy to grow through the uterine wall, which can lead to hemorrhage.\u003c/p>\n\u003cp>The disorder used to be exceedingly rare in the U.S. In the 1950s, it appeared in \u003ca href=\"https://elischolar.library.yale.edu/cgi/viewcontent.cgi?article=1702&context=ymtdl\" target=\"_blank\" rel=\"noopener\">one in every 30,000 births\u003c/a>. Today, placenta accreta appears in \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916820/\" target=\"_blank\" rel=\"noopener\">one in every 500 births\u003c/a>. Its rise has coincided with the rise in C-sections, the rate of which is \u003ca href=\"https://www.nlm.nih.gov/exhibition/cesarean/part3.html\" target=\"_blank\" rel=\"noopener\">six times\u003c/a> what it was fifty years ago. Today, \u003ca href=\"https://www.cdc.gov/nchs/fastats/delivery.htm\" target=\"_blank\" rel=\"noopener\">one in three babies\u003c/a> is born via C-section.\u003c/p>\n\u003cp>A woman having her sixth C-section – like Kane – has a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16738145\" target=\"_blank\" rel=\"noopener\">much higher chance\u003c/a> of developing placenta accreta.\u003c/p>\n\u003cp>“If I had known that this was a possibility, there’s no way I would have ever done this,” Kane says. “There’s no way I would have put my life at risk and risk my children losing their mom.”\u003c/p>\n\u003cp>It was by chance that Kane ended up at Pomona Valley Hospital Medical Center. She lives in Apple Valley, Calif., in the high desert and more than an hour’s drive away.\u003c/p>\n\u003cfigure id=\"attachment_11683720\" class=\"wp-caption alignright\" style=\"max-width: 500px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11683720\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/health6.jpeg\" alt=\"\" width=\"500\" height=\"374\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6.jpeg 500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6-160x120.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6-240x180.jpeg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/health6-375x281.jpeg 375w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003cfigcaption class=\"wp-caption-text\">Cayti Kane was diagnosed with placenta accreta, a dangerous complication. But Pomona Valley Hospital Medical Center was prepared and two weeks later, Kane delivered a healthy boy via C-section. \u003ccite>(Courtesy of Pomona Valley Hospital Medical Center)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At 30 weeks pregnant, she went into pre-term labor and when she arrived at her local hospital, her regular doctor was out of town. In what Kane calls an “extremely good decision,” the on-call doctor transferred her to Pomona Valley, because of the risks associated with her five previous C-sections.\u003c/p>\n\u003cp>Pomona Valley was prepared for her delivery. But just as important, the small, rural hospital where Kane delivered previously – also a member of the statewide collaborative – was quick to identify a problem it was not prepared for and send her to one that was.\u003c/p>\n\u003cp>At Pomona Valley, Dr. Rodriguez immediately diagnosed Kane with placenta accreta. Two weeks later, Kane delivered a healthy boy via C-section. When, as expected, she hemorrhaged, she was surrounded by a team able to handle it.\u003c/p>\n\u003cp>From 2006 to 2013, the maternal death rate in California \u003ca href=\"https://www.cmqcc.org/research/ca-pamr-maternal-mortality-review\" target=\"_blank\" rel=\"noopener\">fell 55 percent\u003c/a>. These protocols – the checklists, carts, drills and teamwork – have not only saved women from dying, they have also dramatically reduced the rate of women who nearly died.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.cmqcc.org/sites/default/files/Main%20etal%20SMM%20HEM%20at%20SMFM%20copy.pdf\" target=\"_blank\" rel=\"noopener\">study\u003c/a> in The American Journal of Obstetrics and Gynecology found hospitals that signed up to implement the toolkits lowered the rate of severe maternal morbidity due to hemorrhage by nearly 21 percent. In hospitals not participating, that rate dropped by just over one percent.\u003c/p>\n\u003cp>As of June 2018, \u003ca href=\"https://www.cmqcc.org/news/cmqcc-releases-online-version-first-annual-report\" target=\"_blank\" rel=\"noopener\">88 percent\u003c/a> of California’s birthing hospitals have joined, accounting for 95 percent of all the births in the state.\u003c/p>\n\u003cp>\u003cem>NPR’s Meg Anderson and Barbara Van Woerkom and ProPublica’s Nina Martin contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Overlooked Pond Could Become San Leandro’s Secret Weapon in Water Pollution Control",
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"headTitle": "Overlooked Pond Could Become San Leandro’s Secret Weapon in Water Pollution Control | KQED",
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"content": "\u003cp>\u003cem>This is part of our ongoing series about where taxpayer funds from 2016’s Measure AA to restore the San Francisco Bay are going. Find all the stories \u003ca href=\"https://www.kqed.org/news/tag/measure-aa\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>The parking lot outside of \u003ca href=\"https://www.sanleandro.org/depts/pw/wpcp/about.asp\" target=\"_blank\" rel=\"noopener\">San Leandro’s Water Pollution Control Plant\u003c/a> has a lingering stench. Its odor partly comes from the average 5 million gallons of wastewater it processes a day and from its neighbor, a trash dump.\u003c/p>\n\u003cp>A short walk away from the lot the smell subsides a little at a small patch of wetland. That’s where I met up with plant manager Justin Jenson. He’s showing me another project getting tax money from Measure AA, the “Clean and Healthy Bay” measure passed two years ago. To me, the area just looks like a neglected pond.\u003c/p>\n\u003cp>“This used to be a polishing pond,” says Jenson. “That means we used to actually send our treatment plant effluent out here and process it further.”\u003c/p>\n\u003cp>Effluent is the treated water that comes out of wastewater facilities. Jenson says, now, this 4.3 acre pond is basically just used as temporary water storage. But it has the potential to be so much more.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The more than $500,000 granted to this project will go toward the design and permitting for the restoration of the pond and to create a treatment wetland.\u003c/p>\n\u003cp>“It changes this from what you see right here which is an ugly, old, unused pond into something that’s actually used to produce very, very clean water,” says Jenson.\u003c/p>\n\u003cfigure id=\"attachment_11680685\" class=\"wp-caption alignnone\" style=\"max-width: 770px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11680685\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut.jpg\" alt=\"\" width=\"770\" height=\"725\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut.jpg 770w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-160x151.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-240x226.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-375x353.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-520x490.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">The pond is overgrown with algae and has been neglected for years. A broken foot bridge crosses over it. \u003ccite>(San Leandro Water Pollution Control Plant)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The flora in a treatment wetland make the water very, very clean by filtering out additional nutrients, like nitrogen and phosphorous, coming out of the wastewater plant. According to the U.S. Geological Survey, too much of these nutrients in a body of water can actually begin to pollute it and cause harmful algae blooms.\u003c/p>\n\u003cp>Jenson says, the state water board has strict regulations regarding cleaned wastewater discharge into the San Francisco Bay and he expects water quality rules to become even tighter in the years to come. He says water treatment alternatives like this project will help the San Leandro plant stay ahead of the curve while also keeping the Bay’s water cleaner and healthier.\u003c/p>\n\u003cp>“With more people moving to the Bay Area, there’s more potential for pollution and nutrient build-up in bay,” says Jenson. “We want to make sure that we’re able to meet the water regulations. This pond could be something that helps us weather them.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Jenson hopes this project will become part of a growing network of water treatment wetlands across the Bay Area. Both the Discovery Bay and Oro Loma wastewater treatment plants have already piloted their own treatment wetland program.\u003c/p>\n\u003cfigure id=\"attachment_11680687\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11680687\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-800x618.jpg\" alt=\"\" width=\"800\" height=\"618\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-800x618.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-160x124.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-1020x788.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-1200x927.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-1180x912.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-960x742.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-240x185.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-375x290.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-520x402.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut.jpg 1650w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">When finished, the treatment wetland will provide more wildlife habitat and a nicer view for San Francisco Bay Trail hikers. \u003ccite>(San Leandro Water Pollution Control Plant)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\n",
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"excerpt": "How Measure AA funds will go toward the restoring a pond to create a treatment wetland.",
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"title": "Overlooked Pond Could Become San Leandro’s Secret Weapon in Water Pollution Control | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This is part of our ongoing series about where taxpayer funds from 2016’s Measure AA to restore the San Francisco Bay are going. Find all the stories \u003ca href=\"https://www.kqed.org/news/tag/measure-aa\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>The parking lot outside of \u003ca href=\"https://www.sanleandro.org/depts/pw/wpcp/about.asp\" target=\"_blank\" rel=\"noopener\">San Leandro’s Water Pollution Control Plant\u003c/a> has a lingering stench. Its odor partly comes from the average 5 million gallons of wastewater it processes a day and from its neighbor, a trash dump.\u003c/p>\n\u003cp>A short walk away from the lot the smell subsides a little at a small patch of wetland. That’s where I met up with plant manager Justin Jenson. He’s showing me another project getting tax money from Measure AA, the “Clean and Healthy Bay” measure passed two years ago. To me, the area just looks like a neglected pond.\u003c/p>\n\u003cp>“This used to be a polishing pond,” says Jenson. “That means we used to actually send our treatment plant effluent out here and process it further.”\u003c/p>\n\u003cp>Effluent is the treated water that comes out of wastewater facilities. Jenson says, now, this 4.3 acre pond is basically just used as temporary water storage. But it has the potential to be so much more.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The more than $500,000 granted to this project will go toward the design and permitting for the restoration of the pond and to create a treatment wetland.\u003c/p>\n\u003cp>“It changes this from what you see right here which is an ugly, old, unused pond into something that’s actually used to produce very, very clean water,” says Jenson.\u003c/p>\n\u003cfigure id=\"attachment_11680685\" class=\"wp-caption alignnone\" style=\"max-width: 770px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11680685\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut.jpg\" alt=\"\" width=\"770\" height=\"725\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut.jpg 770w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-160x151.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-240x226.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-375x353.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31801_San-Leandro-Pond-2-qut-520x490.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">The pond is overgrown with algae and has been neglected for years. A broken foot bridge crosses over it. \u003ccite>(San Leandro Water Pollution Control Plant)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The flora in a treatment wetland make the water very, very clean by filtering out additional nutrients, like nitrogen and phosphorous, coming out of the wastewater plant. According to the U.S. Geological Survey, too much of these nutrients in a body of water can actually begin to pollute it and cause harmful algae blooms.\u003c/p>\n\u003cp>Jenson says, the state water board has strict regulations regarding cleaned wastewater discharge into the San Francisco Bay and he expects water quality rules to become even tighter in the years to come. He says water treatment alternatives like this project will help the San Leandro plant stay ahead of the curve while also keeping the Bay’s water cleaner and healthier.\u003c/p>\n\u003cp>“With more people moving to the Bay Area, there’s more potential for pollution and nutrient build-up in bay,” says Jenson. “We want to make sure that we’re able to meet the water regulations. This pond could be something that helps us weather them.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Jenson hopes this project will become part of a growing network of water treatment wetlands across the Bay Area. Both the Discovery Bay and Oro Loma wastewater treatment plants have already piloted their own treatment wetland program.\u003c/p>\n\u003cfigure id=\"attachment_11680687\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11680687\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-800x618.jpg\" alt=\"\" width=\"800\" height=\"618\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-800x618.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-160x124.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-1020x788.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-1200x927.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-1180x912.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-960x742.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-240x185.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-375x290.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut-520x402.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31800_fig_3_site_detail-qut.jpg 1650w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">When finished, the treatment wetland will provide more wildlife habitat and a nicer view for San Francisco Bay Trail hikers. \u003ccite>(San Leandro Water Pollution Control Plant)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In a cramped office in San Pablo, a group of health care providers work as fast as they can to treat a growing line of people seeking treatment. Already, at the break of dawn on this April morning, the line is spilling down the hall and out the front door.\u003c/p>\n\u003cp>Since LifeLong Medical Care opened in April 2015, the staff has grown used to long lines. The facility opened the same week that neighboring Doctors Medical Center (DMC), one of West Contra Costa County’s most relied-upon hospitals, closed its doors after years of financial strife.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If there’s a Nordstrom, there’ll be health care. Health care follows the dollar, simple as that.’\u003cbr>\n\u003ccite>Dr. Desmond Carson, LifeLong Medical Care\u003c/cite>\u003c/aside>\n\u003cp>Located directly across the street from the now-shuttered DMC, LifeLong is one of the few urgent care facilities left to serve more than 400,000 residents in Richmond and surrounding cities.\u003c/p>\n\u003cp>Unlike DMC, LifeLong provides only urgent care, is not a full-service hospital and does not have an emergency department. When patients come in with life-threatening emergencies, LifeLong’s staff does their best to connect them to services elsewhere. But there aren’t many options nearby.\u003c/p>\n\u003cp>Alta Bates in Berkeley is 11 miles south and the Contra Costa Regional Medical Center in Martinez is 16 miles to the east. The only other high-volume emergency option is John Muir Medical Center in Walnut Creek, more than 20 miles away. Add in rush-hour traffic, and travel times from West Contra Costa County increase dramatically.\u003c/p>\n\u003cfigure id=\"attachment_11679813\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11679813 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-520x293.jpg 520w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">(Graphic by Hao Guo)\u003c/figcaption>\u003c/figure>\n\u003cp>Now that DMC is closed, the only emergency room left in the Richmond/San Pablo area is Kaiser’s Richmond Medical Center, a 50-bed hospital. In a statement, Kaiser reported a 50 percent increase in ER visits since DMC closed in 2015.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Time is muscle,” said Dr. Desmond Carson, an urgent care physician at LifeLong. The farther that residents have to travel, Carson said, the worse their chances are of surviving.\u003c/p>\n\u003cp>For East Bay residents, access to emergency care might soon be getting even harder to come by. In 2016, Sutter Health, which owns Alta Bates Medical Center in Berkeley, announced it will close the emergency room and consolidate those services into its Oakland location at an unspecified time in the future. The Oakland facility is located 2.6 miles south of the Berkeley facility.\u003c/p>\n\u003cp>In a statement, Sutter Health explained that California’s seismic regulations require the Alta Bates campus to cease operating as a hospital by 2030. Aware of the community’s concerns, Sutter also assured that this transition won’t be abrupt either.\u003c/p>\n\u003cfigure id=\"attachment_11679810\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11679810\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-520x293.jpg 520w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Doctors Medical Center in San Pablo closed in 2015. (Bo Kovitz)\u003c/figcaption>\u003c/figure>\n\u003cp>According to Dr. Brian Potts, who runs the emergency department at Alta Bates, a planned transition that could take as long as 10 years will allow enough time to build the infrastructure necessary for what he projects to be the biggest emergency room in the East Bay.\u003c/p>\n\u003cp>And the transition will be worth it, said Potts, explaining that consolidating services under one roof, rather than having two separate emergency rooms miles apart, will improve quality of care.\u003c/p>\n\u003cp>Many in the community fear the closure of Alta Bates’ emergency department is part of a similar story: hospital leaders more concerned with cost efficiency than providing care, no matter the cost. As a result, East Bay residents are facing life in a hospital desert. Gunshot wounds, delivering babies and heart attacks could become even more life-threatening when the move does happen.\u003c/p>\n\u003cp>“The harder you make it to get to that care, the more difficult it’s going to be and the more of a need it’s going to be,” said Marty Lynch, LifeLong’s CEO. “There’s no question that folks in Richmond and folks in San Pablo need a good system of emergency care.”\u003c/p>\n\u003cfigure id=\"attachment_11679816\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11679816 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/5_Lifelong-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-520x293.jpg 520w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">LifeLong Medical Care in San Pablo is one of the few urgent care facilities remaining in West Contra Costa County. (Bo Kovitz)\u003c/figcaption>\u003c/figure>\n\u003cp>Kathleen Sullivan, a community leader in Richmond who fought to keep DMC open, found herself rushing her husband to the emergency room when he was shot in the streets last year. Doctors at Kaiser’s Richmond facility, she said, couldn’t operate on him and spent about 30 minutes determining which hospital to send him to. They finally came to the decision to send him to John Muir Medical Center, over 20 miles away in Walnut Creek.\u003c/p>\n\u003cp>By that time, it was 5 p.m. It was bumper-to-bumper traffic, all the way there.\u003c/p>\n\u003cp>But Sullivan’s husband was lucky. If the bullet had pierced just a quarter of an inch in either direction, it would have hit a major artery, and he would have died long before they left town. Sullivan calls it a death sentence to be shot or hurt in Richmond. She said residents often don’t even bother to call the ambulance. “What’s the point?”\u003c/p>\n\u003cp>“Look at other cities that have a hospital that’s sitting in their town. They’ve found the resources to go in and renovate the hospital and keep it there,” said Sullivan. “Hospitals lose the incentive to work through alternatives because it’s not financially lucrative to try to meet halfway for communities who are primarily Medi-Cal.”\u003c/p>\n\u003cp>DMC, whose medical base was about 80 percent Medi-Cal recipients, closed after years of financial crisis brought on, in part, by this reimbursement model.\u003c/p>\n\u003cfigure id=\"attachment_11679809\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11679809 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-520x293.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Desmond Carson is a physician at LifeLong Medical Care in San Pablo. (Bo Kovitz) \u003ccite>(Bo Kovitz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Desmond Carson, who worked at DMC for 15 years, said the hospital closed for a reason.\u003c/p>\n\u003cp>“If there’s a Nordstrom, there’ll be health care. Health care follows the dollar, simple as that,” he said. It’s not profitable, he added, to serve struggling black and brown communities.\u003c/p>\n\u003cp>Mariana Moore, a director at the nonprofit Richmond Community Foundation, agreed.\u003c/p>\n\u003cp>“If you look at the reimbursement model from the federal level down to local hospitals that serve primarily Medi-Cal patients, it’s not a sustainable financial model,” said Moore. “These closures happen in communities that are people of color, that are low income, that have less political power, and it’s just the story of our country, as well as the story [Contra Costa County] in this time.”\u003c/p>\n\u003cp>To LifeLong CEO Lynch and his staff, the memory of the DMC closure lingers every day at the urgent care.\u003c/p>\n\u003cp>“There’s a long history of feeling that the community did not necessarily get served as it needed to be served,” Lynch said. “There’s a long history of feeling like, ‘Well, why was the county medical center built in Martinez (in 1998), far away from West Contra Costa.’ The community felt that was both a mistake and a conscious disregard for the needs of poor communities.’”\u003c/p>\n\u003cp>Lynch remembers what DMC meant to this high-need community. Every day, he sees reminders of what the community lost: not just in the number of people crowded into his waiting room, but in the feeling that the community is not being heard.\u003c/p>\n\u003cp>\u003cem>Additional reporting by Nuria Marquez Martinez.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was updated to include the distance between the Alta Bates Berkeley facility and the Oakland facility. \u003c/em>\u003c/p>\n\n",
"blocks": [],
"excerpt": "Doctors Medical Center closed in 2015 and Alta Bates is closing its Berkeley ER. For East Bay residents, access to emergency care might soon be getting even harder to come by.",
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"title": "Video: Emergency Care Options Dwindle in the East Bay | KQED",
"description": "Doctors Medical Center closed in 2015 and Alta Bates is closing its Berkeley ER. For East Bay residents, access to emergency care might soon be getting even harder to come by.",
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"nprByline": "\u003ca href=\"https://www.bokovitz.com/\" rel=\"noopener\" target=\"_blank\">Bo Kovitz\u003c/a> and \u003ca href=\"https://journalism.berkeley.edu/person/hao_guo/\" rel=\"noopener\" target=\"_blank\">Hao Guo\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a cramped office in San Pablo, a group of health care providers work as fast as they can to treat a growing line of people seeking treatment. Already, at the break of dawn on this April morning, the line is spilling down the hall and out the front door.\u003c/p>\n\u003cp>Since LifeLong Medical Care opened in April 2015, the staff has grown used to long lines. The facility opened the same week that neighboring Doctors Medical Center (DMC), one of West Contra Costa County’s most relied-upon hospitals, closed its doors after years of financial strife.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If there’s a Nordstrom, there’ll be health care. Health care follows the dollar, simple as that.’\u003cbr>\n\u003ccite>Dr. Desmond Carson, LifeLong Medical Care\u003c/cite>\u003c/aside>\n\u003cp>Located directly across the street from the now-shuttered DMC, LifeLong is one of the few urgent care facilities left to serve more than 400,000 residents in Richmond and surrounding cities.\u003c/p>\n\u003cp>Unlike DMC, LifeLong provides only urgent care, is not a full-service hospital and does not have an emergency department. When patients come in with life-threatening emergencies, LifeLong’s staff does their best to connect them to services elsewhere. But there aren’t many options nearby.\u003c/p>\n\u003cp>Alta Bates in Berkeley is 11 miles south and the Contra Costa Regional Medical Center in Martinez is 16 miles to the east. The only other high-volume emergency option is John Muir Medical Center in Walnut Creek, more than 20 miles away. Add in rush-hour traffic, and travel times from West Contra Costa County increase dramatically.\u003c/p>\n\u003cfigure id=\"attachment_11679813\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11679813 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/2_map-of-ERs-520x293.jpg 520w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">(Graphic by Hao Guo)\u003c/figcaption>\u003c/figure>\n\u003cp>Now that DMC is closed, the only emergency room left in the Richmond/San Pablo area is Kaiser’s Richmond Medical Center, a 50-bed hospital. In a statement, Kaiser reported a 50 percent increase in ER visits since DMC closed in 2015.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Time is muscle,” said Dr. Desmond Carson, an urgent care physician at LifeLong. The farther that residents have to travel, Carson said, the worse their chances are of surviving.\u003c/p>\n\u003cp>For East Bay residents, access to emergency care might soon be getting even harder to come by. In 2016, Sutter Health, which owns Alta Bates Medical Center in Berkeley, announced it will close the emergency room and consolidate those services into its Oakland location at an unspecified time in the future. The Oakland facility is located 2.6 miles south of the Berkeley facility.\u003c/p>\n\u003cp>In a statement, Sutter Health explained that California’s seismic regulations require the Alta Bates campus to cease operating as a hospital by 2030. Aware of the community’s concerns, Sutter also assured that this transition won’t be abrupt either.\u003c/p>\n\u003cfigure id=\"attachment_11679810\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11679810\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/3_DMC-closed2-520x293.jpg 520w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Doctors Medical Center in San Pablo closed in 2015. (Bo Kovitz)\u003c/figcaption>\u003c/figure>\n\u003cp>According to Dr. Brian Potts, who runs the emergency department at Alta Bates, a planned transition that could take as long as 10 years will allow enough time to build the infrastructure necessary for what he projects to be the biggest emergency room in the East Bay.\u003c/p>\n\u003cp>And the transition will be worth it, said Potts, explaining that consolidating services under one roof, rather than having two separate emergency rooms miles apart, will improve quality of care.\u003c/p>\n\u003cp>Many in the community fear the closure of Alta Bates’ emergency department is part of a similar story: hospital leaders more concerned with cost efficiency than providing care, no matter the cost. As a result, East Bay residents are facing life in a hospital desert. Gunshot wounds, delivering babies and heart attacks could become even more life-threatening when the move does happen.\u003c/p>\n\u003cp>“The harder you make it to get to that care, the more difficult it’s going to be and the more of a need it’s going to be,” said Marty Lynch, LifeLong’s CEO. “There’s no question that folks in Richmond and folks in San Pablo need a good system of emergency care.”\u003c/p>\n\u003cfigure id=\"attachment_11679816\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11679816 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/5_Lifelong-1020x574.jpg\" alt=\"\" width=\"640\" height=\"360\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/5_Lifelong-520x293.jpg 520w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">LifeLong Medical Care in San Pablo is one of the few urgent care facilities remaining in West Contra Costa County. (Bo Kovitz)\u003c/figcaption>\u003c/figure>\n\u003cp>Kathleen Sullivan, a community leader in Richmond who fought to keep DMC open, found herself rushing her husband to the emergency room when he was shot in the streets last year. Doctors at Kaiser’s Richmond facility, she said, couldn’t operate on him and spent about 30 minutes determining which hospital to send him to. They finally came to the decision to send him to John Muir Medical Center, over 20 miles away in Walnut Creek.\u003c/p>\n\u003cp>By that time, it was 5 p.m. It was bumper-to-bumper traffic, all the way there.\u003c/p>\n\u003cp>But Sullivan’s husband was lucky. If the bullet had pierced just a quarter of an inch in either direction, it would have hit a major artery, and he would have died long before they left town. Sullivan calls it a death sentence to be shot or hurt in Richmond. She said residents often don’t even bother to call the ambulance. “What’s the point?”\u003c/p>\n\u003cp>“Look at other cities that have a hospital that’s sitting in their town. They’ve found the resources to go in and renovate the hospital and keep it there,” said Sullivan. “Hospitals lose the incentive to work through alternatives because it’s not financially lucrative to try to meet halfway for communities who are primarily Medi-Cal.”\u003c/p>\n\u003cp>DMC, whose medical base was about 80 percent Medi-Cal recipients, closed after years of financial crisis brought on, in part, by this reimbursement model.\u003c/p>\n\u003cfigure id=\"attachment_11679809\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11679809 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-1200x675.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-1180x664.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-960x540.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-240x135.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-375x211.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/1_Dr.-Carson4-520x293.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Desmond Carson is a physician at LifeLong Medical Care in San Pablo. (Bo Kovitz) \u003ccite>(Bo Kovitz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Desmond Carson, who worked at DMC for 15 years, said the hospital closed for a reason.\u003c/p>\n\u003cp>“If there’s a Nordstrom, there’ll be health care. Health care follows the dollar, simple as that,” he said. It’s not profitable, he added, to serve struggling black and brown communities.\u003c/p>\n\u003cp>Mariana Moore, a director at the nonprofit Richmond Community Foundation, agreed.\u003c/p>\n\u003cp>“If you look at the reimbursement model from the federal level down to local hospitals that serve primarily Medi-Cal patients, it’s not a sustainable financial model,” said Moore. “These closures happen in communities that are people of color, that are low income, that have less political power, and it’s just the story of our country, as well as the story [Contra Costa County] in this time.”\u003c/p>\n\u003cp>To LifeLong CEO Lynch and his staff, the memory of the DMC closure lingers every day at the urgent care.\u003c/p>\n\u003cp>“There’s a long history of feeling that the community did not necessarily get served as it needed to be served,” Lynch said. “There’s a long history of feeling like, ‘Well, why was the county medical center built in Martinez (in 1998), far away from West Contra Costa.’ The community felt that was both a mistake and a conscious disregard for the needs of poor communities.’”\u003c/p>\n\u003cp>Lynch remembers what DMC meant to this high-need community. Every day, he sees reminders of what the community lost: not just in the number of people crowded into his waiting room, but in the feeling that the community is not being heard.\u003c/p>\n\u003cp>\u003cem>Additional reporting by Nuria Marquez Martinez.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was updated to include the distance between the Alta Bates Berkeley facility and the Oakland facility. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "the-female-orgasm-comes-quietly-to-the-streets-of-san-francisco",
"title": "The Female Orgasm Comes (Quietly) to the Streets of San Francisco",
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"content": "\u003cp>[dropcap]Y[/dropcap]ou can see it almost a block away: the word “orgasm” in gigantic letters on a San Francisco bus shelter. Although a seeming milestone in the world of outdoor advertising, it’s not at all clear what’s being sold.\u003c/p>\n\u003cp>The product in question is a “smart” vibrator called the Lioness — a cross between a sex toy and a fitness tracker that produces data synced to a smartphone app.\u003c/p>\n\u003cp>“People can use this to figure out what works for them and what doesn’t,” said Liz Klinger, CEO and co-founder of \u003ca href=\"https://lioness.io/\">Lioness,\u003c/a> a women’s sexual health company. “You can tweak it to your heart’s content.”\u003c/p>\n\u003cp>My first encounter with Klinger and Lioness co-founder James Wang was in the basement of Sutardja Dai Hall on the UC Berkeley campus in February 2015. An editor at California Magazine had asked me to do \u003ca href=\"https://alumni.berkeley.edu/california-magazine/just-in/2015-03-18/orgasm-app-uc-berkeley-nurtured-tech-team-launches-its-smart\">a story about the venture,\u003c/a> then known as SmartBod, which was developing the vibrator with the help of a Cal technology incubator.\u003c/p>\n\u003cp>More than three years later, the startup is located in an airy office near Jack London Square in Oakland, occupied by seven full-time employees and three interns. The firm started shipping the vibrator in August 2017. Klinger said that they’ve sold more than 1,000 of the $229 devices and Lioness is on target to be profitable this year or next.\u003c/p>\n\u003cfigure id=\"attachment_11680239\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680239 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1020x765.jpg\" alt=\"\" width=\"640\" height=\"480\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-520x390.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">An ad for a Lioness “smart” vibrator was installed on June 18 on Pacific Avenue at Hyde Street in San Francisco. \u003ccite>(Patricia Yollin/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Lioness, which belongs to the “rabbit” genre of vibrator made famous in \u003ca href=\"https://www.youtube.com/watch?time_continue=12&v=o-RozcHd08k&has_verified=1\">a 1998 “Sex and the City” episode,\u003c/a> provides biofeedback on one’s sessions and measures many aspects of sexual pleasure, including how long it takes to have an orgasm, its duration and its intensity. Much like with a Fitbit, Klinger said, users can track their experiences and experiment in a structured way — and there are lots of software updates.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Users have ranged from women in their mid-20s to an 86-year-old. Some are Silicon Valley types — the “quantified selfers,” Klinger said — but many Lioness buyers are from Texas, Utah, the Midwest and the Deep South.\u003c/p>\n\u003cp>“There are a lot of people who have questions about sex,” she said. “This is a way to observe things about yourself.”\u003c/p>\n\u003cp>Klinger has noticed how, in her case, the data change based on such variables as alcohol, porn, stress, menstrual cycle, using the vibrator with a partner and, on 4/20, edible cannabis, which produced more forceful vibrations than she’d ever experienced.\u003c/p>\n\u003cp>“There were these peaks that would not stop,” Klinger said, as she held up her smartphone to illustrate the point.\u003c/p>\n\u003cfigure id=\"attachment_11680243\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680243 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-800x1067.jpg\" alt=\"\" width=\"800\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-900x1200.jpg 900w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-1920x2560.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-1180x1573.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-960x1280.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-240x320.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-375x500.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-520x693.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Liz Klinger, co-founder and CEO of Lioness, shows the app that is used with the company’s “smart” vibrator, lying on the table, at the company’s office near Jack London Square in Oakland \u003ccite>(Patricia Yollin/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The company has won numerous awards, including second place at the South by Southwest 2014 Business Idea Challenge, and appeared at a pop-up at this year’s Consumer Electronics Show in Las Vegas. Still, there are easier things in life than marketing an object like the Lioness.\u003c/p>\n\u003cp>\u003cstrong>‘So Many Restrictions’ on Getting Word Out\u003c/strong>\u003c/p>\n\u003cp>“We were thinking of ways to get the word out,” Klinger said. “There are so many restrictions on this. So we started thinking of outdoor ads. A billboard on (U.S.) 101 would be great, but bus shelter ads are good for our budget.”\u003c/p>\n\u003cp>After prolonged negotiations between Lioness and Clear Channel Outdoor advertising company, the ads went up June 18 at 10 San Francisco bus shelters, mostly on or near Nob Hill, where they’ll be on display for about a month.\u003c/p>\n\u003cp>There were many hurdles: Ad copy was scrupulously edited, the words “vibrator” and “vagina” were forbidden — although “orgasm” somehow made the cut — and a full picture of the device was not allowed. All three versions of the ad have the same background: a chart of pelvic-floor vibrations during an orgasm, captured with the Lioness app.\u003c/p>\n\u003cp>“You’ll only recognize it if you’re in the know,” said Klinger.\u003c/p>\n\u003cp>But isn’t that a problem? When is an advertisement so subtle that the message becomes impenetrable?\u003c/p>\n\u003cp>Since the ads went up, Klinger said, San Francisco traffic on the Lioness website has quadrupled. But on a Friday morning visit to five of the ads, I didn’t find a single person who could figure out what was being sold.\u003c/p>\n\u003cfigure id=\"attachment_11680246\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680246 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut.jpg\" alt=\"\" width=\"1920\" height=\"1836\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-160x153.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-800x765.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-1020x975.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-1200x1148.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-1180x1128.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-960x918.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-240x230.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-375x359.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-520x497.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-32x32.jpg 32w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">This ad for a Lioness “smart” vibrator occupies a bus shelter on Pacific Avenue at Polk Street in San Francisco. \u003ccite>(Patricia Yollin/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On Jackson at Van Ness, professional driver Dawayne Baker contemplated an ad that said “Come For Fun, Stay For Data” and showed part of the gray silicone vibrator.\u003c/p>\n\u003cp>“Probably it’s a bunch of females running a startup,” he speculated. When he found out that the product was a smart vibrator, he laughed. “I would never have known that. This is way in left field.”\u003c/p>\n\u003cp>On Pacific at Polk, Katarina Kauftheil was equally mystified by the same Lioness ad.\u003c/p>\n\u003cp>“I’m not really sure. Maybe it’s an awareness ad. Or something for a feminist website. But it’s too discreet,” said Kauftheil, a student at the Academy of Art who sits next to the ad most days while she’s waiting for the inbound 12-Folsom. She admitted she’d been “intrigued” by the words at the bottom: “Revolutionizing the way we approach female sexuality.”\u003c/p>\n\u003cp>So, had she checked out the Lioness website, since its address was right under that slogan?\u003c/p>\n\u003cp>“No. I guess I wasn’t intrigued enough,” said Kauftheil. After learning what the ad was about, she added, “I don’t think you equate vibrators with data.”\u003c/p>\n\u003cp>Two blocks east, “Good Vibes, Better Data” didn’t get a glance. Even the most blatant of the ads, “Redefining Orgasm,” failed to attract much attention — not unlike bus shelter ads for 24 Hour Fitness, the SPCA, Super Lotto and Alaska Airlines, featuring Kevin Durant. Instead, passers-by were fixated on \u003cem>other\u003c/em> devices and oblivious to their surroundings.\u003c/p>\n\u003cp>At the southeast corner of Clay and Leavenworth, a restaurant worker who gave his name only as Tran couldn’t make sense of the orgasm ad. “I think it’s how to get high with sex,” he finally decided. “But people don’t have time to think about this.”\u003c/p>\n\u003cp>Ads for vibrators are nothing new. The object debuted as a home medical appliance in 1899 and showed up in magazine advertisements by 1904. Fourteen years later, an ad in a Sears Roebuck catalog — for “aids that every woman appreciates” — described a $5.95 device as “very useful and satisfactory for home service.”\u003c/p>\n\u003cp>\u003cstrong>‘Part of the Neighborhood’ \u003c/strong>\u003c/p>\n\u003cp>Still, Klinger believes the presence of Lioness ads on the streets of San Francisco has broken new ground. A few days after the ads were installed, she went into the city to check them out.\u003c/p>\n\u003cp>“One was right by CVS and Trader Joe’s and in a normal-looking area,” she recalled. “I went, ‘Oh my God, I never thought this would happen.’ It’s a great feeling. You’re part of the neighborhood, where people are getting prescriptions or groceries. Even if it’s subtle, you’re being treated in the same way as everyone else.”\u003c/p>\n\u003cp>Ads for formerly taboo subjects like marijuana have popped up on buses and billboards. Commercials for erectile dysfunction remedies are all over TV. But even though women’s bodies have been used to advertise all kinds of things for decades, Klinger said, it’s still challenging to find ways to publicize products designed for female pleasure. Unbound, a company that sells sex toys for women, discovered that earlier this year when the MTA in New York City initially \u003ca href=\"https://www.nytimes.com/2018/05/17/nyregion/subway-sex-toy-ads-mta.html\">rejected its subway ad campaign,\u003c/a> claiming it violated rules against obscenity.\u003c/p>\n\u003cp>Clear Channel makes the final decisions on bus shelter advertisements, based on the approved ad policy of the San Francisco Municipal Transportation Agency, said SFMTA spokesman Paul Rose.\u003c/p>\n\u003cp>“We have not received complaints or feedback” about the Lioness ads, he said.\u003c/p>\n\u003cp>In an email, Lioness marketing manager Corinne Santoro wrote, “Clear Channel was very willing to work with us to find a way to make this successful, which was very refreshing. It did seem clear, however, that they didn’t have a lot of experience working with subject matter like ours.”\u003c/p>\n\u003cp>There didn’t appear to be any actual guidelines, Santoro said, and Clear Channel had to approve everything internally to make sure the ads complied with “community standards.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Interestingly, they had absolutely no problem with including the orgasm data,” said Santoro. “They figured, correctly, that very few would actually be able to identify it for what it is.”\u003c/p>\n\u003cfigure id=\"attachment_11680249\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680249 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1020x816.jpg\" alt=\"\" width=\"640\" height=\"512\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1200x960.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1180x944.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-960x768.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-240x192.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-375x300.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-520x416.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park.jpg 1500w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">The team from Lioness, a women’s sexual health company in Oakland, visits Dolores Park in San Francisco on Gay Pride weekend on June 23, 2018. James Wang, far left, and Liz Klinger, far right, are the firm’s co-founders, with a human version of the Lioness vibrator in the middle. It was 88 degrees. \u003ccite>(Courtesy of Lioness)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">Y\u003c/span>\u003c/p>\u003cp>ou can see it almost a block away: the word “orgasm” in gigantic letters on a San Francisco bus shelter. Although a seeming milestone in the world of outdoor advertising, it’s not at all clear what’s being sold.\u003c/p>\n\u003cp>The product in question is a “smart” vibrator called the Lioness — a cross between a sex toy and a fitness tracker that produces data synced to a smartphone app.\u003c/p>\n\u003cp>“People can use this to figure out what works for them and what doesn’t,” said Liz Klinger, CEO and co-founder of \u003ca href=\"https://lioness.io/\">Lioness,\u003c/a> a women’s sexual health company. “You can tweak it to your heart’s content.”\u003c/p>\n\u003cp>My first encounter with Klinger and Lioness co-founder James Wang was in the basement of Sutardja Dai Hall on the UC Berkeley campus in February 2015. An editor at California Magazine had asked me to do \u003ca href=\"https://alumni.berkeley.edu/california-magazine/just-in/2015-03-18/orgasm-app-uc-berkeley-nurtured-tech-team-launches-its-smart\">a story about the venture,\u003c/a> then known as SmartBod, which was developing the vibrator with the help of a Cal technology incubator.\u003c/p>\n\u003cp>More than three years later, the startup is located in an airy office near Jack London Square in Oakland, occupied by seven full-time employees and three interns. The firm started shipping the vibrator in August 2017. Klinger said that they’ve sold more than 1,000 of the $229 devices and Lioness is on target to be profitable this year or next.\u003c/p>\n\u003cfigure id=\"attachment_11680239\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680239 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1020x765.jpg\" alt=\"\" width=\"640\" height=\"480\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31784_vibrator-vibes-qut-1-520x390.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">An ad for a Lioness “smart” vibrator was installed on June 18 on Pacific Avenue at Hyde Street in San Francisco. \u003ccite>(Patricia Yollin/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Lioness, which belongs to the “rabbit” genre of vibrator made famous in \u003ca href=\"https://www.youtube.com/watch?time_continue=12&v=o-RozcHd08k&has_verified=1\">a 1998 “Sex and the City” episode,\u003c/a> provides biofeedback on one’s sessions and measures many aspects of sexual pleasure, including how long it takes to have an orgasm, its duration and its intensity. Much like with a Fitbit, Klinger said, users can track their experiences and experiment in a structured way — and there are lots of software updates.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Users have ranged from women in their mid-20s to an 86-year-old. Some are Silicon Valley types — the “quantified selfers,” Klinger said — but many Lioness buyers are from Texas, Utah, the Midwest and the Deep South.\u003c/p>\n\u003cp>“There are a lot of people who have questions about sex,” she said. “This is a way to observe things about yourself.”\u003c/p>\n\u003cp>Klinger has noticed how, in her case, the data change based on such variables as alcohol, porn, stress, menstrual cycle, using the vibrator with a partner and, on 4/20, edible cannabis, which produced more forceful vibrations than she’d ever experienced.\u003c/p>\n\u003cp>“There were these peaks that would not stop,” Klinger said, as she held up her smartphone to illustrate the point.\u003c/p>\n\u003cfigure id=\"attachment_11680243\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680243 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-800x1067.jpg\" alt=\"\" width=\"800\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-900x1200.jpg 900w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-1920x2560.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-1180x1573.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-960x1280.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-240x320.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-375x500.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31787_alt_766-520x693.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Liz Klinger, co-founder and CEO of Lioness, shows the app that is used with the company’s “smart” vibrator, lying on the table, at the company’s office near Jack London Square in Oakland \u003ccite>(Patricia Yollin/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The company has won numerous awards, including second place at the South by Southwest 2014 Business Idea Challenge, and appeared at a pop-up at this year’s Consumer Electronics Show in Las Vegas. Still, there are easier things in life than marketing an object like the Lioness.\u003c/p>\n\u003cp>\u003cstrong>‘So Many Restrictions’ on Getting Word Out\u003c/strong>\u003c/p>\n\u003cp>“We were thinking of ways to get the word out,” Klinger said. “There are so many restrictions on this. So we started thinking of outdoor ads. A billboard on (U.S.) 101 would be great, but bus shelter ads are good for our budget.”\u003c/p>\n\u003cp>After prolonged negotiations between Lioness and Clear Channel Outdoor advertising company, the ads went up June 18 at 10 San Francisco bus shelters, mostly on or near Nob Hill, where they’ll be on display for about a month.\u003c/p>\n\u003cp>There were many hurdles: Ad copy was scrupulously edited, the words “vibrator” and “vagina” were forbidden — although “orgasm” somehow made the cut — and a full picture of the device was not allowed. All three versions of the ad have the same background: a chart of pelvic-floor vibrations during an orgasm, captured with the Lioness app.\u003c/p>\n\u003cp>“You’ll only recognize it if you’re in the know,” said Klinger.\u003c/p>\n\u003cp>But isn’t that a problem? When is an advertisement so subtle that the message becomes impenetrable?\u003c/p>\n\u003cp>Since the ads went up, Klinger said, San Francisco traffic on the Lioness website has quadrupled. But on a Friday morning visit to five of the ads, I didn’t find a single person who could figure out what was being sold.\u003c/p>\n\u003cfigure id=\"attachment_11680246\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680246 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut.jpg\" alt=\"\" width=\"1920\" height=\"1836\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-160x153.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-800x765.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-1020x975.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-1200x1148.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-1180x1128.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-960x918.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-240x230.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-375x359.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-520x497.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31785_vibrator-data-qut-32x32.jpg 32w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">This ad for a Lioness “smart” vibrator occupies a bus shelter on Pacific Avenue at Polk Street in San Francisco. \u003ccite>(Patricia Yollin/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On Jackson at Van Ness, professional driver Dawayne Baker contemplated an ad that said “Come For Fun, Stay For Data” and showed part of the gray silicone vibrator.\u003c/p>\n\u003cp>“Probably it’s a bunch of females running a startup,” he speculated. When he found out that the product was a smart vibrator, he laughed. “I would never have known that. This is way in left field.”\u003c/p>\n\u003cp>On Pacific at Polk, Katarina Kauftheil was equally mystified by the same Lioness ad.\u003c/p>\n\u003cp>“I’m not really sure. Maybe it’s an awareness ad. Or something for a feminist website. But it’s too discreet,” said Kauftheil, a student at the Academy of Art who sits next to the ad most days while she’s waiting for the inbound 12-Folsom. She admitted she’d been “intrigued” by the words at the bottom: “Revolutionizing the way we approach female sexuality.”\u003c/p>\n\u003cp>So, had she checked out the Lioness website, since its address was right under that slogan?\u003c/p>\n\u003cp>“No. I guess I wasn’t intrigued enough,” said Kauftheil. After learning what the ad was about, she added, “I don’t think you equate vibrators with data.”\u003c/p>\n\u003cp>Two blocks east, “Good Vibes, Better Data” didn’t get a glance. Even the most blatant of the ads, “Redefining Orgasm,” failed to attract much attention — not unlike bus shelter ads for 24 Hour Fitness, the SPCA, Super Lotto and Alaska Airlines, featuring Kevin Durant. Instead, passers-by were fixated on \u003cem>other\u003c/em> devices and oblivious to their surroundings.\u003c/p>\n\u003cp>At the southeast corner of Clay and Leavenworth, a restaurant worker who gave his name only as Tran couldn’t make sense of the orgasm ad. “I think it’s how to get high with sex,” he finally decided. “But people don’t have time to think about this.”\u003c/p>\n\u003cp>Ads for vibrators are nothing new. The object debuted as a home medical appliance in 1899 and showed up in magazine advertisements by 1904. Fourteen years later, an ad in a Sears Roebuck catalog — for “aids that every woman appreciates” — described a $5.95 device as “very useful and satisfactory for home service.”\u003c/p>\n\u003cp>\u003cstrong>‘Part of the Neighborhood’ \u003c/strong>\u003c/p>\n\u003cp>Still, Klinger believes the presence of Lioness ads on the streets of San Francisco has broken new ground. A few days after the ads were installed, she went into the city to check them out.\u003c/p>\n\u003cp>“One was right by CVS and Trader Joe’s and in a normal-looking area,” she recalled. “I went, ‘Oh my God, I never thought this would happen.’ It’s a great feeling. You’re part of the neighborhood, where people are getting prescriptions or groceries. Even if it’s subtle, you’re being treated in the same way as everyone else.”\u003c/p>\n\u003cp>Ads for formerly taboo subjects like marijuana have popped up on buses and billboards. Commercials for erectile dysfunction remedies are all over TV. But even though women’s bodies have been used to advertise all kinds of things for decades, Klinger said, it’s still challenging to find ways to publicize products designed for female pleasure. Unbound, a company that sells sex toys for women, discovered that earlier this year when the MTA in New York City initially \u003ca href=\"https://www.nytimes.com/2018/05/17/nyregion/subway-sex-toy-ads-mta.html\">rejected its subway ad campaign,\u003c/a> claiming it violated rules against obscenity.\u003c/p>\n\u003cp>Clear Channel makes the final decisions on bus shelter advertisements, based on the approved ad policy of the San Francisco Municipal Transportation Agency, said SFMTA spokesman Paul Rose.\u003c/p>\n\u003cp>“We have not received complaints or feedback” about the Lioness ads, he said.\u003c/p>\n\u003cp>In an email, Lioness marketing manager Corinne Santoro wrote, “Clear Channel was very willing to work with us to find a way to make this successful, which was very refreshing. It did seem clear, however, that they didn’t have a lot of experience working with subject matter like ours.”\u003c/p>\n\u003cp>There didn’t appear to be any actual guidelines, Santoro said, and Clear Channel had to approve everything internally to make sure the ads complied with “community standards.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Interestingly, they had absolutely no problem with including the orgasm data,” said Santoro. “They figured, correctly, that very few would actually be able to identify it for what it is.”\u003c/p>\n\u003cfigure id=\"attachment_11680249\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11680249 size-large\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1020x816.jpg\" alt=\"\" width=\"640\" height=\"512\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1200x960.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-1180x944.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-960x768.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-240x192.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-375x300.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park-520x416.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/vibrator-dolores-park.jpg 1500w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">The team from Lioness, a women’s sexual health company in Oakland, visits Dolores Park in San Francisco on Gay Pride weekend on June 23, 2018. James Wang, far left, and Liz Klinger, far right, are the firm’s co-founders, with a human version of the Lioness vibrator in the middle. It was 88 degrees. \u003ccite>(Courtesy of Lioness)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\n\u003c/div>\u003c/p>",
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"title": "Tiny Alameda Beach to Get Funds to Restore Rare Bay Area Sand Dunes",
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"headTitle": "Tiny Alameda Beach to Get Funds to Restore Rare Bay Area Sand Dunes | KQED",
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"content": "\u003cp>\u003cem>This is part of our ongoing series about where taxpayer funds from 2016’s Measure AA to restore the San Francisco Bay are going. Find all the stories \u003ca href=\"https://www.kqed.org/news/tag/measure-aa\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>In the city of Alameda, there’s a beach so small you might miss it. In fact, I did when I first tried to find it. All 2 acres of it.\u003c/p>\n\u003cp>“It’s a hidden gem but the locals know it very well,” says Joe Sullivan, program manager for the \u003ca href=\"http://www.ebparks.org/about/planning/#encinal\" target=\"_blank\" rel=\"noopener\">Encinal Dune Restoration and Shoreline Stabilization Project\u003c/a>. “It’s a popular fishing spot. And it’s also a really popular beach for non-motorized boats.”\u003c/p>\n\u003cp>\u003ca href=\"http://sfbaywatertrail.org/trailhead/encinal-beach/\" target=\"_blank\" rel=\"noopener\">Encinal Beach\u003c/a> is on the former naval weapons station at Alameda Point. Sullivan says that, back in the day, the Navy built a structure called a breakwater to protect its base from the bay, and in a happy accident, the breakwater created a small beach.\u003c/p>\n\u003cp>Over the years, this beach formed sand dunes. Sullivan says dunes like these have largely disappeared from the Bay Area because of urbanization.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There aren’t many little dune areas in the Bay and this is one that happened to be created here,” Sullivan says. “It is obviously a result of human activity, but it’s unique.”\u003c/p>\n\u003cfigure id=\"attachment_11678545\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11678545\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">This beach is popular with fishermen and kayakers, despite the bay debris that litters the shore. \u003ccite>(Joe Sullivan/East Bay Regional Park District)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Thanks to Measure AA, $450,000 will go toward restoring these rare dunes, which are now overrun with invasive ice plants. Sullivan says these plants may look nice, but it doesn’t allow any other vegetation to grow in the area.\u003c/p>\n\u003cp>“It’s good at what it does, which means you get this monoculture of one invasive species,” Sullivan says. “It doesn’t provide any beneficial habitat to any wildlife at all.”\u003c/p>\n\u003cp>Once the dunes are re-established with native plants, the area will be prime habitat for several threatened bird species like the snowy plover, the California least tern and the red knot.\u003c/p>\n\u003cp>This “diamond in the rough,” as Sullivan calls it, will also get a much needed face-lift. Some aged chain-link fencing, an old rusty barge and general debris — like washed-up creosote logs — will be removed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And overall access to the beach park will be improved, too, with a new parking lot, an upgraded boat launch platform, signage (no more getting lost trying to find it!) and restrooms.\u003c/p>\n\n",
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"excerpt": "In one of the smaller projects funded by Measure AA tax money, Alameda’s tiny Encinal Beach will get a sand dune restoration and a face-lift.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This is part of our ongoing series about where taxpayer funds from 2016’s Measure AA to restore the San Francisco Bay are going. Find all the stories \u003ca href=\"https://www.kqed.org/news/tag/measure-aa\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>In the city of Alameda, there’s a beach so small you might miss it. In fact, I did when I first tried to find it. All 2 acres of it.\u003c/p>\n\u003cp>“It’s a hidden gem but the locals know it very well,” says Joe Sullivan, program manager for the \u003ca href=\"http://www.ebparks.org/about/planning/#encinal\" target=\"_blank\" rel=\"noopener\">Encinal Dune Restoration and Shoreline Stabilization Project\u003c/a>. “It’s a popular fishing spot. And it’s also a really popular beach for non-motorized boats.”\u003c/p>\n\u003cp>\u003ca href=\"http://sfbaywatertrail.org/trailhead/encinal-beach/\" target=\"_blank\" rel=\"noopener\">Encinal Beach\u003c/a> is on the former naval weapons station at Alameda Point. Sullivan says that, back in the day, the Navy built a structure called a breakwater to protect its base from the bay, and in a happy accident, the breakwater created a small beach.\u003c/p>\n\u003cp>Over the years, this beach formed sand dunes. Sullivan says dunes like these have largely disappeared from the Bay Area because of urbanization.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There aren’t many little dune areas in the Bay and this is one that happened to be created here,” Sullivan says. “It is obviously a result of human activity, but it’s unique.”\u003c/p>\n\u003cfigure id=\"attachment_11678545\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11678545\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/07/RS31670_Encinal-Debris-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">This beach is popular with fishermen and kayakers, despite the bay debris that litters the shore. \u003ccite>(Joe Sullivan/East Bay Regional Park District)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Thanks to Measure AA, $450,000 will go toward restoring these rare dunes, which are now overrun with invasive ice plants. Sullivan says these plants may look nice, but it doesn’t allow any other vegetation to grow in the area.\u003c/p>\n\u003cp>“It’s good at what it does, which means you get this monoculture of one invasive species,” Sullivan says. “It doesn’t provide any beneficial habitat to any wildlife at all.”\u003c/p>\n\u003cp>Once the dunes are re-established with native plants, the area will be prime habitat for several threatened bird species like the snowy plover, the California least tern and the red knot.\u003c/p>\n\u003cp>This “diamond in the rough,” as Sullivan calls it, will also get a much needed face-lift. Some aged chain-link fencing, an old rusty barge and general debris — like washed-up creosote logs — will be removed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And overall access to the beach park will be improved, too, with a new parking lot, an upgraded boat launch platform, signage (no more getting lost trying to find it!) and restrooms.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Welcome to Alviso, where at any given time it can be 10 to 15 feet below sea level. \u003c/p>\n\u003cp>This neighborhood, which used to be its own bona fide town, sits on the southernmost tip of the bay in San Jose, and it’s the next stop in our series about \u003ca href=\"https://www.kqed.org/news/tag/measure-aa\" rel=\"noopener\" target=\"_blank\">where our money from Measure AA is going\u003c/a>. That’s the “Clean and Healthy Bay” tax measure that passed two years ago.\u003c/p>\n\u003cp>Alviso has a population of about 5,000. It is surrounded by three bodies of water: the San Francisco Bay, Guadalupe River and Coyote Creek. So as you can probably imagine, flooding has always been an issue here. That’s what the \u003ca href=\"http://www.southbayshoreline.org/index.html\">South Bay Shoreline Project\u003c/a> is trying to change.\u003c/p>\n\u003cp>“There are people that show up to our public meetings whose homes have flooded three times in their lifetime,” says project manager John Bourgeois.\u003c/p>\n\u003cfigure id=\"attachment_11678421\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11678421\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-800x525.jpg\" alt=\"\" width=\"800\" height=\"525\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-800x525.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-160x105.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-240x157.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-375x246.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-520x341.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut.jpg 826w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">In 1983, heavy storms caused the Guadalupe River and Coyote Creek to overflow its banks and flood Alviso’s streets. The town now has flood protections from these bodies of water but is still unprotected from the San Francisco Bay. \u003ccite>(U.S. Fish and Wildlife Service)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Alviso currently has flood control measures for its surrounding creeks and streams, but there’s nothing to protect it from the bay.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That’s why part of the $4.4 million allocated to the shoreline project from Measure AA will go toward the construction of a new levee and flood gates. When finished it’ll protect the area from a one percent flood, also known as a 100 year flood. This project will also restore close to 3,000 acres of former salt ponds to tidal wetlands which will add even more flood protection to Alviso.\u003c/p>\n\u003cp>Officials estimate any flood event in the neighborhood would cause more than $100 million in property damages. That estimate doubles in amount, to nearly $200 million in property damages, if a 100 year flood were to occur.\u003c/p>\n\u003cfigure id=\"attachment_11678420\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11678420\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-800x1200.jpg\" alt=\"\" width=\"800\" height=\"1200\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-240x360.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-375x563.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-520x780.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A view of some of Alviso’s surrounding salt ponds slated to be restored by the restoration project. \u003ccite>(Cris Benton)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So you may be wondering, why all this money to protect this one neighborhood?\u003c/p>\n\u003cp>Well, Brenda Buxton with the California Coastal Conservancy says the restoration here affects the entire Bay Area.\u003c/p>\n\u003cp>“Without the flood protection measures, you don’t get the tidal restoration and without the tidal restoration you don’t get a clean, healthy bay full of wildlife,” said Buxton. “Wildlife moves all over. It’s all interconnected.”\u003c/p>\n\u003cp>And there is one more bonus for the community of Alviso that hits them right in their pocketbooks. After the new levee structures are built and tidal restoration is restored, FEMA will remove the neighborhood from its flood zone list making Alviso property owner’s flood insurance premiums go down.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Levee construction is set to begin later this year.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Welcome to Alviso, where at any given time it can be 10 to 15 feet below sea level. \u003c/p>\n\u003cp>This neighborhood, which used to be its own bona fide town, sits on the southernmost tip of the bay in San Jose, and it’s the next stop in our series about \u003ca href=\"https://www.kqed.org/news/tag/measure-aa\" rel=\"noopener\" target=\"_blank\">where our money from Measure AA is going\u003c/a>. That’s the “Clean and Healthy Bay” tax measure that passed two years ago.\u003c/p>\n\u003cp>Alviso has a population of about 5,000. It is surrounded by three bodies of water: the San Francisco Bay, Guadalupe River and Coyote Creek. So as you can probably imagine, flooding has always been an issue here. That’s what the \u003ca href=\"http://www.southbayshoreline.org/index.html\">South Bay Shoreline Project\u003c/a> is trying to change.\u003c/p>\n\u003cp>“There are people that show up to our public meetings whose homes have flooded three times in their lifetime,” says project manager John Bourgeois.\u003c/p>\n\u003cfigure id=\"attachment_11678421\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11678421\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-800x525.jpg\" alt=\"\" width=\"800\" height=\"525\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-800x525.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-160x105.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-240x157.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-375x246.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut-520x341.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31667_Alviso1983floodfromssppt_-qut.jpg 826w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">In 1983, heavy storms caused the Guadalupe River and Coyote Creek to overflow its banks and flood Alviso’s streets. The town now has flood protections from these bodies of water but is still unprotected from the San Francisco Bay. \u003ccite>(U.S. Fish and Wildlife Service)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Alviso currently has flood control measures for its surrounding creeks and streams, but there’s nothing to protect it from the bay.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That’s why part of the $4.4 million allocated to the shoreline project from Measure AA will go toward the construction of a new levee and flood gates. When finished it’ll protect the area from a one percent flood, also known as a 100 year flood. This project will also restore close to 3,000 acres of former salt ponds to tidal wetlands which will add even more flood protection to Alviso.\u003c/p>\n\u003cp>Officials estimate any flood event in the neighborhood would cause more than $100 million in property damages. That estimate doubles in amount, to nearly $200 million in property damages, if a 100 year flood were to occur.\u003c/p>\n\u003cfigure id=\"attachment_11678420\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11678420\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-800x1200.jpg\" alt=\"\" width=\"800\" height=\"1200\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-240x360.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-375x563.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/06/RS31666_12375643685_f6c92ffd8a_o-qut-520x780.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A view of some of Alviso’s surrounding salt ponds slated to be restored by the restoration project. \u003ccite>(Cris Benton)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So you may be wondering, why all this money to protect this one neighborhood?\u003c/p>\n\u003cp>Well, Brenda Buxton with the California Coastal Conservancy says the restoration here affects the entire Bay Area.\u003c/p>\n\u003cp>“Without the flood protection measures, you don’t get the tidal restoration and without the tidal restoration you don’t get a clean, healthy bay full of wildlife,” said Buxton. “Wildlife moves all over. It’s all interconnected.”\u003c/p>\n\u003cp>And there is one more bonus for the community of Alviso that hits them right in their pocketbooks. After the new levee structures are built and tidal restoration is restored, FEMA will remove the neighborhood from its flood zone list making Alviso property owner’s flood insurance premiums go down.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Levee construction is set to begin later this year.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Jahi McMath, Teen at Center of Medical and Religious Debate on Brain Death, Has Died",
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"content": "\u003cp>Jahi McMath, the teenager who was at the center of a medical and religious debate over brain death, has died, according to her family’s lawyer. She was 17.\u003c/p>\n\u003cp>McMath died June 22 at a hospital in New Jersey, the family’s lawyer, Christopher Dolan, \u003ca href=\"https://dolanlawfirm.com/2018/06/jahi-mcmath-has-died-in-new-jersey/\" rel=\"noopener\" target=\"_blank\">said in a statement\u003c/a>. He said a hospital doctor listed the preliminary cause of death as bleeding due to liver failure.\u003c/p>\n\u003cp>Nailah Winkfield, McMath’s mother, said in the statement that she is “devastated by the loss of her daughter” but that Jahi ultimately “has forced the world to rethink the issue of brain death.”\u003c/p>\n\u003cp>McMath had been on a ventilator since 2013. In December of that year, she had a tonsillectomy at UCSF Benioff Children’s Hospital Oakland in California, which resulted in complications. Doctors there said McMath had irreversible brain damage, and a coroner issued a death certificate.\u003c/p>\n\u003cp>But Winkfield refused to agree with that assessment and \u003ca href=\"https://www.npr.org/sections/thetwo-way/2013/12/30/258447566/judge-orders-brain-dead-girl-can-stay-on-life-support\" rel=\"noopener\" target=\"_blank\">took the battle to court\u003c/a> to keep McMath on life support. She cited her Christian beliefs and that her daughter still sometimes moved her toes and fingers. Winkfield believed that her daughter was not dead.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A judge extended life support for McMath, who was 13 at the time.\u003c/p>\n\u003cp>Eventually, Winkfield transferred her daughter to a hospital in New Jersey. According to \u003ca href=\"http://www.braindeath.org/law/newjersey.htm\" rel=\"noopener\" target=\"_blank\">a New Jersey statute\u003c/a>, death can’t be declared “in violation of individual’s religious beliefs.”\u003c/p>\n\u003cp>This legal battle spurred a nationwide debate over brain death — and what constitutes death.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372912/\" rel=\"noopener\" target=\"_blank\">Uniform Declaration of Death Act\u003c/a>, which has been in place since 1981, defines death as the “irreversible cessation of all functions of the entire brain, including the brain stem.”\u003c/p>\n\u003cp>In the world of medical ethics, as \u003ca href=\"https://www.npr.org/sections/health-shots/2014/01/10/261391130/why-hospitals-and-families-still-struggle-to-define-death\" rel=\"noopener\" target=\"_blank\">NPR’s Maanvi Singh reported in 2014\u003c/a>, there are varying views on death.\u003c/p>\n\u003cp>“There’s the commonly accepted view that a person is dead when all brain functions cease,” Singh wrote. “But there’s also the view that a person is only dead after their heart stops beating.”\u003c/p>\n\u003cp>And another view, according to Singh, holds that “a person can be brain-dead even if certain minor functions of the brain remain. For example, if a patient shows a gag reflex, but no other signs of life, they should be considered brain-dead.”\u003c/p>\n\u003cp>Winkfield continues to assert that her daughter died June 22, 2018 — not in 2013.\u003c/p>\n\u003cp>“Jahi McMath was not brain-dead or any other kind of dead,” Winkfield said in a statement. “She was a little girl who deserved to be cared for and protected not called a dead body. When she finally was treated like a human being, she got better.”\u003c/p>\n\u003cp>Winkfield said the way she communicated with her daughter might not have been like how other parents communicate with their children. But she said that her daughter’s heart rate would increase when Winkfield walked into the room, and that her daughter could respond to Winkfield’s voice with slight body movements.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dolan, the family’s lawyer, said, “The fight to hold the negligent doctors who allowed Jahi to suffer a severe brain injury will continue.” He has filed a wrongful death suit in California Superior Court in Alameda County, as well as a federal lawsuit seeking to have her 2013 death certificate reversed and her date of death marked as June 22, 2018. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Jahi+McMath%2C+Teen+At+Center+Of+Medical+And+Religious+Debate+On+Brain+Death%2C+Has+Died&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"headline": "Jahi McMath, Teen at Center of Medical and Religious Debate on Brain Death, Has Died",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jahi McMath, the teenager who was at the center of a medical and religious debate over brain death, has died, according to her family’s lawyer. She was 17.\u003c/p>\n\u003cp>McMath died June 22 at a hospital in New Jersey, the family’s lawyer, Christopher Dolan, \u003ca href=\"https://dolanlawfirm.com/2018/06/jahi-mcmath-has-died-in-new-jersey/\" rel=\"noopener\" target=\"_blank\">said in a statement\u003c/a>. He said a hospital doctor listed the preliminary cause of death as bleeding due to liver failure.\u003c/p>\n\u003cp>Nailah Winkfield, McMath’s mother, said in the statement that she is “devastated by the loss of her daughter” but that Jahi ultimately “has forced the world to rethink the issue of brain death.”\u003c/p>\n\u003cp>McMath had been on a ventilator since 2013. In December of that year, she had a tonsillectomy at UCSF Benioff Children’s Hospital Oakland in California, which resulted in complications. Doctors there said McMath had irreversible brain damage, and a coroner issued a death certificate.\u003c/p>\n\u003cp>But Winkfield refused to agree with that assessment and \u003ca href=\"https://www.npr.org/sections/thetwo-way/2013/12/30/258447566/judge-orders-brain-dead-girl-can-stay-on-life-support\" rel=\"noopener\" target=\"_blank\">took the battle to court\u003c/a> to keep McMath on life support. She cited her Christian beliefs and that her daughter still sometimes moved her toes and fingers. Winkfield believed that her daughter was not dead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A judge extended life support for McMath, who was 13 at the time.\u003c/p>\n\u003cp>Eventually, Winkfield transferred her daughter to a hospital in New Jersey. According to \u003ca href=\"http://www.braindeath.org/law/newjersey.htm\" rel=\"noopener\" target=\"_blank\">a New Jersey statute\u003c/a>, death can’t be declared “in violation of individual’s religious beliefs.”\u003c/p>\n\u003cp>This legal battle spurred a nationwide debate over brain death — and what constitutes death.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372912/\" rel=\"noopener\" target=\"_blank\">Uniform Declaration of Death Act\u003c/a>, which has been in place since 1981, defines death as the “irreversible cessation of all functions of the entire brain, including the brain stem.”\u003c/p>\n\u003cp>In the world of medical ethics, as \u003ca href=\"https://www.npr.org/sections/health-shots/2014/01/10/261391130/why-hospitals-and-families-still-struggle-to-define-death\" rel=\"noopener\" target=\"_blank\">NPR’s Maanvi Singh reported in 2014\u003c/a>, there are varying views on death.\u003c/p>\n\u003cp>“There’s the commonly accepted view that a person is dead when all brain functions cease,” Singh wrote. “But there’s also the view that a person is only dead after their heart stops beating.”\u003c/p>\n\u003cp>And another view, according to Singh, holds that “a person can be brain-dead even if certain minor functions of the brain remain. For example, if a patient shows a gag reflex, but no other signs of life, they should be considered brain-dead.”\u003c/p>\n\u003cp>Winkfield continues to assert that her daughter died June 22, 2018 — not in 2013.\u003c/p>\n\u003cp>“Jahi McMath was not brain-dead or any other kind of dead,” Winkfield said in a statement. “She was a little girl who deserved to be cared for and protected not called a dead body. When she finally was treated like a human being, she got better.”\u003c/p>\n\u003cp>Winkfield said the way she communicated with her daughter might not have been like how other parents communicate with their children. But she said that her daughter’s heart rate would increase when Winkfield walked into the room, and that her daughter could respond to Winkfield’s voice with slight body movements.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dolan, the family’s lawyer, said, “The fight to hold the negligent doctors who allowed Jahi to suffer a severe brain injury will continue.” He has filed a wrongful death suit in California Superior Court in Alameda County, as well as a federal lawsuit seeking to have her 2013 death certificate reversed and her date of death marked as June 22, 2018. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Jahi+McMath%2C+Teen+At+Center+Of+Medical+And+Religious+Debate+On+Brain+Death%2C+Has+Died&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
"id": "snap-judgment",
"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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