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  • Rep. Steny Hoyer to retire, ending storied career in elected office

    Rep. Steny Hoyer to retire, ending storied career in elected office

    Rep. Steny H. Hoyer announced Thursday he will not run for reelection and will end a nearly six-decade career in elected office that spanned his rising-star days in Maryland government to a two-decade run as the No. 2 U.S. House Democrat.

    Hoyer, the third-longest-serving member of the House, said he reached the decision over the holidays with his family, feeling content with a career that never brought the brass ring of the House speaker’s gavel but put him at the center of this century’s biggest debates.

    “At this young age, it’s probably premature,” the 86-year-old quipped in a two-hour interview Tuesday at his sprawling home on the Patuxent River in St. Mary’s County.

    Now three years out of leadership, Hoyer remains an active legislator but feared ending up like many other elderly lawmakers, becoming physically or mentally frail in their final days in office.

    “I did not want to be one of those members who clearly stayed, outstayed his or her ability to do the job,” said Hoyer.

    He delivered a formal announcement in a House floor speech Thursday morning, with dozens of colleagues from both sides of the aisle on hand to cheer.

    In his remarks, Hoyer made clear he was not like the more than 40 other House members who, largely fed up with Congress, are running for other offices or retiring. Hoyer said he still loves the institution, while recognizing that his style of extending a courteous hand to the political opposition is outdated.

    Hoyer spent decades on the Appropriations Committee, helping to pour billions of dollars into a congressional district that begins just a few miles east of the Capitol. But Hoyer’s final years on the panel have seen it snarled in partisan gridlock.

    In the Tuesday interview, Hoyer said his constituents, more reliant on the federal government than most, ask when Congress will work in a more functional way, a question that Hoyer puts back on those voters.

    “As long as the people of America elect angry, confrontational people, don’t be surprised that democracy works and you get an angry, confrontational Congress,” Hoyer said.

    Hoyer said American politics are in a state of decades-long deterioration. But he blamed President Donald Trump for making bipartisan comity harder than ever, pointing out the pardons of those convicted for the Jan. 6, 2021, Capitol attack during his interview with The Washington Post, which took place on the fifth anniversary of the insurrection.

    “His greatest strength, he has no shame, does not,” Hoyer said of Trump. “And his people don’t care whatever he does, pardoning 1,600 people who committed treason. Just astounding, and then he gets away with it.”

    Hoyer will go down in history behind only Leslie C. Arends (R., Ill.) for length of leadership service in the No. 2 post for a House caucus without ever getting promoted to the top spot. From the early 1940s until 1974, Arends totaled almost 30 years as the GOP’s first deputy.

    Hoyer’s list of legislative accomplishments is long — including authoring the Americans With Disabilities Act and the election law responding to the disputed 2000 presidential race — but his biggest contribution may have been serving as a cooling agent when partisan temperatures ran hot in the raucous House.

    Many Republicans viewed him as an honest broker and a lighter touch than Rep. Nancy Pelosi (D., Calif.), who led the caucus for the 20 years Hoyer served as her deputy.

    In his Thursday speech, Hoyer lamented the decay of bipartisan relationships and a House that produces less legislation than in years past.

    “I am deeply concerned that this House is not living up to the Founders’ goals,” Hoyer told his colleagues. “I urge my colleagues on both sides of the aisle to examine their conscience, renew their courage.”

    Hoyer lost a 2001 race for minority whip to Pelosi, a contest that highlighted the party’s pivot away from the South and Midwest and toward the more professional class of voters along the coasts. When Pelosi took charge in January 2003, the caucus unanimously elected Hoyer as her top lieutenant.

    Hoyer said he understands why “tough-as-nails” Pelosi remained leader so long, calling her the best of 10 speakers he served under in nearly 45 years in the House.

    “Sure, I would have loved to have been speaker. Who wouldn’t love to be speaker? But they’re not deep regrets,” he said in the interview.

    Hoyer and Pelosi, along with Rep. James E. Clyburn (D., S.C.), are together linked for their historically long runs as the top three lawmakers running the caucus. They notched victories such as the 2008 financial rescue, the 2010 Affordable Care Act and several trillion dollars worth of pandemic relief this decade.

    When Republicans won the House majority in the 2022 midterms, all three decided to step down and let a younger generation take the reins of the caucus. Pelosi announced in November that she will not run for reelection, while Clyburn has so far signaled he will run again.

    “Ironically, Nancy, Jim and I have not talked about any one of our actions or any one of our retirements. So I haven’t talked to Nancy. I haven’t talked to Jim,” Hoyer said.

    Pelosi, 85, and Hoyer are retiring as their party is still in a heated debate over whether its elder statesmen have stayed too long in Washington, particularly after President Joe Biden’s late exit from the 2024 presidential campaign.

    Hoyer’s wife, Elaine C. Kamarck, a Brookings Institution political scholar, dubbed the trio of Pelosi, Hoyer, and Clyburn as “super-agers” for their ability to effectively run the Democratic caucus while in their 80s, but Hoyer is conscious of passing the baton to the next generation.

    Pelosi, Hoyer, and Clyburn carved out different responsibilities and represented a new, diverse 21st-century caucus: a liberal woman from California’s tech center; a White man with close ties to the shrinking ranks of Democrats from the South and Midwest; and the highest-ranking Black member of Congress.

    Hoyer said he considers passage of the Affordable Care Act a prototype for when their leadership style worked. Pelosi — who has “a spine of steel,” he said — led the effort and had the bona fides to tell liberals what the best deal possible was. Hoyer served as sounding board for dozens of Democrats in competitive districts worried about their 2010 elections.

    “A number of people would say I played an important part in bringing along people who had concerns about it from their district’s standpoint,” he said.

    Democrats lost a stunning 63 seats in those midterms and spent eight subsequent years in the minority, leading some to question whether new, younger leadership was needed.

    Pelosi and Hoyer have had a sometimes strained relationship — dating at least to the late 1990s when they began a several-year campaign against one another for a leadership post — but the caucus seemingly wanted that balance.

    “We were put together by the caucus,” Hoyer said. “And what I mean by that, Nancy was elected, I was elected and Clyburn was elected. We weren’t elected as a team.”

    The current House Democratic leadership team — Minority Leader Hakeem Jeffries (N.Y.), Minority Whip Katherine Clark (Mass.) and Rep. Pete Aguilar (Calif.) — effectively ran together three years ago trying to replicate the ideological and diverse balance of the old team.

    Hoyer had not yet drawn a top primary challenge in his congressional district, but his exit will undoubtedly prompt many younger Maryland politicians to consider running in a race where Hoyer said he will not make an early endorsement.

    His early endorsement of Wes Moore, helped elevate the then-long-shot candidate to victory in the 2022 Maryland governor’s race. Now running for reelection at 47, Moore is mentioned as a future presidential candidate — a campaign Hoyer said he hopes to play a role in.

    “His true genius resides not simply in the grand American story he has helped to write, but in the many quiet moments of service and support he has given,” Moore said in a statement.

    A vast majority of House members have no idea Hoyer’s first image in politics was as a young man in a hurry. Just 27 when he took office in the Maryland state Senate in 1967, Hoyer became the chamber’s president at 35 and plotted a run for governor in 1978, with his ultimate ambition being the U.S. Senate.

    “I was a little ahead of myself,” he recalled Tuesday. He eventually accepted a spot as lieutenant governor candidate on a ticket that lost the party nomination badly.

    His start in politics was launched when, as an undergraduate at the University of Maryland, he attended a campus rally for Sen. John F. Kennedy’s presidential campaign in 1960.

    Following a file clerk job at the Central Intelligence Agency, Hoyer began working for Rep. Daniel Brewster (D., Md.), would move with him to the Senate in 1963 and meet a young Pelosi as a co-worker.

    In 1981, after the local congresswoman suffered a heart attack and fell into a coma, Hoyer narrowly won a crowded primary and was on his way up the ladder in the U.S. House.

    The family of his first wife bought land in St. Mary’s County on the Patuxent in 1989, and the Hoyers built their getaway home well outside his district.

    The 1992 redistricting brought this rural territory into Hoyer’s 5th Congressional District, and the couple turned it into a permanent home. An educator in Prince George’s County schools, Judith Hoyer died in 1997 and the congressman passed legislation creating “Judy Centers” for early-childhood programs.

    The home, dubbed “Hoyer’s Point of View,” hosted his wedding to Kamarck in 2023. A proud Dane who’s looked out for Nordic interests on the Helsinki Commission, Hoyer flies the flag of Denmark alongside those of Maryland and the U.S.

    Hoyer said he’s not sure how he will handle life outside elective politics, but he has a ready answer when people ask him about Congress.

    “How do we make this better?” he said. “You do. You’re a voter. You send the right people there, it’ll get better.”

  • These clever dogs rival toddlers when it comes to learning words

    These clever dogs rival toddlers when it comes to learning words

    In many households, it’s a forbidden four-letter word. It can’t be uttered aloud, only spelled, so those within earshot don’t get too worked up.

    “Can you take the dog for a W-A-L-K?”

    Many dog owners know their pets excel at learning words such as “walk,” “sit,” “stay,” and even their own names. But researchers have discovered the word-acquisition ability of certain canines can rival that of toddlers.

    A study published in the journal Science on Thursday found that some dogs can learn words simply by overhearing conversations, even when the pets are not directly addressed, an ability humans begin to acquire at about 18 months old.

    “This can really give us more appreciation to how exceptional dogs can be,” said lead author Shany Dror, a comparative cognition researcher at the University of Veterinary Medicine in Vienna and Eötvös Loránd University in Budapest.

    For their experiments, Dror and her team recruited 10 dogs and their owners from around the world. The breeds included a miniature Australian shepherd, a German shepherd, a Labrador retriever, and several border collies — all herding or sporting breeds known for their trainability.

    Dogs tend to be better at learning words for actions — think “fetch” or “roll over” — than at retaining the names of objects. So Dror sought out what she called “gifted” dogs that had previously demonstrated an ability to learn the names of their toys.

    Basket, a 7-year-old border collie in New York, was among them.

    “I noticed she started to actually know the names of her toys without me giving her assistance when she was about 8 months old,” said one of her owners, Elle Baumgartel-Austin.

    The researchers instructed the dog owners to discuss two toys that their dogs had never seen before. The dogs were present for those conversations. But the owners never directly addressed their pets.

    “It was very funny watching the video after the fact, just to see what she was doing,” Baumgartel-Austin said. Basket had followed the toy with her eyes as they talked. “She got a little frustrated. It was not very fun to see two humans play with a toy that she wanted.”

    To assess what the dogs learned by eavesdropping, a day or more later the owners were guided to place the toys in a different room among other plushies and then ask their dog to retrieve one of the two new toys by name. Seven of the 10 dogs, including Basket, regularly fetched the correct toy. Although the sample size was small, the results were statistically significant.

    The discovery not only reveals a previously unknown cognitive ability of canines, but it could also offer clues to how human language may have evolved.

    Overhearing the conversations of parents and other adults is part of how toddlers learn to talk. That some dogs are able to do so as well suggests that an ability to read social cues needed to follow a conversation predates language itself.

    “This is something that came before language,” Dror said. “Because dogs don’t have language, and yet they do have these abilities.”

    Gabriella Lakatos, a researcher at Britain’s University of Hertfordshire who also has studied human-dog interactions, said the findings “extend the list of behaviors and abilities previously described in dogs as analogous to those of young children.”

    Among other animals, the ability to eavesdrop has also been documented in bonobos. Canine researchers have known since the early 2000s that some dogs can recognize more than 200 items by name and can even infer the names of new toys by excluding ones they already know.

    But Juliane Kaminski, a comparative psychology associate professor at Britain’s University of Portsmouth who conducted that early research, cautioned against overinterpreting the results to say dogs can deeply learn language the same way people do. “The interpretation in terms of ‘word learning’ in the linguistic sense seems a little too strong for me,” she said. “What the study shows is that dogs can learn labels without being explicitly directed toward” an object.

    She added it is still unclear why only a handful of dogs are able to learn the names of their toys. Her own work with label-learning dogs suggests they are more curious and focused than their less-gifted canine counterparts.

    “However, what we do not know is what comes first,” Kaminski said. Are some dogs born better learners? Or do they simply get used to fetching objects when asked?

    “It’s a chicken-and-egg problem, and we need further research to explore this,” she said.

    Dror tried for years in vain to train other less gifted but still very good dogs — including her own German shepherd, Mitos — to associate names with toys. “Nothing worked. It was very frustrating.”

    Still, Mitos nuzzled his way into the new paper. He died last year at 15, just as Dror was submitting the research for publication, and she dedicated the paper to him. “It’s definitely hard to lose someone that’s been such a huge part of your life for so long,” she said.

    Now, Dror has a new puppy — a schipperke named Flea. She is introducing her to toys and hoping she can learn.

  • Judge blocks Trump administration from purging DEI-related terms from Head Start grant applications

    Judge blocks Trump administration from purging DEI-related terms from Head Start grant applications

    WASHINGTON — A federal judge has temporarily blocked the Trump administration’s efforts to remake Head Start, ordering it to stop purging words it associates with diversity, equity and inclusion from grant applications and barring it from laying off any more federal employees in the Office of Head Start.

    The order came this week in a lawsuit filed in April against Department of Health and Human Services Secretary Robert F. Kennedy Jr. and other officials. The lawsuit accuses the Trump administration of illegally dismantling Head Start by shutting down federal Head Start offices and laying off half the staff. It also challenges the administration’s attempts to bar children who are in the U.S. illegally from Head Start programs and to ban language they view as suggestive of DEI.

    The plaintiff organizations representing Head Start providers and parents said in a court filing last month that officials told a Head Start director in Wisconsin to axe the terms “race,” “belonging” and “pregnant people” from her grant application. They later sent a list with nearly 200 words the department discouraged her from using in her application, including “Black,” “Native American,” “disability” and “women.”

    A Health and Human Services spokesperson said he could not comment on the judge’s order.

    Head Start, founded six decades ago as part of President Lyndon B. Johnson’s War on Poverty, is an early education and family support program that serves hundreds of thousands of children who come from low-income households, foster homes or homelessness. It is federally funded but operated by nonprofits, schools and local governments.

    Joel Ryan, who heads the Washington State Head Start & Early Childhood Education and Assistance Program, said the order halts an attack on Head Start centers.

    “When a Head Start program has their funding withheld because of their efforts to provide effective education to children with autism, serve tribal members on a reservation, or treat all families with respect, it is an attack on the fundamental promise of the Head Start program,” Ryan said.

    The directive on the forbidden words raised confusion for Head Start directors, who must describe how they will use the money in grant applications and are required by law to provide demographic information about the families they serve. A director in Washington state said in a court filing the guidance led her to cancel staff training on how to support children with autism and children with trauma.

    The order from U.S. District Judge Ricardo S. Martinez of Seattle, published Monday, bars Health and Human Services from cutting any more employees and from punishing Head Start providers if they use the prohibited language.

  • As a shooting unfolded at Brown, students turned to anonymous app for answers before official alerts

    As a shooting unfolded at Brown, students turned to anonymous app for answers before official alerts

    PROVIDENCE, R.I. — When a gunman began firing inside an academic building on the Brown University campus, students didn’t wait for official alerts warning of trouble. They got information almost instantly, in bits and bursts — through phones vibrating in pockets, messages from strangers, rumors that felt urgent because they might keep someone alive.

    On Dec. 13 as the attack at the Ivy League institution played out during finals week, students took to Sidechat, an anonymous, campus-specific message board used widely at U.S. colleges, for fast-flowing information in real time.

    An Associated Press analysis of nearly 8,000 posts from the 36 hours after the shooting shows how social media has become central to how students navigate campus emergencies.

    Fifteen minutes before the university’s first alert of an active shooter, students were already documenting the chaos. Their posts — raw, fragmented, and sometimes panicked — formed a digital time capsule of how a college campus experienced a mass shooting.

    As students sheltered in place, they posted while hiding under library tables, crouching in classrooms and hallways. Some comments even came from wounded students, like one posting a selfie from a hospital bed with the simple caption: #finalsweek.

    Others asked urgent questions: Was there a lockdown? Where was the shooter? Was it safe to move?

    It would be days before authorities identified the suspect and found him dead in New Hampshire of a self-inflicted gunshot wound, later linking him to the killing of a Massachusetts Institute of Technology professor.

    Here’s a look at how the shooting unfolded.

    Stream of collective consciousness

    Described by Harvard Magazine as “the College’s stream of collective consciousness,” Sidechat allows anyone with a verified university email to post to a campus feed. On most days, the Brown feed is filled with complaints about dining hall food, jokes about professors, and stress about exams — fleeting posts running the gamut of student life.

    On the Saturday afternoon just before the shooting, a student posted about how they wished they could “play Minecraft for 60 hours straight.” Then, the posts abruptly shifted.

    Crowds began pouring out of Brown’s Barus and Holley building, and someone posted at 4:06 p.m.: “Why are people running away from B&H?”

    Others quickly followed. “EVERYONE TAKE COVER,” one wrote. “STAY AWAY FROM THAYER STREET NEAR MACMILLAN 2 PEOPLE JUST GOT SHOT IM BEING DEAD SERIOUS,” another user wrote at 4:10 p.m.

    Dozens of frantic messages followed as students tried to fill the information gap themselves.

    “so r we on lockdown or what,” one student asked.

    By the time the university alert was sent at 4:21 p.m., the shooter was no longer on campus — a fact Brown officials did not yet know.

    “Where would we be without Sidechat?” one student wrote.

    A university spokesperson said Brown’s alert reached 20,000 people minutes after the school’s public safety officials were notified shots had been fired. Officials deliberately didn’t use sirens to avoid sending people rushing to seek shelter into harm’s way, said the spokesperson, Brian E. Clark, who added Brown commissioned two external reviews of the response with the aim of enhancing public safety and security.

    Long hours of hiding

    Long after the sun had set, students sheltered in dark dorm rooms and study halls. Blinds were closed. Doors were barricaded with dressers, beds, and mini fridges.

    “Door is locked windows are locked I’ve balanced a metal pipe thing on the handle so if anyone even tries the handle from the outside it’ll make a loud noise,” one student wrote.

    Students reacted to every sound — footsteps in hallways, distant sirens, helicopters overhead. When alerts came, the vibrations and ringtones were jarring. Some feared that names of the dead would be released — and that they would recognize someone they knew.

    Law enforcement moved through campus buildings, clearing them floor by floor.

    A student who fled Barus and Holley asked whether anyone could text his parents to let them know he had made it out safely. Others said they had left phones behind in classrooms when they fled, unable to reach frantic loved ones. Ironically, those closest to the shooting often had the least information.

    Many American students expressed emotions hovering between numbness and heartbreak.

    “Just got a text from a friend I haven’t spoken to in nearly three years,” one student wrote. “Our last messages? Me checking in on her after the shooting at Michigan State.” Multiple students replied, saying they’d had similar experiences.

    International students posted about parents unable to sleep on the other side of the world.

    “I just want a hug from my mom,” one student wrote.

    Anxiety sets in

    As the hours dragged on, students struggled with basic needs. Some described urinating in trash cans or empty laundry detergent bottles because they were too afraid to leave their rooms. Others spoke of drinking to cope.

    “I was on the street when it happened & suddenly I felt so scared,” one student wrote. “I ran and didn’t calm down for a while. I feel numb, tired, & about to throw up.”

    Another wrote: “I’m locked inside! Haven’t eaten anything today! I’m so scared i don’t even know if I get out of this alive or dead.”

    Some students posted into the early morning, more than 10 hours into the lockdown, saying they couldn’t sleep. Sidechat also documented acts of kindness, including a student going door to door with macaroni and cheese cups in a dark dorm.

    Information, and its limits

    Students repeatedly asked the same questions — news? sources? — and challenged one another to verify what they saw before reposting it.

    “Frankly I’d rather hear misinformation than people not report stuff they’ve heard,” one student wrote.

    Others pushed back, sharing a Google Doc that would grow to 28 pages where students could find the most updated, verified information. Some posted police scanner transcriptions or warned against relying on artificial intelligence summaries of the developing situation. Professors — who rarely post on the app — joined the feed, urging caution and offering reassurance.

    “If you’re talking about the active situation please add a source!!!” one student wrote.

    But “reliable information,” students noted, often arrived with a delay.

    Within about 30 minutes of the shooting, posts incorrectly claimed the shooter had been caught. Reports of more gunshots — later proven false — continued into the night and the next day, fueling fear and frustration. Asked one student, what are police doing “RIGHT NOW”?

    Replies came quickly.

    “They are trying their best,” one person responded. “Be grateful,” another added. “They are putting their lives in danger at this moment for us to be safe.”

    A campus changed

    Students awoke Sunday to a campus they no longer recognized. It had snowed overnight — the first snowfall of the academic year.

    In post after post, students called the sight unsettling. What was usually a celebration felt instead like confirmation something had irrevocably shifted.

    “It truly hurt seeing the flakes fall this morning, beautiful and tragic,” one student wrote.

    Even as the lockdown lifted, many said they were unsure what to do — where they could go, whether dining halls were open, whether it was safe to move.

    “What do I do rn?” one student posted. “I’m losing my mind.”

    Students walked through fresh snow in a daze, heading to blood donation centers. Others noticed flowers being placed at the campus gates and outside Barus and Holley.

    Many mourned not only the two students killed, but the innocence they felt had been stripped from their campus.

    “Will never see the first snow of the season and not think about those two,” one student wrote.

    With the lockdown ended, students returned to their dorms as Sidechat continued to fill with grief and reflection. Many said Brown no longer felt the same.

    “Snow will always be bloody for me,” one person posted.

  • Trump administration jails migrant teens in Pa. facility known for child abuse

    Trump administration jails migrant teens in Pa. facility known for child abuse

    MORGANTOWN, Pa. — The Trump administration says it is focused on protecting unaccompanied migrant children. It imposed strict new background checks on those seeking custody of young migrants and cut ties with a chain of youth shelters accused of subjecting children in its care to pervasive sexual abuse.

    “This administration is working fearlessly to end the tragedy of human trafficking and other abuses of unaccompanied alien children who enter the country illegally,” said Health Secretary Robert F. Kennedy Jr., who oversees the Office of Refugee Resettlement, or ORR, which cares for unaccompanied migrant children.

    But for the last three months, that office has also locked some teenage migrant boys inside a secure juvenile prison about 50 miles west of Philadelphia with a long and publicly documented history of staff physically and sexually abusing juvenile offenders in its care, a Washington Post investigation has found.

    “ORR is sending children to a juvenile detention center who should not be there,” said Becky Wolozin, a senior attorney at National Center for Youth Law.

    ORR awarded $9 million to Abraxas Alliance in August to hold up to 30 young immigrants deemed a danger to themselves or others in its facility in Morgantown, Berks County. At various times since early October, between five and eight migrant teenage boys have been held inside a dedicated wing of the juvenile detention center, sleeping inside locked cells the size of walk-in closets, according to lawyers who met with them.

    Pennsylvania state inspectors have documented at least 15 incidents since 2013 in which they said staff physically mistreated minors at the Morgantown facility, which holds principally juveniles facing or convicted of criminal offenses. In at least two incidents, officials documented allegations of staff sexually harassing or sexually abusing young residents. The most recent reported abuse occurred in November.

    In a lawsuit filed in 2024, six former residents of the facility allege they were sexually abused by staff between 2007 and 2016, accusing management of enabling a “culture of abuse.”

    A spokesperson for Abraxas Alliance, the Pittsburgh nonprofit that operates the facility, did not respond to a long list of questions about its treatment of children. After some of the incidents cited by inspectors, Abraxas suspended or fired staff members and submitted correction plans to state regulators, promising to retrain workers on proper restraining techniques and install more surveillance cameras.

    ORR has wide latitude over the types of facilities it uses to house children, though federal rules require it to use “the least restrictive setting that is in the best interests of the child.” The rules say ORR may place minors in secure facilities if they have been charged with a crime, or if the agency determines they could harm themselves or others.

    HHS spokesman Andrew Nixon said decisions on where to place migrant children “are based on each child’s specific circumstances, behavior-based risk assessments, and legal criteria.” All the teens at the Morgantown facility were provided a notice with “specific details as to why they are placed there,” he added.

    Some of the migrant boys have no pending criminal charges, and several have parents or close relatives in the U.S. asking to be reunited with them, said Becky Wolozin, a senior attorney at National Center for Youth Law who visited the facility and spoke to some of the boys in November.

    The Post was unable to identify any of the boys or verify Wolozin’s claims about their circumstances, because neither their immigration lawyers nor government officials would share details about their cases due to strict rules protecting the records of minors.

    License revoked

    In November, Pennsylvania revoked one of the three licenses held by different units within the Morgantown facility, Abraxas Academy. The state accused Abraxas of “gross incompetence, negligence, and misconduct” following a Nov. 4 incident of staff violence against a child, state records show. According to those documents, a staff member put his hand on a child’s neck and shoved his face into a table, an incident the facility’s operator did not report to local authorities.

    Ali Fogarty, a spokeswoman for Pennsylvania’s Department of Human Services, said state law prevented her from commenting on the incident, including whether the child was a migrant placed by ORR or another juvenile held in the facility. The state increased its monitoring of the Morgantown facility and reduced its maximum capacity under one license by 25 residents while the company appeals the revocation. Its two other licenses were unaffected, and it is still permitted to hold more than 100 individuals, Fogarty said.

    Nixon, the HHS spokesman, said ORR “will make any necessary adjustments to its use of the facility based on the outcome of the state’s licensing process” and its own review of the incident, adding that “ORR has zero tolerance for sexual abuse and harassment of children in our care.”

    The problems at the nation’s only secure jail for migrant youths are unfolding as the Trump administration pushes measures it says are aimed at safeguarding the 2,300 unaccompanied migrant children in its custody, as well as those it releases to sponsors within the country.

    In March, ORR ended its use of shelters operated by Southwest Keys — a Texas nonprofit which the Justice Department sued in 2024, alleging its workers repeatedly sexually abused children in the nonprofit’s shelters from 2015 to at least 2023. The company said in a 2024 statement that the lawsuit did not “present the accurate picture of the care and commitment our employees provide to the youth and children.” The department dropped the lawsuit last year.

    Around the same time, ORR also began requiring people to provide income documents and submit to DNA testing, fingerprinting and interviews before regaining custody of young migrants, including their own children, which agency officials say will help ensure they are not being claimed by traffickers.

    The Trump administration said President Joe Biden had released tens of thousands migrant children to sponsors with little or no vetting, including to some adults with a history of violent crimes. U.S. Immigration and Customs Enforcement says it’s enlisting the help of local law enforcement agencies to locate the children and verify their safety.

    Jen Smyers, a former deputy director of ORR under Biden, said this population has faced abuse for decades, across several administrations. She said stricter vetting cannot always prevent mistreatment.

    Partly as a result of the Trump administration’s new vetting procedures, the average child remains in ORR custody about six months — nearly three times longer than at the beginning of 2025, government data shows.

    A history of abuse allegations

    By jailing migrant children in a secure detention center, especially one with a recent history of abuse, the administration is exposing these young people to some of the same risks it says it wants to eliminate, said Jonathan White, a former career HHS official who managed the unaccompanied children program during part of Trump’s first term.

    Under any previous administration, a track record of physical or sexual abuse would be “instantly disqualifying” for federal contracts involving the care of minors, White said. “This is the kind of thing under Republican and Democratic administrations you terminate existing grants for — you don’t give new grants to places like that.”

    Abraxas Academy, part of a chain of 10 youth detention and treatment centers, holds dozens of teenage boys from surrounding areas, many of whom are serving sentences for violent crimes or awaiting court hearings. Rob Monzon, a former director of the Morgantown facility, calls it “the most extreme setting in juvenile detention.” Its young inmates, some who claim to be from gangs, frequently lash out at one another, vandalize the building and attack staff members, he said.

    State inspection records show that staff members have at times responded with violence.

    One staff member “picked up [a child] by the shirt and threw the child to the ground, holding the child down with a knee, and banging the child into the wall,” a 2013 report on the state’s website said. Another threw punches at a different minor and yet another bit an incarcerated child in the abdomen, other reports said. The reports noted that one staff member “frequently escalates situations” by applying restraint holds that are “known to cause pain to the child.”

    Workers have been trained to defend themselves by placing inmates into restrictive holds, waiting for them to calm down and calling for help from other employees, according to Shamon Tooles, who worked as a supervisor at Abraxas Academy for eight months in 2023. But due to a lack of training, supervision, and frequent short-staffing, he said, some workers resorted to fighting back.

    “A lot of the staff were just scared,” said Tooles, who said he does not condone any mistreatment of children.

    In December 2016, Pennsylvania state inspectors said they found “a preponderance of evidence” that a staff member sexually harassed a child at the Morgantown facility. The staff member, who was not identified, was put on leave and subsequently resigned.

    One of the former detainees who is suing Abraxas Alliance claimed a staff member took away his food or gym privileges or locked him in his room if he did not comply with sexual requests.

    In court records, attorneys for Abraxas Alliance denied any wrongdoing and said they would need the names of all the abusers to confirm details of the alleged abuse. The lawsuit, which covers allegations lodged by 40 former residents from five Abraxas facilities, is still active and no trial date has been set.

    Nixon, the HHS spokesman, said Abraxas Academy was the only state-licensed facility that submitted a bid on the ORR contract that “operated a secure care facility for youth between the ages of 13 to 17.” He said the contract is part of an effort to “restore” the government’s capacity to hold “children whose needs cannot be safely supported” in less restrictive settings.

    Fresh paint

    Abraxas Academy sits at the end of a three-mile road, deep in the farmlands of Amish country. It’s so remote that when nine boys escaped through a hole in the barbed wire fence in 2023, they were quickly discovered a few miles away, lost and shivering in the rain, ready to go back, according to Paul Stolz, the police chief of nearby Caernarvon Township.

    When Wolozin visited Nov. 5, she said the walls smelled like fresh paint and workers were still renovating the floors of the wing designated for immigrant boys, separate from the teens serving criminal sentences. At that time, there were eight migrant boys; at least two have since been transferred to less restrictive facilities, and another was moved to an adult detention center upon turning 18, according to their lawyers. At least two new detainees arrived in December.

    Wolozin’s group advocates for children in the foster care, juvenile detention and immigration detention systems and has special permission to meet with them per the terms of a landmark 1997 legal agreement. She has personally supported Democratic politicians and causes.

    According to Wolozin, the conditions for migrant boys at Abraxas Academy mirror those of children serving criminal sentences. The boys are woken from their cells and counted every morning. Their use of a “family room,” with TVs, board games and bean bag chairs, is restricted to certain times, as is their access to an outdoor recreation area with farm animals and an indoor gym. Some have told lawyers and advocates they have been limited to two 15-minute phone calls to family members per week. Federal rules require at least three calls per week.

    Wolozin, who interviewed five of the migrant boys but has not reviewed their files, said one appeared to have severe cognitive disabilities. Another had completed his sentence for a criminal charge and was set to be released to his family but was instead transferred to ORR custody. Others had never been in jail before.

    “What became very apparent to me is that ORR is sending children to a juvenile detention center who should not be there,” she said.

    The vast majority of the migrant children in government custody live in shelters where they move freely around a campus. But the government can place children in more restrictive settings if they are deemed a risk — a broad authority that former child welfare officials say ORR has misused.

    In 2018, ORR found it had “inappropriately placed” 18 of the 32 minors who were in secure facilities at the time, according to the court deposition of a former agency official. One child, the official said, had been placed in a jail because they were an “annoyance” and not an actual danger.

    ORR had moved away from juvenile detention centers since 2023, after the government settled lawsuits that claimed children in these facilities were subjected to inhumane punishments or illegally locked up based on being mislabeled gang members. As part of the settlements, ORR agreed to implement new rules providing stronger legal protections for migrant children in custody.

    Now, the administration is expanding the practice of secure detention once more. Along with the 30 beds for migrant teens at Abraxas Academy, ORR is exploring a second secure facility that would hold up to 30 additional migrant children in Texas, government procurement records show.

    Advocates for migrant youths say these jails are unnecessary and harmful — and evident from the government’s tumultuous history with ORR detention centers before the Abraxas contract.

    ‘I just went on myself’

    Young people detained at Virginia’s Shenandoah Valley Juvenile Center said in 2018 court declarations that they had been locked in small rooms for most of the day. Some said they were beaten by guards. If they acted out, some said, they were put in a restraint chair, with straps around their head, elbows, legs and feet, and wheeled into a room where they were left to sit alone for hours with their head covered in a white mesh hood so they couldn’t spit on the guards.

    “This is embarrassing, but on one occasion, I had to pee, and they wouldn’t let me, so I just went on myself,” a child identified as “R.B.” said in a court filing. “I know one or two other kids this happened to as well; they peed on themselves while they were in the chair.”

    Shenandoah’s operators said their use of the restraint chair was not abuse. ORR policies permit such restrains as a last resort. A federal judge ruled in 2018 that the government had improperly placed minors in secure facilities including Shenandoah but did not determine whether its use of restraints constituted abuse.

    California’s Yolo County Juvenile Detention Center commonly used chemical agents and physical force to control children, the state’s attorney general found in 2019. A spokeswoman for Yolo County said in an emailed statement that the facility took measures to reduce its reliance on chemical agents, including staff training on nonviolent crisis intervention.

    Community activists pressured city and state officials to stop jailing migrant children there, citing lawsuits and the growing costs of defending against them. One Salvadoran teen alleged in court papers he was shipped across the country to the facility simply because New York police claimed he was a member of MS13. A federal judge found no unequivocal evidence of the boy’s ties to any gang.

    By 2023, Shenandoah, Yolo and another juvenile detention center in Alexandria, Va., had all opted not to renew their contracts with ORR.

    “Nobody wants these contracts,” said Holly S. Cooper, co-director of the Immigration Law Clinic at UC Davis, who was involved in the effort to end the Yolo contract. “There was a massive public outcry.”

    According to Smyers, ORR’s No. 2 official at the time, the agency in late 2023 solicited proposals for a new kind of facility where children could have restrictions increased or reduced depending on their behavior. ORR has not awarded this contract, but Nixon said it is still a priority.

    Fights, an escape attempt

    The Abraxas chain of youth detention and treatment centers has changed ownership at least twice. At the time of many of the abuse incidents in the inspection reports, it was owned by private prison firm Geo Group, which purchased the chain for $385 million in 2010. Geo has said in court records it is not aware of any sexual abuse.

    The company sold parts of the Abraxas business to a nonprofit group run by Jon Swatsburg, the unit’s longtime executive, for $10 million in 2021. At the time, Geo was losing federal contracts and being shunned by major banks in response to community activism against its business. Geo still owns the building in Morgantown and leases it out to Abraxas Alliance, securities filings show.

    A spokesman for Geo did not respond to requests for comment.

    Swatsburg, who has overseen the properties for more than two decades, was paid $752,000 by Abraxas and related entities in 2022, according to the most recent tax filings available. Inperium, an investor in the nonprofit group, said Swatsburg was departing in 2023, but he continued to list himself as president and chairman of Abraxas in corporate filings in 2024 and 2025. As of last year, Swatsburg was also listed as a vice president of Geo Group.

    Last year alone, police responded to at least 34 incidents at the facility, local records show, including inmate fights, at least one attempted escape, a suicidal detainee, an incident that left three police officers with minor injuries and another incident in which a staff member’s finger was partly amputated by a door.

    Meanwhile, the migrant boys at Abraxis have told advocates that they feel stuck.

    “They had plans and family, and lives and school and girlfriends, and things going on that they planned to do,” Wolozin said. “Instead, they are in this place.”

  • U.S. reverses course on limiting alcohol to one or two drinks a day

    U.S. reverses course on limiting alcohol to one or two drinks a day

    Thousands of people pause their cocktail consumption and embrace Dry January every year. The percentage of Americans who say they drink alcohol has hit new lows. And more and more, researchers warn we should stay away from drinking all together.

    But the ongoing debate over the health harms of alcohol took a turn Wednesday after the United States dropped its long-standing guidance to consume no more than one or two drinks per day. It marks a pull back in messaging for the federal government — under President Joe Biden, the U.S. surgeon general recommended adding cancer warnings to alcohol products, and reassessing limits on alcohol consumption.

    During a news conference rolling out new U.S. dietary guidelines on Wednesday, Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, said people should drink judiciously. Then he added it is a “social lubricant that brings people together” and “there’s probably nothing healthier than having a good time with friends in a safe way.”

    Critics scoffed at the characterization, saying Oz was echoing talking points from the alcohol industry. Mike Marshall, CEO of the U.S. Alcohol Policy Alliance, called the statement irresponsible and said the pared-down guidelines fly in the face of Health Secretary Robert F. Kennedy Jr.’s Make American Healthy Again movement.

    “Alcohol is a toxic, addictive carcinogen,” Marshall said. “The fact the guidelines are going backward is disappointing and alarming.”

    The new guidelines call for people to “consume less alcohol for better overall health” while cautioning pregnant women, those recovering from alcohol use disorder and patients taking certain medications to avoid alcohol all together.

    Previous U.S. Department of Agriculture guidelines were significantly more detailed, defining moderate consumption as no more than two drinks a day for men, and one drink for women — while explaining the risks associated with heavy drinking, such as heart disease, liver disease, and some types of cancer. They also defined binge drinking as five drinks within two hours for men, and four for women.

    Public health advocates said the government’s new messaging was vague and glossed over the harms of alcohol.

    The new guidelines do not allow “Americans to really have any sort of sense of where the risks begin,” said Marissa Esser, a public health consultant who headed the Centers for Disease Control and Prevention Alcohol Program until it was disbanded by the Trump administration in April. “Americans deserve to be informed about this information in order for them to be able to make their own decisions about their drinking and their health.”

    The language on alcohol was included as part of broader overhaul of dietary guidelines under Kennedy, which included calls for Americans to limit intake of processed foods while endorsing products such as whole milk, butter, and red meat.

    The release of the new guidelines comes as Americans have become increasingly wary of the well-studied harms of drinking, which apart from diseases can include violence, domestic strife, and car crashes. Last year, a Gallup poll found that 53% of Americans say drinking in moderation is bad for health, the first time the polling company found a majority who feel that way.

    Americans’ alcohol consumption surged during the worst of the coronavirus pandemic, causing even more deaths. The number of adult drinkers also grew: Gallup found in 2022 that 67% of Americans reported drinking, the highest number in decades. Rates have since decreased, as researchers have noted a steep decline in drinking among young people.

    The industry and some Republican lawmakers had pushed back against federally funded studies, including the one published in January 2025 that concluded even moderate drinking could carry health risks.

    Tim Naimi, one of the co-authors of that report, noted that males who consume two drinks per week have a 1 in 25 chance of dying prematurely from alcohol. Naimi said he had hoped that guidelines would be tighter, calling for no more than a few drinks per week, or no more than one per day for men and women.

    But Naimi said he appreciated that the guidelines still espouse limiting alcohol for better health. “I think that’s what the public now understands — when it comes to alcohol, the less is better,” said Naimi, director of the University of Victoria’s Canadian Institute for Substance Use Research.

    Countries such as Canada and the United Kingdom have pushed citizens to drink less, reflecting the broader scientific consensus about the harms of alcohol, said David H. Jernigan, a Boston University professor of health law and a critic of alcohol industry marketing.

    “The human body is the same no matter what country you’re in,” Jernigan said, adding: “With these vague guidelines, the alcohol industry got a really nice New Year’s present.”

    The alcohol industry has struggled amid tariffs and Americans prioritizing wellness, drinking less, or embracing nonalcoholic options. Nearly 30% of U.S. consumers said they planned to spend less money on alcoholic drinks during the next three months amid tighter budgets and economic unease, McKinsey & Company reported in December.

    A coalition of alcohol industry groups on Wednesday issued a cautious statement, emphasizing that guidelines have long stressed moderation and that the new version is “underpinned by the preponderance of scientific evidence.” The Beer Institute, a trade group, added that the nation’s beer industry has “championed responsible consumption for decades” and encourages moderation in drinking.

    The alcohol industry worried that under Kennedy and Trump — who famously doesn’t drink — guidelines could have been stricter, said Dave Williams, president of Bump Williams Consulting, an analytics research firm that specializes in the alcoholic beverage industry.

    “The latest guidelines came as more of a relief, but aren’t necessarily a fix” for the industry’s troubles, he said.

  • The ICE agent in Minneapolis was not in the vehicle’s path when he fired at Renee Good, video shows

    The ICE agent in Minneapolis was not in the vehicle’s path when he fired at Renee Good, video shows

    A deadly encounter in Minneapolis on Wednesday between federal Immigration and Customs Enforcement agents and a 37-year-old woman escalated in a matter of seconds.

    In the aftermath, Homeland Security Secretary Kristi L. Noem said the woman had committed an act of “domestic terrorism,” first disobeying officers’ commands and then weaponizing her SUV by attempting to “run a law enforcement officer over.” President Donald Trump said the woman “violently, willfully and viciously ran over the ICE officer.”

    A frame-by-frame analysis of video footage, however, raises questions about those accounts. The SUV did move toward the ICE agent as he stood in front of it. But the agent was able to move out of the way and fire at least two of three shots from the side of the vehicle as it veered past him, according to the analysis.

    Video taken by a witness shows Renee Nicole Good’s vehicle, a burgundy Honda Pilot SUV, stopped in the middle of a one-way road in a residential area of south Minneapolis on Wednesday morning. That footage and other videos examined by The Washington Post do not show the events leading up to that moment.

    The agent, who has not been publicly identified, can be seen standing behind Good’s SUV, holding up a phone and pointing it toward a woman who also has her phone out. The two appear to be recording each other.

    The agent then walks around the passenger side of Good’s vehicle.

    ICE officer kills a Minneapolis driver in a deadly start to Trump’s latest immigration operation

    A pickup truck pulls up, and two additional agents exit the vehicle and approach Good, the video shows. A voice can be heard saying to “get out” of the car at least two times. One of the agents puts a hand on the opening of the driver’s side window and with his other hand tugs twice quickly on the door handle, but the driver’s door does not open.

    That same agent puts his hand farther in the opening of Good’s window, and almost simultaneously, the SUV begins to back up.

    The woman killed by an ICE agent in Minneapolis was a mother of three, a poet, and new to the city

    The agent who was first seen behind Good’s SUV reemerges in front of the vehicle, still appearing to hold up a phone. The SUV quickly pulls forward, and then veers to the right, in the correct direction of traffic on the one-way street.

    As the vehicle moves forward, video shows, the agent moves out of the way and at nearly the same time fires his first shot. The footage shows that his other two shots were fired from the side of the vehicle.

    Driver shot in Minneapolis is at least the fifth person killed in U.S. immigration crackdown

    Videos examined by The Post, including one shared on Truth Social by Trump, do not clearly show whether the agent is struck or how close the front of the vehicle comes to striking him. Referring to the officer, Trump wrote in his post that it was “hard to believe he is alive.” Video shows the agent walking around the scene for more than a minute after the shooting.

    Good’s SUV travels a short distance before crashing into a car parked on the opposite side of the street.

    The FBI and Minnesota’s Bureau of Criminal Apprehension are investigating the shooting. The White House and the Department of Homeland Security did not immediately respond to a request seeking comment for this story.

  • Why are malnutrition deaths soaring in America?

    Why are malnutrition deaths soaring in America?

    Something strange is happening with malnutrition.

    It’s by far the fastest-growing cause of death in America, soaring sixfold over the past decade or so, according to our analysis of death certificate data from the Centers for Disease Control and Prevention.

    To be sure, we wouldn’t yet call it commonplace. But while it accounts for fewer than 1 in 100 deaths, its toll is rising so fast that it’s now in the same league as arterial disease, mental disorders, and deaths from assault.

    But when you dig into the data, it doesn’t look like our mental image of malnutrition, one which revolves around food banks and famine. For starters, it doesn’t quite map to economic hardship.

    It tends to kill somewhat more people in lower-income states, and among folks with less education in general. But the relationship isn’t as strong as you’d think, and it bears surprisingly little relation to state measures of food insecurity or food stamp use.

    More important, we’re worried here about the meteoric rise in deaths, not the level. And the rise is much harder to explain with demographics. We see it across the board. Every state, every education level, every race, every gender.

    When we split the numbers every which way, only one metric showed clear differences: age. Americans 85 or older die of malnutrition at around 60 times the rate of the rest of the population, and such deaths are rising about twice as fast among that group.

    What’s going on? Are older Americans struggling to eat?

    Yes (but). Uche Akobundu, a dietitian who directs nutrition strategy at Meals on Wheels America, told us the program’s local providers “consistently report serving seniors who struggle to afford or access nutritious food while living on fixed incomes and facing rising costs for housing, utilities, and healthcare.”

    Indeed, the share of Americans 65 or older who report some level of food insecurity hit a high in 2023. The rate among the 85-plus crowd was lower, but still near record levels.

    And those records may not be broken, at least after 2024. The source we used, a supplement to the Census Bureau’s Current Population Survey, has been canceled by the Agriculture Department. The forthcoming release could be the last.

    But before we declared this a closed case, we stepped back and put the numbers in context. Food insecurity among older Americans has risen 5% from 2011 to 2023. That’s not a good number, or one you can just wave off. But at the same time, it can’t explain a 746% increase in malnutrition deaths over that period. (And, yes, we adjusted for the aging population.)

    So, we called the American Society for Parenteral and Enteral Nutrition — also known as ASPEN or, more descriptively, the nation’s intravenous-nutrition and feeding-tube experts. If there’d been a sudden surge of malnutrition among older Americans, ASPEN would have noticed.

    Peggi Guenter led clinical practice, quality, and advocacy at ASPEN for two decades. Her best guess is simple: Malnutrition “has always been there. … We’re just identifying and documenting it better than we ever have in the past.”

    What happened in the past? Well, it has never been unusual for someone with a serious condition to lose weight. Watching a loved one waste away isn’t a modern phenomenon. But physicians used to see malnutrition as part of the patient’s overall decline.

    But around 2010, researchers started accumulating evidence that showed what they had long assumed: The lack of nutrients was, itself, a risk factor. A pile of papers now tell that malnourished people have more emergency room visits, spend longer in the hospital, and need more healthcare.

    Doctors weren’t trained to diagnose it separately, especially since research has shown it wasn’t as easy as lab-testing for a single indicator, according to Alison Steiber, chief research, impact, and strategy officer at the Academy of Nutrition and Dietetics.

    That started to change in 2012. That’s when, prompted partly by new research finding malnutrition could be driven by inflammation as well as lack of calories, ASPEN and the nutrition academy released the Consensus Statement on “Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).”

    Not long after, in 2014, we saw the first big jump in death certificates labeled with malnutrition as the underlying cause of death. Nobody’s willing to say the declaration caused the rise in diagnoses. “Cause” is a sacred, hard-earned word in medicine. But it’s also true that the nutrition academy, ASPEN, and friends went all out to ensure that the statement caused physicians to be aware that they needed to diagnose malnutrition more often.

    The Academy of Nutrition and Dietetics, ASPEN, and their allies taught clinicians from all over the country to diagnose malnutrition by looking not just for weight loss, but also for factors such as muscle loss, loss of under-the-skin fat pads, fluid retention, and simply not eating enough. They held awareness weeks, tons of trainings and — perhaps most notably — launched an ambitious Malnutrition Quality Improvement Initiative, which worked with hundreds of hospitals starting in 2013.

    All those efforts paid off.

    “I started practicing in 2010, and I was not trained to identify malnutrition in my education program, like in my internship,” said Michelle Schneider, ASPEN’s manager of clinical practice. And the 2012 paper and awareness push “is when I myself started … really evaluating the set of clinical characteristics that can identify and diagnose malnutrition.”

    When she and her colleagues started looking for malnutrition, their hospital’s related case numbers went up. It happened all over the country. As a rule of thumb, multiple experts told us that at least 1 in 5 hospital patients probably suffer from some kind of malnutrition. In 2010, about 3% were diagnosed with it. By 2018, it hit 9%, Guenter and her colleagues found.

    “As with other conditions, such as celiac disease, increased prevalence rates do not necessarily reflect more cases, but rather improved detection, diagnosis, and intervention,” Steiber told us.

    But what about older patients specifically? We called on the American Academy of Hospice and Palliative Medicine and got ludicrously lucky: They put us in touch with their chief medical officer, Kristina Newport.

    Newport runs palliative medicine at Penn State Health, speaks in fully formed paragraphs, and probably could have dictated a better version of this column over breakfast before she’d had her first coffee. She confirmed everything we’d heard — then added another variable.

    “The other thing that happened around this timeline is that CMS, the Center for Medicare and Medicaid Services, changed the impact of the diagnosis of some of these diagnoses that fall under malnutrition,” she said.

    “When hospitals are measured on their mortality, the calculation includes a comparison of how many people actually die compared to how many people are expected to die. And that expected number is determined by the complexity of documented illnesses as reflected in diagnosis codes. So when there was more weight given to malnutrition as a diagnosis code — when it was better defined, based on the understanding that nutrition often correlates with severity of illness — all of a sudden, it changed the calculation.”

    So, hospitals and other providers were given a strong incentive to look out for malnutrition, because now official statistics (correctly) recognized it increases the odds that someone will have an awful outcome, which means you’re not penalized as much if said outcome occurs.

    “Long-term care facilities have also started paying very close attention to weight loss and are held accountable for folks having abnormal weight loss,” she added. In fact, nursing homes must have a dietitian or nutrition specialist on staff.

    And hospice, which can be part of many medical or at-home settings, has its own incentives.

    “You’re only eligible for hospice enrollment if you’re expected to die within six months and if you’re not pursuing life-prolonging treatments,” she told us. “The hospice clinicians have to regularly demonstrate that somebody is progressing toward death, which is crazy, right? And so one of the ways that they have to routinely demonstrate that there’s evidence that this person is dying is to routinely assess different aspects of nutrition.”

    It might not be weight loss, since people in failing health might retain water, but you can still look at arm circumference and other metrics. It helps demonstrate the decline needed to maintain eligibility (and payment) for hospice services, she said, and it can be an indirect way to measure the progress of a patient’s disease, particularly for folks who might not have a clear terminal illness.

    “So your 85-year-old woman who has a little bit of cognitive impairment but has never been diagnosed with dementia — she gets a urinary tract infection every once in a while, but she doesn’t have one right now. She had mild diabetes. None of those things are explicitly taking her life,” Newport said. “The most objective thing you can say is she continues to lose weight.”

    “Somebody like that may end up with a diagnosis of malnutrition on her death certificate because none of those other things obviously took her life. Right? But it wasn’t because she didn’t have access to food.”

    In fact, regardless of your condition, weight loss and loss of appetite are one of the most common pathways toward death as the body shuts down.

    So, malnutrition is often a normal part of dying. It hints at the presence of other underlying conditions. So how did it end up as the underlying cause of death on almost 25,000 death certificates last year?

    Newport had a hint for us on that one, too. We cherish death certificates as one of the most authoritative data sources out there — and they are, since they cover pretty much the entire population and are certified by professionals. But those professionals are human.

    “Despite the importance of the cause of death and filling out this form, there’s very little education or standardization of doing it,” she told us. “So that’s just something to keep in mind.”

    And we did. So we set out to learn about death certificates.

    We started with the folks who quarterback the entire certification process and make sure the families and doctors get what they need. We called the funeral directors.

    Chris Robinson just finished his term as president of the National Funeral Directors Association. He also runs Robinson Funeral Homes at the foot of South Carolina’s sliver of the Blue Ridge.

    When someone dies, Robinson gets a report from the hospital, hospice, or coroner. It tells him their next of kin and date of birth. He meets with the family to fill in vital statistics. But he’s not allowed to fill in the cause of death.

    “We submit it electronically to the certifying physician or coroner, whoever’s going to certify the death,” Robinson told us. “And then they send it back to us with the cause of death.” Robinson then sends the certificate to the health department to be finalized, so he can get official paper death certificates for the family.

    That pointed us to the next step in following the certificate on its journey. That step was Reade Quinton. Quinton is president of the National Association of Medical Examiners. He also runs the pathology residency at the Mayo Clinic. Filling out the cause of death on certificates — and teaching others to do so — is a large part of his career.

    “There’s a science and an art to filling out a death certificate,” he told us. It’s a forensic pathologist’s job to ask why, to get to the root of the problem. Ideally, he said, you’ll rarely see malnourishment on a death certificate by itself — the document should also define the underlying cause.

    You see, under cause of death, a typical certificate has four blanks. You start with what Quinton would call the “final insult,” and then tease out the causal chain until, by the fourth blank — if you need that many — you’ve listed the underlying cause.

    So, the chain might go something like: gastrointestinal bleeding due to swollen veins in the esophagus due to cirrhosis due to alcohol use disorder. In that case, the alcohol abuse would be the underlying cause.

    Malnutrition could play a role in that four-step mortality chain. But why are people listing it as the ultimate cause? Quinton’s not sure, but death certification isn’t really taught in depth outside of pathology residencies, and most deaths aren’t certified by pathologists.

    “There’s a large number of people … who fill out death certificates,” Quinton explained. “So you may have forensic pathologists filling them out in certain cases, you may have hospitalists filling them out, residents on service who are still in training, coroners. It’s incredibly variable depending on whose jurisdiction the death occurred in.”

    And looking at the data, we see clues that most of these malnutrition deaths probably weren’t certified by medical examiners.

    For example, we’ve seen very little growth in malnutrition deaths in hospitals in recent years. The increase has been sharpest at nursing homes and long-term care facilities, where some residents may arrive with nutrition issues, followed by deaths at home or hospice. Similarly, almost no patients who had an autopsy got malnutrition listed as a cause of death.

    Is it a perfect smoking gun? No. Malnutrition is a routine part of death. And unless someone suspects neglect, routine deaths often don’t cross the desk of specialists such as Quinton and his protégés.

    But we reckon it’s a hint, especially when paired with something else we heard from Quinton and several others.

    “Electronic records are so accessible now,” he told us. “We have a lot more information at our fingertips than we had 10 or 20 years ago. So is it possible that now they’re getting a better list of underlying conditions and saying, ‘Oh, he’s got malnutrition,’ and so they put that on there as well.”

    And that’s our best guess. A better understanding of malnutrition means it has appeared on more medical charts. And from there, it occasionally makes its way onto a death certificate, perhaps helped by a harried physician.

    But does that mean rising malnutrition deaths are a mirage?

    We didn’t really expect Kurt Soffe to answer that question. The fine folks at the National Funeral Directors Association put us in touch with Soffe, the director of Jenkins-Soffe Funeral Home south of Salt Lake City, to answer questions about death certificates in Utah, the state with the highest rate of malnutrition deaths.

    But when he logged on to Zoom, we saw Soffe was on his phone. He was in the driver’s seat of his vehicle, parked outside the retirement facility where he’d just dropped off his wife. Her 93-year-old father had just entered hospice.

    He said he’d seen diagnoses like malnutrition on more and more death certificates. But all the time he spent with grieving families still didn’t prepare him for the reality.

    “He was a robust healthy man just a few months ago,” Soffe said. “And he basically is 120 pounds of nothing now.”

    His father-in-law suffered a stroke. Doctors removed the blockage, but away from his beloved home and even-more-beloved yard, he lost the desire to eat. He told them everything tasted like “sand.”

    “We tried Boost protein drinks, we tried protein bars, we tried steak and potatoes, we tried everything,” Soffe told us.

    It reminded us of something we heard from Newport, the palliative care physician.

    “One of the main ways we take care of people we love is we feed them, right? And so it’s very distressing for caregivers to look at their loved ones and to see that they don’t want to eat. … We have to understand that in some situations, it’s not something we can fix.”

    We watched Soffe struggle with that conflict in real time.

    “You watch his mental change, his physical change, his capacity to communicate change, and then just watch him decline by the millimeter,” Soffe said, his voice breaking.

    “I’ve been in funeral service all my life and have been a caregiver all my life. Born and raised in the building, and I found myself absent of words because I didn’t know what to even say to my own father-in-law, who I knew was dying.”

    “There really isn’t anything to say other than ‘I love you’ and ‘thank you.’”

    Soffe’s father-in-law died about 12 hours later.

  • At CES, auto and tech companies transform cars into proactive companions

    At CES, auto and tech companies transform cars into proactive companions

    LAS VEGAS — In a vision of the near future shared at CES, a girl slides into the back seat of her parents’ car and the cabin instantly comes alive. The vehicle recognizes her, knows it’s her birthday, and cues up her favorite song without a word spoken.

    “Think of the car as having a soul and being an extension of your family,” Sri Subramanian, Nvidia’s global head of generative AI for automotive, said Tuesday.

    Subramanian’s example, shared with a CES audience on the show’s opening day in Las Vegas, illustrates the growing sophistication of AI-powered in-cabin systems and the expanding scope of personal data that smart vehicles may collect, retain, and use to shape the driving experience.

    Across the show floor, the car emerged less as a machine and more as a companion as automakers and tech companies showcased vehicles that can adapt to drivers and passengers in real time — from tracking heart rates and emotions to alerting if a baby or young child is accidentally left in the car.

    Bosch debuted its new AI vehicle extension that aims to turn the cabin into a “proactive companion.” Nvidia, the poster child of the AI boom, announced Alpamayo, its new vehicle AI initiative designed to help autonomous cars think through complex driving decisions. CEO Jensen Huang called it a “ChatGPT moment for physical AI.”

    But experts say the push toward a more personalized driving experience is intensifying questions about how much driver data is being collected.

    “The magic of AI should not just mean all privacy and security protections are off,” said Justin Brookman, director of marketplace policy at Consumer Reports.

    Unlike smartphones or online platforms, cars have only recently become major repositories of personal data, Brookman said. As a result, the industry is still trying to establish the “rules of the road” for what automakers and tech companies are allowed to do with driver data.

    That uncertainty is compounded by the uniquely personal nature of cars, Brookman said. Many people see their vehicles as an extension of themselves — or even their homes — which he said can make the presence of cameras, microphones, and other monitoring tools feel especially invasive.

    “Sometimes privacy issues are difficult for folks to internalize,” he said. “People generally feel they wish they had more privacy but also don’t necessarily know what they can do to address it.”

    At the same time, Brookman said, many of these technologies offer real safety benefits for drivers and can be good for the consumer.

    On the CES show floor, some of those conveniences were on display at automotive supplier Gentex’s booth, where attendees sat in a mock six-seater van in front of large screens demonstrating how closely the company’s AI-equipped sensors and cameras could monitor a driver and passengers.

    “Are they sleepy? Are they drowsy? Are they not seated properly? Are they eating, talking on phones? Are they angry? You name it, we can figure out how to detect that in the cabin,” said Brian Brackenbury, director of product line management at Gentex.

    Brackenbury said it’s ultimately up to the car manufacturers to decide how the vehicle reacts to the data that’s collected, which he said is stored in the car and deleted after the video frames, for example, have been processed.

    “One of the mantras we have at Gentex is we’re not going to do it just because we can, just because the technology allows it,” Brackenbury said, adding that “data privacy is really important.”

  • South Jersey’s Isabeau Levito in third after short program at U.S. Figure Skating Championships

    South Jersey’s Isabeau Levito in third after short program at U.S. Figure Skating Championships

    ST. LOUIS — Two-time defending champion Amber Glenn set the record for a women’s short program at the U.S. Figure Skating Championships on Wednesday night, giving her a narrow lead over world champion Alysa Liu heading into the free skate.

    South Jersey native Isabeau Levito was third with 75.72 points on the opening night of the national championships, which are the last opportunity for skaters to impress the U.S. Figure Skating officials who will decide the team for the Milan Cortina Olympics on Sunday.

    South Jersey’s Isabeau Levito looks to vault herself onto the Olympic team this week

    Liu had broken the record mere minutes before Glenn’s skate with a score of 81.11 points, earning a standing ovation from a crowd packed into the home of the St. Louis Blues. But then Glenn took the ice and was flawless from an opening triple axel to a finishing combination spin, earning 83.05 points, a hug from coach Damon Allen and a standing ovation of her own.

    “I knew that I came here to do my job,” Glenn said, “and I was happy to see that scores were up, scores were good, and I was able to keep them going up. I felt a responsibility to keep it going better and better and better.”

    Glenn wound up being the best.

    The dance competition gets started Thursday night alongside the men’s short program.

    Levito, the 2023 champion and a former world silver medalist, had to withdraw from nationals last year because of injury. But she looked as if she had never missed a day, performing with style and grace to a medley of music honoring Sophia Loren.

    “I felt really happy with myself that I did my job,” said the 18-year-old Levito, who lives and trains in Mount Laurel. “I feel like I’m in a really good place right now.”

    Isabeau Levito, here competing at Skate Canada, performed a short program honoring Sophia Loren on Wednesday.

    The 26-year-old Glenn, who four years ago missed nationals and a shot at the Beijing Games because of COVID-19, channeled her trademark power and emotion into a program set to “Like A Prayer” by Madonna. Glenn followed her axel with a triple flip-triple toe loop, and her triple loop merely catapulted her into a rollicking finish to an energetic program.

    Allen was waiting for her rinkside, dressed in a maroon suit to match Glenn’s dazzling maroon dress.

    “Of course I feel ecstatic. The score was huge,” Glenn said. “My grandma passed last year, and she was with me from Day 1, and I just felt it today, and I’m not usually one of those people that says it, but I felt like I had something help me today.”

    Glenn’s showcase came on the heels of a similarly splendid performance from the 20-year-old Liu, who finished sixth at the Beijing Games, then stepped away from the sport entirely because of burnout, but is in the midst of a remarkable comeback.

    Last year, she became the first American world champion since Kimmie Meissner in 2006.

    Now, Liu is among a few U.S. hopefuls trying to deliver women’s Olympic gold for the first time since Sarah Hughes in 2002.

    Liu performed the same short program from last year’s world championships, opening with a whirling triple flip, landing a solid double axel and finishing with what coach Phillip DiGuglielmo called her best triple lutz-triple loop of the season.

    “I’m really happy with the lutz,” Liu said. “That was good. That was real good.”

    Competitors are not always rivals. Just ask the top American women’s figure skaters, Isabeau Levito and Amber Glenn. | from 2024

    Earlier in the night, Alisa Efimova and Misha Mitrofanov began defense of their U.S. pairs title with a near-perfect short program, leaving them nearly eight points clear of the field as they hold out hope of making the American team for the Winter Games.

    While the 28-year-old Mitrofanov was born in the U.S., his 26-year-old partner was born in Finland. And despite the couple having wed in early 2024 and Efimova getting a green card approved that summer, she still is waiting for the U.S. to decide whether to waive a three-year waiting period to become a citizen — one of the requirements to represent a nation in the Olympics.

    But time is running out before U.S. Figure Skating must announce its Olympic team on Sunday.

    “We’re hoping maybe a last-minute miracle might happen,” Mitrofanov said.

    Efimova and Mitrofanov seemed to glide inside Enterprise Center on Wednesday night. They opened their short program with a beautiful triple twist, landed their side-by-side triple toe loop in sync, their throw triple loop covered a long expanse of ice, and they finished by pumping their firsts as their music came to a close.

    They wound up with a season-best 75.31 points, while Audrey Shin and Balazs Nagy were second with 67.67, Ellie Kam and Danny O’Shea right behind with 67.13, and Valentina Plazas and Maximiliano Fernandez were in fourth with 67.03.

    “We’re definitely very proud with how we skated tonight. The crowd was amazing,” Mitrofanov said. “We really trusted each other. We trusted our training. I was a little more nervous than normal, to be honest, and I was proud of Alisa holding my hand throughout.”