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Objectives: ACL reconstruction is one of the most common knee procedures performed annually in the United States. Athletes participating in cutting and pivoting sports are at high risk for ACL injury. In the general population, most graft choices including allograft, bone-patellar tendon-bone (BTB) autograft, hamstring autograft and quadriceps autograft have all been shown to excellent results following reconstruction. However, in the high-level cutting and pivoting athlete, the optimal graft for reconstruction remains controversial. Most consider BTB autograft to be the gold standard for such athletes. However, BTB autografts have drawbacks including anterior knee pain, difficulty kneeling and possible patellar fracture and patellar tendon rupture. Quadriceps autograft has increased in popularity since it offers a thicker graft with more favorable tensile properties compared to BTB and hamstring autografts. The quadriceps autograft has nearly twice the cross sectional area, higher load to failure and greater stiffness than the BTB autograft. Studies have shown equivalent outcomes when directly comparing BTB autograft vs. soft tissue quadriceps autograft in the general population. No studies have directly compared these two grafts in athletes participating in cutting and pivoting sports. We hypothesized that the quadriceps autograft would lead to similar patient outcomes, re-tear rates, return to sport and complications as BTB autografts in the cutting and pivoting athlete. Methods: A retrospective review of cutting and pivoting athletes with ACL tears treated with BTB autograft or soft tissue quadriceps autograft with at least 2 years of follow up was performed. Only athletes participating in cutting and pivoting sports were included in the study. Four sports were considered to be cutting and pivoting including soccer, football, lacrosse and basketball. The decision on which graft to use was based on the athlete's choice after discussing the pros and cons of each graft. Exclusion criteria included those athletes with recurrent ACL tears, multiligamentous injuries, previous meniscal surgery and those requiring osteotomies. International Knee Documentation Committee Subjective Knee Evaluation (IKDC) and Lysholm knee scoring scale were used to evaluate patient reported outcomes. Through chart review, ability to return to sport, time to return to sport and complications were identified. The postoperative rehabilitation protocol for both grafts was identical. Results: There were 32 athletes in the soft tissue quadriceps autograft group and 36 in the BTB autograft group. The average age was 18.6 years for the quad group and 19.7 years for the BTB autograft group (p=0.63). Females made up 62.5% of the quadriceps group and 44.4% of the BTB group (p=0.14). The quad group was made up of 56.3% high school and 43.7% college athletes compared to 61.1% high school and 38.9% college athletes in the BTB autograft group (p=0.53). Soccer was the most common sport with 16 in the quad group and 14 in the BTB group. The rest of the quad group included 8 football players, 4 lacrosse and 4 basketball players. The remaining BTB group consisted of 12 football players, 8 lacrosse and 2 basketball players. Meniscal surgery was performed in combination with the ACL reconstruction in 17 (53.1%) of the quad group and 22 (61.1%) of the BTB autograft group (p=0.37). Average graft size was 9.5mm for the quad autograft group and 10 for the BTB autograft group. The 2-year IKDC score was 93.6 for the quad group and 95.1 for the BTB group (p=0.45). The 2 year Lysholm scores were 95.7 and 96.1 for the quad and BTB groups respectively. Return to play at the same or higher level was 90.6% in the quad group and 86.1% in the BTB autograft group (p=0.82). Time to return was also similar between the groups with 7.1 months for the quad group and 7.6 months for the BTB autograft group. There was 1 re-tear which required revision in the BTB group and no re-tears in the quad group (p=0.34). Arthrofibrosis requiring MUA and lysis of adhesions occurred in 2 quad autografts and 4 BTB autografts (p=0.49). One contralateral ACL rupture occurred in the quad autograft group and 4 in the BTB autograft group (p=0.21). Conclusions: The optimal ACL graft in high level athletes participating in cutting and pivoting sports remains in question. In our comparison of quadriceps autograft compared to BTB autograft in this athletic population, no difference in patient reported outcomes, return to sport or re-tear rates was identified. Based on these findings, quadriceps autograft is as effective as BTB autografts in cutting and pivoting athletes and should be part of the graft choice discussion with the athlete. [ABSTRACT FROM AUTHOR]

This paper explores recent state legislative processes in Colorado and Texas related to bills proposing support for restorative justice as a juvenile diversion tool for criminal courts. It uses two maximum variation case studies to explore issue statements related to theoretically-supported factors likely to influence the adoption of restorative justice legislation, and draws conclusions about the importance of political partisanship, economic strain, and key figures such as policy entrepreneurs, advocacy coalitions, and interest groups in legislative decision-making. Emerging themes suggest that support for restorative justice policies is at least sometimes bipartisan and is unlikely to be motivated by economic interests. Collaborative processes within a traditionally adversarial system distinguished successful restorative justice decision-making in Colorado. [ABSTRACT FROM AUTHOR]

Recovery is an important but understudied phase in the disaster management cycle. Researchers have identified numerous socio-demographic factors that help explain differences in recovery among households, but are less clear on the importance of place, which we define as a household's locality and local governance. In this paper, we examine the influence of place on disaster recovery through a study of the 2013 Colorado floods. Our findings are based on data collected from interviews, observation of recovery meetings, and a survey of 96 flood-affected households. We show that place shapes a household's disaster recovery by structuring: (1) physical exposure to hazards; (2) which local government has jurisdiction over recovery decisions; (3) local planning culture and its approach to citizen participation; and (4) the strength of social capital networks. Our findings expand the recovery literature and show that place-level variables should be taken into consideration when conceptualizing household recovery and resilience. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore perspectives of Somali refugees on female genital mutilation/cutting (FGM/C) and potential changes in these after migration.Design/methodology/approach Qualitative semi-structured interviews were conducted in Denver, Colorado, USA, with 13 Somali refugees. Thematic content analysis was used to analyze the data.Findings Change of perspectives regarding the support of FGM/C were noted among all participants, with most opposing infibulations, FGM/C type III, after migration but supporting Sunna, the cutting of the clitoris, FGM/C type I. Changes were prompted by education on FGM/C and resettling resulting in an awareness that infibulation is not a religious requirement nor undergone by all women. Cultural beliefs regarding the importance of virginity, purity and honor to the family underpinning the rationale of FGM/C were prevalent and some confusion in dealing with these cultural values was found. Women reported health care providers (HCPs) not being culturally prepared for women with FGM/C.Research limitations/implications Despite limitations to the study, findings indicate the complex process of migration and acculturation, leaving communities with cultural values in a context where these are not accepted. More research and discussion with the Somali immigrant community is required to better understand the practice of FGM/C after immigration, and how to deal with these cultural values.Originality/value Findings suggest some girls may still be at risk of some types of FGM/C after migration. Public health professionals, social and immigration workers should be aware of a potential risk. HCPs should prepare for caring for women with FGM/C. [ABSTRACT FROM AUTHOR]

The Mountain Pine Beetle (MPB) infestation in Colorado and Wyoming impacts federal and state forest managers, the recreation and tourism industry, ecosystem services, and the general sustainability of livelihoods in proximity to forested areas. Using qualitative analyses, this paper investigates whether a linkage exists between individuals' value orientations and their attitudes toward forest management in relation to MPB infestations. Data were obtained in 2011 from three open-ended questions in a mail survey of residents in Colorado and Wyoming. Our qualitative analysis revealed four value orientation types: 1) biocentric, 2) anthropocentric, 3) spiritual/therapeutic, and 4) pluralist. Additionally, respondents were generally supportive of forest management practices and the majority had a 'do what you need to save the forest' attitude. A linkage between value orientations toward the national forest and management practices was identified. Research and management implications are discussed. [ABSTRACT FROM AUTHOR]

Drawing on research from Colorado’s Front Range (the Denver/Boulder metropolitan area), this paper examines the validity of the ‘post-political’ hypothesis for explaining contentiousness and non-contentiousness in urban space. Examining major urban redevelopment efforts in Denver and a controversy over homeless people sleeping in public space in Boulder, we suggest that the literature on post-politics too narrowly circumscribes the realm of political action and in so doing loses analytical force and risks misunderstanding the nature of political engagement in the city. By contrast, a less circumscribed, more supple definition of politics allows for a better understanding of how the question of ‘Whose City?’– who the city is for – is always up for grabs. The appearance of post-political consensus, when it occurs, is itself a political achievement, the making of a hegemony, not an explanation. [ABSTRACT FROM AUTHOR]

During spring 2020, emergency remote teaching became the norm for hundreds of higher education institutions in the United States due to the COVID-19 pandemic. Librarians were suddenly tasked with moving in-person services and resources online. For librarians with instruction responsibilities, this online mandate meant deciding between synchronous and asynchronous sessions, learning new technologies and tools for active learning, and vetting these same tools for security issues and ADA compliance. In an effort to understand our shared and unique experiences with emergency remote teaching, the authors surveyed 202 academic instruction librarians in order to answer the following questions: (1) What technology tools are academic librarians using to deliver content and engage student participation in emergency remote library sessions during COVID-19? (2) What do instruction librarians perceive as the strengths and weaknesses of these tools? (3) What digital literacy gaps are instruction librarians identifying right now that may prevent access to equitable information literacy instruction online? This study will deliver and discuss findings from the survey as well as make recommendations toward best practices for utilizing technology tools and assessing them for equity and student engagement. [ABSTRACT FROM AUTHOR]

• A case study based on the national BCycle bike-sharing program was presented. • The bike usage patterns were compared among different membership groups. • The spatio-temporal trends of empty and full bike stations were examined. • The current system configuration was optimized under three hypothetical scenarios. • This study has important implications to other cities in the BCycle program. Many cities around the world have integrated bike-sharing programs into their public transit systems to promise sustainable, affordable transportation and reduce environmental pollution in urban areas. Investigating the usage patterns of shared bikes is of key importance to understand cyclist's behaviors and subsequently optimize bike-sharing programs. Based on the historical trip records of bike users and station empty/full status data, this paper evaluated and optimized the bike-sharing program BCycle in the city of Boulder, Colorado, the United States, using a combination of different methods including the Potential Path Area (PPA) and the Capacitated Maximal Covering Location Problem (CMCLP). Results showed significantly different usage patterns between membership groups, revealed diverse imbalance patterns of bike supply and demand across stations in the city and provided three system upgrading strategies about maximizing the service coverage. This case study is committed to future energy conservation and sustainable energy systems nationwide and ultimately worldwide, by holding immerse potential to adapt the resulting optimization strategies to the cities with a similar urban context across the United States, as well as more emerging bike-sharing programs in other countries, such as China. [ABSTRACT FROM AUTHOR]

Nelson et al. (2015) presented design principles for foundations on expansive soils. The design principles consider free-field heave throughout the design life of a structure as the basis for foundation design. The design principles also consider water migration in the vadose zone, and the time required for subsoil wetting over the design life of the structure. This paper presents a method to validate th foundation design method presented in Nelson et al. (2015). The validation was performed using detailed long-term data obtained on a building constructed on expansive soils at the Denver International Airport, Denver, Colorado, USA. Water migration in the vadose zone and heave of floor slabs and drilled pier foundations were monitored over the time period from 2000 to 2016 and extended to a 25 year period (1991 - 2016) beginning at the end of construction. Water content profiles were modeled using VADOSE/W software, and heave of slabs and piers were computed using the design method presented in Nelson et al. (2015). The depth of wetting and changes in water content were used to compute heave according to the design method. Calculated heave was compared to the survey data. It was shown that the design method was capable of predicting heave to within 30 percent of the measured heave over a 25-year period. [ABSTRACT FROM AUTHOR]

Recent scholarship has highlighted the significant environmental impact of the rapidly expanding hydraulic fracturing industry, which is projected to grow from USD 15.31 billion in 2021 to USD 28.93 billion in 2028 at a Compound Annual Growth Rate (CAGR) of 9.5%. Recognizing the need for comprehensive, national-scale evaluations, this review of the literature investigates contamination and induced seismicity associated with shale gas hydraulic fracturing in the United States. Employing systematic reviews of the literature and federal reports up until July 2023, this study reveals multiple areas of concern, including water and soil contamination, seismic activity, and air pollution. A notable finding is the average use of 2.4 million gallons of water per well in hydraulic fracturing, of which only 15–35% is typically retrieved. However, ongoing studies are actively exploring remediation strategies, including advancements in monitoring and treatment technologies, as well as the potential of reusing wastewater for hydraulic fracturing, as exemplified by the Garfield County region in Colorado; they utilized 100% wastewater to mitigate the impact of contamination. These findings underscore the need for stringent regulations, sustained research, and effective management practices. This work emphasizes the importance of a collaborative approach that leverages field studies, experimental investigations, and computational advancements to ensure the responsible development of shale gas resources. [ABSTRACT FROM AUTHOR]

Except for the addition of modern material remains, the archaeological record is a finite resource, which means that, at some point in the future, there will be nothing left to find. In this paper, we model trends in archaeological discovery based on the growth of the field and the probability of site discovery. We compare this model to seven diverse datasets of archaeological discovery trends: (1) all sites from the state of Wyoming, USA; (2) high-altitude archaeological sites from the state of Colorado, USA; (3) mostly complete Neandertal crania; (4) monumental sites of the Maya Classic period; (5) proboscidean kill/scavenge sites globally; (6) Upper Paleolithic sites from Europe; and (7) a compilation of shipwreck discoveries. We forecast discovery trends over the current century. We show that, for all datasets, rates of discovery are in decline, and some segments of the record are near depletion. [ABSTRACT FROM AUTHOR]

Despite promising results from individual-level studies, state-level studies of the effectiveness of comprehensive background-check (CBC) policies in reducing firearm fatalities have yielded null results in multiple states. These prior studies focused on CBC laws adopted in the 1990s, when record keeping was far less complete. We estimated the effect of the implementation of CBC policies on state-level firearm homicide and suicide rates in states implementing CBC policies from 2013 to 2015 (Colorado, Delaware, Oregon, and Washington). We compared age-adjusted firearm homicide and suicide rates, measured annually from 15 years prior to policy implementation until 2019, in each treated state to rates in control groups constructed using the synthetic control group method. Differences in firearm homicide rates for Colorado, Oregon, and Washington post treatment were all small (0.09 to 0.18 per 100,000 residents per year) and not well distinguished from natural variation. Oregon had on average 0.80 per 100,000 fewer firearm suicides per year than did synthetic Oregon post treatment. However, these results were inconsistent across modeling approaches and not well distinguished from natural variation. Our models produced poor fit for Delaware. Coupled with previous null results from Indiana, California, Maryland, Pennsylvania, and Tennessee, the present results suggest that extending background check requirements to private transfers alone and implementing these policies as is currently done is not sufficient to achieve significant state-level reductions in firearm fatalities. [ABSTRACT FROM AUTHOR]

Context: The authors examined the association between state-level policy protections and selfrated health disparities between transgender and cisgender adults. Methods: They used data on transgender (n =4,982) and cisgender (n=1.168,859) adults from the 2014-2019 Behavioral Risk Factor Surveillance System. The authors estimated state-specific health disparities between transgender and cisgender adults, and they used multivariable logistic regression models to compare adjusted odds ratios between transgender and cisgender adults by state-level policy environments. Findings: Transgender adults were significantly more likely to report poor/fair health, frequent mental distress, and frequent poor physical health days compared to cisgender adults. Disparities between transgender and cisgender adults were found in states with strengthened protections and in states with limited protections. Compared to transgender adults in states with limited protections. transgender adults in states with strengthened protections were marginally less likely to report frequent mental distress. Conclusions: Transgender adults in most states reported worse self-rated health than their cisgender peers. Much more research and robust data collection on gender identity are needed to study the associations between state policies and transgender health and to identify best practices for achieving health equity for transgender Americans. [ABSTRACT FROM AUTHOR]

Sleep's impact on quality of life and health among the general population is well documented. Meanwhile, there is a growing number of policies across the United States that criminalize homelessness by outlawing sleeping or sheltering in public, but there is little research about sleep quality among people experiencing homelessness within the context of larger systems. Using data (N = 484) collected to explore public health implications of criminalization of homelessness, this study describes sleep among people experiencing homelessness in Denver, Colorado through an ecological systems perspective. Participants reported an average of 3.6 hours of sleep in a 24-hour period and participants, on average, slept 2.87 hours without being interrupted. Race, disability status, and military status have statistically significant correlations with interrupted sleep, suggesting the systems and structures associated with these demographics may be related to poor sleep. Furthermore, there is a statistically significant correlation between amount of sleep and uninterrupted sleep and feelings of depression, experiencing images or hallucinations, and feeling sick. In building upon previous research which shows that people experiencing homelessness typically get less than the recommended amount of sleep, this study illuminates both the systemic and self-reported health and well-being implications that poor sleep has among people experiencing homelessness. [ABSTRACT FROM AUTHOR]

In the United States, buildings account for 35% of total energy-related carbon dioxide emissions, making them important contributors to decarbonization. Carbon intensities in the power grid are time-varying and can fluctuate significantly within hours, so shifting building loads in response to the carbon intensities can reduce a building's operational carbon emissions. This paper presents a rule-based carbon responsive control framework that controls the setpoints of thermostatically controlled loads responding to the grid's carbon emission signals in real time. Based on this framework, four controllers are proposed with different combinations of carbon accounting methods and control rules. To evaluate their performance, we performed simulation studies using models of a 27-home, all-electric, net zero energy residential community located in Basalt, Colorado, United States. The carbon intensity data of four future years from the Cambium data set are adopted to account for the evolving resource mix in the power grid. Various performance metrics, including energy consumption, carbon emission, energy cost, and thermal discomfort, were used to evaluate the performance of the controllers. Sensitivity analysis was also conducted to determine how the control thresholds and intervals affect the controllers' performance. Simulation results indicate that the carbon responsive controllers can reduce the homes' annual carbon emissions by 6.0% to 20.5%. However, the energy consumption increased by 0.9% to 6.7%, except in one scenario where it decreased by 2.2%. Compared to the baseline, the change in energy cost was between −2.9% and 3.4%, and thermal discomfort was also maintained within an acceptable range. The little impact on energy cost and thermal discomfort indicates there are no potential roadblocks for customer acceptance when rolling out the controllers in utility programs. [ABSTRACT FROM AUTHOR]

Although the coronavirus disease 2019 (COVID-19) has amplified risk factors known to increase children's vulnerability to abuse and neglect, emerging evidence suggests declines in maltreatment reporting and responding following COVID-19 social distancing protocols in the United States. Using statewide administrative data, this study builds on the current state of knowledge to better understand the volume of child protection system (CPS) referrals and responses in Colorado, USA before and during the early phase of the COVID-19 pandemic and to determine whether there were differences in referral and response rates by case characteristics. Results indicated an overall decline in referrals and responses during COVID-19 when compared to the previous year. Declines were specific to case characteristics, such as reporter and maltreatment type. Implications regarding the impact of the COVID-19 pandemic on child maltreatment reporting and CPS response are discussed. [ABSTRACT FROM AUTHOR]

Little is known about the prevalence of young adult refugees' primary care use following resettlement in Colorado. Among a sample of Bhutanese and Burmese young adult refugees resettled in Colorado, proportions with a primary care provider (PCP), physical exam in the last 12 months, and knowledge to make an appointment were calculated across 4 years and compared within the refugee population by demographics using Pearson's Chi-Squared tests and compared to older refugees and to the general population using two-tailed tests of proportions. Greater than 70% of young adult refugees reported a physical exam in the last 12 months during the 4 years after arrival. Disparities were identified within young adult refugees by sex, marital status and country of origin. Young adult refugees were significantly different than both refugees over 55 and the general population in terms of their primary care use. Young adult refugees need support to identify PCPs earlier in resettlement and maintain primary care use years after resettlement. [ABSTRACT FROM AUTHOR]

Straight-line winds are arguably the most challenging element considered by operational forecasters when issuing severe thunderstorm warnings. Determining the potential maximum surface wind gust prior to an observed, measured gust is very difficult. This work builds upon prior research that quantified a relationship between the observed outflow boundary speed and corresponding measured wind gusts. Whereas this prior study was limited to a 30-case dataset over eastern Colorado, the current study comprises 943 cases across the contiguous United States and encompasses all times of day, seasons, and regions while representing various convective modes and associated near-storm environments. The wind gust ratios (WGRs), or the ratio between a measured wind gust and the associated outflow boundary speed, had a nationwide median of 1.44, mean of 1.68, 25th percentile of 1.19, and 75th percentile of 1.91. WGRs varied considerably by region, season, time of day, convective mode, near-storm environment, and outflow boundary speed. WGRs tended to be higher in the plains, Intermountain West, and southern coastal regions, lower in the cool season and during the morning and overnight, and lower in linear convective modes relative to supercell and disorganized modes. Environments with stronger mean winds and low- to midlevel shear vector magnitudes tended to have lower WGRs, whereas those with steeper low-level lapse rates and other thermodynamic characteristics favorable for momentum transfer and evaporative cooling tended to have higher WGRs. As outflow boundary speed increases, WGRs—and their variability—decrease. Applying these findings may help operational meteorologists to provide more accurate severe thunderstorm warnings. Significance Statement: Forecasting thunderstorm peak wind gusts is a challenge for operational forecasters, especially in comparison with forecasting hail. This study improves upon a method from 1988 to forecast these wind gusts, which uses the ratio of peak thunderstorm wind gust divided by thunderstorm speed. Herein, we expanded the sample from 30 to 943 cases and from eastern Colorado to across the contiguous United States, with a focus on airports where winds are especially impactful to aviation. We found considerable variability in typical ratios of wind gusts to thunderstorm motion speed based upon the time of day, season, region, and mode and environment of the thunderstorms, with an average ratio of 1.68. The results herein may help to improve the accuracy of severe thunderstorm warnings, allowing the public to more readily prepare for the associated hazards. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients with cerebral palsy and other static encephalopathies (CP) are known to be at increased risk of sleep-related breathing disorders (SRBD). Few studies have reviewed whether intrathecal baclofen (ITB) can contribute to SRBD. OBJECTIVE: To assess the prevalence of SRBD in patients with CP receiving ITB by using nocturnal polysomnography (NPSG). METHODS: We performed a retrospective chart review of patients receiving ITB who had NPSG at Children's Hospital Colorado (CHCO) and Seattle Children's Hospital (SCH) from 1995 to 2019. The Gross Motor Function Classification System (GMFCS) measured the severity of motor disability. Screening sleep questionnaires collected subjective data and NPSG provided objective data of SRBD. RESULTS: All patients except one were GMFCS 4 or 5 with median age at ITB pump placement of 9.7 years. The screening questionnaire for SRBD detected one or more nighttime symptoms in > 82% of all patient groups. Pre-ITB criteria for a SRBD was met in 83% of patients at CHCO and 91% at SCH. Post-ITB prevalence remained similarly high. CONCLUSIONS: NPSG identified a high prevalence of SRBD in these cohorts from CHCO and SCH. Our study showed neither improvement nor worsening of SRBD in patients receiving ITB. [ABSTRACT FROM AUTHOR]

Contracting between private health plans and hospitals has been described as "chaos behind a veil of secrecy." We develop a novel algorithm that classifies inpatient claims as one of three contract types-discounted charges, fixed rates, or per diems-and apply it to the 2009-2014 Colorado All Payer Claims Database. Of $1.1 billion in classifiable private health plan payments for inpatient care in Colorado, we find that 42.1% were fixed rates, 41.1% were discounted charges, and 16.0% were per diems. We find wide variation in contract types among private health plans and hospital types, and a pronounced shift over the study period in private plans' contract types, away from discounted charges, and toward fixed rates. To test our algorithm's validity, we apply it to Colorado Medicare and Medicaid claims-both of which are known primarily to pay using fixed rates-and find, reassuringly, that 86.3% of Medicare payments (98.6% when we exclude Medicare claims with special payment rules) and 79.7% of Medicaid payments are classified as fixed rates. [ABSTRACT FROM AUTHOR]

Purpose: Although cesarean delivery is the most common surgical procedure in the United States, postoperative opioid prescribing varies greatly. We hypothesized that patient characteristics, procedural characteristics, or both would be associated with high vs low opioid use after discharge. This information could help individualize prescriptions.Methods: In this prospective cohort study, we quantified opioid use for 4 weeks following hospital discharge after cesarean delivery. Predischarge characteristics were obtained from health records, and patients self-reported total opioid use postdischarge on weekly questionnaires. Opioid use was quantified in milligram morphine equivalents (MMEs). Binomial and Poisson regression analyses were performed to assess predictors of opioid use after discharge.Results: Of the 233 patients starting the study, 203 (87.1%) completed at least 1 questionnaire and were included in analyses (86.3% completed all 4 questionnaires). A total of 113 patients were high users (>75 MMEs) and 90 patients were low users (≤75 MMEs) of opioids postdischarge. The group reporting low opioid use received on average 44% fewer opioids in the 24 hours before discharge compared with the group reporting high opioid use (mean = 33.0 vs 59.3 MMEs, P <.001). Only a minority of patients (11.4% to 15.8%) stored leftover opioids in a locked location, and just 31 patients disposed of leftover opioids.Conclusions: Knowledge of predischarge opioid use can be useful as a tool to inform individualized opioid prescriptions, help optimize nonopioid analgesia, and reduce opioid use. Additional studies are needed to evaluate the impact of implementing such measures on prescribing practices, pain, and functional outcomes. [ABSTRACT FROM AUTHOR]

Clinical laboratory quality improvement (QI) efforts can include population test utilization. The authors used a health care organization's Medical Data Warehouse (MDW) to characterize a gap in guideline-concordant laboratory testing recommended for safe use of antirheumatic agents, then tested the effectiveness of laboratory-led, technology-enabled outreach to patients at reducing this gap. Data linkages available through the Kaiser Permanente Colorado MDW and electronic health record were used to identify ambulatory adults taking antirheumatic agents who were due/overdue for alanine aminotransferase (ALT), aspartate aminotransferase (AST), complete blood count (CBC), or serum creatinine (SCr) testing. Outreach was implemented using an interactive voice response system to send patients text or phone call reminders. Interrupted time series analysis was used to estimate reminder effectiveness. Rates of guideline-concordant testing and testing timeliness in baseline vs. intervention periods were determined using generalized linear models for repeated measures. Results revealed a decrease in percentage of 3763 patients taking antirheumatic agents due/overdue for testing at any given time: baseline 24.3% vs. intervention 17.5% (P < 0.001). Among 3205 patients taking conventional antirheumatic agents, concordance for all ALT testing was baseline 52.8% vs. intervention 65.4% (P < 0.001) among patients chronically using these agents and baseline 20.6% vs. intervention 26.1% (P < 0.001) among patients newly starting these agents. The 95th percentiles for days to ALT testing were baseline 149 vs. intervention 117 among chronic users and baseline 134 vs. intervention 92 among new starts. AST, CBC, and SCr findings were similar. Technology-enabled outreach reminding patients to obtain laboratory testing improves health care system outcomes. [ABSTRACT FROM AUTHOR]

Bicapite, KNa2Mg2(H2PV145+ O42)·25H2O, is a new mineral species (IMA2018-048) discovered at the Pickett Corral mine, Montrose County, Colorado, U.S.A. Bicapite occurs as square tablets up to about 0.2 mm on edge on montroseite-corvusite-bearing sandstone. Crystals are dark red-brown, often appearing black. The streak is orange, and the luster is vitreous. Bicapite is brittle, has a Mohs hardness of 1½, and displays one excellent cleavage on {100}. The measured density is 2.44(2) g/cm3. Bicapite is uniaxial (+), w = 1.785(5), e ≈ 1.81 (white light); pleochroism is red-brown; E > O, slight. The electron probe microanalysis and results of the crystal structure determination provided the empirical formula (based on 67 O apfu) (K1.23Na2.23Mg1.48)∑4.94[H2.51P1.02(V13.915+ Mo0.076+)∑13.98O42]·25H2O. Bicapite is tetragonal, I4/m, with a = 11.5446(12) Å, c = 20.5460(14) Å, V = 2738.3(6) Å3, and Z = 2. The strongest four lines in the diffraction pattern are [d in Å (I) (hkl)]: 10.14 (100) (002,101); 2.978 (29) (134,206); 2.809 (11) (305); and 2.583 (11) (420,008). The atomic arrangement of bicapite was solved and refined to R1 = 0.0465 for 1008 independent reflections with I > 2sI. The structural unit is a [H2PV125+ O40(V5+O)2]7– heteropolyanion composed of 12 distorted VO6 octahedra surrounding a central PO4 tetrahedron and capped on opposite sides by two VO5 square pyramids; the structural unit is a modification of the a-isomer of the Keggin anion, [XM12O40]n-. Charge balance in the structure is maintained by the [KNa2Mg2(H2O)25]7+ interstitial complex. The name bicapite is in recognition of this being the only known mineral with a structure based on a bicapped Keggin anion. The discovery of bicapite and numerous other natural polyoxometalate compounds in the Colorado Plateau uranium/ vanadium deposits make that the most productive region found to date for naturally occurring polyoxometalate compounds. [ABSTRACT FROM AUTHOR]

Copyright of Review of Policy Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coloradesmus, gen. nov., is established in the family Macrosternodesmidae based on Speodesmus aquiliensis Shear, 1984, comb. nov. and includes four new species: Coloradesmus hopkinsae sp. nov., C. manitou sp. nov., C. beckleyi sp. nov., and C. warneri sp. nov. All are from high altitude limestone caves in Colorado, USA, and are likely troglobionts. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is known to impact family functioning and decrease family quality of life. Unfortunately, many parents of children with ASD are left to coordinate their child's care with little ongoing support or education. There is a growing interest in parent-to-parent (P2P) programs to provide family supports with the goal of improving family outcomes. This study investigates a P2P program for families of children newly diagnosed with ASD that combines (1) family-centered action planning, (2) education on accessing complex systems of care, and (3) ongoing mentorship by a trained Parent Mentor for six months. In a randomized controlled trial, the intervention was given to a group of parents (N = 33) and compared to a waitlist group (N = 34). The intervention consisted of development of an individualized action plan and training on navigating service systems immediately after entry into the program, followed by monthly check-ins by a trained parent mentor for six months. An intent-to-treat analysis examined the impact of CPM on family quality of life, family functioning, service utilization, and program acceptability and satisfaction. The intervention improved satisfaction with disability-related services and prevented rigidity in family functioning. Services used outside of school increased for both groups but did not meet the national recommendation. Participants described the program as highly acceptable and indicated that it improved their emotional wellbeing. The CPM program may be a useful tool for helping families cope with their child's ASD; although, additional research is needed to confirm these effects. [ABSTRACT FROM AUTHOR]

Under the prior appropriation doctrine, water rights are better defined and specified than under the riparian doctrine, but diversion requirements left instream flows unprotected. Primarily in the 1970s and 80s, states sought to extend water rights to include instream flow (henceforth ISF) uses, allowing for new appropriations and market-based transactions to establish ISF rights within the private property system rather than using eminent domain or the public trust doctrine to bolster ISFs. Due to cumbersome administrative processes and other transaction costs, relatively few transfers or appropriations have occurred. Those that have often have rights subordinate (through legal qualifications) or at least junior to earlier diversion rights, leading critics to question the right-based preservation. This article rigorously analyzes the case of Colorado, one of the most active programs in the US within the most regimented water right systems. Despite relatively few acquisitions, the junior ISF appropriations have protected numerous miles of streams by 1) deflecting future diversionary rights, 2) requiring protection of any upstream transfers, and 3) reducing upstream withdrawals from existing diversion rights despite ISF's junior status. The shift to diverting more downstream stems from additional investment in monitoring and enforcement which provides informational externalities to existing water right holders. [ABSTRACT FROM AUTHOR]

Background: Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited.Objective: The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado.Design and Participants: The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations.Main Measures: Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data.Results: Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without.Conclusions: The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into national efforts to eliminate health disparities. [ABSTRACT FROM AUTHOR]

Delay in the processing of criminal cases has long been viewed as a serious national problem. Substantial differences exist among courts in the average time it takes to resolve both felony and misdemeanor cases, with past research producing inconclusive results on the causes of observed variation. In response, and with the support of the Arnold Foundation, the objective of this article is to highlight predictable variation in the timeliness of criminal case processing and how this knowledge supports court efforts to become more expeditious. Drawing on an extensive set of felony and misdemeanor cases resolved in seven Colorado courts, statistical analysis uncovers important patterns in the composition of criminal caseloads and clarifies how composition influences case duration. Moreover, similarities in the makeup of criminal caseloads show the utility of fundamental principles of criminal caseflow management and how courts benefit from being assessed comparatively against established performance benchmarks. [ABSTRACT FROM AUTHOR]

The article focuses on the laws passed in Colorado and Florida which require an equal access to local tax revenues for charter schools in 2017. Topics include the commitment of charter advocates to seek the equal funding for charter schools through local tax-override revenue, the role of the Community of Practice Community of Practice (COP) coalition in promoting the legislative bill in Colorado, and the challenges faced by bipartisan coalitions in Florida.

Cities are key sites of action for adaptation to climate change. However, there are a wide variety of responses to hazards at the municipal level. Why do communities take adaptive action in the face of weather- and climate-related risk? We studied what cities are doing in response to existing natural hazards, such as floods, droughts, and blizzards as an analog for understanding the drivers of adaptive behavior toward climate change risks. We conducted a survey of 60 U.S. municipalities followed by six in-depth case studies in the intermountain west states of Colorado, Wyoming and Utah that regularly experience weather and climate extreme events. Our analysis shows that perception of risk and external factors such as planning requirements and availability of funding stand out as important drivers. Nevertheless, political action is rarely driven by a single factor or event. Overall, our results suggest that multiple factors interact or act in combination to produce an enabling environment for action in the face of weather- and climate-related risk. [ABSTRACT FROM AUTHOR]

The nature of asymmetrical warfare--defined by improvised explosive devices, indirect fire attacks, and suicide attacks-- has significantly altered the patterns of post-service challenges faced by veterans. Dealing with the unseen wounds of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) that result from this type of combat has been one of the most difficult leadership challenges of my career as a young officer. Although our nation's medical response to PTSD and TBI is well documented, the judicial challenges are not as apparent. Most recently, our nation has responded to this challenge with an alternative court, the Veterans Trauma Court (VTC), modeled on longstanding drug courts. The VTC offers a legal solution to the complex problems faced by our veterans, particularly those suffering from TBI and PTSD. Although there is much literature advocating for VTCs, there is a dearth of research examining the actual operations of the VTC or its measurable outcomes. VTCs are at a point of development, particularly the one studied in this Comment, where metrics are available, operations have been standardized, and recommendations can be made. The 4th Judicial District's VTC, the subject of this study, provides a particularly powerful case study because the district has a large, diverse military population. By incorporating research gathered over two years on this VTC, this Comment attempts to understand the mechanics and operations of a veterans trauma court as a case study for other veteran courts. [ABSTRACT FROM AUTHOR]

Active transportation (AT) may represent an ideal opportunity to accumulate physical activity (PA). Thus, the purpose of this study was to describe the AT profile among students from two Colorado school districts. Students completed a survey on AT resulting in a final dataset (n = 3738) from which descriptive and inferential statics were calculated. Respondents were 11.32 ± 2.82 years of age (Boys = 48.27 %; Girls = 51.73 %). Most students (87.29 %) traveled to or from school via automobile, while 11.17 % walked and 1.53 % biked. Boys rode bicycles to school significantly more ( p < 0.0001) than girls, and when walking, accumulated significantly more time ( p = 0.02) than females. When examining by grade level significant differences were found for days/week walking ( p = 0.0002) to school and biking ( p < 0.001) to school. High school students accumulated significantly ( p < 0.0001) more time walking to school than middle or elementary school students. Similarly, high school students spent more time biking ( p < 0.0001) to school than middle school and elementary school respondents. These findings indicate that travel to school by automobile is still the dominant mode of travel for most public school students. Further, males were generally more likely to obtain extra time in AT. Moreover, older students were more likely to engage in AT, and to spend more time during their AT. [ABSTRACT FROM AUTHOR]

The authors in this article argue that the Francisco Maestas et al vs. George H. Shone et al (1914) case is one of the earliest Mexican American challenges to school segregation in the United States. Unidentified for over a century, the lawsuit took place in southern Colorado, a region of the nation where Mexican Americans have deep historical roots. This case was unique because the racial background and linguistic needs of Mexican American children were contested. First, plaintiffs (Mexican Americans) argued their children were racially distinct as Mexicans and used the Colorado Constitution to challenge segregation because the state prohibited public schools from classifying and distinguishing children based on color and race. Defendants (school board members and the superintendent) countered that Mexican American children were Caucasian and claimed they were no different from other White children in the school district. Second, school district officials maintained that non-English speaking Mexican American children were placed in a separate school in order to serve their linguistic needs. The district court judge discovered that school officials had created a policy that sent all Mexican American children to the separate school. To the extent that many Mexican American children were English speaking, the district court judge ruled in favor of Francisco Maestas on the grounds that school officials could not prevent English-speaking Mexican American children from attending schools of their choice in general and schools that were closer to their homes in particular. [ABSTRACT FROM AUTHOR]

The article offers information on the harm of payday loans to consumers and need for payday loans reform in the U.S. Topics discussed include unaffordable payments to loans results in lack of money to pay other bills and high prices of payday loans that drain resources; availability of small credit at lower prices and with affordable payments to people with low credit scores and savings in Colorado; and regulatory uncertainty around acceptable underwriting practices, loan terms, and pricing.

Background and aims Since 2012 four US states have legalized the retail sale of cannabis for recreational use by adults, and more are likely to follow. This report aimed to (1) briefly describe the regulatory regimes so far implemented; (2) outline their plausible effects on cannabis use and cannabis-related harm; and (3) suggest what research is needed to evaluate the public health impact of these policy changes. Method We reviewed the drug policy literature to identify: (1) plausible effects of legalizing adult recreational use on cannabis price and availability; (2) factors that may increase or limit these effects; (3) pointers from studies of the effects of legalizing medical cannabis use; and (4) indicators of cannabis use and cannabis-related harm that can be monitored to assess the effects of these policy changes. Results Legalization of recreational use will probably increase use in the long term, but the magnitude and timing of any increase is uncertain. It will be critical to monitor: cannabis use in household and high school surveys; cannabis sales; the number of cannabis plants legally produced; and the tetrahydrocannabinol (THC) content of cannabis. Indicators of cannabis-related harms that should be monitored include: car crash fatalities and injuries; emergency department presentations; presentations to addiction treatment services; and the prevalence of regular cannabis use among young people in mental health services and the criminal justice system. Conclusions Plausible effects of legalizing recreational cannabis use in the United States include substantially reducing the price of cannabis and increasing heavy use and some types of cannabis-related harm among existing users. In the longer term it may also increase the number of new users. [ABSTRACT FROM AUTHOR]

Truancy and related school attendance issues are serious problems nationwide, and are often the result of a punitive school-based paradigm that harms more students than the protocols help. While some school districts and juvenile courts have shifted toward a rehabilitative paradigm and approach truancy with preventive efforts, unfortunately, this is not the norm. This manuscript summarizes and reviews: (1) the prevalence of the problems within schools and juvenile courts; (2) truancy and delinquency's inter-related risk and protective factors for children and adolescents and the disproportionate impact on some students; and (3) the evidence of what schools and related stakeholders can do to improve student truancy/attendance problem outcomes. The analysis concludes with case examples from two states (Colorado and Ohio) that have taken dichotomous approaches to addressing truancy, and what child and adolescent social workers should do to fix the problems. [ABSTRACT FROM AUTHOR]

This section offers news briefs on relating to addiction as of June 2016. It announces the implementation of the Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules 2014 in India. It reports the prescription drug monitoring to be introduced in Victoria to prevent overdoses, as well as the ruling by the Texas Supreme Court upholding a state Supreme Court decision to impose a special tax on cigarette makers.

This Comment proposes constitutional and statutory amendments that would allow water courts to consider the public interest in water allocations. It offers a model public interest standard and argues that this public interest standard is an economic necessity given the shifting contributions of water-reliant industries and the nature of their water needs. Assuming the purpose of Colorado water law is to promote growth and the economic health of the state, then Colorado must adjust the guiding laws to reflect the current economic reality. Where facilitating economic growth formerly required consumptive diversions from streams to subsidize homesteads, ranches, and mines, now it often means leaving the water in streams to maximize real estate values and the conditions desirable for the recreation and service economies. This Comment argues that Colorado will allocate its limited water resources more efficiently by implementing a public interest standard that allows water courts to consider local and state economic interests. [ABSTRACT FROM AUTHOR]

The article presents a study on special education gap in New York City and Denver, Colorado. It mentions the key factors contributing to this gap including the differences in rates of students being classified as having a Specific Learning Disability (SLD). Also discussed are the role played by students identified as having speech and language disabilities in this gap issue, the application and enrollment of students in charter school and the impact of student mobility on special education gap.