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On the 'Frontier,' a New Approach to Public Health
By BEN DAITZ, The New York Times, November 15, 2005
LORDSBURG, N.M. - Southwestern New Mexico's boot heel scuffs a low desert landscape at the end of the Rocky Mountain chain. Here, the Butterfield Stagecoach line once ran passengers and mail through starkly beautiful stands of ocotillo and cholla cactus to California, followed soon by the Southern Pacific Railroad and, ultimately, Interstate 10.
Lordsburg, with a population of 3,300, is a railroad town, the largest town in Hidalgo County, classified by federal health standards as a "frontier county" because of the paucity of population and health services.
For years, the nearest doctors and dentists were in Tucson, 152 miles west, Las Cruces, 60 miles east, or Silver City, 45 miles north. Then Charlie Alfero came to town.
A 52-year-old mandolin-picker with a laid-back style, Mr. Alfero had directed the state's Community Health Services Division and the University of New Mexico School of Medicine's rural outreach program, where he helped communities resurrect failing hospitals and develop clinics.
Mr. Alfero spent four years in the late 1990's commuting 600 miles round trip from Albuquerque to Lordsburg, often weekly, helping a local volunteer board develop what has become Hidalgo Medical Services, a community partnership that has helped revitalize the health care and economic well-being of Hidalgo and southwestern New Mexico.
The model for Mr. Alfero's vision is the health commons, a new take on a definition rooted in an age-old sharing of resources. For Mr. Alfero, that meant one-stop shopping for medical, dental and mental health care, family support and economic development. It also meant that the community voiced what it wanted to see in a health care system.
"Samuel Clemens said the only real change happens locally, and that's been my motto forever," Mr. Alfero said, addressing more than 100 employees, patients and dignitaries here to celebrate the 10th anniversary of Hidalgo Medical Services.
The crowd gathered in the lobby of the new, 22,000-square-foot full-service center, which has exam rooms, social service offices and a dental clinic with a computer screen at each chair.
The crowd, like the community at large, was a mix of Hispanics and Anglos. They ate tamales, tacos, rice and beans, aware that just down the hall was the office of La Vida, the clinic's diabetes outreach program.
"We're just taking a little break from our diets to celebrate," a patient said. "This diabetes program and the promatoras turned my life around."
Promatoras de salud are community health workers, local residents trained in chronic disease management who serve patients in the rural areas and isolated ranches. Promatoras are the backbone of Hidalgo's health care delivery system, serving as liaisons and translators and as a much needed social support network.
Elva Quimby, a 50-year-old former cosmetologist, said: "I think I've always been a promatora. I just thrive on helping people."
Ms. Quimby paid a home visit to Frank Ogas, 44, a construction worker who fell off a roof last year. While recuperating, he had a major heart attack, which was further complicated by newly diagnosed diabetes.
"The doctors say I'm a ticking time bomb," Mr. Ogas told Ms. Quimby. "I'm under a lot of stress because I've got no income now, and I can't pay my bills."
"Frank, I pull tricks out of my sleeve," Ms. Quimby said.
"This is the best job of my life," Ms. Quimby said. "I've done everything from translating for a 14-year-old girl who was delivering a baby - poor thing - to combing the hair of a client who had died."
Hidalgo Medical Services now has seven state, federal and locally supported community health centers in two adjoining counties, and patient visits have increased to a projected 48,000 this year from 8,000 three years ago. Visits for family support services have jumped to more than 30,000 from 2,000 in the same time.
The health initiatives have also resulted in substantial investments in housing and small businesses, state parks and international trade.
"We know that each doctor who comes to a rural town hires 18 folks directly and indirectly," said Dr. Arthur Kaufman, chairman of the department of family and community medicine at the University of New Mexico. "That's big business in a small community, but Charlie's taken it one step further, using health as a catalyst for social and economic development in the region.
"Now other communities in the state are wanting to replicate the model."
Mr. Alfero said the communities the health centers serve "have come together with a common vision grounded in a commitment to systems of mutual support. That's a rare thing in a self-focused society."
Philosophers Notwithstanding, Kansas School Board Redefines Science
By DENNIS OVERBYE, The New York Times, November 15, 2005
Once it was the left who wanted to redefine science.
In the early 1990's, writers like the Czech playwright and former president Vaclav Havel and the French philosopher Bruno Latour proclaimed "the end of objectivity." The laws of science were constructed rather than discovered, some academics said; science was just another way of looking at the world, a servant of corporate and military interests. Everybody had a claim on truth.
The right defended the traditional notion of science back then. Now it is the right that is trying to change it.
On Tuesday, fueled by the popular opposition to the Darwinian theory of evolution, the Kansas State Board of Education stepped into this fraught philosophical territory. In the course of revising the state's science standards to include criticism of evolution, the board promulgated a new definition of science itself.
The changes in the official state definition are subtle and lawyerly, and involve mainly the removal of two words: "natural explanations." But they are a red flag to scientists, who say the changes obliterate the distinction between the natural and the supernatural that goes back to Galileo and the foundations of science.
The old definition reads in part, "Science is the human activity of seeking natural explanations for what we observe in the world around us." The new one calls science "a systematic method of continuing investigation that uses observation, hypothesis testing, measurement, experimentation, logical argument and theory building to lead to more adequate explanations of natural phenomena."
Adrian Melott, a physics professor at the University of Kansas who has long been fighting Darwin's opponents, said, "The only reason to take out 'natural explanations' is if you want to open the door to supernatural explanations."
Gerald Holton, a professor of the history of science at Harvard, said removing those two words and the framework they set means "anything goes."
The authors of these changes say that presuming the laws of science can explain all natural phenomena promotes materialism, secular humanism, atheism and leads to the idea that life is accidental. Indeed, they say in material online at kansasscience2005.com, it may even be unconstitutional to promulgate that attitude in a classroom because it is not ideologically "neutral."
But many scientists say that characterization is an overstatement of the claims of science. The scientist's job description, said Steven Weinberg, a physicist and Nobel laureate at the University of Texas, is to search for natural explanations, just as a mechanic looks for mechanical reasons why a car won't run.
"This doesn't mean that they commit themselves to the view that this is all there is," Dr. Weinberg wrote in an e-mail message. "Many scientists (including me) think that this is the case, but other scientists are religious, and believe that what is observed in nature is at least in part a result of God's will."
The opposition to evolution, of course, is as old as the theory itself. "This is a very long story," said Dr. Holton, who attributed its recent prominence to politics and the drive by many religious conservatives to tar science with the brush of materialism.
How long the Kansas changes will last is anyone's guess. The state board tried to abolish the teaching of evolution and the Big Bang in schools six years ago, only to reverse course in 2001.
As it happened, the Kansas vote last week came on the same day that voters in Dover, Pa., ousted the local school board that had been sued for introducing the teaching of intelligent design.
As Dr. Weinberg noted, scientists and philosophers have been trying to define science, mostly unsuccessfully, for centuries.
When pressed for a definition of what they do, many scientists eventually fall back on the notion of falsifiability propounded by the philosopher Karl Popper. A scientific statement, he said, is one that can be proved wrong, like "the sun always rises in the east" or "light in a vacuum travels 186,000 miles a second." By Popper's rules, a law of science can never be proved; it can only be used to make a prediction that can be tested, with the possibility of being proved wrong.
But the rules get fuzzy in practice. For example, what is the role of intuition in analyzing a foggy set of data points? James Robert Brown, a philosopher of science at the University of Toronto, said in an e-mail message: "It's the widespread belief that so-called scientific method is a clear, well-understood thing. Not so." It is learned by doing, he added, and for that good examples and teachers are needed.
One thing scientists agree on, though, is that the requirement of testability excludes supernatural explanations. The supernatural, by definition, does not have to follow any rules or regularities, so it cannot be tested. "The only claim regularly made by the pro-science side is that supernatural explanations are empty," Dr. Brown said.
The redefinition by the Kansas board will have nothing to do with how science is performed, in Kansas or anywhere else. But Dr. Holton said that if more states changed their standards, it could complicate the lives of science teachers and students around the nation.
He added that Galileo - who started it all, and paid the price - had "a wonderful way" of separating the supernatural from the natural. There are two equally worthy ways to understand the divine, Galileo said. "One was reverent contemplation of the Bible, God's word," Dr. Holton said. "The other was through scientific contemplation of the world, which is his creation.
"That is the view that I hope the Kansas school board would have adopted."
Q & A: How Helpful Is Garlic?
By C. CLAIBORNE RAY, The New York Times, November 15, 2005
Q. Has eating fresh garlic or ingesting garlic supplements been documented in reputable clinical trials to increase levels of H.D.L., the so-called good cholesterol?
A. "Unfortunately, no," said Dr. Sheldon S. Hendler, co-editor of the PDR for Nutritional Supplements, the standard reference in the field.
Dr. Hendler pointed out, however, that some studies have suggested that garlic and garlic supplements may be useful in lowering levels of L.D.L., the so-called bad cholesterol.
In a 2001 Australian study, for example, a group of 46 patients with high cholesterol were randomly chosen either to get dietary counseling on reducing fat consumption and garlic pills or to get counseling and a placebo. Neither they nor their doctors knew which pill they were getting.
The group that received garlic in their pills had a significant reduction in total cholesterol and L.D.L. cholesterol, while the placebo group had a nonsignificant increase in total cholesterol and L.D.L. cholesterol. H.D.L. cholesterol was significantly increased in the placebo group compared with the garlic group.
Commercial garlic supplements are highly variable in the amount of the valuable compounds they contain, like allicin, so label information should be carefully compared.
Some of these compounds have been shown to inhibit the control enzyme in the synthesis of cholesterol, the same enzyme that is inhibited by the popular statin drugs.
(This story reminds me of the article![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
notmarcie pointed me to last week)
Vital Signs: Prevention: A Bacterium That Improves Your Work Habits
By NICHOLAS BAKALAR, The New York Times, November 15, 2005
When workers take daily doses of a bacterium found in breast milk and in the digestive systems of healthy humans, they are less likely to call in sick with gastrointestinal or respiratory symptoms, a new study has found.
The study involved 181 workers, who were divided into two groups at random; half were given a strain of Lactobacillus reuteri, and half were given a placebo in identical packaging. Neither group knew which it was receiving.
One of the authors of the study, Anders Zachrisson, is the medical director of a firm that holds several patents on L. reuteri. Results were published online on Nov. 7 in Environmental Health.
Twenty-six percent of people in the placebo group, but only 11 percent in the L. reuteri group, reported taking sick leave during the 80-day study. Over all, taking daily doses of L. reuteri reduced reports of illness by 60 percent.
"We have sufficient clinical data to support the daily use of L. reuteri," Mr. Zachrisson said.
Although the study did not definitively determine the mechanism for the effect, the authors speculate that L. reuteri stimulates the immune system by recruiting CD4+ cells, a mechanism that has been observed in other studies, both human and animal.
L. reuteri is not widely available in food, but at least one American dairy company uses it as a yogurt culture. It is commonly sold as a nutritional supplement.
The authors acknowledge that this was a small study, but say the results are striking. They also note that no side effects were reported. "We take the position that L. reuteri is best when it's used to maintain health, as a preventive," Mr. Zachrisson said.
Study: Heart Attacks Drop With Smoking Ban
By THE ASSOCIATED PRESS, The New York Times, November 14, 2005
DALLAS (AP) -- Heart attack rates in Pueblo, Colo., dropped by 27 percent in the 18 months after a smoking ban was imposed in bars, restaurants and other public places, according to a new study.
Researchers found that 399 heart attack patients were admitted to hospitals in the 18 months before the July 2003 ban and 291 after.
In a nearby county without a smoking ban, the number of heart attacks held steady during the same period, according to the research presented Monday at an American Heart Association meeting.
''I was probably skeptical that such an ordinance would have such a rapid effect,'' said the study's leader, Dr. Mori Krantz, a cardiologist and director of prevention programs at the Colorado Prevention Center.
But he noted that other research has shown that exposure to secondhand smoke can cause adverse cardiovascular effects within minutes -- and that the latest survey seems to bear that out.
Dr. Donald Lavan, a cardiologist at the University of Pennsylvania and a heart association spokesman, called the study preliminary but important.
''We know that when people stop smoking, we start to see improvements in six months for the individual,'' but this study shows the benefit to the community as well, he said.
''It reaffirms the fact that secondhand smoke is deleterious to all people,'' Lavan said.
In 2003, the city of Helena, Mont., found that during the six months an indoor smoking ban was enforced, hospital admissions for heart attacks dropped from seven a month to about three.
Pueblo, which has a population of about 100,000, is about 110 miles south of Denver.
By BEN DAITZ, The New York Times, November 15, 2005
LORDSBURG, N.M. - Southwestern New Mexico's boot heel scuffs a low desert landscape at the end of the Rocky Mountain chain. Here, the Butterfield Stagecoach line once ran passengers and mail through starkly beautiful stands of ocotillo and cholla cactus to California, followed soon by the Southern Pacific Railroad and, ultimately, Interstate 10.
Lordsburg, with a population of 3,300, is a railroad town, the largest town in Hidalgo County, classified by federal health standards as a "frontier county" because of the paucity of population and health services.
For years, the nearest doctors and dentists were in Tucson, 152 miles west, Las Cruces, 60 miles east, or Silver City, 45 miles north. Then Charlie Alfero came to town.
A 52-year-old mandolin-picker with a laid-back style, Mr. Alfero had directed the state's Community Health Services Division and the University of New Mexico School of Medicine's rural outreach program, where he helped communities resurrect failing hospitals and develop clinics.
Mr. Alfero spent four years in the late 1990's commuting 600 miles round trip from Albuquerque to Lordsburg, often weekly, helping a local volunteer board develop what has become Hidalgo Medical Services, a community partnership that has helped revitalize the health care and economic well-being of Hidalgo and southwestern New Mexico.
The model for Mr. Alfero's vision is the health commons, a new take on a definition rooted in an age-old sharing of resources. For Mr. Alfero, that meant one-stop shopping for medical, dental and mental health care, family support and economic development. It also meant that the community voiced what it wanted to see in a health care system.
"Samuel Clemens said the only real change happens locally, and that's been my motto forever," Mr. Alfero said, addressing more than 100 employees, patients and dignitaries here to celebrate the 10th anniversary of Hidalgo Medical Services.
The crowd gathered in the lobby of the new, 22,000-square-foot full-service center, which has exam rooms, social service offices and a dental clinic with a computer screen at each chair.
The crowd, like the community at large, was a mix of Hispanics and Anglos. They ate tamales, tacos, rice and beans, aware that just down the hall was the office of La Vida, the clinic's diabetes outreach program.
"We're just taking a little break from our diets to celebrate," a patient said. "This diabetes program and the promatoras turned my life around."
Promatoras de salud are community health workers, local residents trained in chronic disease management who serve patients in the rural areas and isolated ranches. Promatoras are the backbone of Hidalgo's health care delivery system, serving as liaisons and translators and as a much needed social support network.
Elva Quimby, a 50-year-old former cosmetologist, said: "I think I've always been a promatora. I just thrive on helping people."
Ms. Quimby paid a home visit to Frank Ogas, 44, a construction worker who fell off a roof last year. While recuperating, he had a major heart attack, which was further complicated by newly diagnosed diabetes.
"The doctors say I'm a ticking time bomb," Mr. Ogas told Ms. Quimby. "I'm under a lot of stress because I've got no income now, and I can't pay my bills."
"Frank, I pull tricks out of my sleeve," Ms. Quimby said.
"This is the best job of my life," Ms. Quimby said. "I've done everything from translating for a 14-year-old girl who was delivering a baby - poor thing - to combing the hair of a client who had died."
Hidalgo Medical Services now has seven state, federal and locally supported community health centers in two adjoining counties, and patient visits have increased to a projected 48,000 this year from 8,000 three years ago. Visits for family support services have jumped to more than 30,000 from 2,000 in the same time.
The health initiatives have also resulted in substantial investments in housing and small businesses, state parks and international trade.
"We know that each doctor who comes to a rural town hires 18 folks directly and indirectly," said Dr. Arthur Kaufman, chairman of the department of family and community medicine at the University of New Mexico. "That's big business in a small community, but Charlie's taken it one step further, using health as a catalyst for social and economic development in the region.
"Now other communities in the state are wanting to replicate the model."
Mr. Alfero said the communities the health centers serve "have come together with a common vision grounded in a commitment to systems of mutual support. That's a rare thing in a self-focused society."
Philosophers Notwithstanding, Kansas School Board Redefines Science
By DENNIS OVERBYE, The New York Times, November 15, 2005
Once it was the left who wanted to redefine science.
In the early 1990's, writers like the Czech playwright and former president Vaclav Havel and the French philosopher Bruno Latour proclaimed "the end of objectivity." The laws of science were constructed rather than discovered, some academics said; science was just another way of looking at the world, a servant of corporate and military interests. Everybody had a claim on truth.
The right defended the traditional notion of science back then. Now it is the right that is trying to change it.
On Tuesday, fueled by the popular opposition to the Darwinian theory of evolution, the Kansas State Board of Education stepped into this fraught philosophical territory. In the course of revising the state's science standards to include criticism of evolution, the board promulgated a new definition of science itself.
The changes in the official state definition are subtle and lawyerly, and involve mainly the removal of two words: "natural explanations." But they are a red flag to scientists, who say the changes obliterate the distinction between the natural and the supernatural that goes back to Galileo and the foundations of science.
The old definition reads in part, "Science is the human activity of seeking natural explanations for what we observe in the world around us." The new one calls science "a systematic method of continuing investigation that uses observation, hypothesis testing, measurement, experimentation, logical argument and theory building to lead to more adequate explanations of natural phenomena."
Adrian Melott, a physics professor at the University of Kansas who has long been fighting Darwin's opponents, said, "The only reason to take out 'natural explanations' is if you want to open the door to supernatural explanations."
Gerald Holton, a professor of the history of science at Harvard, said removing those two words and the framework they set means "anything goes."
The authors of these changes say that presuming the laws of science can explain all natural phenomena promotes materialism, secular humanism, atheism and leads to the idea that life is accidental. Indeed, they say in material online at kansasscience2005.com, it may even be unconstitutional to promulgate that attitude in a classroom because it is not ideologically "neutral."
But many scientists say that characterization is an overstatement of the claims of science. The scientist's job description, said Steven Weinberg, a physicist and Nobel laureate at the University of Texas, is to search for natural explanations, just as a mechanic looks for mechanical reasons why a car won't run.
"This doesn't mean that they commit themselves to the view that this is all there is," Dr. Weinberg wrote in an e-mail message. "Many scientists (including me) think that this is the case, but other scientists are religious, and believe that what is observed in nature is at least in part a result of God's will."
The opposition to evolution, of course, is as old as the theory itself. "This is a very long story," said Dr. Holton, who attributed its recent prominence to politics and the drive by many religious conservatives to tar science with the brush of materialism.
How long the Kansas changes will last is anyone's guess. The state board tried to abolish the teaching of evolution and the Big Bang in schools six years ago, only to reverse course in 2001.
As it happened, the Kansas vote last week came on the same day that voters in Dover, Pa., ousted the local school board that had been sued for introducing the teaching of intelligent design.
As Dr. Weinberg noted, scientists and philosophers have been trying to define science, mostly unsuccessfully, for centuries.
When pressed for a definition of what they do, many scientists eventually fall back on the notion of falsifiability propounded by the philosopher Karl Popper. A scientific statement, he said, is one that can be proved wrong, like "the sun always rises in the east" or "light in a vacuum travels 186,000 miles a second." By Popper's rules, a law of science can never be proved; it can only be used to make a prediction that can be tested, with the possibility of being proved wrong.
But the rules get fuzzy in practice. For example, what is the role of intuition in analyzing a foggy set of data points? James Robert Brown, a philosopher of science at the University of Toronto, said in an e-mail message: "It's the widespread belief that so-called scientific method is a clear, well-understood thing. Not so." It is learned by doing, he added, and for that good examples and teachers are needed.
One thing scientists agree on, though, is that the requirement of testability excludes supernatural explanations. The supernatural, by definition, does not have to follow any rules or regularities, so it cannot be tested. "The only claim regularly made by the pro-science side is that supernatural explanations are empty," Dr. Brown said.
The redefinition by the Kansas board will have nothing to do with how science is performed, in Kansas or anywhere else. But Dr. Holton said that if more states changed their standards, it could complicate the lives of science teachers and students around the nation.
He added that Galileo - who started it all, and paid the price - had "a wonderful way" of separating the supernatural from the natural. There are two equally worthy ways to understand the divine, Galileo said. "One was reverent contemplation of the Bible, God's word," Dr. Holton said. "The other was through scientific contemplation of the world, which is his creation.
"That is the view that I hope the Kansas school board would have adopted."
Q & A: How Helpful Is Garlic?
By C. CLAIBORNE RAY, The New York Times, November 15, 2005
Q. Has eating fresh garlic or ingesting garlic supplements been documented in reputable clinical trials to increase levels of H.D.L., the so-called good cholesterol?
A. "Unfortunately, no," said Dr. Sheldon S. Hendler, co-editor of the PDR for Nutritional Supplements, the standard reference in the field.
Dr. Hendler pointed out, however, that some studies have suggested that garlic and garlic supplements may be useful in lowering levels of L.D.L., the so-called bad cholesterol.
In a 2001 Australian study, for example, a group of 46 patients with high cholesterol were randomly chosen either to get dietary counseling on reducing fat consumption and garlic pills or to get counseling and a placebo. Neither they nor their doctors knew which pill they were getting.
The group that received garlic in their pills had a significant reduction in total cholesterol and L.D.L. cholesterol, while the placebo group had a nonsignificant increase in total cholesterol and L.D.L. cholesterol. H.D.L. cholesterol was significantly increased in the placebo group compared with the garlic group.
Commercial garlic supplements are highly variable in the amount of the valuable compounds they contain, like allicin, so label information should be carefully compared.
Some of these compounds have been shown to inhibit the control enzyme in the synthesis of cholesterol, the same enzyme that is inhibited by the popular statin drugs.
(This story reminds me of the article
notmarcie pointed me to last week)Vital Signs: Prevention: A Bacterium That Improves Your Work Habits
By NICHOLAS BAKALAR, The New York Times, November 15, 2005
When workers take daily doses of a bacterium found in breast milk and in the digestive systems of healthy humans, they are less likely to call in sick with gastrointestinal or respiratory symptoms, a new study has found.
The study involved 181 workers, who were divided into two groups at random; half were given a strain of Lactobacillus reuteri, and half were given a placebo in identical packaging. Neither group knew which it was receiving.
One of the authors of the study, Anders Zachrisson, is the medical director of a firm that holds several patents on L. reuteri. Results were published online on Nov. 7 in Environmental Health.
Twenty-six percent of people in the placebo group, but only 11 percent in the L. reuteri group, reported taking sick leave during the 80-day study. Over all, taking daily doses of L. reuteri reduced reports of illness by 60 percent.
"We have sufficient clinical data to support the daily use of L. reuteri," Mr. Zachrisson said.
Although the study did not definitively determine the mechanism for the effect, the authors speculate that L. reuteri stimulates the immune system by recruiting CD4+ cells, a mechanism that has been observed in other studies, both human and animal.
L. reuteri is not widely available in food, but at least one American dairy company uses it as a yogurt culture. It is commonly sold as a nutritional supplement.
The authors acknowledge that this was a small study, but say the results are striking. They also note that no side effects were reported. "We take the position that L. reuteri is best when it's used to maintain health, as a preventive," Mr. Zachrisson said.
Study: Heart Attacks Drop With Smoking Ban
By THE ASSOCIATED PRESS, The New York Times, November 14, 2005
DALLAS (AP) -- Heart attack rates in Pueblo, Colo., dropped by 27 percent in the 18 months after a smoking ban was imposed in bars, restaurants and other public places, according to a new study.
Researchers found that 399 heart attack patients were admitted to hospitals in the 18 months before the July 2003 ban and 291 after.
In a nearby county without a smoking ban, the number of heart attacks held steady during the same period, according to the research presented Monday at an American Heart Association meeting.
''I was probably skeptical that such an ordinance would have such a rapid effect,'' said the study's leader, Dr. Mori Krantz, a cardiologist and director of prevention programs at the Colorado Prevention Center.
But he noted that other research has shown that exposure to secondhand smoke can cause adverse cardiovascular effects within minutes -- and that the latest survey seems to bear that out.
Dr. Donald Lavan, a cardiologist at the University of Pennsylvania and a heart association spokesman, called the study preliminary but important.
''We know that when people stop smoking, we start to see improvements in six months for the individual,'' but this study shows the benefit to the community as well, he said.
''It reaffirms the fact that secondhand smoke is deleterious to all people,'' Lavan said.
In 2003, the city of Helena, Mont., found that during the six months an indoor smoking ban was enforced, hospital admissions for heart attacks dropped from seven a month to about three.
Pueblo, which has a population of about 100,000, is about 110 miles south of Denver.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2005-11-15 04:18 pm (UTC)