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a heal for thier home 23

october-november, 2013

sPECIAL Supplement to the inlander

inside:

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Health SPOKANE • EASTERN W ASHINGTON • NORTH IDAHO 1227 W. Summit Parkway, Spokane, Wash. 99201 phone: 509-325-0634

editor Anne McGregor

annem@inhealthnw.com

managing editor Jacob H. Fries a r t DIRE C TOR Chris Bovey calendar editor Chey Scott photographer Young Kwak contributors Cat Carrel, Anna Clausen, Dean Davis, Lisa Fairbanks-Rossi, Heidi Groover, E.J. Iannelli, Jane Kay, Mike McCall, Deanna Pan, Katy Raddatz, Stephen Schlange, Carrie Scozzaro, Matt Thompson, Daniel Walters, Lisa Waanenen production manager Wayne Hunt a d v e r t i s i n g SALES MANAGER Kristi Gotzian director of marketing Kristina Elverum advertising sales Autumn Adrian, Jamie Albertini, Bonnie Amstutz, Bruce Deming, Gail Golden, Carolyn Padgham-Walker, Janet Pier, Emily Walden Sales coordination Raevyn West, Rebecca Rison, Angela Rendall design and production Tom Stover, Derrick King, Alissia Blackwood Mead, Jessie Spaccia DISTRIBUTION MANAGER Trevor Rendall business manager Dee Ann Cook credit manager Kristin Wagner publisher Ted S. McGregor Jr. general manager Jeremy McGregor

InHealth is published every other month and is available free at more than 500 locations throughout the Inland Northwest. One copy free per reader. Subscriptions are available and cost $2.50 per issue. Call x213. Reaching Us: Editorial: x261; Circulation: x226; Advertising: x223. copyright All contents copyrighted © Inland Publications, Inc. 2013. InHealth is locally owned and has been published every other month by Inland Publications, Inc. since 2004.

S U PP L E M E N T TO T H E I N L A N D E R

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t my son’s back-to-school night, his geography teacher explained that along with learning about landforms and cultures, the class would be studying the world’s environment and all its challenges. The teacher became unexpectedly grave: “It can get pretty scary,” he said. Who knew kids would need more parental reassurance after geography class than after reading The Hunger Games? The state of the world can be overwhelming, but we do have control over the health status of our own homes. In our Healthy Homes section, we take a look at some easy ways to make sure your home is not only good for you, but also good for the environment we all share. Our In-Depth feature concerns a mother’s relentless quest to unravel the mystery behind the ever-increasing numbers of children diagnosed with autism. She suspects we’re not being careful enough about what women are exposed to during their pregnancies — from prescribed medications to environmental chemicals. A WSU researcher thinks she may be onto something. While “upstream” thinking about the causes of cognitive disabilities is essential, right now one in seven people in Spokane lives with a disability, and nearly 8,000 reside in nursing homes, adult family homes or other institutions. I think you’ll be happy to read about a group dedicated to checking in on the welfare of these most vulnerable members of our community. Maybe you’ll even want to help out. To your health!

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CHECK-IN STAY CONNECTED Send letters and story ideas to InHealth Editor Anne McGregor at annem@inhealthnw.com. Join the conversation on the InHealth Facebook page and at InHealthNW.com

ON OUR FACEBOOK

What do you do to make your home a more healthy place? MONIQUE KOCH HARRIS: Cleaning green with nontoxic cleaners. BRIANNA MARTIN: No junk food, and no soda! KYLE NORBERT: Plants. JENNIFER DENTON: Clean it. And open the windows at least once a day, especially in the winter. MICHAEL M. MORAN: No beans! BRENDA LYNN MARTINSON: Clean the bathroom often!

SUPERFOOD

Sweet Potatoes Shine ATTRIBUTES: There are many varieties of sweet potatoes — some have yellow flesh, while others are deep orange or even purple. What we call a yam is really a variety of sweet potato. The richer the yellow-orange flesh is in color, the more beta carotene the potato contains. Purple sweet potatoes are an excellent source of antioxidants. SUPERPOWERS: One yellow-orange sweet potato can contain more than enough beta carotene to satisfy your entire daily requirement of vitamin A. They’re also packed with vitamin C and manganese, not to mention 15 percent of your recommended dietary allowance for fiber. And a sweet potato rings in at just about a hundred calories.

ANDREW BURNS: Feng Shui. Xuan Kong Fei Xing, to be precise. KAREN GALLION: Vacuum often. For each week you need a day for each person living there (animals included, by the way). Five people = five times that week. JOEY PEKALA: Nothing, I’m a pretty unhealthy dude. 

HOW TO USE THEM: Forget about candied nuts and added sugar. Instead, steam half-inch slices of sweet potatoes for seven minutes to maximize their nutritive properties. Then toss with toasted walnuts and a light vinaigrette for a tasty side dish. — ANNE McGREGOR

ASK DR. MATT

EVA SILVERSTONE: We share “three good things” around the dinner table. This way we focus on the positive of our day and not the humdrum or dreary. It seems to put us all in better moods and refocus our energies — plus it makes for great dinner conversation. CJ VOGES: Nothing. Being around unhealthy stuff and people makes me mostly immune to unhealthy stuff. Unhealthy people...not so much. I just avoid them as much as possible.

WEAKNESS: You’ll need to add a little fat to cooked sweet potatoes to aid absorption of the beta carotene.

For a Cough, Try a Little Honey

A

Matt Thompson is a pediatrician at Spokane’s Kids Clinic.

n interesting Israeli study was published in Pediatrics within the past year, comparing how well cough symptoms responded to three different types of honey and a sweet date extract. Three hundred kids aged 1 to 5 received either a honey treatment or the placebo date extract. While the frequency and severity of coughs decreased in all the kids over the subsequent nights, the kids who got honey improved significantly more. It’s not entirely clear why honey would work to calm a cough. One theory is that the nerve fibers involved in the cough reflex are similar to those that respond to sweet tastes. Or it may be that the antioxidant properties of honey are partly responsible for the impact on cold symptoms and coughs. There is a caveat: Honey absolutely must not be given to children under 12 months old for any reason. This is because of the risk of botulism. After 12 months, the gut has decreased permeability that won’t allow botulism spores to pass through. This was a fairly small study, and though blind and randomized, the measurement of symptom improvement — based on parent questionnaires — was quite subjective. However, it raises the possibility that there may be some benefit to this intervention, and further investigation is warranted. In the meantime, it’s good to have alternatives to over-the-counter cold medicines that sleepy parents often reach for. These OTC meds are not without risks. Prior to the FDA recommending that parents not give these medicines to children, there were thousands of ER visits yearly in the U.S., probably related to the side effects of cough and cold medicines. Most likely, the troubles were more related to overdosing on the medicines. I won’t be throwing out the purple stuff from my medicine cabinet quite yet, but I may try a few teaspoonfuls of honey first. — MATT THOMPSON OCTOBER-NOVEMBER, 2013

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CHECK-IN HEALTH NEWS

A New Vital Sign?

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CHARITY CORNER

Pets and Purrs

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t’s the hard heart that fails to melt when looking into the eyes of a companion animal. But not all cats and dogs are as lucky as those sleeping at the foot of the bed every night. The Spokane Humane Society has assisted homeless pets of the Inland Northwest for 116 years — providing food, shelter and medical care to unwanted or neglected animals, as well as spay and neuter surgeries, veterinary care and many other services for pet owners. The organization, one of the area’s largest animal-welfare nonprofits, depends solely on donations to operate. One of their biggest fundraisers is the annual Furr Ball, a gala evening hosted at the Davenport Hotel. Associate Shelter Director Kerry Wiltzius says last year’s Furr Ball raised more than $70,000 for the shelter, and tickets for this year’s event are already going fast. Partygoers will enjoy a cocktail hour and hors d’oeuvres, followed by dinner and a live auction of eight decorated, themed Christmas trees. Each tree is decked out with more than $2,000 worth of items. One of the best parts of the evening? The Parade of Animals, when 20 adoptable pets from the shelter will strut their stuff. Stick around until the end of the live auction to meet some of the dogs and cats introduced during the parade. They’ll be available for cuddles, or even better, adoption. — CHEY SCOTT Spokane Humane Society’s 13th Annual Furr Ball • Sat, Nov. 23 at 6 pm • $125/person • The Davenport Hotel • 10 S. Post St. • spokanehumanesociety.org • 467-5235

long with “Where does it hurt?” your doctor should be asking “Where do you live?” That’s because where and how you live, work and eat accounts for up to 60 percent of your risk for premature death — and nearly all of these things are, to some extent, under your control to change. But four out of five physicians report feeling “underequipped” to address their patients’ social needs. Rishi Manchanda, a Los Angeles physician and author of the TED book The Upstream Doctors, is trying to draw attention to the “vital sign” of where you live. He relates the story of a patient who came to his clinic complaining of debilitating headaches. After visiting neurologists and ERs and undergoing thousands of dollars of testing, she still had no diagnosis. But at Manchanda’s clinic, patients are given a screening based on the American Housing Survey. With the patient’s survey in hand, it took just 15 minutes for Manchanda to zero in on the cause of her problem: mold and mildew in her home. That’s the kind of “upstream” thinking Manchanda thinks more doctors need to develop. He’s established a website dedicated to giving physicians tools to assess — and address — the “social conditions that make people sick.” Look for increased emphasis on “upstreamists” as Washington becomes one of the first states to implement Medicaid Health Homes. Think of these as bigger and broader than your typical patient-centered medical home. In this holistic medical neighborhood, not only will enrollees receive medical and behavioral care, they will also get coordinated non-medical support, including help with housing, transportation and even legal services. — ANNE McGREGOR

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their own words

Josh Neblett Josh Neblett, 27, is the CEO and a co-founder of GreenCupboards.com, a Spokane-based e-tailer focused on ‘green’ products

If you want to ‘go green,’ what are some of the first steps? It can be so overwhelming. 

 Green is defined differently for every single person. There are many different ways you can go green. We find that people care more about the health aspect in many ways, so our biggest categories, for example, are like “baby,” right? You’ll drink poisonous stuff all day, but that baby’s not coming near anything. That happens to be our biggest category. Everyone kind of defines green their own way — BPA-free, or recyclable, or solar, or whatever it might be. We have different ways that you can shop with the filters, so you can figure out what things matter to you and try to find products that fit into those categories. The general population is not going to go way out of their way to go extreme green, so you’ve got to make it easy. What’s been the economic impact for Spokane? We have 73 employees now. The revenue growth has been great. That’s been exciting to see, and in terms of the economics of Spokane, to be honest, I don’t know if it would have been possible in other areas because we were able to leverage internships pretty heavily. We weren’t in a position initially, keeping with kind of a bootstrap mentality, to go out and hire six-figure bigwigs around town or from other e-commerce companies. In fact, GreenCupboards.com grew out of one of your classes at Gonzaga University, didn’t it? I was lined up to be a financial advisor. But I took this class and kind of got formally introduced to entrepreneurship. “Creating New Ventures” was the course. I immediately, within the first couple of weeks, figured out that this was my calling, passion, whatever it is. I really had the bug. You’ve got to have a few loose screws in the head to pursue entrepreneurship, but I had those. I’ve always had kind of the business mindset. I always wanted to do yard sales for the parents and take a commission and that kind of stuff. I always had it in my bloodstream — whether it is healthy or not, who knows! But it’s working out. — INTERVIEW BY ANNE McGREGOR young kwak photo

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bout three years ago, Joy Fuller and Ginny Meyer began scrutinizing the labels on their household skin-care products. The more they read, the more concerned they became. Most of the lotions in their bathroom cabinets — despite the products’ reassuring claims to soothe, nourish, heal or revitalize — contained worrying toxins. “My husband’s shaving cream had propane in it,” says Fuller. She also noticed that parabens and sodium lauryl sulfate (aka SLS) were ubiquitous ingredients. “They’ve found parabens when they go into cancer tumors, [and] SLS is just a cheap way to get foam. I sold cosmetics for about 15 years, and when I really look at all the things I was exposed to, I’m a little horrified.” The pair started making nontoxic skin-care products for themselves and family members “as a little test. We thought, gosh, these really feel good. We were so pleasantly surprised, I began sharing them with other friends. They loved them and raved about them as well.” Those homemade gifts quickly evolved into Just Good Stuff, a specialized range of organically

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sourced skin-care products with basic ingredients. At first it centered on two distinct lines of body butter: one with “heavier, more emollient” shea, preferred by Fuller, and the other with “lighter” mango, preferred by Meyer. Soon came lip balm, moisturizers, soaps, a shave bar made of kale and clay, and lip tints. “A lot of natural products that are out on the market don’t even choose tints that are safe for the lips. We choose wonderful ingredients. We don’t use fake things,” says Fuller. “Truly, you could eat most of our products.” As “girls that like to look for a bargain,” the pair made a commitment to keeping their products affordable. The shave bar is only $3, and the body butters are around $12. And though Meyer has reluctantly decided to leave the company to maintain a better work/life balance, Fuller will continue without missing a beat. That means Just Good Stuff will continue to be found right where it’s always been: places like Pilgrim’s, Main Market Co-op, Huckleberry’s and Sun People Dry Goods. — E.J. IANNELLI

reathing gives life. Isn’t it amazing that our bodies take more than 20,000 breaths per day, and that each breath removes up to 70 percent of toxins in our bodies? And we don’t even have to think for this to happen — it just does. Focused breathing exercises can help reduce stress, depression, anxiety, ADD, headaches and other disorders of the body and mind. In as little as five minutes a day, we can practice a simple breathing technique that can center us, help us focus, reduce stress and bring more productivity to our lives, even when chaos surrounds us. Begin by sitting quietly and taking several deep breaths through your nose, focusing on where your breath enters and exits the body. When you are ready, inhale slowly to a count of three. Hold for one count and exhale slowly Cat Carrel is a certified through your nose life coach in Spokane. to three counts. Next inhale to five, hold for two and exhale for five. Then inhale to the count of seven, hold for five, and exhale to seven. Resume calm, relaxed breathing until you are ready to continue your day. This breathing exercise takes less than five minutes and can be done anywhere, anytime we feel stressed, even while driving. — CAT CARREL

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Sudoku

RatingS: Gentle (left), Diabolical (right) To complete Sudoku, fill the board by entering numbers 1 to 9 such that each row, column and 3x3 box contains every number uniquely. Answers to all puzzles on page 41

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Codewords

Each letter has been replaced by with a number. Using the starter clues, work out the words that must go in each cell on the codeword grid. Some well-known phrases and names may also be found. For a two-letter clue, turn to page 34. 13

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Rating: Gentle Like Sudoku, no single number can repeat in any row or column. But rows and columns are divided by black squares into compartments. These need to be filled in with numbers that complete a ‘straight’ — a set of numbers with no gaps but can be in any order. Clues in black cells remove that number as an option in that row and column, and are not part of any straight. Glance at the solution above to see how ‘straights’ are formed.

4

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3 4 4 7 9 1 8 5 3 7 3 2 1 7 9 7 2

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news

in-depth

Jill Escher: “The autism explosion has been with us for more than two decades … and we have our heads in the sand.” Katy Raddatz photo

Mom on a Mission

With two of her three children having autism, Jill Escher aims to unravel a scientific mystery BY JANE KAY

J

ill Escher, a dark-haired dynamo of smarts and stamina, was gently stopping her son, Jonny, 14, from ripping up the mail. He had just emptied spice bottles onto the table to make finger paints. Upstairs, her daughter, Sophie, 7, was sending out incomprehensible cries. It could mean that Sophie had opened a box of crayons, eaten some and rubbed the rest into the carpet, or smeared a tube of

toothpaste on the mirror. And while Escher tried to calm Sophie, Jonny could be tossing his iPad over the fence, tearing all the ivories off the piano, chewing the furniture, or wandering out into traffic. For Escher, the anguish of autism is doubled. Both Jonny and Sophie have been diagnosed with autism, the fast-growing category of neurological disease afflicting one in every 88 U.S. children. The Escher

children’s intellectual development is stalled at an early preschool level, and they need constant care and protection. For years, Escher and her husband Christopher worried about what could have gone wrong. Why would two of their three children wind up autistic, defying the odds? Was it their genes? Their environment? Their food? The couple tried to ...continued on next page OCTOBER-NOVEMBER, 2013

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news

“mom on a mission,” continued... hunt down any health problems in their lineage but found none. A glass of wine while pregnant? Paint fumes? Pollution from freeways? New studies appear with regularity, suggesting causes but offering no definitive answers. “To be perfectly honest, I had given up trying to find out. I felt I would die never knowing what happened to my children. No one could tell me,” Escher said. But three years ago, Jill Escher had an epiphany, one that now consumes her waking hours and nighttime dreams. After prodding her mother for clues from her past, Escher discovered some hidden history: Her mother had sought help conceiving at a fertility clinic. As she grew in her mother’s womb, Escher was bombarded with synthetic hormones and other drugs. Now Escher’s dogged quest to unravel why this happened to her children has drawn the attention of scientists, and may ultimately lead to a greater understanding of how prescription drugs — and perhaps chemicals in the environment — may secretly and subtly harm the health of generations to come. “The autism explosion has been with us for more than two decades, and we

Michael Skinner is a pioneer in environmental epigenetics. wsu photo have little to show about what’s causing it,” Escher said. “We have many hundreds of thousands of functionally disabled people who didn’t exist before, and we have our heads in the sand.”

From generation to generation

Scientists know that some chemicals can alter developing embryos and fetuses, which can lead to disease later in life. In recent years, they’ve learned the damage doesn’t necessarily stop there. Something a pregnant woman is exposed to may alter not just her children, but also her grandchildren and possibly future generations. This is how the “germ line” hypothesis works: Cells in what is called a “germ line” form eggs in the female fetus and precursors to sperm in the male fetus. The germ line establishes an unbroken link from generation to generation. But when a pregnant woman is exposed to chemicals, the germ line may be altered. That would mean that eggs developing in the fetus — the future third generation — could be changed, leading to abnormalities or disease. The disrupted programming in how genes are turned on and off  — the very genes that instruct cell growth and function — may be passed on to more descendants.

The power of pharmaceuticals to do just that came to light with a synthetic estrogen that harmed at least two generations of offspring of women who took it. DES, or diethylstilbestrol, was prescribed to up to 10 million pregnant women in the United States and United Kingdom from 1938 to 1971 in an effort to prevent miscarriage and premature birth. DES daughters, exposed in the womb, are at an increased risk for a rare form of cancer of the vagina and cervix and other reproductive disorders, and the sons have increased risk for some reproductive problems. Startling scientists, DES granddaughters turned up with an increased incidence of urinary and genital malformations, irregular menstrual cycles and other abnormalities. These findings were profound: A single exposure of a pregnant woman could induce defects in her fetus’ developing eggs that are transmitted to the next generation. Now health experts probing autism wonder: Could this be a clue? Could a pregnant woman’s exposure to something alter the brains of her grandchildren?

A personal quest

When Escher’s first child Evan was born in 1997, he met his developmental markers.

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Two years later came Jonathan. “He was really colicky, and always seemed to be in some pain that we couldn’t soothe. He would sit in the backyard and pick up rocks and dirt,” she said. She saw the ominous signs: no eye contact, no babbling as a baby. The Eschers took him for an assessment. As soon as the doctor walked into the waiting room, he suspected autism. “Jonny is a brick. Nothing permeates his skull. He was just impervious to what we were trying to teach him. He was an affectionate little boy and remains so today,” Escher said. When Sophie was born seven years after Jonathan, she showed similar signs. She didn’t play or make eye contact. Her diagnosis came soon after. Genetic testing revealed no known abnormalities in either child, and no clinician could think of any reason for two children with such severe disabilities. According to the Centers for Disease Control and Prevention, parents who have a child with autism have only a 2 to 18 percent chance of having a second autistic child. In 2000 and 2002, one in every 150 U.S. children was diagnosed with autism spectrum disorders, which affect the brain’s normal development of social and communication skills. But the rate climbed to one in 88 in 2008, according to the CDC. Many experts believe the rise is due to a combination of a real increase in prevalence plus improved diagnoses. “We don’t know why the numbers are increasing, and we don’t know which portions of the brain are affected when a person has autism,” said neuroscientist David Amaral, research director at the University of California, Davis MIND Institute. “Twenty years ago, the view in the field was that autism was totally a genetic disorder, and if you could figure out which genes were involved, then you would understand the cause of autism. Now we’ve gotten to the point where we’re saying environmental factors have just as much influence as genetics,” he said. With no scientific training, Escher, 47, has educated herself enough to discuss new research with Amaral and other autism experts. She has a law degree from the University of California, Berkeley, and five years’ experience as a clerk in the U.S. District Court in San Jose, Calif. Five years ago, Escher and her husband founded a small family fund that first financed school recreational activities for autistic children, and research into its causes.

To her horror, she learned that researchers had discovered an autism cluster in West Los Angeles, where she grew up. In her search for answers, Escher came across a Tel Aviv University study linking in vitro fertilization with increased risk of autism. “That’s when it hit me that I might have been a fertility kid,” she said. She remembered a scrap of information tucked away. At 13, the cover of Time magazine featured a test tube to illustrate creating a baby with the aid of science. Someone — she thinks it was her dad — said to her, “You were just like that baby. You were a miracle child.” She wasn’t a test tube baby, but she wondered if her mother had taken fertility drugs. Escher called her mother and asked. “They gave me a whole bunch of stuff. I don’t know what it was,” her mother said. At Escher’s request, her mother called her former obstetrician. Four pages of records, stored on microfilm, were sent to Escher. Scrawled over the pages was a list of synthetic hormone drugs that her mother took. Over and over, she saw steroid hormones: Deluteval (a progestin with estradiol) and prednisolone. Escher learned that her mother had gone to a fertility clinic where she was prescribed Pergonal and Clomid to induce ovulation, as well as a continuing regimen of hormones and steroids as a way to prevent miscarriage during the pregnancy.

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Millions and millions of women who are now grandmothers took many medications during their pregnancies in the ’50s and ’60s. Escher wondered: Could the fertility, nausea and miscarriage drugs heavily prescribed in past decades alter the fetus and lead to lasting, transgenerational abnormalities such as autism? So far no one has looked, although one ambitious study is about to be launched in Europe. 5.0 h “Right now, research looks at environment and it looks at genetics. But it doesn’t look at the environmental effects on the germ line. These are critical questions. So far we’re silent on them,” Escher said. Science is very compartmentalized, she said. “We already have all the pieces. We just need to put them in order. But you don’t have one person stringing it all together.” Escher is trying to be the one to do that. One of the first scientists she contacted ...continued on next page

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news “mom on a mission,” continued... was Michael Skinner, a professor in the School of Molecular Biosciences at Washington State University. Skinner laid out the shift in thinking that is setting off waves of disagreement among geneticists. For more than a century, scientists believed that only alterations in the actual DNA sequence of genes could be passed on to subsequent generations. But now scientists believe that molecules called the “epigenome” modify a person’s instruction-giving genome in a way that tells it what to do, and where and when to do it. And the epigenome is much more easily influenced by environmental factors than the genome. Skinner explained it to Escher this way: “Think of the genome as the computer, and the epigenome as the software.”  The hypothesis is that if the germ cells are affected in the fetus, disruptions in signals can be transmitted to subsequent generations without affecting the DNA sequence. If at least three generations of offspring are affected, Skinner calls it “transgenerational.”

“I had given up trying to find out. I felt I would die never knowing what happened to my children.” “In essence, what your grandmother was exposed to when she was pregnant may cause disease in you and your grandchildren. Therefore, the potential hazard of environmental toxicants is dramatically increased, in particular for pregnant women in mid-gestation, six to 18 weeks,” Skinner said at a symposium on epigenetics and autism at UC Davis in March, partly supported by a grant from the Escher Fund for Autism. In lab animals, Skinner and other scientists have linked a dozen chemicals, including phthalate plasticizers, the insecticide DEET and a fungicide, to transgenerational epigenetic changes that have led to tumors, prostate disease, reproductive problems and other problems in at least three generations of offspring. Environmental epigenetics may have an important role in the origins of autism, Skinner said. “The majority of brain disease has been shown not to be genetically based, and autism is likely environmentally

an unexplained explosion U.S. children diagnosed with autism per thousand

11.3

9.0 8.0 6.6

2002

induced during some period of development,” he said.

more research needed

Possible links between autism and multigenerational effects of environmental exposures are in the early stages, and they remain a topic of debate among scientists. “So far there are only a handful of gene mutations that are found in the human autism population. For the majority of patients we know something else is going on, and that might be epigenetic changes,” said Emilie Rissman, professor of biochemistry and molecular genetics at the University of Virginia School of Medicine. Many diseases have increased faster than can be explained by normal genetic mechanisms. The epigenetic phenomenon could be a reason. “If environmental factors influence gene expression, the risk of someone having autism could increase,” said UC Davis’ Amaral. But Amaral said more basic science is needed to figure out the possible effects of environmental toxicants and pharmaceuticals. “Not enough is being done,” he said. “There are many pieces of information learned from more than a decade of study that need to be connected before any conclusion can be made about autism,” said Andrea Gore, professor of pharmacology and toxicology at the University of Texas at Austin. Gore was one of the first researchers to show in lab animals that prenatal exposure to hormone-like chemicals interfered with development of the neurological and reproductive systems, leading to abnormalities, including social and neurobehavioral disorders. “It’s too soon to make a direct connection between exposure to synthetic reproductive hormones and autism,” Gore said. “We think most behavioral disorders are a combination of genetic predisposition, natural differences in reproductive hormones and differences in environmental

2004

2006

2008

exposures.” University of California, Davis, autism researcher Janine M. LaSalle said human studies over many generations would be needed to determine whether genomes and epigenomes may be increasingly susceptible to autism due to a multitude of environmental factors. With lab animals, Gore and her colleagues will conduct transgenerational studies of hormone-mimicking chemicals to try to understand molecular changes in the brain and the connection between nerve cells and behavior. “The caveat is that animals don’t get autism spectrum disorders. All we can do is look at perturbations of normal behavior in ways that we believe may mimic some aspects of autism,” she said.

family histories

Last summer, Escher, along with Alycia Halladay of the national nonprofit Autism Speaks, presented the germ line disruption hypothesis to a committee of the National Institute of Mental Health, which is congressionally mandated to deal with the autism crisis. The National Institutes of Health has begun funding some epigenetics studies related to autism and prescription drugs. A large study in Europe, led by the Mount Sinai School of Medicine, is looking at medications taken by mothers and the health of their offspring. UC Davis researchers are examining links between exposure to air pollution and pesticides, epigenetic changes and increased risk of autism. Johns Hopkins University researchers are testing for epigenetic changes in autistic children associated with prenatal exposures to environmental chemicals. The National Institute of Mental Health is financing some studies on pharmaceuticals, including an investigation of whether antidepressants are causing epigenetic changes. And an ambitious, first-of-its-kind study of 8,000 people in Denmark, partially paid

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antidepressants under the scope

P

regnancy can be a stressful, emotional experience and women who become depressed may turn to medication for help. But researchers in Sweden have reported a link between antidepressants and autism. Pregnant women taking SSRIs showed a more-than-triple increase in risk of offspring with autism spectrum disorder. Other researchers in the San Francisco Bay Area examined the association between autism and antidepressants during pregnancy. In a study published last year, they found a more than twofold increased risk of autism associated with SSRIs, with the strongest effect found in the first trimester. One research group concluded that “fetal and infant exposure to SSRIs should be examined in humans, particularly those with developmental dysfunction, such as autism.“ When asked about any ongoing studies by the U.S. Food and Drug Administration, spokeswoman Andrea Fischer responded: “The FDA is not aware of any studies demonstrating that antidepressant use causes autism.” There have been no studies looking for potential epigenetic or germ line effects of SSRIs. WSU’s Michael Skinner is intrigued, and wants to study germ line changes related to pharmaceuticals, but says the research funds aren’t there. “In my opinion, it’s a catch-22. If we can’t find research money to do the studies, then the medical community is not going to pay attention. All it would take is a few good publications to raise the red flag. Then the industry would respond accordingly, and the FDA would respond,” he said. — Jane Kay for by Escher’s fund, will look for connections between any pharmaceuticals they were exposed to in the womb and neurological disorders of their children. Scientists, Escher said, have access to a treasure trove: the parents and grandparents of autistic children. “Most autism families can generate very strong clues about what could have happened with their children. But it requires probing deep into ancestral exposures. The clues are there,” she said. As for her own anguish, “I love my kids. But I don’t want this to happen to anyone else. It’s too hard. It’s too damaging.” n A version of this story first appeared in Environmental Health News (environmentalhealthnews.org).

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health grades

Volunteer ombudsman Tamela Carlson leaves the SNAP offices in north Spokane on her rounds to check in on those who might have trouble speaking up for themselves. stephen schlange photo

Eyes and Ears

SNAP’s Long Term Care Ombudsman Program helps look out for some of the region’s most vulnerable people: those living in long-term care facilities BY HEIDI GROOVER

T

wo days a week, 52-year-old Tamela Carlson grabs a 2-inchthick binder filled with detailed laws and regulations and winds her way past 100 rooms housing elderly, sick and wheelchair-bound patients. She checks in at the front desk, then pops her head into rooms throughout the facility, waving to some patients and stopping to talk to others. Sometimes she just says hello; other times she listens and listens. A volunteer for the nonprofit SNAP’s

Long Term Care Ombudsman program, Carlson is assigned to check in on a north Spokane nursing home, looking for signs of insufficient care or helping patients resolve concerns or questions. The program handles serious abuse issues if they come up, but more often deals with the small comforts or questions from patients or their families about care plans. “Everything else gets taken away. They lose their loved ones, they lose their homes, they lose their independence. So much is

lost as they get older,” Carlson says of the people she visits. “It’s helping them hang on to what little bit they have left, [like] their favorite chair or a few decorations from home.” The program is mandated by amendments to the federal Older Americans Act, which outlined protections states must have for elderly people living in assisted living facilities and strengthened protections against age discrimination. The Eastern Washington program, an extension of the

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statewide ombudsman, currently has about 40 volunteers and an office that takes calls from around the region, serving nearly 300 nursing homes, assisted living facilities and small adult family homes (where a caretaker looks after just a few people), says program director Linda Petrie. The program covers five Eastern Washington counties, from Spokane south to Whitman, north to Pend Oreille and west to Ferry. The program is all-volunteer, making it naturally vulnerable to understaffing. But it’s still robust compared to other states, where an ombudsman program can be as little as a poster in an assisted living facility offering a phone number to call with complaints or concerns. “Elderly people always deserve dignity and respect. As ombudsmen we go into these facilities and can become the eyes and ears for the residents or, perhaps, for their family members who do not live in Spokane,” says Sharon Niblock, another volunteer with the program. Six years ago, when her own mother was in an assisted living facility and Niblock found herself unhappy with the care, the ombudsman program helped her move her mom to another facility. Now, at 70, Niblock says the program gives her the opportunity to stay active and give back to the community. She checks on three South Hill locations any time she’s out running errands, stopping in sometimes just to say “hello” and help build relationships with residents. This, volunteers say, is crucial to getting residents to trust the program enough to actually express concerns about their care. “In that age group — 80, 90, 100 — when they were growing up they were basically socialized not to complain,” Niblock says.

T

he need for oversight is great. According to the Nursing Home Report Card Project — a report released annually by the nonprofit Families for Better Care — nearly 90 percent of all nursing homes have been cited by state agencies for deficiencies in care, and one in five nursing homes has mistreated or neglected residents in almost half of all states. “I’ve seen more neglect and abuse than anyone needs to see in a lifetime,” says Brian Lee, the executive director of Florida-based Families for Better Care, who has also worked in ombudsman programs in Illinois and Florida. “There have been many attempts to improve [nursing home care], but it’s no better today than it’s been in a long time, if ever.” Families for Better Care ranks each

CHECKING THE REPORT CARD

Find state report cards from Families for Better Care at nursinghomereportcards.com. Similar state-by-state reports, sponsored in part by the AARP, can be found at longtermscorecard.org. Find and compare nursing homes based on health inspections, staffing and quality measures at medicare.gov/nursinghomecompare. — HEIDI GROOVER state with a letter grade based on data from state and federal agencies measuring performance and resident complaints. This year, Idaho received an A grade, while Washington got just a C. According to the reports, Idaho nursing homes offer more hours of staffing per resident — a crucial metric for measuring how attentive care is. (The ideal for “direct care staffing hours” per resident per day, Lee says, is 2.8. Washington is at just 2.5; Idaho is at 2.75.) But Washington had a higher rate of verified ombudsman complaints, which, while it negatively reflects on the state’s score, could also mean the state simply has a more active ombudsman program, Lee says. More than 85 percent of facilities in both Washington and Idaho report deficiencies, and more than 30 percent have “severe deficiencies,” which are “immediate jeopardy or actual harm violations that resulted in resident injury, abuse, neglect, or death,” according to the group. Back in SNAP’s quiet, tree-surrounded headquarters near Spokane Falls Community College, Petrie says just the existence of oversight can mean facilities behave better, and that improves care for everyone. Despite struggling with funding cutbacks and volunteers who come and go, Petrie says, volunteers addressed 304 complaints and logged more than 5,500 hours in facilities across the region last year. Now, Petrie has just trained a new crop of volunteers to help with the program, arming them with an understanding of rules and regulations, plus old-fashioned intuition. “We’re looking at quality of life stuff,” Petrie says. “You have a sense. If somebody’s not being listened to, you know. I think we all have that instinct [to say] ‘Hey, this person’s being overlooked.’”  heidig@inlander.com To volunteer with the Eastern Washington Long Term Care Ombudsman Program, call 456-7133. To report a concern about a facility in Eastern Washington, call 800-562-6028. To report a concern in North Idaho, call 800-786-5536.

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LIVING

Home

is where your

Healthis Where you spend your time has an impact on your health. Choose wisely STORY BY LISA WAANANEN

T

he large brick building was dilapidated, almost condemned. Once a railroad hub, where streetcars and then freight cars were repaired and maintained, the tall windows had been sealed with cinderblocks years earlier. Mold had found a welcoming place to thrive, and mice had taken up residence. The building firm McKinstry decided to make it their new Inland Northwest headquarters. Kim Pearman-Gillman, McKinstry’s director of strategic market development, remembers how musty it was inside. They found lead paint and hydrocarbons from the engines and oil. And the company had to consider the whole site: The soil was contaminated with lead and arsenic, and BNSF arranged to have more than 3,000 tons of hazardous waste carefully removed from the site. In just over a year, the structure was transformed into a light-filled, LEED-certified office space, both sustainably built and energy efficient. “We wanted to take an older building and make it something very ...continued on next page

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LIVING HEALTHY HOMES “HOME IS WHERE YOUR HEALTH IS,” CONTINUED... special,” Pearman-Gillman says. The building is now a handsome testament to the belief that Spokane’s historic structures can be effectively salvaged, but it’s also an example of how to think about building toward a healthier environment. We tend to think of home improvement in terms of fresh paint, new light fixtures and remodeling dreams, while we think of

the Washington State University College of Nursing, who specializes in environmental health. Americans spend more than 90 percent of the time indoors, and the majority of that in their homes. Whether a charming old Craftsman, a renovated loft or brand new construction, all housing carries some possible risks that can be especially harmful for children. It’s obvious to parents that children need to hold a hand to cross the

says. If you spray your lawn or garden for pests, for example, use the lowest dose that’s effective and wash contaminated clothes separately. “You’re going to want to take your boots off at the door,” she says. Thousands of homes in Spokane have been assisted by a city program that offers testing for lead and other hazards. Shannon Meagher, program director of the Community Building Division at Kiemle & Hagood Company, which administers the program, says the main priority is to protect children. If tests detect hazards, a field agent works with the homeowners to come up with an action plan and arrange for improvements to be done affordably. But they also tell families that one thorough check-up isn’t enough to guarantee safety, because hazards can enter the home in many ways. Take the shiny plastic mardi gras beads that tend to show up everywhere — most may be fine, but some imported items have tested off the charts for lead and other metals like cadmium and arsenic. “Unless you test it, you can’t tell,” Meagher says.

GET THE LEAD OUT

The reclaimed interior of the SIEER Building at McKinstry Station. DEAN DAVIS PHOTO healthy living as matter of eating well and getting to the gym. In fact, the places we live can affect our health in serious and long-term ways, and preventative care is required to check for health hazards that could be lurking in our homes and workplaces undetected. “What we’ve learned is that many environmental health risks in homes are invisible,” says Patricia Butterfield, dean of

street, Butterfield says, but environmental safety can be more troubling because it’s not as straightforward. “A lot of environmental health information is technical, and people need commonsense answers,” she says. “They just need to know what to do.” Along with testing for radon, lead and carbon monoxide, the important thing is to stay vigilant for possible risks, Butterfield

Most parents of young children are familiar with the risks of lead paint, which was banned in 1978. But lead paint is found in virtually all homes built before 1940, and a federal survey in 2011 found lead-based paint hazards in more than 20 percent of all homes. The presence of lead paint isn’t always a hazard — if it’s not flaking off or gathering as dust, like on window sills, it’s not an immediate health risk. Home renovations can reintroduce the risk factor if precautions aren’t taken to remove dust. The nonprofit National Center for Healthy Housing estimates that more than 1 million children are exposed to ...continued on page 27

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11 Tips for a healthier home by Lisa Waananen and Chris Bovey

FIREPLACE

TOYS

Imported toys occasionally contain lead. Also be careful with family heirlooms and antiques.

Fireplaces are a major source of indoor pollution if not vented properly to the outdoors.

STOVE

Cooking food is a huge source of indoor air pollution, especially with gas stoves. Always turn on the range hood.

ASBESTOS

Asbestos was commonly used in home construction. Make sure it is not disturbed or damaged.

LEAD-BASED PAINT

Almost every home built before 1940 has leadbased paint somewhere. Make sure it’s not flaking or turning to dust.

PROJECTS

Be mindful of hobbies like welding, furniture refinishing and gardening. Wash contaminated clothing separately.

RADON

The Inland Northwest is known for having high levels of radon. Test the basement, where concentrations are highest.

CLEANING SUPPLIES

Use environmentally friendly and non-toxic cleaning supplies to keep caustic chemicals out of your home. Turn on a fan or open a window while cleaning.

SOIL

Watch for soil contaminants, like lead paint flaking off from the house. Don’t grow vegetables in suspect soil.

MOLD SINK

Water from a private well should be tested annually for bacteria, heavy metals and other contaminants.

Watch for leaks and condensation, which can make an inviting environment for mold.

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living healthy homes

Kitchen Emissions You may be inadvertently cooking up pollution BY LISA WAANANEN

T

he kitchen is the heart of a modern home — but a growing body of research shows that, despite our contemporary appliances, it also remain a major source of indoor air pollution. Air quality in a significant number of homes with gas stoves wouldn’t meet outdoor pollution standards, researchers at the Lawrence Berkeley National Laboratory found this year. The Southern

California lab is a hub for studying indoor air quality and the ways it contributes to long-term health respiratory and cardiovascular risks. “Your home is really your fishbowl,” scientist Jennifer Logue explains in a new Q&A video series to answer consumer questions. “It’s where you live, it’s where you breathe, it’s where you’re exposed.” Not only did the team find hazardous levels of nitrogen dioxide

and carbon monoxide in typical kitchens, they also put a variety of range hoods to the test and found

that most aren’t very effective at whisking those pollutants out of the house — and that’s if people even

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remember to turn them on. Gas burners release the most chemicals, but electric burners and toasters also produce fine particles that can enter the lungs. Now they’re working on a rating system that will tell consumers which range hoods are most effective, and a goal down the line would be seeing quieter range hoods that turn on automatically when meals are being prepared. Berkeley Lab tips for reducing kitchen air pollution:  Always turn on the range hood when cooking or baking.  Make sure your range hood filters to the outdoors, not circulating within your home.  Cook on your back burners if your range hood does not cover the entire surface.  Look for range hoods that move at least 200 cubic feet of air per minute.  If it’s not possible to install a range hood in your kitchen, opening windows is better than nothing. 

“HOME IS WHERE YOUR HEALTH IS,” CONTINUED... lead paint hazards each year during remodeling projects or renovations. Parents should be aware that young children can easily come into contact with lead, even if they’re not chewing on window sills. “They explore the world through touch and taste,” Meagher says. “You can’t stop that behavior.” Lead-based paint can be found on vintage furniture or heirloom toys, too, and in other non-paint sources: High levels of lead have been found in a range of imported goods like miniblinds, dishes and even toys and jewelry meant for children.

HIDDEN HEALTH RISK

Like lead, asbestos isn’t harmful if it’s contained and left alone. But the fibrous mineral can cause lung scarring and cancer over extended exposure. It was a popular building material through the 1970s and can be found in houses built into the ’90s, often as insulation in attics or around pipes and boilers. It’s important to identify asbestos before beginning any home renovations, and health agencies recommend hiring asbestos abatement professionals if asbestos must be disturbed.

CHECK FOR RADON

The Inland Northwest is known for having high levels of radon, a naturally occurring radioactive gas that can seep into homes from the ground, and Meagher says they’ve seen that to be the case in homes they’ve tested. “We are finding some pretty high numbers in this area,” she says. Radon is no small risk — behind smoking, the colorless and odorless gas is the leading cause of lung cancer in the U.S. Homes are tested in the

United States’ homeowners will spend more than $150 billion on remodeling in 2013. — Harvard Joint Center for Housing Studies basement or lowest floor, and a radon-mitigation system that vents the gas out of the house can be installed if levels are dangerously high. New homes in the area are required to have radonresistant features, but it’s still a good idea to test that the systems are working properly. 

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living healthy homes

The Gee regularly attracts curious passersby in the Logan neighborhood. What’s not as apparent are the home’s energy-saving features. YOUNG KWAK photos

Life in a Green House This eye-catching orange house offers an environmentally friendly lifestyle BY ANNA CLAUSEN

W

hen you picture college housing, you often think of a run-down house, perhaps with a ratty couch on the porch and students sweating out the summers and wearing parkas inside during the winter to save a few bucks. You don’t picture living in a green house

— green, as in environmentally minded (technically it’s bright orange) — but I’ve been fortunate enough to call it home. The Gee House, as it’s called, is a co-op home in the Logan Neighborhood. The residential building is LEED (Leadership in Energy and Environmental Design)

Platinum certified, as well as Energy Star rated. It’s also won a bevy of awards, most recently the Best of America Living Award. Buzz Price, the owner, teamed up with Dennis Cunningham, president of ActiveWest Builders, to create, design and build his dream home. While Price knew he wanted

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to make the building a co-op-style house, Cunningham brought the environmental aspect to the project. Cunningham makes it quite clear that a LEED certification isn’t easy to come by. Every part of the building and its materials had to be inspected and certified, and inspected again. The building’s main source of heat comes from water under the cement floors. Every appliance, from the laundry room to the kitchen, is Energy Star rated. The windows are strategically placed throughout the house for natural light, and the design allows for the airflow to negate the need for much air conditioning. All materials used to build the Gee came from within 500 miles, and 90 percent of the waste material was recyclable. The list goes on, and makes it apparent how much thought and dedication went into creating the house. During his college years at Berkeley, Price lived in a house a lot like the Gee. He wanted to bring the style back to Spokane. “That was the best way to live in college. You were less isolated, and more like

One-third of U.S. homebuilders expect to be fully dedicated to green building by 2016. — Green Outlook Report, McGraw-Hill a family than just living together,” he said. When he was envisioning the Gee, he wanted it to be a place for friends and families to gather and enjoy all of the unique features the structure has to offer. But it’s not just family and friends who have noticed my house. Complete strangers have stopped me on my way out to either tell me how “tight” the house is or ask me what it is more times than I can count. I see cars slow down and stare dumbfounded at the place. People don’t know what to make of this huge orange, modern building next to a Mexican restaurant in the Logan Neighborhood. That was Price’s intent. “I call it nose-on-window marketing. I want people to look in and be fascinated by it. It really grabs your eye,” he said. Cunningham doesn’t know if the LEED Platinum-and-green building will catch on in Spokane, due to the added price and time commitment it takes to make a building green, but Price hopes to construct more buildings like the Gee House at other colleges once he starts to turn a profit. 

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LIVING

COOKING

TOP: Salmon with fall vegetables. BOTTOM: Scenes from Syringa, and Chef Viljo Basso. MIKE McCALL PHOTOS

A Fusion of Flavors Celebrating fall with a unique blend of Northwest and Japanese cuisines BY CARRIE SCOZZARO

I

nspiration comes in many forms for Viljo Basso of Coeur d’Alene’s Syringa Japanese Cafe & Sushi Bar. “I draw it from other chefs,” says Basso, whose post-culinary-school experiences in Seattle ranged from classic French cooking under Rover’s chef/owner Thierry Rautureau to celebrating Northwest cuisine at the former Cascadia. Also in Seattle, Basso

learned Japanese cooking at Mashiko and was head chef at the now-shuttered Saito’s. When the Bassos returned home to Coeur d’Alene in 2002, Viljo worked alongside Ryuhei Tanaka of the now-closed Takara. Armed with a passion for seafood, his very sharp chef knives and an idea for a sushi restaurant that he originally conceived while at culinary school in Oregon,

Basso opened Syringa in 2006 with his wife Autumn. Dishes at Syringa are predominantly Japanese. The restaurant is highly regarded for its very fresh fish, generous portions and fare that goes above and beyond typical offerings of sushi, sashimi, tempura and yakisoba noodles. The Hamachi Kama, for example, is a humble “collar” of bone-in

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Your Downtown Full-Service Grocery Store & Deli yellowtail tuna, expertly cooked with a light crust and delicate, lemony Ponzu sauce. Basso’s advice for selecting fish? If you’re buying a whole fish, he says, look for clear eyes, nice red gills, shiny skin. Don’t be put off by the slippery texture; that means the fish is fresh. Filets, says Basso, should be brightly colored, moist and slightly firm; avoid anything cracked or soft. That’s the kind of advice that aspiring cooks appreciate, no matter their age. Basso enjoys partnering with other regional chefs to share their knowledge. In addition to teaching sushimaking for adults at Coeur d’Alene’s Pilgrim’s Market, last summer he teamed up with chef Adam Hegsted of the Coeur d’Alene Resort & Casino, chef Ryan Stoy of The Cellar and fellow sushi chef Troy Chandler from Bonsai Bistro to teach a cooking class for kids as part of Art on the Edge, a local program assisting youngsters who are in transitional housing. And last year, he joined Hegsted’s team invited to cook for the prestigious James Beard Foundation. His willingness to experiment keeps Syringa’s menu fresh, with occasional unexpected glimpses of his past restaurant experiences — in dishes like potato croquettes or Alaskan scallops with Swiss chard and vanilla teriyaki sauce. “I also draw inspiration from the seasons,” adds Basso, who recently returned from a seafood trade show in Seattle to bring us this issue’s recipe: wild salmon accompanied by a colorful hash of Chanterelle mushroom, yam and squash, topped with Basso’s spin on traditional Japanese miso (fermented soybean). Salmon showcases the northwest at its best, says Basso. “And it’s the perfect complement to wild mushrooms.” He adds, “We are blessed to live in an area that provides us with a myriad of forageable products right out our own front doors.” 

RECIPE

Salmon with Fall Vegetables

Hash

1 orange or yellow yam or sweet potato diced, medium cubes Handful Chanterelle mushrooms (substitute other types if you prefer or eliminate) 1 yellow squash diced, medium cubes 1 zucchini diced, medium cubes 1 onion diced, medium cubes 2 tablespoons olive oil Tablespoon butter

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1. In a heavy sauté pan, melt oil and butter over medium heat. Add onions, cook until translucent. Add yams and mushrooms. Stir and cook until all water has evaporated and mushrooms wilt a bit. Add yellow squash and zucchini, making sure to keep all the ingredients moving in the pan. Reduce heat to low, cook until vegetables are soft but not mushy. 2. Taste and adjust seasoning accordingly.

Miso sauce

6 tablespoons ounces white miso (in refrigerator section at Asian markets/specialty stores) 4 tablespoons rice wine vinegar 2 tablespoons mayonnaise  White pepper Blend all ingredients together. Add pepper as needed, mayonnaise if too salty (miso is salty) and vinegar if it’s too thick to coat back of spoon.

Fish

4 six-ounce portions salmon, skin on (or other firm fish) Salt and pepper to taste Tablespoon butter, for cooking 1. Preheat oven to 400 degrees. Season each side of fish with salt and pepper. In a heavy, ovenproof sauté pan on mediumhigh heat, add butter, stir and cook until it turns brown. Add salmon. Cook a few minutes until you can see caramelizing on one side of the fish — lift gently with spatula to check. 2. Turn salmon over gently in the pan, place whole pan in preheated oven. Cook an additional 4-5 minutes until fish is medium-done (1-2 minutes longer if you like it firmer). Check for doneness by placing a knife tip in the fish and slightly lifting the flesh. 3. Remove from pan and place on paper towel to absorb excess fat. To plate, spoon warm hash onto a plate. Place salmon on top, spoon miso sauce over top.

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Health 31 9/26/13 1:07 AM

living

Psychologist Jennifer Van Wey explains how the brain can benefit from a progressive training regimen. Stephen Schlange photo boomers

A Gym for Your Brain Log in and start training BY DEANNA PAN

A

re you easily distracted? Do you have trouble putting names to faces? Are you prone to losing your keys, cellphone, glasses or wallet, or walking into a room in your house and forgetting why you were there in the first place? Once we reach our 40s, our brains start to shrink — literally. It’s microscopic atrophy, a normal part of aging. But if you’re worried about staying sharp, a little regular exercise can keep your mind agile, healthy

and strong. A growing body of evidence suggests that engaging in frequent mentally stimulating activity can improve “executive functions,” like working memory, processing speed, mental flexibility, and verbal fluency, and even reduce one’s risk of dementia. “Your brain is like a muscle,” says Jennifer Van Wey, a psychologist with the Spokane-based Northwest Neurobehaviorial Institute. “You want to work it out.”

B

rain training games have become a multimillion-dollar business. Lumosity, one of the most popular online brain training programs, has grown dramatically since it was launched in 2005 and now boasts 40 million subscribers worldwide. A Stanford University study published in May found that breast cancer survivors who had undergone chemotherapy showed “significant improvements” ...continued on page 34

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living “a gym for your brain,” continued... in various cognitive functions after playing Lumosity games over 12 weeks. Mickey Brown, 60, a Spokane developer, logs in to Lumosity and plays for 15 minutes every morning with his cup of coffee. In 2004, Brown was a victim of a serious motorcycle accident outside of McCall, Idaho. He remembers waking up “six weeks later and 75 pounds lighter” at Seattle’s Harborview Medical Center. “Everything was broken,” he says. A medically induced coma significantly hampered his ability to remember. For about two and a half years afterward, his memory was spotty. He started using Lumosity about a year ago and has noticed his memory and attention improve. “My short-term memory loss was profound and long-term memory was affected. I’m finding now that it is helping me,” Brown says. “When I set something down or put my keys somewhere, I remember. We all take that for granted.” Lumosity measures your “brain performance index” based on your results in training games targeting specific cognitive abilities, such as attention, problem solving,

memory, mental speed and flexibility. With brain’s an organ and these are protective Lumosity, you can create a “personalized factors, Van Wey explains. Chronic physitraining program” tailored to the brain cal and mental health problems exacerbate functions you’d most like to improve. Varicognitive decline. ous exercises test your capacity to process “Those three things are absolutely cruinformation, remember names and objects, cial,” Van Wey says. “There’s a lot of good or solve equations. The games progresevidence, not just anecdotal evidence, but a sively adapt to your lot of good evidence that people skill level, so as you who have been unhealthy with get better, the games their eating, who are overweight, from the puzzle on page 13 become more difficult. who are very stressed, who don’t “It’s rehab for the sleep well, all of the sudden 8 = E; 6 = D brain,” says Brown. make some big lifestyle changes, “I’d recommend it to and their brain health improves anyone, particularly anybody who enjoys dramatically.” mental challenges.” For brain games, Van Wey recommends a program called Dakim BrainFitness, he Northwest Neurobehaviogeared toward adults 60 and older, because rial Institute offers its own brain it boasts proven results from a UCLA training program for those who’d study. But, she says, regardless of the prefer in-person instruction. “Brain Boot game or program you use, “it’s good to do Camp” is a three-hour interactive course on anything to keep your brain active.” And a Mondays and Fridays for people who want routine is important. to improve their visual and verbal mem“If you’re going to get healthy or lose ory. In addition to teaching strategies for weight, you’re not going to go to the gym remembering things like names and faces, once and have any kind of improvement,” the course also emphasizes the importance she says. “It’s going to have to be part of of stress reduction, exercise and healthy your life, routinely, and the more you pracnutrition in enhancing one’s memory. Your tice, the better you get at it.” n

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Farmgirlfit owners Jaunessa Walsh (left) and Jenni Niemann power through their regimen.

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he inside of Farmgirlfit is not, as you might be tempted to think, strewn with hay bales. There are no fences to hop, no scarecrows to hurl or kick, no tractors to tow with thick rope. In fact, given its austere purple and gray color scheme, it looks a lot like any other contemporary gym, replete with rowing machines and pull-up bars. On the wall there’s a whiteboard with a list of names and ascending times next to them. And then, yes, almost tucked away in the corner, some giant tractor tires. All that familiarity is misleading, though. Farmgirlfit is a deliberately different exercise regimen, or rather, a different approach to exercise in general. Because it’s designed by women exclusively for women, it offers an alternative to the common style of crossfit training that tends to be geared — both physically and psychologically — toward men. That’s because military-style training informs a lot of crossfit workouts. As a result, crossfit can either place too much emphasis on weights, thereby overtaxing women, or it can be too timid when it comes to female weight training. “The personalities that are attracted to [crossfit] tend to be more intense,” says Jaunessa Walsh, who co-owns Farmgirlfit

with fellow Gonzaga alumna Jenni Niemann. “More men seek out weightlifting, whereas women want to change up what they’re doing. They look more for pilates, or now barre (ballet-inspired workouts) is the big phrase, or BodyPump. Women just don’t naturally gravitate towards weights as much.” With this basic difference in mind, back in 2011 Walsh and Niemann set about designing a fitness program that catered to women and their practical exercise needs. The pair aimed “to focus on quality of life,” rather than “gimmicky devices” or fitness for fitness’ sake, which ultimately translates to “being able to do the things you want to do: keeping up with your kids, your grandkids, being able to stand up without having to heave off your chair,” Walsh says. “The name Farmgirlfit came from the idea of getting back to basics. Jenni grew up on a farm in Oregon, and a lot of people who grew up in rural communities were fit because they had to be,” Walsh explains. “Our lifestyle doesn’t necessarily require that, but that doesn’t mean we can’t work towards it.” The regimen they’ve designed is split into segments called The Grind, supplemented by an optional high-energy work-

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out called Volt:30. The Grind has four variants for different days of the week, and each one has four different levels to accommodate varying fitness abilities. What they all have in common is that they try to allow each woman to work at her own pace, and they’re a holistic, rather than a targeted, form of exercise. “There are different ways to work out if you’re looking to bulk up, versus if you’re trying to be strong but leaner,” Walsh says. “We’ve tried to take this model of high-intensity interval training” — or HIIT, as it’s commonly abbreviated — “using full-body range of motion. So we don’t isolate muscle

groups. We do movements that work the whole body and are more core- (or middlebody) centric. We try to take that style and bring it to women in a way that is achievable for them, but also challenging.” For all their planning, however, Walsh and Niemann were surprised by the type of women who became regulars. “When we started, given the ages that Jenni and I were, we thought it was going to be younger women. It’s really been a slightly older demographic, a lot of younger moms who have school-aged kids. They want to refocus on themselves.” Which isn’t to say that Farmgirlfit limits it-

self to those age ranges. “We do have quite a few women above 50, above 60, who’ve had tremendous results.” Across the breadth of its participants, the testimonials have been glowing and consistent. What Farmgirlfit members cite isn’t just the quality of the workout itself, but the inspiration and encouragement that strengthens their resolve. “They know when they walk in the door it’s going to be a tough workout,” says Walsh. “They’re going to have to work hard. But if you do, you’re going to get the results that you want. And we’ve built it in a way that you can get there.” n

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LIVING BEAUTY

Under the Skin

The tool developed by CryoShape to treat keloid scars.

A cool new way to treat keloids and excess scarring BY LEAH SOTTILE

F

or more than a decade, Joey Jones’ life was overtaken by a deep, allconsuming shame. It was a shame that kept him from swimming or sunbathing. He avoided hugging people as they might feel the scars under his shirt. At about age 18, Jones says he started to develop large raised scars resulting from the slightest nick in his skin — acne, vaccines, a small scratch. When he went to the gym, the thick scars, called keloids, would burn underneath his T-shirt. During hot weather, they would itch. Keloids are a pretty common affliction, but they are “hard to treat,” says Dr. Benjamin Hsu, a dermatologist at Northwest Dermatology in Spokane. “[Keloids are] basically a thick or overgrown scar.”

The scars are mysterious. “Why it happens to some people, it’s not really clear,” Hsu says, adding that dermatologists have noticed that keloids tend to affect people with darker skin, and appear most often on the torso. “We’re not sure why.” What is certain is that keloids can be traumatic. “This isn’t just a cosmetic thing,” says Jones. “It’s the itch, the pain and the disfigurement and the emotion behind it.” Spokane Valley dermatologist Thomas Ryan agrees. “They’re sensitive and tender, and you can’t imagine what a bunch of keloids will do to a teenager’s social life.” Treatment of the stubborn scars has generally involved freezing them with liquid nitrogen, cortisone injections, lasers and even radiation; but, according to Ryan,

while many patients experience some degree of improvement, nothing has been all that successful. At Jones’ urging, Ryan agreed to learn to perform intralesional cryotherapy. Instead of freezing the keloid from the surface, the technique involves using a probe through which liquid nitrogen flows, freezing the keloid from the inside out. In this way, the deeper, abnormal cells of the keloid can be destroyed, while leaving nearby skin intact. “I was pleasantly surprised,” by the treatment, says Ryan. “There hasn’t been much you can do that produces much of an effect… It’s at least as effective as anything else I’ve done, probably more so.” 

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benefit

OCTOBER-NOVEMBER events LAUGH FOR THE CURE Comedy night fundraiser event benefiting the Eastern Washington Affiliate of the Susan G. Komen for the Cure, featuring comedian Shaun Jones and opener Drew Barth. Oct. 3 at 6 pm. $75/person. The Lincoln Center, 1316 N. Lincoln St. Visit: komeneasternwashington.org Call: 315-5940 INTO AFRICA Partnering for Progress hosts its annual fundraising gala featuring dinner, wines and a silent and live auction to benefit its mission of continuing its health and education projects in Kenya. Oct. 4 at 6 pm. $65/person. The Lincoln Center, 1316 N. Lincoln St. Visit: intoafricaauction.org Call: 720-8408 BARK FOR LIFE The annual fundraiser dog walk benefits the American Cancer Society and honors the caregiving qualities of canine companions as well as pets who have been lost to cancer. Oct. 5 at 10 am. $10-$25. Whispering Pines Park, Eagle Ridge neighborhood in Southwest Spokane. Visit: relayforlife.org/BarkSpokaneWA Call: 242-8291 WALK FOR WISHES Make-A-Wish Foundation’s annual fundraiser 5K walk/run generates funds to help grant wishes of local children with life-threatening medical conditions. Oct. 5 from 8:45 am to noon. $100 minimum fundraising goal encouraged. Mirabeau Meadows, 13500 Mirabeau Pkwy. Visit: akwa.wish.org Call: 206-623-5300 HOEDOWN FOR HOPE The nonprofit Spokane HOPE (Hearing-Oral Program of Excellence) School’s annual fundraiser features dinner, cocktails, dancing, live music

and a raffle. Oct. 5 at 5 pm. $55/person. Rockin’ B Ranch, 3912 Spokane Bridge Rd., Liberty Lake. Visit: spokanehopeschool.org CIRCLE OF HOPE Attend a benefit breakfast at the Davenport Hotel to learn more about The Spokane Guilds’ School’s services for children and their families. Oct. 6 from 7:30 to 8:30 am. Free. The Davenport Hotel, 10 S. Post St. For more information or to RSVP: contact Korin Neal at 326-1651. RUN FOR THE ANGELS Participate in a 5K run/walk benefiting the Inland Northwest SID Foundation. Other events include a silent auction, crib bumper drive and remembrance ceremony. Oct. 6 at 4 pm. $15-$30. Riverstone Park gazebo, 1800 Tilford Lane, CdA. Visit: inwsids.org Call: 208-557-4371 PARTY IN PINK The third annual Zumbathon fitness event raises funds for breast cancer prevention and awareness, and includes a pre-event vendor trade show. $20-$25. Event trade show Oct. 5 from 9 am-4 pm, The Warehouse, 800 N. Hamilton St. Zumbathon event Oct. 6 from 10 am to noon, Northern Quest, 100 N. Hayford Rd. Visit: spokanepartyinpink.com BEYOND PINK The fourth annual event features models wearing designer-created bras in fundraiser to help lowincome women receive thermography breast scans. Oct. 11 from 5-9 pm. $35/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit: beyondpink.net …continued on next page

Friday, November 8, 2013

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hospital stay can be scary, stressful, uncomfortable and just plain boring. Even when you’re not feeling well, it’s no fun to be confined to bed and faced with days of watching TV or reading. That’s where the Arts In Healing program is hoping to make a difference — by giving patients the opportunity for a pleasant diversion in the form of painting, music, jewelry making and other creative outlets during their stays at Sacred Heart or Holy Family hospitals. Jane Matern, director of Providence’s Spiritual Care Services, says the de-stressing effects of the art program’s activities sometimes can even reduce the need for pain medications and speed patient healing. Arts In Healing is entirely funded by donations, and on Wednesdays in October a group of area restaurants — including Laguna Cafe, Rock City Grill, Vintages @ 611, Huckleberry’s 9th Street Bistro and others — will donate a portion of their soup sales as part of the program’s Soup for the Soul fundraiser event. In addition, children who’ve been impacted by Arts In Healing have decorated soup bowls to be sold at the hospitals’ cafeterias. — CHEY SCOTT

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LIVING

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OCTOBER- NOVEMBER EVENTS SIGNATURE CHEFS AUCTION Annual fundraiser event for the March of Dimes featuring an auction, food prepared by notable Inland Northwest chefs and beverages from local wineries and breweries. Oct. 12 at 6 pm. $150/person. Red Lion at the Park, 303 W. North River Dr. Visit: marchofdimes.com Contact: dheinemann@marchofdimes.com BISHOP’S POOR MAN’S MEAL BRUNCH This annual fundraiser, now in its 28th year, offers an open house and brunch meal to benefit Catholic Charities of Spokane’s House of Charity men’s homeless shelter’s sleeping program. Oct. 13 from 10 am-1 pm. Ticket prices TBA. House of Charity, 32 W. Pacific Ave. Visit: catholiccharitiesspokane.org Call: 358-4250 GOLF BENEFIT Breast Cancer awareness golf benefit--$10 of each entry is donated to Spokane’s American Cancer Society. Oct. 13 at 1 pm. $65 includes coupons for food. Coeur d’Alene Casino, 25 miles south of Coeur d’Alene at the junciton of US-95 and Hwy. 58. cdacasino.com GUARDIANS OF HOPE Annual breakfast benefiting Cancer Patient Care. Oct. 17 from 7:30-8:30 am. The Davenport Hotel, Grand Pennington Ballroom, 10 S. Post St. Visit: cancerpatientcare.org Call: 456-0446 THE PUMPKIN BALL Annual black-tie gala benefiting the Sacred Heart Children’s Hospital and the Vanessa Behan Crisis Nursery, featuring dinner, auction and entertainment. Oct. 19 at 5:30 pm. Spokane Convention Center, 334 W. Spokane Falls Blvd. $150/person. Visit: thepumpkinball.org Call: 474-2819 PEOPLE WHO CARE Eleventh annual fundraiser breakfast and luncheon benefiting Transitions for Women, serving women and children in the Inland Northwest. Oct. 23, breakfast at 7:30 am, lunch at noon. Free admission. Red Lion Inn at the Park, 303 W. North River Dr. Visit: help4women.org Call: 328-6702 MASQUE-YOUR-AID BENEFIT The sixth annual fundraiser gala raises funds for Communities In Schools of Spokane County, a public school dropout-prevention organization. The event features food, drinks, student stories and more. Oct. 25 from 6-9:30 pm. $50/person, $75/couple. Red Lion Hotel at the Park, 201 W. North River Dr. Visit: cisspokane. org Call: 413-1436 YWCA WOMEN OF ACHIEVEMENT LUNCHEON The 31st annual event, themed “A Day of Inspiration” features keynote speaker Leslie Morgan Steiner, author of the NYT best-selling memoir Crazy Love, recognizes local community leaders and raises funds to support women

and children through YWCA programs. Oct. 30 from 11:30 am-1:30 pm. $125/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit: ywcaspokane. org Call: 789-9299

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HOPE HOUSE CELEBRITY FASHION SHOW Fashion show featuring local celebrities, luncheon, wine tasting, a silent auction and more to benefit Volunteers of America’s Hope House. Nov. 1 at 11 am. $45/person. Doubletree Hotel, 322 N. Spokane Falls Ct. Visit: voaspokane.org Call: 624-2378 LINKING FAMILIES FOR LIFE The fourth annual benefit dinner supports Catholic Charities of Spokane’s CAPA (Childbirth and Parenting Assistance) program, which works with vulnerable families to provide parenting support to change generational cycles of abuse and neglect. Nov. 1 at 5:30 pm. $50/person. Spokane Club, 1002 W. Riverside Ave. Visit: catholiccharitiesspokane.org Call: 455-4986 EPICUREAN DELIGHT The 32nd annual black-tie gala event features 30 local wineries and breweries and more than 30 local restaurants, with proceeds benefiting the Inland Northwest Blood Center. Nov. 8 from 6 pm to midnight. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit: epicureandelight.org Call: 232-4567 HONORING HOMETOWN HEROES The annual Red Cross luncheon event honors local leaders who have significantly contributed to the community through heroism and service. Nov. 13 from noon5 pm. Northern Quest, 100 N. Hayford Rd. Visit: redcross.org Call: 326-3330 LITTLE BLACK DRESS OF THE YWCA This quarterly program is intended to encourage local women to network and find meaningful relationships with other women, and to keep YWCA supporters informed of the organization’s work and needs. Nov. 14 from 5:30-7:30 pm. $25/ event or $300/annual membership. Barrister Winery, 1213 W. Railroad Ave. Visit: ywcaspokane.org Call: 789-9299 JINGLE BELL RUN This festive 5K run/ walk is a fundraiser for the Arthritis Foundation and features holidaythemed costumes. Nov. 16 starting at 9 am. $10-$20. Riverfront Park, 507 N. Howard St. Visit: spokanejinglebellrun. kintera.org Call: 315-9862  The calendar is a free service, on a space-available basis. Mark submissions “InHealth Calendar” and include the time, date, address, cost and a contact number. Mail: 1227 W. Summit Parkway, Spokane, WA 99201; Fax: 325-0638; or E-mail: calendar@inhealthnw.com.

Individual Health Coverage is required as of January 2014. Let us know how we can help you and guide you through the new requirements to ensure you are on the right path!

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Jill Staples at Alexandria’s House young kwak PHOTO

PEOPLE

Home Schooling Teaching the arts of mothering and making a home BY DANIEL WALTERS

I

n 1980, a terrified 18-year-old named Jill Staples gave birth to a little girl she named Erin. And she had no idea what to do. “I didn’t know how it was going to work out.

I didn’t know how I was going to support her,” Staples says. “I didn’t know how in the world I was going to do this with a baby.” Three decades later in a modified

duplex near Gonzaga University, Staples has heard this sort of story again and again from the teen girls who live there, who struggle with pregnancy or motherhood. And when those girls tell her that she doesn’t understand what they’re going through, she has a response. “I can’t be in your shoes, because I didn’t live your life,” Staples tells them. But then she explains a little about her past. How she got pregnant as a teen, and how it gave her focus. “It gives me credibility with them. They do know I had to struggle and I had to walk the same path they are.” Today Staples manages Alexandria’s House — a transitional housing program

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run by the Volunteers of America. It’s intended to be both a safe place for expectant and new teen mothers and a training ground to turn them into better moms. Up to six pregnant teenagers or moms can stay there at a time. The atmosphere at the house is not much different from an ordinary family home — in the summer, the lush green backyard hosts birthday parties, complete with balloons and decorations. There are parties at Christmas and Thanksgiving. In the kitchen, the young mothers take turns cooking for the rest of the house. Some enter with plenty of cooking skills, while others are taught the art of making spaghetti or tacos, working up to more elaborate dishes like casseroles. “They’ll teach you how to deep clean, they’ll teach you to how to cook,” says Asmin Foster, a former resident. “If you need help with your kids— when I had twin boys, they helped me.” They’re given support to make goals and achieve them. But the most important piece, Staples says, is “helping stop the generational cycle of abuse and neglect.” In a sense, these mothers are taught to become fluent in “baby,” translating their children’s cries and actions into what they really need. “We’re teaching them to be the best safe haven for their children. Our program is their safe haven,” Staples says. “Our statement is to always be bigger, stronger, wiser and kind.” As she talks, Staples is mostly understated. She shies away from photographs. But to the young women she’s mentored, her support means everything. One of the house’s ‘graduates’ got married and moved to Fort Hood, Texas. When U.S. Army psychiatrist Nidal Hasan went on a shooting spree on the base in November 2009, killing 13 people, the base shut down. That mother couldn’t get to her children at the base’s day care, and she couldn’t reach her husband. So she called Staples. “I just talked to her,” Staples says. “I talked to her every 45 minutes to an hour until she received her children back into her arms.” The house offers an atmosphere of consistency and fairness, and while there are consequences for breaking its rules, Staples says it’s important for the young women to know that even when they’re disciplined, it’s not done in anger. “They learn that then they can trust,” Staples says. “That even if they fall down and make mistakes, we still care about them.” n

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Inhealth October 2013