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ByMikeStobbe The Associated Press NEW YORK U.S. health of- ficials on Tuesday released a draft of long-awaited fed- eral guidelines on circum- cision, saying medical evi- dence supports having the procedure done and health insurers should pay for it. The Centers for Disease Control and Prevention guidelines stop short of telling parent to get their newborn sons circumcised. That is a personal decision that may involve religious or cultural preferences, said the CDC's Dr. Jonathan Mermin. But "the scientific evi- dence is clear that the ben- efits outweigh the risks," added Mermin, who over- sees the agency's programs on HIV and other sexually transmitted diseases. These are the first fed- eral guidelines on circum- cision, a brief medical pro- cedure that involves cutting away the foreskin around the tip of the penis. Germs can grow underneath the foreskin, and CDC offi- cials say the procedure can lower a male's risk of sex- ually-transmitted diseases, penile cancer and even uri- nary tract infections. The CDC started work- ing on the guidelines about seven years ago, when a cluster of influential stud- ies in Africa indicated cir- cumcision might help stop spread of the AIDS virus. "The benefits of male circumcision have become more and more clear over the last 10 years," said Dr. Aaron Tobian, a Johns Hop- kins University researcher involved in one of the Afri- can studies. But the guidelines are important, because the rates of newborn male cir- cumcision have been drop- ping, he added. The guidelines are being published in the federal reg- ister Tuesday. For the next 45 days, the CDC will re- ceive public comment be- fore finalizing them next year. They are likely to draw intense opposition from anti-circumcision advo- cacy groups, said Dr. Doug- las Diekema, a Seattle phy- sician who worked on a circumcision policy state- ment issued by the Amer- ican Academy of Pediatrics in 2012. "This is a passionate is- sue for them and they feel strongly that circumcision is wrong," said Diekema, a professor of pediatrics at the University of Washing- ton. The CDC guidelines largely mirror the pediatri- cian group's statement, but the CDC's document incor- porates more research and comes from an organiza- tion that many may see as more neutral on the topic, Diekema said. The thinking on circum- cision has swung wildly over the years. It's been practiced by Jews and Muslims for thousands of years, but didn't become common in this country until the 20th century. By one estimate, only 25 percent of U.S. male new- borns were circumcised in 1900. It gradually became the cultural norm, and in the 1950s and 1960s surpassed 80 percent. But then the trend reversed. Part of it had to do with changing demographics, as the U.S. population grew to include larger numbers of Mexican- Americans and other eth- nic groups that didn't tra- ditionally circumcise their children. Also, opposition to the procedure grew from advo- cates who decried the pain, bleeding and risk of infec- tions to newborns. Their message was aided by the Internet and by the neutral stance of physicians groups — including, for a time, the American Academy of Pe- diatrics. A wave of state Medic- aid programs stopped pay- ing for newborn circumci- sions, which cost roughly $150 to $200. The list even- tually rose to 18 states, ac- cording to CDC numbers. By 2010 the newborn cir- cumcision rate was down to about 58 percent, according to one CDC estimate. But even as the circum- cision rate dropped, more medical evidence came in supporting it — particularly three rigorous and influen- tial studies in Africa that looked at the spread of HIV and other sexually trans- mitted diseases in circum- cised and uncircumcised men and their partners. In the new guidelines, the CDC says there is now strong evidence that male circumcision can: —Cut a man's risk of get- ting HIV from an infected female partner by 50 to 60 percent. —Reduce their risk of genital herpes and certain strains of human papillo- mavirus by 30 percent or more. —Lower the odds of uri- nary tract infections during infancy, and cancer of the penis in adulthood. Studies have not shown that circumcision will re- duce an HIV-infected man's chances of spreading the AIDS virus to women. And research has not found cir- cumcision to be a help in stopping spread of HIV dur- ing gay sex. The guidelines say cir- cumcision is safer for new- borns and infants than for older males, noting the complication rate rises from 0.5 percent in new- borns to 9 percent in chil- dren ages 1 to 9, according to the CDC. Minor bleeding and pain are the most com- mon problems, experts say. FEDERAL GUIDELINES CDC:Circumcisionbenefitsoutweighrisks NOAHBERGER—THEASSOCIATEDPRESSFILE Anti-circumcision activists Frank McGinness, right, and Jeff Brown rally with about 25 protesters outside a San Francisco courthouse.. By Carla K. Johnson The Associated Press Hospitals can be perilous for patients because of pre- ventable infections, drug er- rors and falls. But new data released Tuesday show the danger has waned over the past few years. A federal research agency found a 17 percent decline in such errors from 2010 to 2013, according to the re- port. Using methods devel- oped by health care quality experts, it estimated that 50,000 fewer patients died in the hospital and about $12 billion in health care costs was saved as a result of the decline. Health and Human Ser- vices Secretary Sylvia Burwell called the reduc- tion significant as she an- nounced the findings at a conference in Baltimore. "It represents historic progress on health care qual- ity," Burwell said. "It repre- sents healthier patients and health care dollars being spent more wisely." Medicare and private in- surers have started reduc- ing or withholding pay- ments when hospitals make mistakes. The report men- tions those financial penal- ties as likely contributors to the improvement. The Obama administra- tion also has worked with hospitals to spread ideas to improve safety. Burwell credited public-private ef- forts such as the Partner- ship for Patients, which has 3,700 participating hospitals focused on reducing errors and reducing unnecessary return trips to the hospital. In May, the administra- tion reported the Medi- care readmission rate for hospitals has been slowly dropping, from 19 percent in 2011 to 17.5 percent two years later. That meant an estimated 150,000 fewer hospital readmissions over two years. Dr. Peter Angood of the American Association for Physician Leadership, who wasn't involved in the fed- eral report, said the health care industry has a long way to go, and it's still un- clear which patient safety strategies work best in hos- pitals. He noted that the re- port finds that one in 10 hospital patients still expe- rience such errors. "A 10 percent signifi- cant error rate that creates harm, disability and possi- ble death is way too high in American health care," An- good said. The report analyzed con- ditions patients experience in the hospital such as med- ication errors, catheter-as- sociated urinary tract in- fections, bloodstream in- fections, pressure ulcers and surgical-site infections. 2010 TO 2013 Report finds 17 percent drop in hospital patient harm By Christine Armario The Associated Press LOS ANGELES When his high school English stu- dents came to class, Tom Rademacher knew there would be one thing on their mind: a grand jury's deci- sion not to indict the white police officer who shot and killed Michael Brown in Ferguson, Missouri. So the Minneapolis teacher put aside his les- son plans for the day and asked them a simple ques- tion: How did they feel? Some teens said they were sad, others angry. One said he logged off Twit- ter and Facebook to avoid dealing with upset friends. "That's the definition of white privilege," student Nia Golston replied. "You get to look away while I, be- ing African-American, have to live like this." In the aftermath of the Ferguson announcement, classrooms across the na- tion are taking up uncom- fortable topics — race, po- lice use of force and poverty, among others — to give stu- dents a voice and help them make sense of events. Some teachers are using the discussion to weave in history lessons. One school in the Bronx read Martin Luther King, Jr.'s "Letter from Birmingham Jail." Others are reviewing pri- mary source documents, like officer Darren Wil- son's grand jury testimony, to study the case in detail. Some are just inquiring about the emotions evoked by the killing of a person not much older than most high school students. In a story so focused on young black people and their communities, "we aren't hearing enough from black teenagers about what they're feeling and what they're thinking about and what their experiences are," Rademacher said. Sites such as Teachable- Moment.org and groups in- cluding Facing History and Ourselves, a nonprofit in Brookline, Massachusetts, are providing teachers with guidance on incorporating Ferguson into their lessons. Teachers are sharing their ideas and classroom experi- ences online with hashtags such as #FergusonSyllabus and #FergusonInClass. "All the things you hear in the larger community are happening in the mi- crocosm called the class- room," said Steve Becton, social program director of urban education at Facing History and Ourselves. "For the teachers not allowing it to happen, I think it's a missed opportunity." Becton advises teachers to ask nuanced questions: What is the role of law in society? And if a law seems insufficient, how can it be challenged? What is the re- lationship between African- American males and law en- forcement? "How do we help students understand that history?" Becton asked. "Ultimately education is not about facts and dates and figures but about participating in de- mocracy and participating in a civil discourse." School districts in Los Angeles and Washington, D.C., have provided teachers with instructions for lead- ing Ferguson discussions. "The goal is to assist stu- dents in being able to ex- ercise their First Amend- ment rights, to speak out on things they feel passionate about," said Holly Priebe- Diaz, intervention coordi- nator for the Los Angeles Unified School District. Teacher Gregory Michie, who instructs middle-school students in a predominantly Mexican neighborhood in Chicago, spent five weeks earlier this year discussing the context of the Ferguson case, First Amendment is- sues and media coverage. "I teach in a neighbor- hood where a lot of kids have seen violence," he said. "There is a certain level of mistrust, skepticism." Elsewhere, the topic is less welcome or completely off-limits. Teachers in one Illinois classroom, for ex- ample, were advised earlier this year not to talk about the case in class. FEELINGS Nation's classrooms reflect on Ferguson case decision JIM MONE — THE ASSOCIATED PRESS English teacher Tom Rademacher, right, listens as junior Kierra Murray talks about Ferguson, Tuesday at Fair School in Minneapolis. N EWS D AILY REDBLUFF TEHAMACOUNTY T H E V O I C E O F T E H A M A C O U NTY S I N C E 1 8 8 5 PHONE: (530)527-2151 FAX: (530) 527-5774 545 Diamond Avenue • P.O. Box 220 • Red Bluff, CA 96080 Support our classrooms, keep kids reading. DONATE YOUR VACATION newspaper dollars to the Newspaper In Education Program HELP OUR CHILDREN For more details call Circulation Department (530) 527-2151 | NEWS | REDBLUFFDAILYNEWS.COM WEDNESDAY, DECEMBER 3, 2014 6 B