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Sample records for washington state birth

  1. Maternal veterinary occupation and adverse birth outcomes in Washington State, 1992-2014: a population-based retrospective cohort study.

    Science.gov (United States)

    Meisner, Julianne; Vora, Manali V; Fuller, Mackenzie S; Phipps, Amanda I; Rabinowitz, Peter M

    2018-05-01

    Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes. Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (veterinary support staff separately. While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff. These results support the need for further study of the association between veterinary occupation and adverse birth outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Parental Country of Birth and Childhood Vaccination Uptake in Washington State.

    Science.gov (United States)

    Wolf, Elizabeth; Rowhani-Rahbar, Ali; Tasslimi, Azadeh; Matheson, Jasmine; DeBolt, Chas

    2016-07-01

    Underimmunization of certain immigrant populations can place them at high risk of experiencing vaccine-preventable disease outbreaks. We conducted a retrospective cohort study between January 1, 2008, and May 1, 2013, among children included in the Washington State Immunization Information System. We assessed receipt of 1 or more doses of measles-containing, hepatitis A, pneumococcal, and diphtheria-tetanus-acellular pertussis-containing vaccines between 12 and 23 months of age. We compared children with 1 or more parents born in Somalia, Ukraine, Russia, Mexico, or India to children with 2 parents born in the United States. Poisson regression models with robust SEs were used to provide prevalence ratios adjusted for maternal education and number of prenatal visits. We identified 277 098 children, including 65 466 with foreign-born parents. Children of Somali-born parents were less likely to be immunized against measles than children of US-born parents (prevalence ratio: 0.82; 95% confidence interval: 0.80-0.84); this decrease became more pronounced over time (P < .01). No such disparity between these groups was observed with other vaccines. Compared with children of US-born parents, children of Ukrainian-born and Russian-born parents were less likely to be immunized, whereas children of Mexican-born and Indian-born parents were more likely to be immunized with any of the specified vaccines. We found country-specific patterns of immunization that may reflect underlying cultural or other beliefs. Certain immigrant communities with higher rates of immunization refusal may be at risk for vaccine-preventable diseases and require new forms of public health outreach. Copyright © 2016 by the American Academy of Pediatrics.

  3. Oil spill response issues in Washington State

    International Nuclear Information System (INIS)

    Lempriere, P.R.

    1997-01-01

    Washington State statutes and regulations applicable to oil transport and oil spills were described. Specific provisions of the statutes and regulations and other relevant matters were also discussed. Among these were: (1) Washington State oil spill prevention plans, (2) Washington State oil spill contingency plans, (3) best achievable protection, (4) Intertanko's lawsuit against Washington State, (5) oil spill removal organizations, (6) certificates of financial responsibility in Washington State, (7) extent of potential liability under Washington Law, (8) disposal of cleanup materials, and (9) definition of 'qualified individuals' on marine vessels having the authority to implement removal actions

  4. Washington State biomass data book

    International Nuclear Information System (INIS)

    Deshaye, J.A.; Kerstetter, J.D.

    1991-07-01

    This is the first edition of the Washington State Biomass Databook. It assess sources and approximate costs of biomass fuels, presents a view of current users, identifies potential users in the public and private sectors, and lists prices of competing energy resources. The summary describes key from data from the categories listed above. Part 1, Biomass Supply, presents data increasing levels of detail on agricultural residues, biogas, municipal solid waste, and wood waste. Part 2, Current Industrial and Commercial Use, demonstrates how biomass is successfully being used in existing facilities as an alternative fuel source. Part 3, Potential Demand, describes potential energy-intensive public and private sector facilities. Part 4, Prices of Competing Energy Resources, shows current suppliers of electricity and natural gas and compares utility company rates. 49 refs., 43 figs., 72 tabs

  5. Washington State Biofuels Industry Development

    Energy Technology Data Exchange (ETDEWEB)

    Gustafson, Richard [Univ. of Washington, Seattle, WA (United States)

    2017-04-09

    The funding from this research grant enabled us to design, renovate, and equip laboratories to support University of Washington biofuels research program. The research that is being done with the equipment from this grant will facilitate the establishment of a biofuels industry in the Pacific Northwest and enable the University of Washington to launch a substantial biofuels and bio-based product research program.

  6. Report : public transportation in Washington State, 1984

    Science.gov (United States)

    1984-10-01

    This report is an update of the Public Transportation in Washington State publication, dated December 1981. In order to reflect the changes that have occurred since that time, this report contains the most current data obtainable. Chapter One of this...

  7. 2015 State Geodatabase for Washington

    Data.gov (United States)

    US Census Bureau, Department of Commerce — The 2015 TIGER Geodatabases are extracts of selected nation based and state based geographic and cartographic information from the U.S. Census Bureau's Master...

  8. Fuel management at Washington State Ferries

    International Nuclear Information System (INIS)

    Brodeur, P.; Olds, J.

    2008-01-01

    This presentation discussed Washington State Ferry (WSF) operations and provided details of a biodiesel research and demonstration project. Washington has the largest ferry system in the United States, with a total of 28 vessels that operate on 10 routes through 20 terminals. Routes vary by transit times, navigational challenges, and the proximity to population centres. WSF fuel and emissions management initiatives include exhaust emission studies, clean fuel initiatives, machinery upgrades, fuel conservation initiatives, and biodiesel testing. The organization is also using waste heat recovery and a positive restraint system. The WSF biodiesel pilot program was conducted using soy-derived fuels with a purifier disk stack. The program is in agreement with recent legislation requiring that 2 per cent of annual diesel fuel sales are from biodiesel fuels, and state legislation requiring that state agencies use a minimum of 20 per cent biodiesel blends in diesel-powered vessels and vehicles. Details of project partnerships were included. tabs., figs

  9. Drivers' use of marijuana in Washington state : traffic tech.

    Science.gov (United States)

    2016-08-01

    In July 2014, Washington State allowed legal sales of : recreational marijuana. Working with the Washington : Traffic Safety Commission, NHTSA assisted the State in : conducting a roadside study to examine the prevalence : of marijuana use before and...

  10. An assessment of interstate safety investment properties in Washington state.

    Science.gov (United States)

    2014-12-01

    The Washington State Department of Transportation (WSDOT) commissioned the current study, targeting the entire interstate : mainline network in Washington State, to provide strategic direction to multi-biennial investment interstate locations that of...

  11. The State of Washington's Children, Summer 2002. [Tenth Annual Report].

    Science.gov (United States)

    Connell, Frederick A.; Brandon, Richard; Hill, Sheri L.; Carter, S. Louise; Garrison, Michelle M.; DeWys, Shelley; Mandell, Dorothy J.

    This Kids Count report is the tenth to examine annually statewide trends in the well-being of Washington's children and focuses on child poverty and the needs of the working poor. The statistical portrait is based on indicators of child well-being in five areas: (1) family and community, including teen birth rate, teen pregnancy rate, births to…

  12. The State of Washington's Children, Fall 2001. [Ninth Annual Report].

    Science.gov (United States)

    Washington Univ., Seattle. School of Public Health and Community Medicine.

    This Kids Count report is the ninth to examine annually statewide trends in the well-being of Washington's children. The statistical portrait is based on indicators of child well-being in five areas: (1) family and community, including teen birth rate, teen pregnancy rate, divorces involving children, and births to unmarried mothers; (2) economic…

  13. The State of Washington's Children. [Seventh Annual Report].

    Science.gov (United States)

    Marvinney, Sandy, Ed.

    This KIDS COUNT seventh annual report examines statewide trends in the well-being of Washington's children. The statistical portrait is based 24 key indicators of well-being: (1) teen birth rate; (2) teen pregnancy rate; (3) births to unmarried mothers; (4) divorces involving children; (5) family foster caseload; (6) average real wages; (7) per…

  14. Greenhouse gas mitigation options for Washington State

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, N.

    1996-04-01

    President Clinton, in 1993, established a goal for the United States to return emissions of greenhouse gases to 1990 levels by the year 2000. One effort established to help meet this goal was a three part Environmental Protection Agency state grant program. Washington State completed part one of this program with the release of the 1990 greenhouse gas emissions inventory and 2010 projected inventory. This document completes part two by detailing alternative greenhouse gas mitigation options. In part three of the program EPA, working in partnership with the States, may help fund innovative greenhouse gas reduction strategies. The greenhouse gas control options analyzed in this report have a wide range of greenhouse gas reductions, costs, and implementation requirements. In order to select and implement a prudent mix of control strategies, policy makers need to have some notion of the potential change in climate, the consequences of that change and the uncertainties contained therein. By understanding the risks of climate change, policy makers can better balance the use of scarce public resources for concerns that are immediate and present against those that affect future generations. Therefore, prior to analyzing alternative greenhouse gas control measures, this report briefly describes the phenomenon and uncertainties of global climate change, and then projects the likely consequences for Washington state.

  15. Washington State University Algae Biofuels Research

    Energy Technology Data Exchange (ETDEWEB)

    chen, Shulin [Washington State Univ., Pullman, WA (United States). Dept. of Biological Systems Engineering; McCormick, Margaret [Targeted Growth, Inc., Seattle, WA (United States); Sutterlin, Rusty [Inventure Renewables, Inc., Gig Harbor, WA (United States)

    2012-12-29

    The goal of this project was to advance algal technologies for the production of biofuels and biochemicals by establishing the Washington State Algae Alliance, a collaboration partnership among two private companies (Targeted Growth, Inc. (TGI), Inventure Chemicals (Inventure) Inc (now Inventure Renewables Inc) and Washington State University (WSU). This project included three major components. The first one was strain development at TGI by genetically engineering cyanobacteria to yield high levels of lipid and other specialty chemicals. The second component was developing an algal culture system at WSU to produce algal biomass as biofuel feedstock year-round in the northern states of the United States. This system included two cultivation modes, the first one was a phototrophic process and the second a heterotrophic process. The phototrophic process would be used for algae production in open ponds during warm seasons; the heterotrophic process would be used in cold seasons so that year-round production of algal lipid would be possible. In warm seasons the heterotrophic process would also produce algal seeds to be used in the phototrophic culture process. Selected strains of green algae and cyanobacteria developed by TGI were tested in the system. The third component was downstream algal biomass processing by Inventure that included efficiently harvesting the usable fuel fractions from the algae mass and effectively isolating and separating the usable components into specific fractions, and converting isolated fractions into green chemicals.

  16. Trends in Out-of-Hospital Births in the United States, 1990-2012

    Science.gov (United States)

    ... to American Indian women, and 0.54% to Asian or Pacific Islander women. In 2012, out-of-hospital births comprised 3%– ... the United States choose home birth. J Midwifery Womens Health 54(2):119–26. 2009. Health Management Associates. Midwifery licensure and discipline program in Washington ...

  17. 75 FR 52023 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2010-08-24

    ... DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service... of the Thomas Burke Memorial Washington State Museum (Burke Museum), University of Washington...

  18. 75 FR 36672 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2010-06-28

    ... DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service... of the Thomas Burke Memorial Washington State Museum (Burke Museum), University of Washington...

  19. Educator Supply and Demand in Washington State. 2004 Report

    Science.gov (United States)

    Lashway, Larry; Maloney, Rick; Hathaway, Randy; Bryant, B. J.

    2005-01-01

    This report describes the findings of the third Educator Supply and Demand Research study in the State of Washington. The intent of these Washington studies is to provide data to inform and shape decisions and activities in the following ways: (1) Provide useful information for educational policymakers, including the legislature, the State Board…

  20. Expanding Access and Opportunity: The Washington State Achievers Program

    Science.gov (United States)

    Ramsey, Jennifer; Gorgol, Laura

    2010-01-01

    In 2001, the Bill & Melinda Gates Foundation launched a 10-year, multi-million dollar initiative, the Washington State Achievers Program (WSA), to increase opportunities for low-income students to attend postsecondary institutions in Washington State. The Bill & Melinda Gates Foundation granted funds to the College Success Foundation…

  1. Expanding Access and Opportunity: The Washington State Achievers Scholarship

    Science.gov (United States)

    O'Brien, Colleen

    2011-01-01

    In 2001, the Bill & Melinda Gates Foundation launched the multi-year, multi-million dollar Washington State Achievers Scholarship program. Concerned about disparities in college participation for low-income students in the state of Washington versus their wealthier peers, the Gates Foundation partnered with the College Success Foundation…

  2. Low birth weight in the United States.

    Science.gov (United States)

    Goldenberg, Robert L; Culhane, Jennifer F

    2007-02-01

    Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

  3. Recidivism of Supermax Prisoners in Washington State

    Science.gov (United States)

    Lovell, David; Johnson, L. Clark; Cain, Kevin C.

    2007-01-01

    This study of recidivism among Washington supermax prisoners used a retrospective matched control design, matching supermax prisoners one-to-one with nonsupermax prisoners on mental illness status and up to eight recidivism predictors. Supermax prisoners committed new felonies at a higher rate than nonsupermax controls, but the difference was not…

  4. Alternative Fuels for Washington's School Buses: A Report to the Washington State Legislature.

    Science.gov (United States)

    Lyons, John Kim; McCoy, Gilbert A.

    This document presents findings of a study that evaluated the use of both propane and compressed natural gas as alternative fuels for Washington State school buses. It discusses air quality improvement actions by state- and federal-level regulators and summarizes vehicle design, development, and commercialization activities by all major engine,…

  5. 78 FR 2429 - Notice of Inventory Completion: The Museum of Anthropology at Washington State University...

    Science.gov (United States)

    2013-01-11

    ... construction. Archaeologists working for the Washington Archaeological Research Center at Washington State... Reservation. Historical, ethnographic, linguistic, and archaeological information links the site to the...

  6. 77 FR 51564 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2012-08-24

    ... Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington... of human remains under the control of the Thomas Burke Memorial Washington State Museum (Burke Museum...

  7. Digital Learning Compass: Distance Education State Almanac 2017. Washington

    Science.gov (United States)

    Seaman, Julia E.; Seaman, Jeff

    2017-01-01

    This brief report uses data collected under the U.S. Department of Education's National Center for Educational Statistics (NCES) Integrated Postsecondary Education Data System (IPEDS) Fall Enrollment survey to highlight distance education data in the state of Washington. The sample for this analysis is comprised of all active, degree-granting…

  8. Composition at Washington State University: Building a Multimodal Bricolage

    Science.gov (United States)

    Ericsson, Patricia; Hunter, Leeann Downing; Macklin, Tialitha Michelle; Edwards, Elizabeth Sue

    2016-01-01

    Multimodal pedagogy is increasingly accepted among composition scholars. However, putting such pedagogy into practice presents significant challenges. In this profile of Washington State University's first-year composition program, we suggest a multi-vocal and multi-theoretical approach to addressing the challenges of multimodal pedagogy. Patricia…

  9. Refining aging criteria for northern sea otters in Washington State

    Science.gov (United States)

    Schuler, Krysten L.; Baker, Bridget B.; Mayer, Karl A.; Perez-Heydrich, Carolina; Holahan, Paula M.; Thomas, Nancy J.; White, C. LeAnn

    2018-01-01

    Measurement of skull ossification patterns is a standard method for aging various mammalian species and has been used to age Russian, Californian, and Alaskan sea otter populations. Cementum annuli counts have also been verified as an accurate aging method for the Alaskan sea otter population. In this study, cementum annuli count results and skull ossification patterns were compared as methods for aging the northern sea otter (Enhydra lutris kenyoni) population in Washington State. Significant agreement was found between the two methods suggesting that either method could be used to age the Washington population of otters. This study also found that ossification of the squamosal-jugal suture at the ventral glenoid fossa can be used to differentiate male subadults from adults. To assist field biologists or others without access to cementum annuli or skull ossification analysis techniques, a suite of morphologic, physiologic, and developmental characteristics were analyzed to assess whether a set of these more easily accessible parameters could also predict age class for the Washington population of otters. Tooth condition score, evidence of reproductive activity in females, and tooth eruption pattern were identified as the most useful criteria for classifying Washington sea otters as pups, juveniles, subadults, or adults/aged adults. A simple decision tree based on characteristics accessible in the field or at necropsy was created that can be used to reliably predict age class of Washington sea otters as determined by cementum annuli.

  10. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey

    OpenAIRE

    Fleming, Susan E.; Donovan-Batson, Colleen.; Burduli, Ekaterina.; Barbosa-Leiker, Celestina.; Hollins Martin, Caroline J.; Martin, Colin R.

    2016-01-01

    Objective:\\ud to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R).\\ud Study design:\\ud a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected...

  11. A 2015 comparison of operational performance : Washington state ferries to ferry operators worldwide.

    Science.gov (United States)

    2015-03-01

    This report provides an update to the 2010 report A Comparison of Operational Performance: : Washington State Ferries to Ferry Operators Worldwide, observing changes in Washington State : Ferries, 23 other ferry systems, and the ferry industry ...

  12. 78 FR 13887 - Notice of Inventory Completion: Washington State Parks and Recreation Commission, Olympia, WA

    Science.gov (United States)

    2013-03-01

    ... Washington State Parks and Recreation Commission at the address below by April 1, 2013. ADDRESSES: Alicia... contact Alicia Woods, Washington State Parks and Recreation Commission, PO Box 42650, Olympia, WA 98504...

  13. 77 FR 48535 - Notice of Inventory Completion: Washington State Parks and Recreation Commission, Olympia, WA

    Science.gov (United States)

    2012-08-14

    ...: Alicia Woods, Washington State Parks and Recreation Commission, P.O. Box 42650, Olympia, WA 98504-2650... it satisfies the criteria in 43 CFR 10.11(c)(1) should contact Alicia Woods, Washington State Parks...

  14. 77 FR 61782 - Notice of Inventory Completion: Washington State Parks and Recreation Commission, Olympia, WA

    Science.gov (United States)

    2012-10-11

    ... Washington State Parks and Recreation Commission at the address below by November 13, 2012. ADDRESSES: Alicia... affiliated with the human remains should contact Alicia Woods, Washington State Parks and Recreation...

  15. Volatile substance misuse deaths in Washington State, 2003-2012.

    Science.gov (United States)

    Ossiander, Eric M

    2015-01-01

    Volatile substance misuse (VSM - also known as huffing or sniffing) causes some deaths, but because there are no specific cause-of-death codes for VSM, these deaths are rarely tabulated. Count and describe VSM deaths occurring in Washington State during 2003-2012. We used the textual cause-of-death information on death certificates to count VSM-associated deaths that occurred in Washington State during 2003-2012. We extracted records that contained words suggesting either a method of inhalation or a substance commonly used for VSM, and reviewed those records to identify deaths on which the inhalation of a volatile substance was mentioned. We conducted a descriptive analysis of those deaths. Fifty-six deaths involving VSM occurred in Washington State during 2003-2012. VSM deaths occurred primarily among adults age 20 and over (91%), males (88%), and whites (93%). Twelve different chemicals were associated with deaths, but 1 of them, difluoroethane, was named on 30 death certificates (54%), and its involvement increased during the study period. Gas duster products were named as the source of difluoroethane for 12 deaths; no source was named for the other 18 difluoroethane deaths. Most VSM deaths occurred among white male adults, and gas duster products containing difluoroethane were the primary source of inhalants. Approaches to deter VSM, such as the addition of bitterants to gas dusters, should be explored.

  16. Home births in the United States, 1990-2009.

    Science.gov (United States)

    MacDorman, Marian F; Mathews, T J; Declercq, Eugene

    2012-01-01

    After 14 years of decline, the percentage of home births rose by 29% from 2004 to 2009, to the point where it is at the highest level since data on this item began to be collected in 1989. The overall increase in home births was driven mostly by a 36% increase for non-Hispanic white women. About 1 out of every 90 births to non-Hispanic white women are now home births. The percentage of home births for non-Hispanic white women was three to five times higher than for any other racial or ethnic group. Home births have a lower risk profile than hospital births, with fewer births to teenagers or unmarried women, and with fewer preterm, low birthweight, and multiple births. The lower risk profile of home compared with hospital births suggests that home birth attendants are selecting low-risk women as candidates for home birth. The increase in the percentage of home births from 2004 to 2009 was widespread and involved selected states from every region of the country. The large variations in the percentage of home births by state may be influenced by differences among states in laws pertaining to births are more prevalent among non-Hispanic white women (7). midwifery practice or out-of-hospital birth (8,9), as well as by differences in the racial and ethnic composition of state populations, as home Studies have suggested that most home births are intentional or planned home births, whereas others are unintentional or unplanned, because of an emergency situation (i.e., precipitous labor, labor complications, or unable to get to the hospital in time) (3,6). Although not representative of all U.S. births (see "Data source and methods"), 87% of home births in a 26-state reporting area (comprising 50% of U.S. births) were planned in 2009. For non-Hispanic white women, 93% of home births were planned (10). Women may prefer a home birth over a hospital birth for a variety of reasons, including a desire for a low-intervention birth in a familiar environment surrounded by family

  17. The FLIP fuel experience at Washington State University

    International Nuclear Information System (INIS)

    Lovas, Thomas A.

    1977-01-01

    The Washington State University TRIGA-fueled modified G.E. reactor was refueled with a partial TRIGA-FLIP core in February, 1976. The final core loading consisted of 35 FLIP and 75 Standard TRIGA fuel rods and provided a core excess reactivity of $7.98. The observed performance of the reactor did not deviate significantly from the design predictions and specifications. Pulsing tests revealed a maximum power output of 1850 MW with a fuel temperature of 449 deg. C from a $2.50 pulse. Slight power fluctuations at 1 Megawatt steady-state operation and post-pulse power oscillations were observed. (author)

  18. 78 FR 64006 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-10-25

    ... inventory of human remains under the control of the Burke Museum. The human remains were removed from Island....R50000] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of... Memorial Washington State Museum, University of Washington (Burke Museum), has completed an inventory of...

  19. 78 FR 59955 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-09-30

    ... completion of an inventory of human remains under the control of the Burke Museum, Seattle, WA. The human....R50000] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of... Memorial Washington State Museum, University of Washington (Burke Museum), has completed an inventory of...

  20. 76 FR 58033 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2011-09-19

    ... DEPARTMENT OF THE INTERIOR National Park Service [2253-665] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington State Museum (Burke...

  1. 76 FR 58034 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2011-09-19

    ... DEPARTMENT OF THE INTERIOR National Park Service [2253-665] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington State Museum (Burke...

  2. 76 FR 58031 - Notice of Intent To Repatriate Cultural Items: Thomas Burke Memorial Washington State Museum...

    Science.gov (United States)

    2011-09-19

    ... DEPARTMENT OF THE INTERIOR National Park Service [2253-665] Notice of Intent To Repatriate Cultural Items: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington State Museum...

  3. 76 FR 58039 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2011-09-19

    ... DEPARTMENT OF THE INTERIOR National Park Service [2253-665] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington State Museum (Burke...

  4. Marijuana, other drugs, and alcohol use by drivers in Washington State.

    Science.gov (United States)

    2016-07-01

    In Washington State legal sales of marijuana began July 8, 2014. A voluntary, anonymous roadside study was conducted to assess the prevalence of drivers testing positive for alcohol and other drugs, including marijuana, on Washingtons roads. Data ...

  5. Marijuana, other drugs, and alcohol use by drivers in Washington state : appendices.

    Science.gov (United States)

    2016-07-01

    In Washington State legal sales of marijuana began July 8, 2014. A voluntary, anonymous roadside study was conducted to assess the prevalence of drivers testing positive for alcohol and other drugs, including marijuana, on Washingtons roads. Data ...

  6. Prevalence of corporal punishment among students in Washington State schools.

    Science.gov (United States)

    Grossman, D C; Rauh, M J; Rivara, F P

    1995-05-01

    To determine the prevalence of corporal punishment in Washington State and the factors associated with its use in Washington elementary and secondary schools. Cross-sectional mail survey performed during the summer of 1992. All elementary and secondary schools in the state of Washington. One thousand eighteen schools (47%) responded to the survey, of which 80% were publicly funded and 63% were located in urban areas. The study sample closely resembled the profile of all schools in the state. Almost 11% of participating schools permitted corporal punishment at the time of the survey and 3.2% reported its actual use during the 1991-1992 school year, resulting in an estimated prevalence of 7.2 incidents per 1000 students per year. Sixteen percent of corporal punishment actions occurred in schools not permitting its use. Ninety percent of public schools relied on district policy regarding corporal punishment. School characteristics associated with the use of corporal punishment included rural location (crude odds ratio, 2.2; 95% confidence interval, 1.5 to 3.4), enrollment of less than 500 students (crude odds ratio, 1.7; 95% confidence interval, 1.1 to 2.7), and kindergarten to eighth-grade or kindergarten to 12th-grade enrollment (crude odds ratio, 2.5; 95% confidence interval, 1.6 to 3.9). The lack of a statewide ban on school corporal punishment at the time of this survey was associated with the continued use of corporal punishment against children in districts that continued to permit it. School policies against corporal punishment were associated with much lower prevalence. Continued efforts are needed to enact and enforce laws in the remaining states that have not yet banned corporal punishment.

  7. Characteristics of planned and unplanned home births in 19 States.

    Science.gov (United States)

    Declercq, Eugene; Macdorman, Marian F; Menacker, Fay; Stotland, Naomi

    2010-07-01

    To estimate the differences in the characteristics of mothers having planned and unplanned home births that occurred at home in a 19-state reporting area in the United States in 2006. Data are from the 2006 U.S. vital statistics natality file. Information on whether a home birth was planned or unplanned was available from 19 states, representing 49% of all home births nationally. Data were examined by maternal age, race or ethnicity, education, marital status, live birth order, birthplace of mother, gestational age, prenatal care, smoking status, state, population of county of residence, and birth attendant. We could not identify planned home births that resulted in a transfer to the hospital. Of the 11,787 home births with planning status recorded in the 19 states studied here, 9,810 (83.2%) were identified as planned home births. The proportion of all births that occurred at home that were planned varied from 54% to 98% across states. Unplanned home births are more likely to involve mothers who are non-white, younger, unmarried, foreign-born, smokers, not college-educated, and with no prenatal care. Unplanned home births are also more likely to be preterm and to be attended by someone who is neither a doctor nor a midwife and is listed as either "other" or "unknown." Planned and unplanned home births differ substantially in characteristics, and distinctions need to be drawn between the two in subsequent analyses. III.

  8. 78 FR 59964 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-09-30

    ....S.C. 3003, of the completion of an inventory of human remains under the control of the Burke Museum....R50000] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of... Washington (Burke Museum), and Central Washington University have completed an inventory of human remains, in...

  9. 77 FR 46117 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2012-08-02

    ... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NAGPRA-10823; 2200-1100-665] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington...

  10. 78 FR 11675 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-02-19

    ... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NAGPRA-12080;2200-1100-665] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington...

  11. 75 FR 36671 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2010-06-28

    ... DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA; Correction AGENCY: National Park... human remains and associated funerary objects in the possession of the Thomas Burke Memorial Washington...

  12. Ergonomics and regulatory politics: the Washington State case.

    Science.gov (United States)

    Silverstein, Michael

    2007-05-01

    Every year in the State of Washington more than 50,000 workers experience a work related musculoskeletal disorder (WMSD), making up more than 30% of all worker compensation cases. In 2000, the Washington State Department of Labor and Industries (L&I) adopted a workplace ergonomics rule requiring employers to reduce worker exposure to hazards that cause or contribute to WMSDs. In 2003, the ergonomics rule was repealed by a margin of 53.5-46.5 in a statewide voter initiative. The official rulemaking record of approximately 100,000 pages, along with supplementary published and unpublished material, was reviewed. The relationship between scientific deliberation and the public policy process in adopting and repealing the ergonomics rule was assessed and described. The deliberative features of the regulatory, judicial, legislative, and ballot processes were compared. The ergonomics rule was successful in the regulatory and legal arenas where the process was most transparent and open to public involvement, differing views could be presented fully, and decision makers were expected to explain their decisions in light of the record. The rule fared most poorly in the legislature and at the ballot box when these features were lost and where considered deliberation was replaced by unconstrained political conflict. Additional checks and balances are needed.

  13. Percutaneous injuries among dental professionals in Washington State

    Directory of Open Access Journals (Sweden)

    Shah Syed M

    2006-10-01

    Full Text Available Abstract Background Percutaneous exposure incidents facilitate transmission of bloodborne pathogens such as human immunodeficiency virus (HIV, hepatitis C virus (HCV and hepatitis B virus (HBV. This study was conducted to identify the circumstances and equipment related to percutaneous injuries among dental professionals. Methods We used workers' compensation claims submitted to the Department of Labor and Industries State Fund during a 7-year period (1995 through 2001 in Washington State for this study. We used the statement submitted by the injured worker on the workers' compensation claim form to determine the circumstances surrounding the injury including the type of activity and device involved. Results Of a total of 4,695 accepted State Fund percutaneous injury claims by health care workers (HCWs, 924 (20% were submitted by dental professionals. Out of 924 percutaneous injuries reported by dental professionals 894 (97% were among dental health care workers in non-hospital settings, including dentists (66, 7%, dental hygienists (61, 18% and dental assistants (667, 75%. The majority of those reporting were females (638, 71%. Most (781, 87% of the injuries involved syringes, dental instruments (77, 9%, and suture needles (23%. A large proportion (90% of injuries occurred in offices and clinics of dentists, while remainder occurred in offices of clinics and of doctors of medicine (9%, and a few in specialty outpatient facilities (1%. Of the 894 dental health care workers with percutaneous injuries, there was evidence of HBV in 6 persons, HCV in 30 persons, HIV in 3 persons and both HBV and HVC (n = 2 exposure. Conclusion Out of hospital percutaneous injuries are a substantial risk to dental health professionals in Washington State. Improved work practices and safer devices are needed to address this risk.

  14. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey.

    Science.gov (United States)

    Fleming, Susan E; Donovan-Batson, Colleen; Burduli, Ekaterina; Barbosa-Leiker, Celestina; Hollins Martin, Caroline J; Martin, Colin R

    2016-10-01

    to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R). a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected using electronic linkages (Qualtrics ™ ). a convenience sample of childbearing women (n=2229) who had planned to birth in their home or birth center from the US (United States) participated. Participants were recruited via professional and personal contacts, primarily their midwives. the total 30-item BSS score mean was 128.98 (SD 16.92) and the 10-item BSS-R mean score was 31.94 (SD 6.75). Sub-scale mean scores quantified the quality of care provision, women's personal attributes, and stress experienced during labour. Satisfaction was higher for women with vaginal births compared with caesareans deliveries. In addition, satisfaction was higher for women who had both planned to deliver in a home or a birth centre, and who had actually delivered in a home or a birth center. total and subscale birth satisfaction scores were positive and high for the overall sample IMPLICATIONS FOR PRACTICE: the BSS and the BSS-R provide a robust tool to quantify women's experiences of childbirth between variables such as birth types, birth settings and providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Opportunities for addressing laminated root rot caused by Phellinus sulphuracens in Washington's forests: A Report from the Washington State Academy of Sciences in cooperation with the Washington State Department of Natural Resources

    Science.gov (United States)

    R. James Cook; Robert L. Edmonds; Ned B. Klopfenstein; Willis Littke; Geral McDonald; Daniel Omdahl; Karen Ripley; Charles G. Shaw; Rona Sturrock; Paul Zambino

    2013-01-01

    This report from the Washington State Academy of Sciences (WSAS) is in response to a request from the Washington State Department of Natural Resources (DNR) to "identify approaches and opportunities ripe for research on understanding and managing root diseases of Douglas-fir." Similar to the process used by the National Research Council, the WSAS upon...

  16. Turning State Data and Research into Information: An Example from Washington State's Student Achievement Initiative

    Science.gov (United States)

    Prince, David; Seppanen, Loretta; Stephens, Deborah; Stewart, Carmen

    2010-01-01

    This chapter discusses Washington State's Student Achievement Initiative, a new performance funding system for community and technical colleges. Its purposes are to improve public accountability by more accurately describing what students achieve from enrolling in state colleges each year and provide incentives through financial rewards to…

  17. Washington State Community Colleges: Impact on the Economy of the State.

    Science.gov (United States)

    Jackson, Sally; And Others

    Using a Virginia study as a model, this study assessed the effect on Washington state's economy of its 27 campus community college system. The study was based on a simple circular cash-flow model for the years 1969-1976 and measured economic impact in three areas: on the level of business volume done in-state, on employment, and on total state…

  18. Safety of union home care aides in Washington State.

    Science.gov (United States)

    Schoenfisch, Ashley L; Lipscomb, Hester; Phillips, Leslie E

    2017-09-01

    A rate-based understanding of home care aides' adverse occupational outcomes related to their work location and care tasks is lacking. Within a 30-month, dynamic cohort of 43 394 home care aides in Washington State, injury rates were calculated by aides' demographic and work characteristics. Injury narratives and focus groups provided contextual detail. Injury rates were higher for home care aides categorized as female, white, 50 to working through an agency (versus individual providers). In addition to direct occupational hazards, variability in workload, income, and supervisory/social support is of concern. Policies should address the roles and training of home care aides, consumers, and managers/supervisors. Home care aides' improved access to often-existing resources to identify, manage, and eliminate occupational hazards is called for to prevent injuries and address concerns related to the vulnerability of this needed workforce. © 2017 Wiley Periodicals, Inc.

  19. NCHS - U.S. and State Trends on Teen Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset assembles all final birth data for females aged 15–19, 15–17, and 18–19 for the United States and each of the 50 states. Data are based on 100% of birth...

  20. Environmental monitoring at Hanford by the state of Washington

    International Nuclear Information System (INIS)

    Conklin, A.W.; Mooney, R.R.; Erickson, J.L.

    1990-01-01

    The Department of Social and Health Services' Office of Radiation Protection (ORP), Washington State's radiation control agency, has a mandate to protect the public from radiation. In 1985, ORP was instructed by the legislature to establish a statewide environmental radiological base line, beginning with Hanford, to verify federal environmental programs, and to enforce federal and state Clean Air Acts. The primary mission of the agency is to protect public health by active involvement in Hanford monitoring and oversight. The state's program was designed not to duplicate but to supplement existing programs and to identify any sampling gaps or problems. Split, side-by-side, and independent samples are collected, with analysis performed by the state's own laboratory. Media sampled have included surface and drinking water, seep and ground water, fruits and vegetables, milk, soils, and air particulates; ambient radiation levels have been determined. Special activities have included split sampling of river seeps with multiple agencies, preliminary dose assessment of early Hanford releases, investigations of 129 I in the environment and in Franklin County drinking water, verification of U.S. Department of Energy (DOE) data on erroneous alarms at the Hanford Plutonium Uranium Extraction Plant, split sampling with a DOE headquarters survey, and participation in several General Accounting Office investigations and a National Academy of Sciences review. The independence of ORP programs guarantees that the public has access to environmental data on the activities of DOE and its contractors. We will describe the interrelationship of ORP and Hanford programs and present results of ORP activities

  1. Vaginal birth after cesarean: neonatal outcomes and United States birth setting.

    Science.gov (United States)

    Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M

    2017-04-01

    Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible

  2. NCHS - Births and General Fertility Rates: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes crude birth rates and general fertility rates in the United States since 1909. The number of states in the reporting area differ historically....

  3. The power professorship program at Washington State University

    International Nuclear Information System (INIS)

    Mosher, C.C.; Shamash, Y.

    1993-01-01

    As with most electric power programs, Washington State University's has existed since the beginning of the engineering program 100 years ago. It has grown and developed largely through the efforts of a few dedicated individuals. The Power Professorship Program has existed since 1972. The Power Professor has been Dr. Clifford C. Mosher until his recent semi-retirement. The Power Professorship was conceived of as an avenue for joint university-industry interaction. Considerable time and ingenuity by visionary engineers and others have resulted in development of a financial base for the Power Professorship Program. The program has been funded equally by public and investor-utility sectors. Following financial difficulties stemming from the Washington Public Power Supply System financial default on public utility bonds for several nuclear projects, funding for the program from the public sector was canceled. After several lean years, public-sector support was again restored by WSU's electrical engineering department offering a contract for services to the utilities in exchange for funding. This contract has been renewed annually, with costs and benefits firmly established through careful analysis and consultation. Problems facing the power industry in the early 1970s with regard to establishing a pipeline of future human resources, were almost identical with those of the present time: indifferent feelings about the industry in general, students being attracted to more glamorous disciplines, and a decline in educational opportunities available in the power area. A 1985 article in the IEEE Power Engineering Review describing today's declining enrollment in power engineering applies equally well to previous periods. A major driving force for initiating utility-industry participation in the Power Professorship Program was the concern for maintaining a source of entry-level engineers with a background in power engineering

  4. 76 FR 73664 - Notice of Inventory Completion: Washington State University, Museum of Anthropology, Pullman, WA

    Science.gov (United States)

    2011-11-29

    ...: Washington State University, Museum of Anthropology, Pullman, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Washington State University, Museum of Anthropology (WSU) has completed an... University, Museum of Anthropology, Pullman, WA 99164-4910, telephone (509) 335-4314. SUPPLEMENTARY...

  5. 77 FR 74871 - Notice of Inventory Completion: The Museum of Anthropology at Washington State University...

    Science.gov (United States)

    2012-12-18

    ... Inventory Completion: The Museum of Anthropology at Washington State University, Pullman, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Museum of Anthropology has completed an... objects may contact the Museum of Anthropology at Washington State University. Repatriation of the human...

  6. 78 FR 2432 - Notice of Inventory Completion: The Museum of Anthropology at Washington State University...

    Science.gov (United States)

    2013-01-11

    ... Inventory Completion: The Museum of Anthropology at Washington State University, Pullman, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Museum of Anthropology has completed an... objects may contact the Museum of Anthropology at Washington State University. Repatriation of the human...

  7. Unmet Student Financial Need in the State of Washington: A Study of the "Need Gap."

    Science.gov (United States)

    Fenske, Robert; And Others

    A study of unmet student financial need in Washington State was conducted by the Washington Council for Postsecondary Education. "Unmet need" is the difference between need and the total amount of aid received by the student through federal, state, and institutional financial aid programs, privately funded scholarships, and nonsubsidized…

  8. 78 FR 59963 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-09-30

    ... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NAGPRA-13770; PPWOCRADN0-PCU00RP14.R50000] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of..., Interior. ACTION: Notice. SUMMARY: The Thomas Burke Memorial Washington State Museum, University of...

  9. 78 FR 50099 - Notice of Inventory Completion: Washington State Parks and Recreation Commission, Olympia, WA

    Science.gov (United States)

    2013-08-16

    ... at the address in this notice by September 16, 2013. ADDRESSES: Alicia Woods, Washington State Parks... Alicia[email protected] . SUPPLEMENTARY INFORMATION: Notice is here given in accordance with the Native... request Alicia Woods, Washington State Parks and Recreation Commission, PO Box 42650, Olympia, WA 98504...

  10. 78 FR 44593 - Notice of Inventory Completion: Washington State Parks and Recreation Commission, Olympia, WA

    Science.gov (United States)

    2013-07-24

    ...: Alicia Woods, Washington State Parks and Recreation Commission, PO Box 42650, Olympia, WA 98504-2650, telephone (360) 902- 0939, email Alicia[email protected] . SUPPLEMENTARY INFORMATION: Notice is here given... written request with information in support of the request to Alicia Woods, Washington State Parks and...

  11. 78 FR 44594 - Notice of Inventory Completion: Washington State Parks and Recreation Commission, Olympia, WA

    Science.gov (United States)

    2013-07-24

    ..., 2013. ADDRESSES: Alicia Woods, Washington State Parks and Recreation Commission, PO Box 42650, Olympia, WA 98504-2650, telephone (360) 902- 0939, email Alicia[email protected] . SUPPLEMENTARY INFORMATION... to Alicia Woods, Washington State Parks and Recreation Commission, PO Box 42650, Olympia, WA 98504...

  12. Staying home to give birth: why women in the United States choose home birth.

    Science.gov (United States)

    Boucher, Debora; Bennett, Catherine; McFarlin, Barbara; Freeze, Rixa

    2009-01-01

    Approximately 1% of American women give birth at home and face substantial obstacles when they make this choice. This study describes the reasons that women in the United States choose home birth. A qualitative descriptive secondary analysis was conducted in a previously collected dataset obtained via an online survey. The sample consisted of 160 women who were US residents and planned a home birth at least once. Content analysis was used to study the responses from women to one essay question: "Why did you choose home birth?" Women who participated in the study were mostly married (91%) and white (87%). The majority (62%) had a college education. Our analysis revealed 508 separate statements about why these women chose home birth. Responses were coded and categorized into 26 common themes. The most common reasons given for wanting to birth at home were: 1) safety (n = 38); 2) avoidance of unnecessary medical interventions common in hospital births (n = 38); 3) previous negative hospital experience (n = 37); 4) more control (n = 35); and 5) comfortable, familiar environment (n = 30). Another dominant theme was women's trust in the birth process (n = 25). Women equated medical intervention with reduced safety and trusted their bodies' inherent ability to give birth without interference.

  13. The politics of home birth in the United States.

    Science.gov (United States)

    Declercq, Eugene

    2012-12-01

    Home birth has emerged as a political issue in several states in the United States, and this essay examines two aspects of home births politics. First, legislative battles over home birth policy do not conform to our typical models of partisan (i.e., Democratic vs Republican) politics, and attempts at advocacy cannot rely on classical strategies of alignment with a dominant party in a state. Second, the debates over home birth have increasingly begun to parallel current partisan battles in their emotion and intensity with the related gridlock and reluctance to consider compromises that are often necessary to achieve policy goals. This essay calls for a greater willingness for all sides to approach home birth less as an ideological mission and more as a health policy challenge to support consumers interested in an integrated system of care. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

  14. Perinatal risks of planned home births in the United States.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Brent, Robert L; Arabin, Birgit; Levene, Malcolm I; Chervenak, Frank A

    2015-03-01

    We analyzed the perinatal risks of midwife-attended planned home births in the United States from 2010 through 2012 and compared them with recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) for planned home births. Data from the US Centers for Disease Control and Prevention's National Center for Health Statistics birth certificate data files from 2010 through 2012 were utilized to analyze the frequency of certain perinatal risk factors that were associated with planned midwife-attended home births in the United States and compare them with deliveries performed in the hospital by certified nurse midwives. Home birth deliveries attended by others were excluded; only planned home births attended by midwives were included. Hospital deliveries attended by certified nurse midwives served as the reference. Perinatal risk factors were those established by ACOG and AAP. Midwife-attended planned home births in the United States had the following risk factors: breech presentation, 0.74% (odds ratio [OR], 3.19; 95% confidence interval [CI], 2.87-3.56); prior cesarean delivery, 4.4% (OR, 2.08; 95% CI, 2.0-2.17); twins, 0.64% (OR, 2.06; 95% CI, 1.84-2.31); and gestational age 41 weeks or longer, 28.19% (OR, 1.71; 95% CI, 1.68-1.74). All 4 perinatal risk factors were significantly higher among midwife-attended planned home births when compared with certified nurse midwives-attended hospital births, and 3 of 4 perinatal risk factors were significantly higher in planned home births attended by non-American Midwifery Certification Board (AMCB)-certified midwives (other midwives) when compared with home births attended by certified nurse midwives. Among midwife-attended planned home births, 65.7% of midwives did not meet the ACOG and AAP recommendations for certification by the American Midwifery Certification Board. At least 30% of midwife-attended planned home births are not low risk and not within

  15. Trends and Characteristics of United States Out-of-Hospital Births 2004-2014: New Information on Risk Status and Access to Care.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene

    2016-06-01

    Out-of-hospital births are increasing in the United States. Our purpose was to examine trends in out-of-hospital births from 2004 to 2014, and to analyze newly available data on risk status and access to care. Newly available data from the revised birth certificate for 47 states and Washington, DC, were used to examine out-of-hospital births by characteristics and to compare them with hospital births. Trends from 2004 to 2014 were also examined. Out-of-hospital births increased by 72 percent, from 0.87 percent of United States births in 2004 to 1.50 percent in 2014. Compared with mothers who had hospital births, those with out-of-hospital births had lower prepregnancy obesity (12.5% vs 25.0%) and smoking (2.8% vs 8.5%) rates, and higher college graduation (39.3% vs 30.0%) and breastfeeding initiation (94.3% vs 80.8%) rates. Among planned home births, 67.1 percent were self-paid, compared with 31.9 percent of birth center and 3.4 percent of hospital births. Vaginal births after cesarean (VBACs) comprised 4.6 percent of planned home births and 1.6 percent of hospital and birth center births. Sociodemographic and medical risk status of out-of-hospital births improved substantially from 2004 to 2014. Improvements in risk status of out-of-hospital births from 2004 to 2014 suggest that appropriate selection of low-risk women is improving. High rates of self-pay for the costs of out-of-hospital birth suggest serious gaps in insurance coverage, whereas higher-than-average rates of VBAC could reflect lack of access to hospital VBACs. Mandating private insurance and Medicaid coverage could substantially improve access to out-of-hospital births. Improving access to hospital VBACs might reduce the number of out-of-hospital VBACs. © 2016 Wiley Periodicals, Inc.

  16. Biomarkers of Sensitivity and Exposure in Washington State Pesticide Handlers

    Science.gov (United States)

    Keifer, M.C.; Checkoway, H.; De Roos, A.J.; Farin, F.M.; Fenske, R.A.; Richter, R.J.; van Belle, G.; Furlong, C.E.

    2011-01-01

    Organophosphate (OP) and N-methyl-carbamate (CB) insecticides are widely used in agriculture in the US and abroad. These compounds – which inhibit acetylcholinesterase (AChE) enzyme activity – continue to be responsible for a high proportion of pesticide poisonings among US agricultural workers. It is possible that some individuals may be especially susceptible to health effects related to OP/CB exposure. The paraoxonase (PON1) enzyme metabolizes the highly toxic oxon forms of some OPs, and an individual's PON1 status may be an important determinant of his or her sensitivity to these chemicals. This chapter discusses methods used to characterize individual PON1 status and reviews previous epidemiologic studies that have evaluated PON1-related sensitivity to OPs in relation to various health endpoints. It also describes an ongoing longitudinal study among OP-exposed agricultural pesticide handlers who are participating in a recently implemented cholinesterase monitoring program in Washington State. This study will evaluate handlers' PON1 status as a hypothesized determinant of butyrylcholinesterase (BuChE) inhibition. Such studies will be useful to determine how regulatory risk assessments might account for differences in PON1-related OP sensitivity when characterizing inter-individual variability in risk related to OP exposure. Recent work assessing newer and more sensitive biomarkers of OP exposure is also discussed briefly in this chapter. PMID:20221867

  17. Cardiopulmonary resuscitation training in Washington state public high schools.

    Science.gov (United States)

    Reder, Sheri; Quan, Linda

    2003-03-01

    To determine the best approaches for increasing cardiopulmonary resuscitation (CPR) training opportunities for public high school students, we conducted a statewide survey of all 310 public high schools in Washington State. The findings describe CPR student training currently provided by high schools, barriers to providing, and strategies to increase CPR training of high school students. The response rate was 89% (276 schools) from a combination of mail and telephone surveys; 35% (n=97) reported that they did not provide any CPR student training. Of the 132 schools that provided CPR student training, 23% trained less than 10% of their students, and 39% trained more than 90% of their students. The majority of public high schools, 70%, did not have any teacher trained to teach CPR or had only one teacher with such training. Yet 80% of schools felt that CPR training is best provided in school settings. Schools perceived the greatest benefit of CPR training as providing students with the skill to save a life (43%). The most frequently identified barriers were logistical: limited time to teach the curriculum (24%), lack of funds (16%), and instructor scheduling difficulties (17%). Less than 5% of respondents voiced any opposition to CPR training, and that opposition was for logistical reasons. To increase CPR training, the single best strategies suggested were: increase funding, provide time in the curriculum, have more certified instructors, and make CPR student training a requirement.

  18. Seismic hazard assessment of the Hanford region, Eastern Washington State

    International Nuclear Information System (INIS)

    Youngs, R.R.; Coppersmith, K.J.; Power, M.S.; Swan, F.H. III

    1985-01-01

    A probabilistic seismic hazard assessment was made for a site within the Hanford region of eastern Washington state, which is characterized as an intraplate region having a relatively low rate of seismic activity. Probabilistic procedures, such as logic trees, were utilized to account for the uncertainties in identifying and characterizing the potential seismic sources in the region. Logic trees provide a convenient, flexible means of assessing the values and relative likelihoods of input parameters to the hazard model that may be dependent upon each other. Uncertainties accounted for in this way include the tectonic model, segmentation, capability, fault geometry, maximum earthquake magnitude, and earthquake recurrence rate. The computed hazard results are expressed as a distribution from which confidence levels are assessed. Analysis of the results show the contributions to the total hazard from various seismic sources and due to various earthquake magnitudes. In addition, the contributions of uncertainties in the various source parameters to the uncertainty in the computed hazard are assessed. For this study, the major contribution to uncertainty in the computed hazard are due to uncertainties in the applicable tectonic model and the earthquake recurrence rate. This analysis serves to illustrate some of the probabilistic tools that are available for conducting seismic hazard assessments and for analyzing the results of these studies. 5 references, 7 figures

  19. NCHS - Births to Unmarried Women by Age Group: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes number of births to unmarried women by age group in the United States since 1940. Methods for collecting information on marital status changed...

  20. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

    Science.gov (United States)

    Steach, John C.

    2011-01-01

    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  1. 78 FR 45958 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-07-30

    ... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NAGPRA-13406; PPWOCRADN0-PCU00RP14.R50000] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke...

  2. 78 FR 44595 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-07-24

    ... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NAGPRA-13407; PPWOCRADN0-PCU00RP14.R50000] Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of Washington, Seattle, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Thomas Burke...

  3. 76 FR 14045 - Notice of Intent To Repatriate a Cultural Item: Museum of Anthropology at Washington State...

    Science.gov (United States)

    2011-03-15

    ...: Museum of Anthropology at Washington State University, Pullman, WA AGENCY: National Park Service... Museum of Anthropology at Washington State University, Pullman, WA, that meets the definition of..., a copper pendant was given to the Museum of Anthropology at Washington State University for intended...

  4. Washington state foster care: dental utilization and expenditures.

    Science.gov (United States)

    Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David

    2014-01-01

    To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages WA FC program for ≥11 months (N = 10,177). Regression models were used to examine associations between utilization and expenditures and sex, race, age group, Supplemental Security Income (SSI) (i.e., disability), substance abuse, behavior problems, placement setting (Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.

  5. Relation between Nitrates in Water Wells and Potential Sources in the Lower Yakima Valley, Washington State

    Science.gov (United States)

    Results of a study EPA conducted to investigate the contribution of various sources to the high nitrate levels in groundwater and residential drinking water wells in the Lower Yakima Valley of Washington State.

  6. 77 FR 33456 - Public Water Supply Supervision Program; Program Revision for the State of Washington

    Science.gov (United States)

    2012-06-06

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9682-4] Public Water Supply Supervision Program; Program... State Public Water Supply Supervision Primacy Program. Washington has adopted regulations analogous to... of Health--Office of Drinking Water, [[Page 33457

  7. Computer-aided dispatch--traffic management center field operational test : Washington State final report

    Science.gov (United States)

    2006-05-01

    This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch - Traffic Management Center Integration Field Operations Test in the State of Washington. The document discusses evaluation findings in the foll...

  8. 76 FR 28066 - Notice of Intent To Repatriate a Cultural Item: Museum of Anthropology at Washington State...

    Science.gov (United States)

    2011-05-13

    ... Cultural Item: Museum of Anthropology at Washington State University, Pullman, WA AGENCY: National Park... possession of the Museum of Anthropology at Washington State University, Pullman, WA, that meets the... notice. One lot of stone, bone, and glass beads was given to the Museum of Anthropology at Washington...

  9. Washington State Briefing Book for low-level radioactive waste management

    International Nuclear Information System (INIS)

    1980-12-01

    The Washington State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Washington. The profile is the result of a survey of NRC licensees in Washington. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment was developed through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the briefing book provides demographic and socioeconomic data and a discussion of relevant government agencies and activities, all of which may impact waste management practices in Washington

  10. Washington State Briefing Book for low-level radioactive waste management

    Energy Technology Data Exchange (ETDEWEB)

    1980-12-01

    The Washington State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Washington. The profile is the result of a survey of NRC licensees in Washington. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment was developed through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the briefing book provides demographic and socioeconomic data and a discussion of relevant government agencies and activities, all of which may impact waste management practices in Washington.

  11. Birth order and Risk of Childhood Cancer: A Pooled Analysis from Five U.S. States

    OpenAIRE

    Von Behren, Julie; Spector, Logan G.; Mueller, Beth A.; Carozza, Susan E.; Chow, Eric J.; Fox, Erin E.; Horel, Scott; Johnson, Kimberly J.; McLaughlin, Colleen; Puumala, Susan E.; Ross, Julie A.; Reynolds, Peggy

    2010-01-01

    The causes of childhood cancers are largely unknown. Birth order has been used as a proxy for prenatal and postnatal exposures, such as frequency of infections and in utero hormone exposures. We investigated the association between birth order and childhood cancers in a pooled case-control dataset. The subjects were drawn from population-based registries of cancers and births in California, Minnesota, New York, Texas, and Washington. We included 17,672 cases less than 15 years of age who were...

  12. The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

    Science.gov (United States)

    Schoonover, Heather

    The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

  13. Report: State of Washington Water Pollution Control State Revolving Fund Financial Statements with Independent Auditor's Report, June 30, 2003

    Science.gov (United States)

    Report #2004-1-00067, May 26, 2004. The financial statements referred to in the first paragraph present fairly the financial position of the Washington Department of Ecology Water Pollution Control State Revolving Fund as of June 30, 2003.

  14. Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State.

    Science.gov (United States)

    Ding, Yao; Thompson, John D; Kobrynski, Lisa; Ojodu, Jelili; Zarbalian, Guisou; Grosse, Scott D

    2016-05-01

    To evaluate the expected cost-effectiveness and net benefit of the recent implementation of newborn screening (NBS) for severe combined immunodeficiency (SCID) in Washington State. We constructed a decision analysis model to estimate the costs and benefits of NBS in an annual birth cohort of 86 600 infants based on projections of avoided infant deaths. Point estimates and ranges for input variables, including the birth prevalence of SCID, proportion detected asymptomatically without screening through family history, screening test characteristics, survival rates, and costs of screening, diagnosis, and treatment were derived from published estimates, expert opinion, and the Washington NBS program. We estimated treatment costs stratified by age of identification and SCID type (with or without adenosine deaminase deficiency). Economic benefit was estimated using values of $4.2 and $9.0 million per death averted. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost-effectiveness ratio (ICER) of net direct cost per life-year saved. Our model predicts an additional 1.19 newborn infants with SCID detected preclinically through screening, in addition to those who would have been detected early through family history, and 0.40 deaths averted annually. Our base-case model suggests an ICER of $35 311 per life-year saved, and a benefit-cost ratio of either 5.31 or 2.71. Sensitivity analyses found ICER values <$100 000 and positive net benefit for plausible assumptions on all variables. Our model suggests that NBS for SCID in Washington is likely to be cost-effective and to show positive net economic benefit. Published by Elsevier Inc.

  15. Community-level policy responses to state marijuana legalization in Washington State.

    Science.gov (United States)

    Dilley, Julia A; Hitchcock, Laura; McGroder, Nancy; Greto, Lindsey A; Richardson, Susan M

    2017-04-01

    Washington State (WA) legalized a recreational marijuana market - including growing, processing and retail sales - through voter initiative 502 in November 2012. Legalized recreational marijuana retail sales began in July 2014. In response to state legalization of recreational marijuana, some cities and counties within the state have passed local ordinances that either further regulated marijuana markets, or banned them completely. The purpose of this study is to describe local-level marijuana regulations on recreational retail sales within the context of a state that had legalized a recreational marijuana market. Marijuana-related ordinances were collected from all 142 cities in the state with more than 3000 residents and from all 39 counties. Policies that were in place as of June 30, 2016 - two years after the state's recreational market opening - to regulate recreational marijuana retail sales within communities were systematically coded. A total of 125 cities and 30 counties had passed local ordinances to address recreational marijuana retail sales. Multiple communities implemented retail market bans, including some temporary bans (moratoria) while studying whether to pursue other policy options. As of June 30, 2016, 30% of the state population lived in places that had temporarily or permanently banned retail sales. Communities most frequently enacted zoning policies explicitly regulating where marijuana businesses could be established. Other policies included in ordinances placed limits on business hours and distance requirements (buffers) between marijuana businesses and youth-related land use types or other sensitive areas. State legalization does not necessarily result in uniform community environments that regulate recreational marijuana markets. Local ordinances vary among communities within Washington following statewide legalization. Further study is needed to describe how such local policies affect variation in public health and social outcomes

  16. Washington State Johnson-O'Malley Indian Education. 1971-72 Annual Report.

    Science.gov (United States)

    Washington Office of the State Superintendent of Public Instruction, Olympia.

    The Johnson-O'Malley (JOM) Act of 1934, amended in 1936, authorizes the Secretary of Interior to enter into a contract with any state which has legal authority and responsibility for the education of American Indian children residing there. The Superintendent of Public Instruction, State of Washington, is legally responsible for state schools and…

  17. Births to teenagers in the United States, 1940-2000.

    Science.gov (United States)

    Ventura, S J; Mathews, T J; Hamilton, B E

    2001-09-25

    This report presents trends in national birth rates for teenagers, with particular focus on the decade of the 1990s. The percent change in rates for 1991-2000 is presented for the United States, and the change for 1991-99 is presented for States. Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin, are discussed. Birth rates for teenagers 15-19 years generally declined in the United States since the late 1950s, except for a brief, but steep, upward climb in the late 1980s until 1991. The 2000 rate (49 births per 1,000) is about half the peak rate recorded in 1957 (96 per 1,000). Still the U.S. rate is considerably higher than rates for other developed countries. During the 1990s rate declines were especially large for black teenagers. State-specific rates fell significantly in all States for ages 15-19 and 15-17 years, and in all but three States for ages 18-19 years. Overall the range of decline in State rates for ages 15-19 years was 11 to 36 percent. For teenagers 15-17 years, the range of decline by State was 13 to 43 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 40 percent or more in seven States. The factors accounting for these declines include decreased sexual activity reflecting changing attitudes towards premarital sex, increases in condom use, and adoption of newly available hormonal contraception, implants, and injectables.

  18. Midwife-attended births in the United States, 1990-2012: results from revised birth certificate data.

    Science.gov (United States)

    Declercq, Eugene

    2015-01-01

    Data on attendance at birth by midwives in the United States have been available on the national level since 1989, allowing for the documentation of long-term trends. New items on payer source and prepregnancy body mass index (BMI) from a 2003 revision of the birth certificate provide an opportunity to examine additional aspects of US midwifery practice. The data in this report are based on records on birth attendant gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), which allows users to create and download specialized tables. Analysis of new items on prepregnancy BMI and birth payer source are limited to the 38 states (86% of US births) that adopted the revised birth certificate by 2012. Between 1989 and 2012, the proportion of all births attended by certified nurse-midwives (CNMs) increased from 3.3% to 7.9%. The proportion of vaginal births attended by CNMs reached an all-time high of 11.9%. Births attended by "other midwives" (typically certified professional midwives) rose to a peak of 28,343, or 0.7% of all US births. The distribution of payer source for CNM-attended births (44% Medicaid; 44% private insurance; 6% self-pay) is very similar to the national distribution, whereas the majority (53%) of births attended by other midwives are self-pay. Women whose births are attended by other midwives are less likely (13%) to have a prepregnancy BMI in the obese range than women attended by CNMs (19%) or overall (24%). The total number of births attended by CNMs and other midwives has remained steady or grown at a time when total US births have declined, resulting in the largest proportions of midwife-attended births in the quarter century that such data have been collected. © 2015 by the American College of Nurse-Midwives.

  19. Comparing Measures of Late HIV Diagnosis in Washington State

    Directory of Open Access Journals (Sweden)

    Laura Saganic

    2012-01-01

    Full Text Available As more US HIV surveillance programs routinely use late HIV diagnosis to monitor and characterize HIV testing patterns, there is an increasing need to standardize how late HIV diagnosis is measured. In this study, we compared two measures of late HIV diagnosis, one based on time between HIV and AIDS, the other based on initial CD4+ results. Using data from Washington's HIV/AIDS Reporting System, we used multivariate logistic regression to identify predictors of late HIV diagnosis. We also conducted tests for trend to determine whether the proportion of cases diagnosed late has changed over time. Both measures lead us to similar conclusions about late HIV diagnosis, suggesting that being male, older, foreign-born, or heterosexual increase the likelihood of late HIV diagnosis. Our findings reaffirm the validity of a time-based definition of late HIV diagnosis, while at the same time demonstrating the potential value of a lab-based measure.

  20. Washington State Need Grant: Less-Than-Halftime Pilot Project (SHB 1345)

    Science.gov (United States)

    Washington Higher Education Coordinating Board, 2006

    2006-01-01

    The 2005 Washington State Legislature authorized, through Substitute House Bill 1345, a two-year pilot project allowing eligible students, who enroll for four or five credits in a term, to receive the State Need Grant (SNG). Several important policy considerations emerged during the pilot project. Board staff explored these issues with financial…

  1. Psychiatric Boarding in Washington State and the Inadequacy of Mental Health Resources.

    Science.gov (United States)

    Bloom, Joseph D

    2015-06-01

    Psychiatric boarding is a term derived from emergency medicine that describes the holding of patients deemed in need of hospitalization in emergency departments for extended periods because psychiatric beds are not available. Such boarding has occurred for many years in the shadows of mental health care as both inpatient beds and community services have decreased. This article focuses on a 2014 Washington State Supreme Court decision that examined the interpretation of certain sections of the Washington state civil commitment statute that had been used to justify the extended boarding of detained psychiatric patients in general hospital emergency departments. The impact of this decision on the state of Washington should be significant and could spark a national debate about the negative impacts of psychiatric boarding on patients and on the nation's general hospital emergency services. © 2015 American Academy of Psychiatry and the Law.

  2. A reconsideration of home birth in the United States.

    Science.gov (United States)

    Minkoff, Howard; Ecker, Jeffrey

    2013-01-01

    Home births continue to constitute only a small percentage of all deliveries in the United States, in part because of concerns about their safety. While the literature is decidedly mixed in regard to the degree of risk, there are several studies that report that home birth may at times entail a small absolute increase in perinatal risks in circumstances that cannot always be anticipated prior to the onset of labor. While the definition of "small" will vary between individuals, and publications vary in the level of risk they ascribe to birth at home, studies with the least methodological flaws and with adequate power often cite an excess death rate in the range of one per thousand. Home birth is, in that regard, but one example of patients' choices and plans that sometimes carry increased risk or include alternatives that individual physicians feel uncomfortable supporting or recommending. Our intention in this opinion piece is not to advocate for or against home birth. Rather, we recognize that home birth is but one example of a patient choice that might differ from what a provider feels is in a woman's best interests. In this article we will discuss ethical considerations in such circumstances using home birth as an example. We consider in this article how the ethical principles of respect for autonomy and non-maleficence can be balanced using, among other examples, the choice by some for a home birth. We discuss how absolute rather than relative risk should guide individuals' evaluation of patient choices. We also consider how in some circumstances, the value and safety added by a physician's participation may outweigh a potentially small increment in absolute risk that might result from a patient's decision to deliver at home because of a perceived physician endorsement. We recognize, however, that doctors and midwives participating in choices they have not recommended, or may even believe will lead to or increase risk for adverse outcomes, presents dilemmas and

  3. Cyanotoxin bioaccumulation in freshwater fish, Washington State, USA.

    Science.gov (United States)

    Hardy, F Joan; Johnson, Art; Hamel, Kathy; Preece, Ellen

    2015-11-01

    Until recently, exposure pathways of concern for cyanotoxins have focused on recreational exposure, drinking water, and dermal contact. Exposure to cyanotoxins through fish consumption is a relatively new area of investigation. To address this concern, microcystins and other cyanotoxins were analyzed in fish collected from nine Washington lakes with recurrent toxic blooms using two types of enzyme-linked immunosorbent assays (ELISAs) and liquid chromatography/mass spectrometry/mass spectrometry (LC-MS/MS). Microcystins or microcystin-like compounds were elevated in fish liver relative to muscle and other tissues (liver>gut>muscle). Microcystin concentrations in fish fillet samples using anti-Adda ELISA (range 6.3-11 μg/kg wet weight) were consistently higher in all fish species than concentrations using anti-microcystin (MC)-leucine-arginine (LR) ELISA (range 0.25-2.4 μg/kg wet weight). MC-leucine-alanine (LA) was the only variant detected in fish (2.5-12 μg/kg in four livers) among the nine variants analyzed by LC-MS/MS. Fish fillets showed no accumulation of the MCs targeted by LC-MS/MS. Other cyanotoxins analyzed (anatoxin-a, saxitoxin, domoic acid, and okadaic acid) were not detected in fish. Based on this and evidence from other studies, we believe that people can safely consume two 8-oz fish fillet meals per week from lakes with blooms producing MCs (clean the fish and discard viscera).

  4. Washington State Energy Use Profile, 1960--1990

    International Nuclear Information System (INIS)

    Anderson, M.

    1992-07-01

    This report is divided into three sections, each with data on energy consumption, prices, and expenditures. The first section presents an overview of statewide energy use trends. The second section presents energy use trends in four basic consuming sectors: residential, commercial, industrial, and transportation. The third section presents energy use trends in specific resource markets: natural gas, petroleum, electricity, coal, and wood. The appendixes contain information about data, sources, and a glossary. Data about Washington's energy resources are reported in two forms: in measures common to the fuel (kWh, barrels, etc.) and in the generic measure British thermal units (Btu). The common measures allow the reader to quickly grasp information in a familiar form. The generic measure allows the reader to compare energy resources. Conversion to Btu occasionally produces counter-intuitive results. For example, in different years, petroleum products have different average energy values, resulting in different conversion factors from barrels to Btu. A large amount of data contained in the Profile has been categorized and presented in a variety of ways. Understanding the meaning of categories is critical to understanding differences between the tables, especially those tables that present similar data. For example, petroleum trends are not the same as transportation trends, though they are similar because transportation is almost entirely dependent on petroleum. In another example, total end-use fuel energy consumption is not the same as total primary energy consumption. End-use fuel consumption does not include energy used for the generation of electricity. Counting both fuel used for electricity generation and electricity itself could result in double counting. Primary fuel consumption, on the other hand, does include energy used for the generation of electricity and is greater than total end-use consumption

  5. United States home births increase 20 percent from 2004 to 2008.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Mathews, T J

    2011-09-01

    After a gradual decline from 1990 to 2004, the percentage of births occurring at home increased from 2004 to 2008 in the United States. The objective of this report was to examine the recent increase in home births and the factors associated with this increase from 2004 to 2008. United States birth certificate data on home births were analyzed by maternal demographic and medical characteristics. In 2008, there were 28,357 home births in the United States. From 2004 to 2008, the percentage of births occurring at home increased by 20 percent from 0.56 percent to 0.67 percent of United States births. This rise was largely driven by a 28 percent increase in the percentage of home births for non-Hispanic white women, for whom more than 1 percent of births occur at home. At the same time, the risk profile for home births has been lowered, with substantial drops in the percentage of home births of infants who are born preterm or at low birthweight, and declines in the percentage of home births that occur to teen and unmarried mothers. Twenty-seven states had statistically significant increases in the percentage of home births from 2004 to 2008; only four states had declines. The 20 percent increase in United States home births from 2004 to 2008 is a notable development that will be of interest to practitioners and policymakers. (BIRTH 38:3 September 2011). © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

  6. Rural Adolescent Alcohol, Tobacco, and Illicit Drug Use: A Comparison of Students in Victoria, Australia, and Washington State, United States

    Science.gov (United States)

    Coomber, Kerri; Toumbourou, John W.; Miller, Peter; Staiger, Petra K.; Hemphill, Sheryl A.; Catalano, Richard F.

    2011-01-01

    Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the…

  7. Economic Conditions During Pregnancy and Adverse Birth Outcomes Among Singleton Live Births in the United States, 1990-2013.

    Science.gov (United States)

    Margerison-Zilko, Claire E; Li, Yu; Luo, Zhehui

    2017-11-15

    We know little about the relationship between the macroeconomy and birth outcomes, in part due to the methodological challenge of distinguishing effects of economic conditions on fetal health from effects of economic conditions on selection into live birth. We examined associations between state-level unemployment rates in the first 2 trimesters of pregnancy and adverse birth outcomes, using natality data on singleton live births in the United States during 1990-2013. We used fixed-effect logistic regression models and accounted for selection by adjusting for state-level unemployment before conception and maternal characteristics associated with both selection and birth outcomes. We also tested whether associations between macroeconomic conditions and birth outcomes differed during and after (compared with before) the Great Recession (2007-2009). Each 1-percentage-point increase in the first-trimester unemployment rate was associated with a 5% increase in odds of preterm birth, while second-trimester unemployment was associated with a 3% decrease in preterm birth odds. During the Great Recession, however, first-trimester unemployment was associated with a 16% increase in odds of preterm birth. These findings increase our understanding of the effects of the Great Recession on health and add to growing literature suggesting that macro-level social and economic factors contribute to perinatal health. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. A comparison of operational performance : Washington state ferries to ferry operators worldwide.

    Science.gov (United States)

    2010-06-01

    This project compares eight measures of performance related to transit service quality (e.g. trip reliability, on-time departures) and cost-efficiency (e.g. farebox recovery, subsidy per passenger) between Washington State Ferries (WSF) and 23 ferry ...

  9. 78 FR 50092 - Notice of Intent To Repatriate Cultural Items: Washington State Parks and Recreation Commission...

    Science.gov (United States)

    2013-08-16

    ... organizations, has determined that the cultural items listed in this notice meet the definition of unassociated... Commission, Olympia, WA that meet the definition of unassociated funerary objects under 25 U.S.C. 3001. This... the site to the Eastern Washington State Historical Society (EWSHS), now known as the Northwest Museum...

  10. 76 FR 73663 - Notice of Intent To Repatriate Cultural Items: Washington State University, Museum of...

    Science.gov (United States)

    2011-11-29

    ... below by December 29, 2011. ADDRESSES: Mary Collins, Director, Washington State University, Museum of... ethnographic collection from the Conner Museum to the Museum of Anthropology. In June of 2011, the curator of collections at the Conner Museum found four unassociated funerary items in the museum storage area and...

  11. Chapter 28A.85 RCW Monitoring Guide. Washington State's Anti-Sex Discrimination Legislation.

    Science.gov (United States)

    Washington Office of the State Superintendent of Public Instruction, Olympia.

    This guide was designed to assist in the assessment of the level of implementation of Washington State's anti-sex discrimination legislation in educational programs and activities. The monitoring guide contains two major sections: a monitoring standards check list and an on-site review packet. The check list provides an overview of the specific…

  12. Accounting Manual for Educational Service Districts in the State of Washington

    Science.gov (United States)

    Lunghofer, Daniel S.

    2010-01-01

    This manual provides principles that are an integral part of the accounting requirements for educational service districts (ESDs) in the state of Washington. They are in conformance with generally accepted accounting principles, except where referenced in the ESD principles that follow. This manual provides guidance on the following topics:(1)…

  13. 78 FR 4804 - Revision to the Washington State Implementation Plan; Tacoma-Pierce County Nonattainment Area

    Science.gov (United States)

    2013-01-23

    ... Washington State Implementation Plan; Tacoma- Pierce County Nonattainment Area AGENCY: Environmental... Tacoma-Pierce County nonattainment area for the 2006 fine particulate matter (PM 2.5 ) National Ambient... Rules.'' The updated PSCAA rules help implement the recommendations of the Tacoma-Pierce County Clean...

  14. Models to predict suitable habitat for juvenile bull trout in Washington state

    Science.gov (United States)

    Jason B. Dunham; G. L. Chandler

    2001-01-01

    This report describes results of research conducted in 2000 to develop models of suitable habitat for juvenile bull trout (Salvelinus confluentus) in Washington State. The research is associated with a cooperative agreement (Agreement #134100H001) between U.S. Fish and Wildlife Service (USFWS) and the U.S. Forest Service, Rocky Mountain Research...

  15. 76 FR 366 - Public Water Supply Supervision Program; Program Revision for the State of Washington

    Science.gov (United States)

    2011-01-04

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9247-4] Public Water Supply Supervision Program; Program... State Public Water Supply Supervision Primacy Program. Washington has adopted a definition for public water system that is analogous to EPA's definition of public water system, and has adopted regulations...

  16. Scientific Framework for Stormwater Monitoring by the Washington State Department of Transportation

    Science.gov (United States)

    Sheibley, R.W.; Kelly, V.J.; Wagner, R.J.

    2009-01-01

    The Washington State Department of Transportation municipal stormwater monitoring program, in operation for about 8 years, never has received an external, objective assessment. In addition, the Washington State Department of Transportation would like to identify the standard operating procedures and quality assurance protocols that must be adopted so that their monitoring program will meet the requirements of the new National Pollutant Discharge Elimination System municipal stormwater permit. As a result, in March 2009, the Washington State Department of Transportation asked the U.S. Geological Survey to assess their pre-2009 municipal stormwater monitoring program. This report presents guidelines developed for the Washington State Department of Transportation to meet new permit requirements and regional/national stormwater monitoring standards to ensure that adequate processes and procedures are identified to collect high-quality, scientifically defensible municipal stormwater monitoring data. These include: (1) development of coherent vision and cooperation among all elements of the program; (2) a comprehensive approach for site selection; (3) an effective quality assurance program for field, laboratory, and data management; and (4) an adequate database and data management system.

  17. Residential Radon Exposure and Lung Cancer: Evidence of an Inverse Association in Washington State.

    Science.gov (United States)

    Neuberger, John S.; And Others

    1992-01-01

    Presents results of a descriptive study of lung cancer death rates compared to county levels of radon in Washington State. Age-specific death rates were computed for white female smokers according to radon exposure. A significant lung cancer excess was found in lowest radon counties. No significant difference was found between the proportion of…

  18. 78 FR 50109 - Notice of Intent To Repatriate Cultural Items: Thomas Burke Memorial Washington State Museum...

    Science.gov (United States)

    2013-08-16

    ... with the appropriate Indian tribes or Native Hawaiian organizations, has determined that the cultural... organization not identified in this notice that wish to claim these cultural items should submit a written....R50000] Notice of Intent To Repatriate Cultural Items: Thomas Burke Memorial Washington State Museum...

  19. Now It's Necessary: Virtual Reference Services at Washington State University, Pullman

    Science.gov (United States)

    Nicol, Erica Carlson; Crook, Linda

    2013-01-01

    While virtual reference services (VRS) are becoming more and more common in academic libraries, implementing and maintaining well-used and effective VRS can be a challenge in the face of competing demands on time, staffing, and funding. Between 2011 and 2012, librarians at Washington State University, Pullman (WSU) have overhauled and reorganized…

  20. Early Detection Rapid Response Program Targets New Noxious Weed Species in Washington State

    Science.gov (United States)

    Andreas, Jennifer E.; Halpern, Alison D.; DesCamp, Wendy C.; Miller, Timothy W.

    2015-01-01

    Early detection, rapid response is a critical component of invasive plant management. It can be challenging, however, to detect new invaders before they become established if landowners cannot identify species of concern. In order to increase awareness, eye-catching postcards were developed in Washington State as part of a noxious weed educational…

  1. 78 FR 78379 - Notice of Inventory Completion: Museum of Anthropology at Washington State University, Pullman, WA

    Science.gov (United States)

    2013-12-26

    ....R50000] Notice of Inventory Completion: Museum of Anthropology at Washington State University, Pullman, WA AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Museum of Anthropology at... Indian tribes or Native Hawaiian organizations, and has determined that there is a cultural affiliation...

  2. Birth and fertility rates for states by Hispanic origin subgroups: United States, 1990 and 2000.

    Science.gov (United States)

    Sutton, Paul D; Mathews, T J

    2006-05-01

    This report presents U.S. and State-level data on births, birth rates, and fertility rates for Hispanic origin subgroups for 1990 and 2000. Data for non-Hispanic whites and non-Hispanic blacks are provided for comparison. Data are presented in detailed tables, graphs, and maps. Between 1990 and 2000, the total U.S. Hispanic population increased 58 percent, from 22,353,999 to 35,305,818. Over the same period of time, births to Hispanic mothers increased 37 percent, from 595,073 to 815,868. The smaller increases in births compared with the population resulted in a falling birth rate among Hispanic mothers (26.7 in 1990 to 23.1 births per 1,000 total population in 2000). Birth and fertility rates for Mexican, Puerto Rican, and Cuban mothers all fell between 1990 and 2000. Among the Hispanic subgroups, fertility rates in 2000 ranged from 105.1 births per 1,000 women aged 15-44 years for Mexican women to 49.3 for Cuban women. Differences in fertility exist not only between Hispanic subgroups but also within groups among States. For example, total fertility rates for Puerto Rican mothers, which estimates the number of children a group of 1,000 women will have in their lifetime, ranged in 2000 from 1,616.5 in New York to 2,403.0 in Pennsylvania.

  3. Security, Violent Events, and Anticipated Surge Capabilities of Emergency Departments in Washington State

    Science.gov (United States)

    Weyand, Jonathan S.; Junck, Emily; Kang, Christopher S.; Heiner, Jason D.

    2017-01-01

    Introduction Over the past 15 years, violent threats and acts against hospital patients, staff, and providers have increased and escalated. The leading area for violence is the emergency department (ED) given its 24/7 operations, role in patient care, admissions gateway, and center for influxes during acute surge events. This investigation had three objectives: to assess the current security of Washington State EDs; to estimate the prevalence of and response to threats and violence in Washington State EDs; and to appraise the Washington State ED security capability to respond to acute influxes of patients, bystanders, and media during acute surge events. Methods A voluntary, blinded, 28-question Web-based survey developed by emergency physicians was electronically delivered to all 87 Washington State ED directors in January 2013. We evaluated responses by descriptive statistical analyses. Results Analyses occurred after 90% (78/87) of ED directors responded. Annual censuses of the EDs ranged from violent threats or acts occurring in their ED. Of these, 93% were directed towards nursing staff, 90% towards physicians, 74% towards security personnel, and 51% towards administrative personnel. Nearly half (48%) noted incidents directed towards another patient, and 50% towards a patient’s family or friend. These events were variably reported to the hospital administration. After an acute surge event, 35% believed the initial additional security response would not be adequate, with 26% reporting no additional security would be available within 15 minutes. Conclusion Our study reveals the variability of ED security staffing and a heterogeneity of capabilities throughout Washington State. These deficiencies and vulnerabilities highlight the need for other EDs and regional emergency preparedness planners to conduct their own readiness assessments. PMID:28435498

  4. Medicinal Cannabis: A Survey Among Health Care Providers in Washington State

    Science.gov (United States)

    Carlini, Beatriz H; Garrett, Sharon B; Carter, Gregory T

    2017-02-01

    Washington State allows marijuana use for medical (since 1998) and recreational (since 2012) purposes. The benefits of medicinal cannabis (MC) can be maximized if clinicians educate patients about dosing, routes of administration, side effects, and plant composition. However, little is known about clinicians' knowledge and practices in Washington State. An anonymous online survey assessed providers' MC knowledge, beliefs, clinical practices, and training needs. The survey was disseminated through health care providers' professional organizations in Washington State. Descriptive analysis compared providers who had and had not authorized MC for patients. Survey results informed the approach and content of an online training on best clinical practices of MC. Four hundred ninety-four health care providers responded to the survey. Approximately two-third were women, aged 30 to 60 years, and working in family or internal medicine. More than half of the respondents were legally allowed to write MC authorizations per Washington State law, and 27% of those had issued written MC authorizations. Overall, respondents reported low knowledge and comfort level related to recommending MC. Respondents rated MC knowledge as important and supported inclusion of MC training in medical/health provider curriculum. Most Washington State providers have not received education on scientific basis of MC or training on best clinical practices of MC. Clinicians who had issued MC authorizations were more likely to have received MC training than those who had not issued MC authorization. The potential of MCs to benefit some patients is hindered by the lack of comfort of clinicians to recommend it. Training opportunities are badly needed to address these issues.

  5. Heat-related illness in Washington State agriculture and forestry sectors.

    Science.gov (United States)

    Spector, June T; Krenz, Jennifer; Rauser, Edmund; Bonauto, David K

    2014-08-01

    We sought to describe heat-related illness (HRI) in agriculture and forestry workers in Washington State. Demographic and clinical Washington State Fund workers' compensation agriculture and forestry HRI claims data (1995-2009) and Washington Agriculture Heat Rule citations (2009-2012) were accessed and described. Maximum daily temperature (Tmax) and Heat Index (HImax) were estimated by claim date and location using AgWeatherNet's weather station network. There were 84 Washington State Fund agriculture and forestry HRI claims and 60 Heat Rule citations during the study period. HRI claims and citations were most common in crop production and support subsectors. The mean Tmax (HImax) was 95°F (99°F) for outdoor HRI claims. Potential HRI risk factors and HRI-related injuries were documented for some claims. Agriculture and forestry HRI cases are characterized by potential work-related, environmental, and personal risk factors. Further work is needed to elucidate the relationship between heat exposure and occupational injuries. © 2014 Wiley Periodicals, Inc.

  6. Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State.

    Science.gov (United States)

    Nicolaidis, Christina; Ko, Cynthia W; Saha, Somnath; Koepsell, Thomas D

    2004-06-17

    BACKGROUND: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups. METHODS: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. RESULTS: Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. CONCLUSIONS: The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories.

  7. Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State

    Directory of Open Access Journals (Sweden)

    Ko Cynthia W

    2004-06-01

    Full Text Available Abstract Background The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW across different racial groups. Methods We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789. We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. Results Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. Conclusions The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories.

  8. Low-level nuclear waste in Washington State

    International Nuclear Information System (INIS)

    Williams, H.

    1986-01-01

    A commercial disposal site for low-level nuclear wastes opened at Hanford in 1965. By 1971 a total of six were in operation: Hanford, Nevada, South Carolina, Kentucky, New York State, and Illinois. The history of the operation of these sites is described. Only the first three listed are still open. The effects of the large volumes of waste expected from Three Mile Island are described. This paper examines the case history of Hanford operations with low-level waste disposal for lessons that might apply in other states being considered for disposal sites

  9. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

    Directory of Open Access Journals (Sweden)

    Amos Grünebaum

    Full Text Available Over the last decade, planned home births in the United States (US have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status.The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States.This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM, nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board.Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53 than home births attended by certified midwives (NNM: 10.0/10,000; RR 1 and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]. The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2.This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal

  10. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A

    2016-01-01

    Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States. This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life) in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams) without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM), nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board. Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53) than home births attended by certified midwives (NNM: 10.0/10,000; RR 1) and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]). The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2). This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal mortality rates

  11. An innovative program to address learning barriers in small schools: Washington State School Nurse Corps.

    Science.gov (United States)

    Fast, Gail Ann; Gray, Lorali; Miles-Koehler, Mona

    2013-01-01

    While all schools in Washington State have had to deal with shrinking financial resources, small, rural school districts, with fewer than 2,000 students, face unique circumstances that further challenge their ability to meet rising student health needs. This article will explore how small districts utilize the services of the Washington State School Nurse Corps (SNC), an innovative program that supports student health and safety while reducing barriers to learning. Through direct registered nursing services and regional nurse administrative consultation and technical assistance, the SNC strengthens rural school districts' capacity to provide a safe and healthy learning environment. In addition, we will examine current research that links health and learning to discover how the SNC model is successful in addressing health risks as barriers to learning. Lastly, as resources continue to dwindle, partnerships between schools, the SNC, and state and local health and education organizations will be critical in maintaining health services and learning support to small, rural schools.

  12. Birth order and risk of childhood cancer: a pooled analysis from five US States.

    Science.gov (United States)

    Von Behren, Julie; Spector, Logan G; Mueller, Beth A; Carozza, Susan E; Chow, Eric J; Fox, Erin E; Horel, Scott; Johnson, Kimberly J; McLaughlin, Colleen; Puumala, Susan E; Ross, Julie A; Reynolds, Peggy

    2011-06-01

    The causes of childhood cancers are largely unknown. Birth order has been used as a proxy for prenatal and postnatal exposures, such as frequency of infections and in utero hormone exposures. We investigated the association between birth order and childhood cancers in a pooled case-control dataset. The subjects were drawn from population-based registries of cancers and births in California, Minnesota, New York, Texas and Washington. We included 17,672 cases confidence intervals using logistic regression, adjusted for sex, birth year, maternal race, maternal age, multiple birth, gestational age and birth weight. Overall, we found an inverse relationship between childhood cancer risk and birth order. For children in the fourth or higher birth order category compared to first-born children, the adjusted OR was 0.87 (95% CI: 0.81, 0.93) for all cancers combined. When we examined risks by cancer type, a decreasing risk with increasing birth order was seen in the central nervous system tumors, neuroblastoma, bilateral retinoblastoma, Wilms tumor and rhabdomyosarcoma. We observed increased risks with increasing birth order for acute myeloid leukemia but a slight decrease in risk for acute lymphoid leukemia. These risk estimates were based on a very large sample size, which allowed us to examine rare cancer types with greater statistical power than in most previous studies, however the biologic mechanisms remain to be elucidated. Copyright © 2010 UICC.

  13. NCHS - Birth Rates for Unmarried Women by Age, Race, and Hispanic Origin: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes birth rates for unmarried women by age group, race, and Hispanic origin in the United States since 1970. National data on births by Hispanics...

  14. NCHS - Teen Birth Rates for Females by Age Group, Race, and Hispanic Origin: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes teen birth rates for females by age group, race, and Hispanic origin in the United States since 1960. National data on births by Hispanic...

  15. Association of Pre-pregnancy BMI and Postpartum Weight Retention Before Second Pregnancy, Washington State, 2003-2013.

    Science.gov (United States)

    Ketterl, Tyler G; Dundas, Nicolas J; Roncaioli, Steven A; Littman, Alyson J; Phipps, Amanda I

    2018-03-06

    Background Maternal overweight and obesity is one of the most common high-risk obstetric conditions associated with adverse birth outcomes. Smaller studies have suggested that pre-pregnancy body mass index (BMI) is associated with postpartum weight retention. Objective The primary objective of this study was to examine the association between pre-pregnancy BMI status and maternal weight retention. Study design We conducted a population-based retrospective cohort study using Washington State birth certificate data from 2003-2013. We included women who had two sequential births during this time period, with the second birth occurring within 18-36 months of the first singleton delivery date. BMI before a women's first pregnancy ("pre-pregnancy BMI") was categorized as normal (18.5-24.9 kg/m 2 ) and overweight/obese (25-40 kg/m 2 ). Women were classified as having returned to first pre-pregnancy BMI if their BMI before their second pregnancy was no more than 1 kg/m 2 more compared to their BMI before their first pregnancy. Analyses were stratified by gestational weight gain during the first pregnancy (below, met, exceeded recommended gestational weight gain). Results A total of 49,132 mothers were included in the study. Among women who met their recommended gestational weight gain, compared to mothers with a normal BMI, obese/overweight mothers were less likely to return to their pre-pregnancy BMI (76.5 vs 72.3%; RR Obese/Overweight  = 0.88; 95% CI: 0.85-0.92). A similar pattern was observed among women who exceeded their recommended gestational weight gain (62.6 vs 53.2%; RR Obese/Overweight  = 0.79, 95% CI: 0.78-0.80). Conclusion Pre-pregnancy BMI in the overweight/obese range is associated with a decreased likelihood of returning to pre-pregnancy BMI. Further research to support women during and after their pregnancy to promote behavior changes that prevent excessive weight gain during pregnancy and weight retention after birth is needed.

  16. Parent's Guide to Special Education in Washington State, 1985-86 [and] Guia para Padres: Para Educacion Especial en el Estado de Washington.

    Science.gov (United States)

    Washington Office of the State Superintendent of Public Instruction, Olympia.

    This pamphlet guides parents of children with disabilities through the procedures for acquiring special education services in the state of Washington. Following an overview of special education, the pamphlet presents information on notice and consent procedures, confidentiality of records, individualized education programs (IEP), the placement…

  17. National Nuclear Waste Policy Act of 1981. Hearings before the Committee on Environment and Public Works, United States Senate, Ninety-Seventh Congress, First Session on S. 1662, October 31, 1981, Richland, Washington; November 9, 1981, Washington, DC

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    Hearings were held on October 31, 1981 in Richland, Washington and on November 9, 1981 in Washington, DC to discuss the effort in S. 1662 to establish a national policy and an environmentally acceptable program for managing nuclear wastes from domestic commercial activities. The Richland hearing was held in recognition that Washington State will bear the major impact of the legislation. Witnesses at the Washington, DC hearing included officials from states that are potential sites for radioactive waste storage and disposal facilities. The hearing record includes the testimony of 16 witnesses in Richland and seven in Washington, DC, followed by a reprint of S. 1662 and additional material submitted for the record

  18. Radiochemistry Education at Washington State University: Sustaining Academic Radiochemistry for the Nation

    International Nuclear Information System (INIS)

    Clark, Sue B.; Nash, Ken; Benny, Paul; Clark, Aurora; Wall, Nathalie; Wall, Don; Yoo, Choong-Shik

    2009-01-01

    Since 2002, Washington State University has been building radiochemistry as a component of its overall chemistry program. Using an aggressive hiring strategy and leveraged funds from the state of Washington and federal agencies, six radiochemistry faculty members have been added to give a total of seven radiochemists out of a department of twenty-five faculty members. These faculty members contribute to a diverse curriculum in radiochemistry, and the Chemistry Department now enjoys a significant increase in the number of trainees, the quantity of research expenditures, and the volume and quality of peer-reviewed scientific literature generated by the radiochemistry faculty and the trainees. These three factors are essential for sustaining the radiochemistry education and research program at any academic institution.

  19. Promoting accountability: hospital charity care in California, Washington state, and Texas.

    Science.gov (United States)

    Sutton, Janet P; Stensland, Jeffrey

    2004-05-01

    Debate as to whether private hospitals meet their charitable obligations is heated. This study examines how alternative state approaches for ensuring hospital accountability to the community affects charitable expenditures and potentially affects access to care for the uninsured. Descriptive and multivariate analyses were used to compare private California hospitals' charity care expenditures with those of hospitals in Texas and Washington state. The key finding from this study is that net of hospital characteristics, market characteristics and community need, Texas hospitals were estimated to provide over 3 times more charity care and Washington hospitals were estimated to provide 66% more charity care than California hospitals. This finding suggests that more prescriptive community benefit or charity care requirements may be necessary to ensure that private hospitals assume a larger role in the care of the uninsured.

  20. Home energy rating system business plan feasibility study in Washington state

    Energy Technology Data Exchange (ETDEWEB)

    Lineham, T.

    1995-03-01

    In the Fall of 1993, the Washington State Energy Office funded the Washington Home Energy Rating System project to investigate the benefits of a Washington state HERS. WSEO established a HERS and EEM Advisory Group. Composed of mortgage lenders/brokers, realtors, builders, utility staff, remodelers, and other state agency representatives, the Advisory Group met for the first time on November 17, 1993. The Advisory Group established several subcommittees to identify issues and options. During its March 1994 meeting, the Advisory Group formed a consensus directing WSEO to develop a HERS business plan for consideration. The Advisory Group also established a business plan subcommittee to help draft the plan. Under the guidance of the business plan subcommittee, WSEO conducted research on how customers value energy efficiency in the housing market. This plan represents WSEO`s effort to comply with the Advisory Group`s request. Why is a HERS Business Plan necessary? Strictly speaking this plan is more of a feasibility plan than a business plan since it is designed to help determine the feasibility of a new business venture: a statewide home energy rating system. To make this determination decision makers or possible investors require strategic information about the proposed enterprise. Ideally, the plan should anticipate the significant questions parties may want to know. Among other things, this document should establish decision points for action.

  1. Electric and magnetic field reduction and research: A report to the Washington State Legislature

    International Nuclear Information System (INIS)

    Geissinger, L.G.; Waller, P.; Chartier, V.L.; Olsen, R.G.

    1993-01-01

    Increasingly, citizens of Washington State are expressing their concerns about possible adverse health effects of electric and magnetic fields (EMF) from electric utility power systems. A number of legislative proposals over the past several years have prompted governmental officials to evaluate available options for reducing electric and magnetic field strengths surrounding these systems (with a concentration on magnetic fields) or otherwise manage public exposure to power lines by increasing land use controls and setbacks for new development. Unsuccessful proposals brought before the Washington Legislature include 2 mG magnetic field limits for new transmission lines at the right-of-way edge; a temporary moratorium on transmission construction; requirements for providing public information on EMF; and expansion of the role of state governmental agencies in transmission siting and design. A successful Whatcom County initiative limits the voltage of new transmission to 115 kV in all but industrial land use zones, an action likely to have an unintended outcome of increasing magnetic fields in some areas. It is clear that better communication is needed about possible options for EMF management, costs and consequences, despite the fact scientific evidence on the existence of human health effects is inconclusive. This paper describes the work that Washington State undertook in 1990-92 in response to Engrossed Substitute Senate Bill 6771 establishing the Electric Transmission Research Needs Task Force. The Task Force was directed to report to the Legislature on possible exposure reduction methods; recommending engineering research that could lead to more effective approaches in the future

  2. Asthma Management in Educational Settings: Implementing Guideline-Based Care in Washington State Schools.

    Science.gov (United States)

    Evans-Agnew, Robin A; Klein, Nicole; Lecce, Sally

    2015-11-01

    Managing asthma in the schools is complex and requires careful planning. This article highlights key steps in implementing guideline-based care for children with asthma in Washington State schools: assessing students, establishing acuity, communicating with parents, and training staff. Advance planning can improve outcomes for students, parents, and school staff in managing this complex and prevalent disease. NASN recently developed asthma management guidelines. Developing state-specific guidelines provides an opportunity to speak specifically to state laws and nurse practice acts while also reinforcing the importance of specialized practice to school nurses, school administrators and teachers, parents, and students. © 2015 The Author(s).

  3. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants

    OpenAIRE

    Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Brent, Robert L.; Levene, Malcolm I.; Chervenak, Frank A.

    2016-01-01

    Introduction Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. Purpose The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of...

  4. Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Dudenhausen, Joachim; Orosz, Brooke; Chervenak, Frank A

    2017-04-01

    The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams). Midwife-attended home births had the highest rate of neonatal deaths [122/95,657 neonatal mortality (NNM) 12.75/10,000; relative risk (RR): 3.6, 95% confidence interval (CI) 3-4.4], followed by hospital physician births (8695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6-1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1). Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9-19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8-3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5-8.1). There are significantly increased risks of neonatal deaths among midwife-attended home births associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. This analysis of the causes of neonatal death in planned home birth shows that it is consistently riskier for newborns to deliver at home than at the hospital. Physicians, midwives, and other health care providers have a professional responsibility to share information about the clinical benefits and risks of clinical management.

  5. Recent Trends in Out-of-Hospital Births in the United States.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Mathews, T J

    2013-01-01

    Although out-of-hospital births are still relatively rare in the United States, it is important to monitor trends in these births, as they can affect patterns of facility usage, clinician training, and resource allocation, as well as health care costs. Trends and characteristics of home and birth center births are analyzed to more completely profile contemporary out-of-hospital births in the United States. National birth certificate data were used to examine a recent increase in out-of-hospital births. After a gradual decline from 1990 to 2004, the number of out-of-hospital births increased from 35,578 in 2004 to 47,028 in 2010. In 2010, 1 in 85 US infants (1.18%) was born outside a hospital; about two-thirds of these were born at home, and most of the rest were born in birth centers. The proportion of home births increased by 41%, from 0.56% in 2004 to 0.79% in 2010, with 10% of that increase occurring in the last year. The proportion of birth center births increased by 43%, from 0.23% in 2004 to 0.33% in 2010, with 14% of the increase in the last year. About 90% of the total increase in out-of hospital births from 2004 to 2010 was a result of increases among non-Hispanic white women, and 1 in 57 births to non-Hispanic white women (1.75%) in 2010 was an out-of-hospital birth. Most home and birth center births were attended by midwives. Home and birth center births in the United States are increasing, and the rate of out-of-hospital births is now at the highest level since 1978. There has been a decline in the risk profile of out-of-hospital births, with a smaller proportion of out-of-hospital births in 2010 than in 2004 occurring to adolescents and unmarried women and fewer preterm, low-birth-weight, and multiple births. © 2013 This article is a U.S. Government work and is in the public domain in the United States.

  6. The first dinosaur from Washington State and a review of Pacific coast dinosaurs from North America.

    Directory of Open Access Journals (Sweden)

    Brandon R Peecook

    Full Text Available We describe the first diagnostic dinosaur fossil from Washington State. The specimen, which consists of a proximal left femur, was recovered from the shallow marine rocks of the Upper Cretaceous (Campanian Cedar District Formation (Nanaimo Group and is interpreted as pertaining to a large theropod on the basis of its hollow medullary cavity and proximally placed fourth trochanter. The Washington theropod represents one of the northernmost occurrences of a Mesozoic dinosaur on the west coast of the United States and one of only a handful from the Pacific coast of Laramidia during the Cretaceous. Its isolated nature and preservation in marine rocks suggest that the element was washed in from a nearby fluvial system. If the femur pertains to a tyrannosauroid, which seems likely given its size and the widespread occurrence of the group across Laramidia during Late Cretaceous times, then it would represent an earlier occurrence of large body size than previously recognized (complete femur length estimated at 1.2 meters. Uncertainty surrounding the latitude of deposition of the Nanaimo Group (i.e., the Baja-British Columbia hypothesis precludes assigning the Washington theropod to either of the putative northern or southern biogeographic provinces of Laramidia.

  7. The first dinosaur from Washington State and a review of Pacific coast dinosaurs from North America.

    Science.gov (United States)

    Peecook, Brandon R; Sidor, Christian A

    2015-01-01

    We describe the first diagnostic dinosaur fossil from Washington State. The specimen, which consists of a proximal left femur, was recovered from the shallow marine rocks of the Upper Cretaceous (Campanian) Cedar District Formation (Nanaimo Group) and is interpreted as pertaining to a large theropod on the basis of its hollow medullary cavity and proximally placed fourth trochanter. The Washington theropod represents one of the northernmost occurrences of a Mesozoic dinosaur on the west coast of the United States and one of only a handful from the Pacific coast of Laramidia during the Cretaceous. Its isolated nature and preservation in marine rocks suggest that the element was washed in from a nearby fluvial system. If the femur pertains to a tyrannosauroid, which seems likely given its size and the widespread occurrence of the group across Laramidia during Late Cretaceous times, then it would represent an earlier occurrence of large body size than previously recognized (complete femur length estimated at 1.2 meters). Uncertainty surrounding the latitude of deposition of the Nanaimo Group (i.e., the Baja-British Columbia hypothesis) precludes assigning the Washington theropod to either of the putative northern or southern biogeographic provinces of Laramidia.

  8. Report of survey results for newly licensed registered nurses in Washington state.

    Science.gov (United States)

    Hirsch, Anne M

    2011-10-01

    Current projections for the need for nurses in Washington state are based on an increase in the need for health care, the aging of the population, and the inability of the nursing educational institutions to supply adequate numbers of graduates. Yet many new graduates are providing anecdotal evidence that they cannot find a job in nursing. This study gathered information regarding the employment of newly licensed registered nurses in Washington between May 2009 and August 2010. Questionnaires were administered to a randomly selected sample of 2,200 newly licensed nurses; 532 responses were returned. Nearly 81% reported current employment as a registered nurse and 69.5% reported that they were very or somewhat satisfied with their employment situation. The job search strategies, type of job sought, and factors contributing to their success are reported. Factors contributing to the success of their job search and to job dissatisfaction are explored. Copyright 2011, SLACK Incorporated.

  9. Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-02-01

    We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.

  10. Contents of risk assessments to support the retrieval and closure of tanks for the Washington State Department of Ecology

    International Nuclear Information System (INIS)

    MANN, F.M.

    2003-01-01

    Before the Integrated Mission Acceleration Plan can be performed, risk assessments of various options must be performed for ORP, DOE Headquarters, and the Washington State Dept. of Ecology. This document focuses on the risk assessments for Ecology

  11. The inner state differences of preterm birth rates in Brazil: a time series study

    OpenAIRE

    de Oliveira, Rosana Rosseto; Melo, Emiliana Cristina; Fujimori, Elizabeth; Mathias, Thais Aidar de Freitas

    2016-01-01

    Abstract Background Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality. The prevalence of premature births has increased worldwide, with regional differences. The objective of this study was to analyze the trend of preterm births in the state of Paraná, Brazil, according to Macro-regional and Regional Health Offices (RHOs). Methods This is an ecological time series study using preterm births records from the national l...

  12. Support for marijuana legalization in the US state of Washington has continued to increase through 2016*

    Science.gov (United States)

    Subbaraman, Meenakshi Sabina; Kerr, William C.

    2017-01-01

    Background Support for the legalization of recreational marijuana continues to increase across the United States and globally. In 2016, recreational marijuana was legalized in the most populous US state of California, as well as three other states. The primary aim of this study was to examine trends in support for recreational marijuana legalization in Washington, a state which has had legal recreational marijuana for almost four years, using data collected over the four years post-legalization. A secondary aim was to examine trends in support for the cultivation of marijuana for personal use. Methods Data come from geographically representative general population samples of adult (aged 18 and over) Washington residents collected over five timepoints (every six months) between January 2014 and April 2016 (N = 4,101). Random Digit Dial was used for recruitment. Statistical analyses involved bivariate comparisons of proportions across timepoints and subgroups (defined by age, gender, and marijuana user status), and multivariable logistic regression controlling for timepoint (time) to formally test for trend while controlling for demographic and substance use covariates. All analyses adjusted for probability of selection. Results Support for legalization in Washington has significantly increased: support was 64.0% (95% CI: 61.2%–67.8%) at timepoint 1 and 77.9% (95% CI: 73.2%–81.9%) at timepoint 5. With each six months’ passing, support increased 19% on average. We found no statistically significant change in support for home-growing. Conclusions Support for marijuana legalization has continued to significantly increase in a state that has experienced the policy change for almost four years. PMID:28448904

  13. Support for marijuana legalization in the US state of Washington has continued to increase through 2016.

    Science.gov (United States)

    Subbaraman, Meenakshi Sabina; Kerr, William C

    2017-06-01

    Support for the legalization of recreational marijuana continues to increase across the United States and globally. In 2016, recreational marijuana was legalized in the most populous US state of California, as well as three other states. The primary aim of this study was to examine trends in support for recreational marijuana legalization in Washington, a state which has had legal recreational marijuana for almost four years, using data collected over the four years post-legalization. A secondary aim was to examine trends in support for the cultivation of marijuana for personal use. Data come from geographically representative general population samples of adult (aged 18 and over) Washington residents collected over five timepoints (every six months) between January 2014 and April 2016 (N=4101). Random Digit Dial was used for recruitment. Statistical analyses involved bivariate comparisons of proportions across timepoints and subgroups (defined by age, gender, and marijuana user status), and multivariable logistic regression controlling for timepoint (time) to formally test for trend while controlling for demographic and substance use covariates. All analyses adjusted for probability of selection. Support for legalization in Washington has significantly increased: support was 64.0% (95% CI: 61.2%-67.8%) at timepoint 1 and 77.9% (95% CI: 73.2%-81.9%) at timepoint 5. With each six months' passing, support increased 19% on average. We found no statistically significant change in support for home-growing. Support for marijuana legalization has continued to significantly increase in a state that has experienced the policy change for almost four years. Copyright © 2017. Published by Elsevier B.V.

  14. The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience.

    Science.gov (United States)

    Grosse, Scott D; Thompson, John D; Ding, Yao; Glass, Michael

    2016-06-01

    Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families. Calculations of net economic benefit from newborn screening include the monetary equivalent of avoided deaths and reductions in costs of care for complications associated with late-diagnosed individuals minus the additional costs of screening, diagnosis, and treatment associated with prompt diagnosis. Since 2001 the Washington State Department of Health has successfully implemented an approach to conducting evidence-based economic evaluations of disorders proposed for addition to the state-mandated newborn screening panel. Economic evaluations can inform policy decisions on the expansion of newborn screening panels. This article documents the use of cost-benefit models in Washington State as part of the rule-making process that resulted in the implementation of screening for medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and 4 other metabolic disorders in 2004, cystic fibrosis (CF) in 2006, 15 other metabolic disorders in 2008, and severe combined immune deficiency (SCID) in 2014. We reviewed Washington State Department of Health internal reports and spreadsheet models of expected net societal benefit of adding disorders to the state newborn screening panel. We summarize the assumptions and findings for 2 models (MCAD and CF) and discuss them in relation to findings in the peer-reviewed literature. The MCAD model projected a benefit-cost ratio of 3.4 to 1 based on assumptions of a 20.0 percentage point reduction in infant mortality and a 13.9 percentage point reduction in serious developmental disability. The CF model projected a benefit-cost ratio of 4.0-5.4 to 1 for a discount rate of 3%-4% and a plausible range of 1-2 percentage point reductions in deaths up to age 10 years. The Washington State cost-benefit models of newborn screening were broadly consistent with peer

  15. Marijuana policy opinions in Washington state since legalization: Would voters vote the same way?

    Science.gov (United States)

    Subbaraman, Meenakshi Sabina; Kerr, William C

    2016-12-01

    In 2012, voters in Washington state approved Initiative 502 (I-502) which legalized recreational marijuana use at the state level. This study examines the relationship between demographics, marijuana and alcohol use, and voting outcomes, as well as how these variables relate to (i) whether voters would still vote the same way (a reflection of satisfaction with the new policy) and (ii) the likelihood of using marijuana purchased from legal retail stores. The sample consists of 2,007 adult Washington state residents recruited through Random Digit Dial between January and October 2014. Bivariate tests and multivariable regressions were used for analyses. Less than five percent of those who voted for marijuana legalization would change their votes, whereas 14% of those who voted against legalization would change their votes. In multivariable models controlling for demographics, substance use, and marijuana-related opinions, those who voted for legalization had half the odds of changing their votes than those who voted against it. Among past-year non-marijuana users, almost 10% were somewhat/very likely to use marijuana if they could buy it from a legal store. Past marijuana use, the belief that adults should be allowed to grow marijuana for personal use, and the belief that marijuana is not very risky for health were all related to increased likelihood of using marijuana purchased from legal stores. Since November 2012, support for marijuana legalization in Washington state has increased; accounting for the proportion of voters who would change their votes suggests that I-502 would pass today with even more votes in favor.

  16. The Association Between Diabetes Mellitus Among American Indian/Alaska Native Populations with Preterm Birth in Eight US States from 2004-2011.

    Science.gov (United States)

    Dorfman, Haley; Srinath, Meghna; Rockhill, Karilynn; Hogue, Carol

    2015-11-01

    Assess risk of preterm birth associated with diabetes mellitus (DM) among American Indian and Alaska Natives (AI/AN), a population with increased risk of DM and preterm birth, and examine whether this association differed by state of residence. We used surveillance data from the Pregnancy Risk Assessment Monitoring System from 12,400 AI/AN respondents with singleton births in Alaska, Minnesota, Nebraska, New Mexico, Oklahoma, Oregon, Utah, and Washington from 2004-2011. We conducted multivariable logistic regression models to estimate the odds ratio adjusted for maternal age and prepregnancy BMI with all observations and then stratified by state. DM was reported in 5.92 % of the study population and preterm birth occurred in 8.95 % of births. Women with DM had 1.92 times higher odds of having a preterm birth than women without DM [95 % confidence interval (CI) 1.21-2.78]. After stratifying on state, women with DM in Nebraska had the greatest odds of preterm birth [aOR 6.63, (95 % CI 3.80-11.6)] while women in Alaska saw a protective effect from DM [aOR 0.17, (95 % CI 0.07-0.42)] compared to women without DM. Overall, AI/AN women with DM had significantly greater odds of preterm birth compared to AI/AN women without DM across states. Substantial differences in this association between states calls for increased public health efforts in high-risk areas as well as further research to assess whether differences are attributable to diagnosis, reporting, tribal, healthcare or lifestyle factors.

  17. Birth order and Risk of Childhood Cancer: A Pooled Analysis from Five U.S. States

    Science.gov (United States)

    Von Behren, Julie; Spector, Logan G.; Mueller, Beth A.; Carozza, Susan E.; Chow, Eric J.; Fox, Erin E.; Horel, Scott; Johnson, Kimberly J.; McLaughlin, Colleen; Puumala, Susan E.; Ross, Julie A.; Reynolds, Peggy

    2010-01-01

    The causes of childhood cancers are largely unknown. Birth order has been used as a proxy for prenatal and postnatal exposures, such as frequency of infections and in utero hormone exposures. We investigated the association between birth order and childhood cancers in a pooled case-control dataset. The subjects were drawn from population-based registries of cancers and births in California, Minnesota, New York, Texas, and Washington. We included 17,672 cases less than 15 years of age who were diagnosed from1980-2004 and 57,966 randomly selected controls born 1970-2004, excluding children with Down syndrome. We calculated odds ratios and 95% confidence intervals using logistic regression, adjusted for sex, birth year, maternal race, maternal age, multiple birth, gestational age, and birth weight. Overall, we found an inverse relationship between childhood cancer risk and birth order. For children in the fourth or higher birth order category compared to first-born children, the adjusted OR was 0.87 (95% CI: 0.81, 0.93) for all cancers combined. When we examined risks by cancer type, a decreasing risk with increasing birth order was seen in the central nervous system (CNS) tumors, neuroblastoma, bilateral retinoblastoma, Wilms tumor, and rhabdomyosarcoma. We observed increased risks with increasing birth order for acute myeloid leukemia but a slight decrease in risk for acute lymphoid leukemia. These risk estimates were based on a very large sample size which allowed us to examine rare cancer types with greater statistical power than in most previous studies, however the biologic mechanisms remain to be elucidated. PMID:20715170

  18. Epithermal neutron beam for BNCT research at the Washington State University TRIGA research reactor

    International Nuclear Information System (INIS)

    Nigg, D.W.; Venhuizen, J.R.; Wheeler, F.J.; Wemple, C.A.; Tripard, G.E.; Gavin, P.R.

    2000-01-01

    A new epithermal-neutron beam facility for BNCT (Boron Neutron Capture Therapy) research and boronated agent screening in animal models is in the final stages of construction at Washington State University (WSU). A key distinguishing feature of the design is the incorporation of a new, high-efficiency, neutron moderating and filtering material, Fluental, developed by the Technical Research Centre of Finland. An additional key feature is the provision for adjustable filter-moderator thickness to systematically explore the radiobiological consequences of increasing the fast-neutron contamination above the nominal value associated with the baseline system. (author)

  19. Prevalence of the parasitic copepod Haemobaphes intermedius on juvenile buffalo sculpins from Washington State

    Science.gov (United States)

    Halpenny, C.M.; Kocan, R.M.; Hershberger, P.K.

    2004-01-01

    The parasitic copepod, Haemobaphes intermedius, was detected in 62% of juvenile buffalo sculpins Enophrys bison, a previously unreported host, from the San Juan Islands archipelago in Washington State. Most infestations were characterized by the presence of a single female copepod infestations with multiple H. intermedius occurred either unilaterally or bilaterally in 29% of parasitized individuals. Impaired condition of parasitized hosts was indicated by significantly lower total lengths and weights (34.9 mm; 1.6 g) than in unparasitized cohorts (38.9 mm; 2.1 g). Host specificity was indicated by the failure to detect H. intermedius in 43 sympatric great sculpins Myoxocephalus polyacanthocephalus from the same location.

  20. Economic Impact of Pacific Northwest National Laboratory on the State of Washington in Fiscal Year 2013

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Niemeyer, Jackie M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-12-01

    Pacific Northwest National Laboratory (PNNL) is a large economic entity, with $1.06 billion in annual funding, $936 million in total spending, and 4,344 employees in fiscal year (FY) 2013. Four thousand, one hundred and one (4,101) employees live in Washington State. The Laboratory directly and indirectly supports almost $1.31 billion in economic output, 6,802 jobs, and $514 million in Washington State wage income from current operations. The state also gains more than $1.21 billion in output, more than 6,400 jobs, and $459 million in income through closely related economic activities, such as visitors, health care spending, spending by resident retirees, and spinoff companies. PNNL affects Washington’s economy through commonly recognized economic channels, including spending on payrolls and other goods and services that support Laboratory operations. Less-commonly recognized channels also have their own impacts and include company-supported spending on health care for its staff members and retirees, spending of its resident retirees, Laboratory visitor spending, and the economic activities in a growing constellation of “spinoff” companies founded on PNNL research, technology, and managerial expertise. PNNL also has a significant impact on science and technology education and community nonprofit organizations. PNNL is an active participant in the future scientific enterprise in Washington with the state’s K-12 schools, colleges, and universities. The Laboratory sends staff members to the classroom and brings hundreds of students to the PNNL campus to help train the next generation of scientists, engineers, mathematicians, and technicians. This investment in human capital, though difficult to measure in terms of current dollars of economic output, is among the important lasting legacies of the Laboratory. Finally, PNNL contributes to the local community with millions of dollars’ worth of cash and in-kind corporate and staff contributions, all of which

  1. ADULT CADDISFLY (TRICHOPTERA) PHENOLOGY AT THE HANFORD REACH NATIONAL MONUMENT, WASHINGTON STATE

    International Nuclear Information System (INIS)

    Zack, Richard S.; Ruiter, David E.; Strenge, Dennis L.; Landolt, Peter J.

    2006-01-01

    Adult caddisflies were sampled on the Wahluke Wildlife Area and Saddle Mountain National Wildlife Refuge subunits of the newly created (2000) Hanford Reach National Monument using 15-watt ''black lights'' from April 2002 through April 2003. A diverse fauna consisting of nine families, 21 genera, and 33 species were collected. Protoptila Coloma Ross, Agraylea multipunctata Curtis, Hydroptila xera Ross, Ceraclea alagma (Ross), Nectopsych Iahontanensis Haddock Oecetis cinerascens (Hagen), and Ylodes reuteri (MacLachlan) represent new records for Washington State. Species composition and phenology are presented in tabular form

  2. Economic Impact of Pacific Northwest National Laboratory on the State of Washington in Fiscal Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Michael J.; Niemeyer, Jackie M.

    2015-11-09

    PNNL is a large economic entity with a total of 4,308 employees, $939 million (M) in total funding, and $1.02 billion (B) in total spending during FY 2014. The number of employees that live in Washington State is 4,026 or 93 percent of the Laboratory staff. he Laboratory directly and indirectly supported $1.45 billion in economic output, 6,832 jobs, and $517 million in Washington State wage income from current operations. The state also gained more than $1.19 billion in output, over 6,200 jobs, and $444 million in income through closely related economic activities such as visitors, health care spending, spending by resident retirees, and spinoff companies. PNNL affects Washington’s economy through commonly recognized economic channels, including spending on payrolls and other goods and services that support Laboratory operations. Less commonly recognized channels also have their own impacts and include company-supported spending on health care for its staff members and retirees, spending of its resident retirees, Laboratory visitor spending, and the economic activities in a growing constellation of “spinoff” companies founded on PNNL research, technology, and managerial expertise. PNNL also has a significant impact on science and technology education and community not-for-profit organizations. PNNL is an active participant in the future scientific enterprise in Washington with the state’s K-12 schools, colleges, and universities. The Laboratory sends staff members to the classroom and brings hundreds of students to the PNNL campus to help train the next generation of scientists, engineers, mathematicians, and technicians. This investment in human capital, though difficult to measure in terms of current dollars of economic output, is among the important lasting legacies of the Laboratory. Finally, PNNL contributes to the local community with millions of dollars’ worth of cash and in-kind corporate and staff contributions, all of which strengthen the

  3. Strategy and field implementation for determining a dangerous waste mixture in Washington State

    International Nuclear Information System (INIS)

    Cowan, Steve; Foster, Rick; Wright, Jamie

    1992-01-01

    Under the Resource Conservation and Recovery Act (RCRA), states rather than the Environmental Protection Agency (EPA) maybe authorized to implement RCRA regulations. Under RCRA, environmental regulations implemented by an authorized state must be at least as stringent as those contained in RCRA. Compared to RCRA, the corresponding regulations of the State of Washington regarding the determination of characteristic wastes are more stringent and complex. This paper discusses the complexities of the regulations and presents a strategy for successfully managing diverse waste streams. This strategy was used during the cleanup of contaminated areas and equipment at the Albany Research Center (ARC) in Albany, Oregon, which processed uranium and thorium for the Manhattan Engineer District and the Atomic Energy Commission during the early days of the nation's atomic energy program. Wastes from the cleanup of ARC were shipped to the Department of Energy (DOE) Hanford Reservation. Because the DOE Hanford Reservation is located in Washington, this paper should be of interest to DOE waste generators. (author)

  4. Ground beetles (Coleoptera, Carabidae of the Hanford Nuclear Site in south-central Washington State

    Directory of Open Access Journals (Sweden)

    Chris Looney

    2014-04-01

    Full Text Available In this paper we report on ground beetles (Coleoptera: Carabidae collected from the Hanford Nuclear Reservation and Hanford National Monument (together the Hanford Site, which is located in south-central Washington State. The Site is a relatively undisturbed relict of the shrub-steppe habitat present throughout much of the western Columbia Basin before the westward expansion of the United States. Species, localities, months of capture, and capture method are reported for field work conducted between 1994 and 2002. Most species were collected using pitfall traps, although other capture methods were employed. Trapping results indicate the Hanford Site supports a diverse ground beetle community, with over 90% of the 92 species captured native to North America. Four species collected during the study period are newly recorded for Washington State: Bembidion diligens Casey, Calosoma obsoletum Say, Pseudaptinus rufulus (LeConte, and Stenolophus lineola (Fabricius. Based on these data, the Site maintains a diverse ground beetle fauna and, due to its size and diversity of habitats, is an important repository of shrub-steppe biodiversity.

  5. Ground beetles (Coleoptera, Carabidae) of the Hanford Nuclear Site in south-central Washington State.

    Science.gov (United States)

    Looney, Chris; Zack, Richard S; Labonte, James R

    2014-01-01

    Carabidae) collected from the Hanford Nuclear Reservation and Hanford National Monument (together the Hanford Site), which is located in south-central Washington State. The Site is a relatively undisturbed relict of the shrub-steppe habitat present throughout much of the western Columbia Basin before the westward expansion of the United States. Species, localities, months of capture, and capture method are reported for field work conducted between 1994 and 2002. Most species were collected using pitfall traps, although other capture methods were employed. Trapping results indicate the Hanford Site supports a diverse ground beetle community, with over 90% of the 92 species captured native to North America. Four species collected during the study period are newly recorded for Washington State: Bembidion diligens Casey, Calosoma obsoletum Say, Pseudaptinus rufulus (LeConte), and Stenolophus lineola (Fabricius). Based on these data, the Site maintains a diverse ground beetle fauna and, due to its size and diversity of habitats, is an important repository of shrub-steppe biodiversity.

  6. Evaluation of a clinic-based cholinesterase test kit for the Washington State Cholinesterase Monitoring Program.

    Science.gov (United States)

    Hofmann, Jonathan N; Carden, Angela; Fenske, Richard A; Ruark, Harold E; Keifer, Matthew C

    2008-07-01

    The Washington State Cholinesterase Monitoring Program for pesticide handlers requires blood draws at local clinics, with samples tested at a central laboratory. At present, workers with inhibited cholinesterase activity may be re-exposed before they can be removed from work. In this study we explored the option of on-site testing at local clinics using the EQM Test-mate Kittrade mark, a portable cholinesterase test kit. Test kit cholinesterase activity measurements were performed on 50 blood samples by our research staff, and compared to measurements on the same samples by the Washington State Public Health Laboratory. Another set of samples was also analyzed with the test kit by medical staff at an eastern Washington clinic. Triplicate measurements with the test kit had a 3.3% average coefficient of variation (CV) for plasma cholinesterase (PChE), and a 3.5% average CV for erythrocyte cholinesterase (AChE) measurements. The kit's PChE measurements were similar to PHL measurements (average ratio of 0.98) when performed in the laboratory, but had a tendency to underestimate activity when used in the clinic setting (average ratio of 0.87). The kit systematically overestimated AChE activity by 42-48% relative to the PHL measurements, regardless of where the samples were analyzed. This easy-to-use test kit appeared to be a viable method for clinic-based PChE measurements, but was less consistent for AChE measurements performed in the clinic. Absolute measurements with the kit need to be evaluated carefully relative to standardized methods. (c) 2008 Wiley-Liss, Inc.

  7. Sponsors of Policy: A Network Analysis of Wealthy Elites, Their Affiliated Philanthropies, and Charter School Reform in Washington State

    Science.gov (United States)

    Au, Wayne; Ferrare, Joseph J.

    2014-01-01

    Background/Context: Charter school policy has evolved into a major component of the current education reform movement in the United States. As of 2012, all but nine U.S. states allowed charter schools, and in one of those nine, Washington State, charter school legislation was passed by popular vote in November 2012. There is a substantial, if…

  8. Selected perinatal outcomes associated with planned home births in the United States.

    Science.gov (United States)

    Cheng, Yvonne W; Snowden, Jonathan M; King, Tekoa L; Caughey, Aaron B

    2013-10-01

    More women are planning home birth in the United States, although safety remains unclear. We examined outcomes that were associated with planned home compared with hospital births. We conducted a retrospective cohort study of term singleton live births in 2008 in the United States. Deliveries were categorized by location: hospitals or intended home births. Neonatal outcomes were compared with the use of the χ(2) test and multivariable logistic regression. There were 2,081,753 births that met the study criteria. Of these, 12,039 births (0.58%) were planned home births. More planned home births had 5-minute Apgar score births (0.24%; adjusted odds ratio, 1.87; 95% confidence interval, 1.36-2.58) and neonatal seizure (0.06% vs 0.02%, respectively; adjusted odds ratio, 3.08; 95% confidence interval, 1.44-6.58). Women with planned home birth had fewer interventions, including operative vaginal delivery and labor induction/augmentation. Planned home births were associated with increased neonatal complications but fewer obstetric interventions. The trade-off between maternal preferences and neonatal outcomes should be weighed thoughtfully. Copyright © 2013 Mosby, Inc. All rights reserved.

  9. Spatial and temporal patterns in preterm birth in the United States.

    Science.gov (United States)

    Byrnes, John; Mahoney, Richard; Quaintance, Cele; Gould, Jeffrey B; Carmichael, Suzan; Shaw, Gary M; Showen, Amy; Phibbs, Ciaran; Stevenson, David K; Wise, Paul H

    2015-06-01

    Despite years of research, the etiologies of preterm birth remain unclear. In order to help generate new research hypotheses, this study explored spatial and temporal patterns of preterm birth in a large, total-population dataset. Data on 145 million US births in 3,000 counties from the Natality Files of the National Center for Health Statistics for 1971-2011 were examined. State trends in early (birth rates were compared. K-means cluster analyses were conducted to identify gestational age distribution patterns for all US counties over time. A weak association was observed between state trends in birth rates and the initial absolute birth rate. Significant associations were observed between trends in birth rates and between white and African American births. Periodicity was observed in county-level trends in birth rates. Cluster analyses identified periods of significant heterogeneity and homogeneity in gestational age distributional trends for US counties. The observed geographic and temporal patterns suggest periodicity and complex, shared influences among preterm birth rates in the United States. These patterns could provide insight into promising hypotheses for further research.

  10. Evaluation of soil bioassays for use at Washington state hazardous waste sites: A pilot study

    International Nuclear Information System (INIS)

    Blakley, N.; Norton, D.; Stinson, M.; Boyer, R.

    1994-01-01

    The Washington State Department of Ecology (Ecology) is developing guidelines to assess soil toxicity at hazardous waste sites being investigated under the Washington Model Toxics Control Act Cleanup Regulation. To evaluate soil toxicity, Ecology selected five bioassay protocols -- Daphnia, Earthworm, Seedling, Fathead Minnow, and Frog Embryo Teratogenesis Assay Xenopus (FETAX) -- for use as screening level assessment tools at six State hazardous waste sites. Sites contained a variety of contaminants including metals, creosote, pesticides, and petroleum products (leaking underground storage tanks). Three locations, representing high, medium, and low levels of contamination, were samples at each site. In general, the high contaminant samples resulted in the highest toxic response in all bioassays. The order of site toxicity, as assessed by overall toxic response, is creosote, petroleum products, metals, and pesticides. Results indicate that human health standards, especially for metals, may not adequately protect some of the species tested. The FETAX bioassay had the greatest overall number of toxic responses and lowest variance. The seedling and Daphnia bioassays had lower and similar overall toxic response results, followed by the earthworm and fathead minnow. Variability was markedly highest for the seedling. The Daphnia and fathead minnow variability were similar to the FETAX level, while the earthworm variability was slightly higher

  11. Marijuana Legalization and Parents' Attitudes, Use, and Parenting in Washington State.

    Science.gov (United States)

    Kosterman, Rick; Bailey, Jennifer A; Guttmannova, Katarina; Jones, Tiffany M; Eisenberg, Nicole; Hill, Karl G; Hawkins, J David

    2016-10-01

    The recent legalization of nonmedical marijuana use in several U.S. states has unknown implications for those who are actively parenting. This study examined parents' reactions to marijuana legalization and changes in attitudes and behaviors over time. Data were from a gender-balanced, ethnically diverse sample of 395 parents in Washington State who were participating in the longitudinal Seattle Social Development Project. Participants were interviewed 15 times between 1985 (age 10) and 2014 (age 39). Adult nonmedical marijuana use was legalized in Washington in 2012 and retail outlets opened in 2014. Results showed (1) one third of parents incorrectly believed the legal age of nonmedical marijuana use to be 18; (2) significant increase in approval of adult marijuana use and decrease in perceived harm of regular use; (3) wide opposition to teen use and use around one's children; and (4) substantial increases in frequency of use and marijuana use disorder among parents who used. Despite increased acceptance and frequency of adult use, parents remain widely opposed to teen use but need facts and strategies for talking with their children about marijuana. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Effects of Maternal Age and Age-Specific Preterm Birth Rates on Overall Preterm Birth Rates - United States, 2007 and 2014.

    Science.gov (United States)

    Ferré, Cynthia; Callaghan, William; Olson, Christine; Sharma, Andrea; Barfield, Wanda

    2016-11-04

    Reductions in births to teens and preterm birth rates are two recent public health successes in the United States (1,2). From 2007 to 2014, the birth rate for females aged 15-19 years declined 42%, from 41.5 to 24.2 per 1,000 females. The preterm birth rate decreased 8.4%, from 10.41% to 9.54% of live births (1). Rates of preterm births vary by maternal age, being higher among the youngest and oldest mothers. It is unknown how changes in the maternal age distribution in the United States have affected preterm birth rates. CDC used birth data to assess the relative contributions of changes in the maternal age distribution and in age-specific preterm birth rates to the overall decrease in preterm birth rates. The preterm birth rate declined in all age groups. The effects of age distribution changes on the preterm birth rate decrease were different in younger and older mothers. The decrease in the proportion of births to mothers aged ≤19 and 20-24 years and reductions in age-specific preterm rates in all age groups contributed to the overall decline in the preterm birth rate. The increase in births to mothers aged ≥30 years had no effect on the overall preterm birth rate decrease. The decline in preterm births from 2007 to 2014 is related, in part, to teen pregnancy prevention and the changing maternal age distribution. Effective public health strategies for further reducing preterm birth rates need to be tailored to different age groups.

  13. State safety oversight program : audit of the tri-state oversight committee and the Washington metropolitan area transit authority, final audit report, March 4, 2010.

    Science.gov (United States)

    2010-03-04

    The Federal Transit Administration (FTA) conducted an on-site audit of the safety program implemented by the Washington Metropolitan Area Transit Authority (WMATA) and overseen by the Tri-State Oversight Committee (TOC) between December 14 and 17, 20...

  14. Effect of severity of illness on cesarean delivery rates in Washington State.

    Science.gov (United States)

    Hitti, Jane; Walker, Suzan; Benedetti, Thomas J

    2017-10-01

    Hospitals and providers are increasingly held accountable for their cesarean delivery rates. In the perinatal quality improvement arena, there is vigorous debate about whether all hospitals can be held to the same benchmark for an acceptable cesarean rate regardless of patient acuity. However, the causes of variation in hospital cesarean delivery rates are not well understood. We sought to evaluate the association and temporal trends between severity of illness at admission and the primary term singleton vertex cesarean delivery rate among hospitals in Washington State. We hypothesized that hospitals with higher patient acuity would have higher cesarean delivery rates and that this pattern would persist over time. In this cross-sectional analysis, we analyzed aggregate hospital-level data for all nonmilitary hospitals in Washington State with ≥100 deliveries/y during federal fiscal years 2010 through 2014 (287,031 deliveries). Data were obtained from the Washington State Comprehensive Hospital Abstract Reporting System, which includes inpatient demographic, diagnosis, procedure, and discharge information derived from hospital billing systems. Age, admission diagnoses and procedure codes were converted to patient-level admission severity-of-illness scores using the All Patient Refined Diagnosis Related Groups classification system. This system is widely used throughout the United States to adjust hospital data for severity of illness. Mean admission hospital-level severity-of-illness scores were calculated for each fiscal year among the term singleton vertex population with no history of cesarean delivery. We used linear regression to evaluate the association between hospital admission severity of illness and the primary term singleton vertex cesarean delivery rate, calculated Pearson correlation coefficients, and compared regression line slopes and 95% confidence intervals for each fiscal year. Hospitals were diverse with respect to delivery volume, level of care

  15. Teen Birth Rates for Age Group 15-19 in the United States by County

    Data.gov (United States)

    U.S. Department of Health & Human Services — This data set contains mean teen birth rates by year for each county and state in the United States. Hierarchical Bayesian space-time models were used to generate...

  16. Cultural Norms in Conflict: Breastfeeding Among Hispanic Immigrants in Rural Washington State.

    Science.gov (United States)

    Hohl, Sarah; Thompson, Beti; Escareño, Monica; Duggan, Catherine

    2016-07-01

    Objectives To examine perceptions, experiences, and attitudes towards breastfeeding among Hispanic women living in rural Washington State. Methods Twenty parous Hispanic women of low acculturation, aged 25-48 years and residents in rural Washington State participated in an exploratory, face-to-face interview. Interviews were audio-recorded, translated and transcribed, and analyzed using a thematic content analysis approach. Results Nine emergent themes were grouped into three overarching categories: (1) Breast is best; (2) Hispanic cultural and familial expectations to breastfeed; and (3) Adapting to life in the United States: cultural norms in conflict. Women said they were motivated to breastfeed because of their knowledge and observations of its health benefits for mother and child. They said breastfeeding is ingrained in their Hispanic cultural heritage, and infant feeding choices of female family members were particularly influential in women's own decision to breastfeed. Women said they experienced embarrassment about breastfeeding in the United States and as a result, often chose to initiate formula feeding as a complement so as to avoid feelings of shame. Additionally, they faced economic pressure to work, key barriers for continued breastfeeding among Hispanics in the United States. Conclusions for Practice Knowledge of the benefits of breastfeeding for mother and child and longstanding cultural practices of breastfeeding are not enough to encourage exclusive breastfeeding to 6 months among this rural Hispanic population. Continued support through family-level interventions as well as work place policies that encourage breastfeeding are needed for rural Hispanics to reach optimal breastfeeding rates.

  17. Birth spacing, human capital, and the motherhood penalty at midlife in the United States

    Directory of Open Access Journals (Sweden)

    Margaret Gough

    2017-08-01

    Full Text Available Background: Researchers have examined how first-birth timing is related to motherhood wage penalties, but research that examines birth spacing is lacking. Furthermore, little research has examined the persistence of penalties across the life course. Objective: The objective is to estimate the effects of birth spacing on midlife labor market outcomes and assess the extent to which these effects vary by education and age at first birth. Methods: I use data from the United States from the 1979-2010 waves of the National Longitudinal Survey of Youth 1979 and dynamic inverse probability of treatment weighting to estimate the effects of different birth intervals on mothers' midlife cumulative work hours, cumulative earnings, and hourly wages. I examine how education and age at first birth moderate these effects. Results: Women with birth intervals longer than two years but no longer than six years have the smallest penalties for cumulative outcomes; in models interacting the birth interval with age at first birth, postponement of a first birth to at least age 30 appears to be more important for cumulative outcomes than birth spacing. College-educated women benefit more from a longer birth interval than less educated women. Conclusions: Childbearing strategies that result in greater accumulation of human capital provide long-run labor market benefits to mothers, and results suggest that different birth-spacing patterns could play a small role in facilitating this accumulation, as theorized in past literature. Contribution: I contribute to the demographic literature by testing the theory that birth spacing matters for mothers' labor market outcomes and by assessing the effects at midlife rather than immediately following a birth.

  18. Beneficial Insect Attraction to Milkweeds (Asclepias speciosa, Asclepias fascicularis in Washington State, USA

    Directory of Open Access Journals (Sweden)

    David G. James

    2016-06-01

    Full Text Available Native plant and beneficial insect associations are relatively unstudied yet are important in native habitat restoration programs for improving and sustaining conservation biological control of arthropod pests in agricultural crops. Milkweeds (Asclepias spp. are currently the focus of restoration programs in the USA aimed at reversing a decline in populations of the milkweed-dependent monarch butterfly (Danaus plexippus; however, little is known of the benefits of these plants to other beneficial insects. Beneficial insects (predators, parasitoids, pollinators attracted to two milkweed species (Asclepias speciosa, Asclepias fascicularis in central Washington State, WA, USA were identified and counted on transparent sticky traps attached to blooms over five seasons. Combining all categories of beneficial insects, means of 128 and 126 insects per trap were recorded for A. speciosa and A. fascicularis, respectively. Predatory and parasitic flies dominated trap catches for A. speciosa while parasitic wasps were the most commonly trapped beneficial insects on A. fascicularis. Bees were trapped commonly on both species, especially A. speciosa with native bees trapped in significantly greater numbers than honey bees. Beneficial insect attraction to A. speciosa and A. fascicularis was substantial. Therefore, these plants are ideal candidates for habitat restoration, intended to enhance conservation biological control, and for pollinator conservation. In central Washington, milkweed restoration programs for enhancement of D. plexippus populations should also provide benefits for pest suppression and pollinator conservation.

  19. Beneficial Insect Attraction to Milkweeds (Asclepias speciosa, Asclepias fascicularis) in Washington State, USA.

    Science.gov (United States)

    James, David G; Seymour, Lorraine; Lauby, Gerry; Buckley, Katie

    2016-06-29

    Native plant and beneficial insect associations are relatively unstudied yet are important in native habitat restoration programs for improving and sustaining conservation biological control of arthropod pests in agricultural crops. Milkweeds (Asclepias spp.) are currently the focus of restoration programs in the USA aimed at reversing a decline in populations of the milkweed-dependent monarch butterfly (Danaus plexippus); however, little is known of the benefits of these plants to other beneficial insects. Beneficial insects (predators, parasitoids, pollinators) attracted to two milkweed species (Asclepias speciosa, Asclepias fascicularis) in central Washington State, WA, USA were identified and counted on transparent sticky traps attached to blooms over five seasons. Combining all categories of beneficial insects, means of 128 and 126 insects per trap were recorded for A. speciosa and A. fascicularis, respectively. Predatory and parasitic flies dominated trap catches for A. speciosa while parasitic wasps were the most commonly trapped beneficial insects on A. fascicularis. Bees were trapped commonly on both species, especially A. speciosa with native bees trapped in significantly greater numbers than honey bees. Beneficial insect attraction to A. speciosa and A. fascicularis was substantial. Therefore, these plants are ideal candidates for habitat restoration, intended to enhance conservation biological control, and for pollinator conservation. In central Washington, milkweed restoration programs for enhancement of D. plexippus populations should also provide benefits for pest suppression and pollinator conservation.

  20. Relationship of infant and fetal mortality to operations at the Hanford Nuclear Reservation, Washington State, 1946-1982

    International Nuclear Information System (INIS)

    Cate, S.; Hansom, J.

    1986-01-01

    The relationship of infant and fetal mortality to numbers of nuclear reactors at the Hanford Nuclear Reservation was investigated. Mortality rates were obtained using 36 years of United States vital statistics data. Three different exposure groups were selected based on meteorologic studies of the Hanford area: group 1, counties downwind of Hanford all year; group 2, counties seasonally downwind; and group 3, counties not downwind. Washington state was used as an additional comparison group. Four periods of operation based on fluctuations in numbers of reactors were characterized. Log-linear analysis revealed that the three groups and Washington state had similar trends in infant mortality rates over the four time periods. On the other hand, the trend in fetal mortality rates for group 1 did differ significantly from trends for the two other groups and Washington state. The trends of fetal mortality rates for group 2, group 3, and Washington state were not statistically different. Fetal mortality rates in group 1, however, failed to decline from period 1 (1946-1954) to period 2 (1955-1964) as expected by the trends for the two groups and Washington state. During period 2, the greatest number of reactors were operating. County-specific analysis showed that, of the counties in group 1, the trend in fetal mortality for Benton County, where Hanford is located, was significantly different from that for Washington state. A possible link between Hanford and an excess in fetal deaths is suggested by the deviation in trend of group 1, which appears localized to Benton County and the period of peak activity at Hanford

  1. Children's Access to Health Insurance and Health Status in Washington State: Influential Factors. Research Brief. Publication #2009-21

    Science.gov (United States)

    Matthews, Gregory; Moore, Kristin Anderson; Terzian, Mary

    2009-01-01

    Health insurance, and especially coverage for children, has been a subject of recent political debate in Washington State, as well as on the national stage. Policy makers and health care providers can use high-quality state-level data to assess which children lack health insurance and devise possible solutions to address this need. Illustrating…

  2. Field observations of the developing legal recreational cannabis economy in Washington State.

    Science.gov (United States)

    Jensen, Eric L; Roussell, Aaron

    2016-07-01

    Washington State legalized the sale of recreational cannabis in 2012. This paper describes the unfolding of the market regulatory regime in an eastern portion of the state, including field descriptions to illustrate the setting. We made observations and conducted interviews of the local supply chain comprising a producer/processor, analytic facility, and retail establishments as well as querying the state director of the regulatory board. Interviews and observations of facilities suggest an overwhelming concern for black market diversion drives state regulatory efforts. The ongoing dialogue between market actors and the state has resulted in a more equitable distribution of profits at different stages in the process. State safety regulations have thus far been shifted to independent laboratories. Banks and insurance companies have slowly begun making inroads into the industry, despite federal prohibition. The law was conceived as a social justice remedy, but the bulk of the legal and regulatory activity surrounds cannabis marketplace management. This has been characterized by concerns for black market diversion, producer/processor profits, and a hands-off approach to safety regulation. Minor cannabis violations as a pathway to criminal justice system involvement have been reduced substantially but disproportionate enforcement upon racial/ethnic minorities continues. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Big data on a big new market: Insights from Washington State's legal cannabis market.

    Science.gov (United States)

    Caulkins, Jonathan P; Bao, Yilun; Davenport, Steve; Fahli, Imane; Guo, Yutian; Kinnard, Krista; Najewicz, Mary; Renaud, Lauren; Kilmer, Beau

    2018-07-01

    Voters in eight U.S. states have passed initiatives to legalize large-scale commercial production of cannabis for non-medical use. All plan or require some form of "seed-to-sale" tracking systems, which provide a view of cannabis market activity at a heretofore unimagined level of detail. Legal markets also create a range of new matters for policy makers to address. Publicly available data were obtained on approximately 45 million individually priced items purchased in the 35 million retail transactions that took place during the first two and a half years of Washington State's legal cannabis market. Records include product type (flower, extract, lotion, liquid edible, etc.), product name, price, and potency with respect to multiple cannabinoids, notably THC and CBD. Items sold can be traced back up the supply chain through the store to the processor and producer, to the level of identifying the specific production batch and mother plant, the firm that tested the product, and test results. Data visualization methods are employed to describe spatial-temporal patterns of multiple correlated attributes (e.g., price and potency) broken down by product. Text-analytic methods are used to subdivide the broad category of "extracts for inhalation" into more homogeneous sub-categories. To understand the competitiveness of the legal cannabis market in Washington we calculate the Herfindahl-Hirschman index (HHI) for processors and retailers. Cannabis prices fell steadily and proportionally at the processor and retailer levels. Retail and wholesale price maintained a roughly 3:1 ratio for multiple product types after some initial fluctuations. Although a wide range of edibles are sold, they account for a modest share of consumer spending; extracts for inhalation are a larger and heterogeneous market segment. The HHI indicates the cannabis market is highly competitive at the processor level, but less so for retail markets at the county level. Washington's state-legal cannabis

  4. Variations in community exposure to lahar hazards from multiple volcanoes in Washington State (USA)

    Science.gov (United States)

    Diefenbach, Angela K.; Wood, Nathan J.; Ewert, John W.

    2015-01-01

    Understanding how communities are vulnerable to lahar hazards provides critical input for effective design and implementation of volcano hazard preparedness and mitigation strategies. Past vulnerability assessments have focused largely on hazards posed by a single volcano, even though communities and officials in many parts of the world must plan for and contend with hazards associated with multiple volcanoes. To better understand community vulnerability in regions with multiple volcanic threats, we characterize and compare variations in community exposure to lahar hazards associated with five active volcanoes in Washington State, USA—Mount Baker, Glacier Peak, Mount Rainier, Mount Adams and Mount St. Helens—each having the potential to generate catastrophic lahars that could strike communities tens of kilometers downstream. We use geospatial datasets that represent various population indicators (e.g., land cover, residents, employees, tourists) along with mapped lahar-hazard boundaries at each volcano to determine the distributions of populations within communities that occupy lahar-prone areas. We estimate that Washington lahar-hazard zones collectively contain 191,555 residents, 108,719 employees, 433 public venues that attract visitors, and 354 dependent-care facilities that house individuals that will need assistance to evacuate. We find that population exposure varies considerably across the State both in type (e.g., residential, tourist, employee) and distribution of people (e.g., urban to rural). We develop composite lahar-exposure indices to identify communities most at-risk and communities throughout the State who share common issues of vulnerability to lahar-hazards. We find that although lahars are a regional hazard that will impact communities in different ways there are commonalities in community exposure across multiple volcanoes. Results will aid emergency managers, local officials, and the public in educating at-risk populations and developing

  5. Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004.

    Science.gov (United States)

    Malloy, M H

    2010-09-01

    Home births attended by certified nurse midwives (CNMs) make up an extremely small proportion of births in the United States (home deliveries compared with certified nurse midwife in-hospital deliveries in the United States as measured by the risk of adverse infant outcomes among women with term, singleton, vaginal deliveries. United States linked birth and infant death files for the years 2000 to 2004 were used for the analysis. Adverse neonatal outcomes including death were determined by place of birth and attendant type for in-hospital certified nurse midwife, in-hospital 'other' midwife, home certified nurse midwife, home 'other' midwife, and free-standing birth center certified nurse midwife deliveries. For the 5-year period there were 1 237 129 in-hospital certified nurse midwife attended births; 17 389 in-hospital 'other' midwife attended births; 13 529 home certified nurse midwife attended births; 42 375 home 'other' midwife attended births; and 25 319 birthing center certified nurse midwife attended births. The neonatal mortality rate per 1000 live births for each of these categories was, respectively, 0.5 (deaths=614), 0.4 (deaths=7), 1.0 (deaths=14), 1.8 (deaths=75), and 0.6 (deaths=16). The adjusted odds ratio (95% confidence interval) for neonatal mortality for home certified nurse midwife attended deliveries vs in-hospital certified nurse midwife attended deliveries was 2.02 (1.18, 3.45). Deliveries at home attended by CNMs and 'other midwives' were associated with higher risks for mortality than deliveries in-hospital by CNMs.

  6. Vital signs: Repeat births among teens - United States, 2007-2010.

    Science.gov (United States)

    2013-04-05

    Teen childbearing has potential negative health, economic, and social consequences for mother and child. Repeat teen childbearing further constrains the mother's education and employment possibilities. Rates of preterm and low birth weight are higher in teens with a repeat birth, compared with first births. To assess patterns of repeat childbearing and postpartum contraceptive use among teens, CDC analyzed natality data from the National Vital Statistics System (NVSS) and the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2007-2010. Based on 2010 NVSS data from all 50 states and the District of Columbia, of more than 367,000 births to teens aged 15-19 years, 18.3% were repeat births. The percentage of teen births that represented repeat births decreased by 6.2% between 2007 and 2010. Disparities in repeat teen births exist by race/ethnicity, with the highest percentages found among American Indian/Alaska Natives (21.6%), Hispanics (20.9%), and non-Hispanic blacks (20.4%) and lowest among non-Hispanic whites (14.8%). Wide geographic disparities in the percentage of teen births that were repeat births also exist, ranging from 22% in Texas to 10% in New Hampshire. PRAMS data from 16 reporting areas (15 states and New York City) indicate that 91.2% of teen mothers used a contraceptive method 2-6 months after giving birth, but only 22.4% of teen mothers used the most effective methods. Teens with a previous live birth were significantly more likely to use the most effective methods postpartum compared with those with no prior live birth (29.6% versus 20.9%, respectively). Non-Hispanic white and Hispanic teens were significantly more likely to use the most effective methods than non-Hispanic black teens (24.6% and 27.9% versus 14.3%, respectively). The percentage of teens reporting postpartum use of the most effective methods varied greatly geographically across the PRAMS reporting areas, ranging from 50.3% in Colorado to 7.2% in New York State. Although the

  7. Perceived impact and feasibility of strategies to improve access to healthy foods in Washington State, USA.

    Science.gov (United States)

    Johnson, Donna B; Quinn, Emilee L; Podrabsky, Mary; Beckwith-Stanley, Nadia; Chan, Nadine; Ellings, Amy; Kovacs, Tricia; Lane, Claire

    2013-12-01

    The present study measured the perceived impact and political and implementation feasibility of state-level policy strategies related to increasing access to healthy foods and limiting unhealthy foods. Potential state-level policy strategies to improve access to healthy foods were identified through a review of evidence-based literature and policy recommendations. Respondents rated the perceived impact and political and implementation feasibility of each policy on a five-point scale using online surveys. Washington State policy process. Forty-nine content experts (national researchers and subject experts), forty policy experts (state elected officials or their staff, gubernatorial or legislative policy analysts) and forty-five other stakeholders (state-level advocates, programme administrators, food producers). In aggregate, respondents rated policy impact and implementation feasibility higher than political feasibility. Policy experts rated policy strategies as less politically feasible compared with content experts (P political and implementation feasibility. These included policies related to nutrition standards in schools and child-care facilities, food distribution systems, urban planning projects, water availability, joint use agreements and breast-feeding supports. Although they may be perceived as potentially impactful, some policies will be more difficult to enact than others. Information about the potential feasibility of policies to improve access to healthy foods can be used to focus limited policy process resources on strategies with the highest potential for enactment, implementation and impact.

  8. Outreach at Washington State University: a case study in costs and attendance

    Science.gov (United States)

    Bernhardt, Elizabeth A.; Bollen, Viktor; Bersano, Thomas M.; Mossman, Sean M.

    2016-09-01

    Making effective and efficient use of outreach resources can be difficult for student groups in smaller rural communities. Washington State University's OSA/SPIE student chapter desires well attended yet cost-effective ways to educate and inform the public. We designed outreach activities focused on three different funding levels: low upfront cost, moderate continuing costs, and high upfront cost with low continuing costs. By featuring our activities at well attended events, such as a pre-football game event, or by advertising a headlining activity, such as a laser maze, we take advantage of large crowds to create a relaxed learning atmosphere. Moreover, participants enjoy casual learning while waiting for a main event. Choosing a particular funding level and associating with well-attended events makes outreach easier. While there are still many challenges to outreach, such as motivating volunteers or designing outreach programs, we hope overcoming two large obstacles will lead to future outreach success.

  9. Three-Dimensional Groundwater Models of the 300 Area at the Hanford Site, Washington State

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Mark D.; Rockhold, Mark L.; Thorne, Paul D.; Chen, Yousu

    2008-09-01

    Researchers at Pacific Northwest National Laboratory developed field-scale groundwater flow and transport simulations of the 300 Area to support the 300-FF-5 Operable Unit Phase III Feasibility Study. The 300 Area is located in the southeast portion of the U.S. Department of Energy’s Hanford Site in Washington State. Historical operations involving uranium fuel fabrication and research activities at the 300 Area have contaminated engineered liquid-waste disposal facilities, the underlying vadose zone, and the uppermost aquifer with uranium. The main objectives of this research were to develop numerical groundwater flow and transport models to help refine the site conceptual model, and to assist assessment of proposed alternative remediation technologies focused on the 300 Area uranium plume.

  10. Rapid deterioration of sediment surface habitats in Bellingham Bay, Washington State, as indicated by benthic foraminifera.

    Science.gov (United States)

    Nesbitt, Elizabeth A; Martin, Ruth A; Martin, David E; Apple, Jude

    2015-08-15

    Foraminiferal assemblages in sediment grab samples were utilized to evaluate the impacts of anthropogenic activities on benthic habitats in Bellingham Bay, Washington State, U.S.A. Seventy-three samples taken in 1987, 1997, 2006 and 2010 yielded 35 species of foraminifera from 28 genera. Assemblage composition and diversity data indicate a marked deterioration between 1987 and 2010, contrary to the published Chemical Index, but analogous to the situation with macrobiota. Correlation of diversity with chemical pollutants and metals did not identify any significant correlations, however, an unrelated but highly relevant study of bottom water dissolved oxygen concentrations and pH in Bellingham Bay suggests eutrophication with accompanying hypoxia and acidification may be part of the cause. Thus, the metrics of contamination alone do not adequately characterize habitat viability, and benthic foraminiferal assemblages provide insight into the health of coastal ecosystems. Published by Elsevier Ltd.

  11. Occupational Hydrofluoric Acid Injury from Car and Truck Washing--Washington State, 2001-2013.

    Science.gov (United States)

    Reeb-Whitaker, Carolyn K; Eckert, Carly M; Anderson, Naomi J; Bonauto, David K

    2015-08-21

    Exposure to hydrofluoric acid (HF) causes corrosive chemical burns and potentially fatal systemic toxicity. Car and truck wash cleaning products, rust removers, and aluminum brighteners often contain HF because it is efficient in breaking down roadway matter. The death of a truck wash worker from ingestion of an HF-based wash product and 48 occupational HF burn cases associated with car and truck washing in Washington State during 2001-2013 are summarized in this report. Among seven hospitalized workers, two required surgery, and all but one worker returned to the job. Among 48 injured workers, job titles were primarily auto detailer, car wash worker, truck wash worker, and truck driver. Because HF exposure can result in potentially severe health outcomes, efforts to identify less hazardous alternatives to HF-based industrial wash products are warranted.

  12. Firearm Ownership, Storage Practices, and Suicide Risk Factors in Washington State, 2013-2016.

    Science.gov (United States)

    Morgan, Erin Renee; Gomez, Anthony; Rowhani-Rahbar, Ali

    2018-05-17

    To characterize firearm ownership and storage practices in Washington State and assess their relationship with suicide risk factors. Using Washington State Behavioral Risk Factor Surveillance System data for 2013 to 2016, we conducted survey-weighted multivariable Poisson regression models to obtain prevalence ratios (PRs) and confidence intervals (CIs). Of 34 884 adult respondents, 34.3% (95% CI = 33.7%, 35.0%) reported a firearm in their household, among whom 36.6% (95% CI = 35.4%, 37.7%) stored their firearm locked and unloaded. There were no differences in mental health indicators by firearm ownership or storage practice status. Binge and chronic alcohol use were somewhat more prevalent among adults from firearm-owning households (PR = 1.2; 95% CI = 1.1, 1.3; PR = 1.2; 95% CI = 1.1, 1.4, respectively) and among those living in households not practicing safe storage (PR = 1.4; 95% CI = 1.2, 1.7; PR = 1.9; 1.5, 2.3, respectively). Variability in mental health does not explain the substantial increased suicide risk among individuals in firearm-owning households. Greater prevalence of alcohol misuse among adults in firearm-owning households not practicing safe storage highlights the need for suicide prevention interventions. (Am J Public Health. Published online ahead of print May 17, 2018: e1-e7. doi:10.2105/AJPH.2018.304403).

  13. Modeling the impact of a carbon tax: A trial analysis for Washington State

    International Nuclear Information System (INIS)

    Mori, Keibun

    2012-01-01

    In recent years, energy policy makers have proposed a carbon tax as an economy-wide policy tool to curb greenhouse gas (GHG) emissions. The quantification of its impact on GHG emissions has relied on an energy-economy model, whose complexity often makes it difficult to comprehend how it simulates the interaction of a carbon tax and energy demand. This study therefore aims at developing an alternative model called the Carbon Tax Analysis Model (C-TAM). The elasticity-based approach used in C-TAM is less sophisticated than an equilibrium-based approach used in an energy-economy model, but C-TAM is designed to maximize its predictive capabilities by using a wide range of elasticities for each sector and fuel use, accounting for likely changes in fuel mix for electricity generation, and addressing the model's sensitivity to elasticity estimates with Monte Carlo simulation. The trial analysis in this study evaluates a potential carbon tax in Washington State, suggesting a carbon tax at US$30 per metric ton of CO 2 (tCO 2 ) lowers GHG emissions by 8.4% from the business-as-usual (BAU) scenario in 2035. The study concludes that C-TAM can provide meaningful policy implications by forecasting detailed impact on revenues and energy demand for each sector and fuel use. - Highlights: ► An elasticity-based model is developed to forecast the impact of a carbon tax. ► This model can show detailed impacts on each sector and fuel use. ► Extensive literature review and sensitivity analyses cover the model's weakness. ► A carbon tax is effective in curbing greenhouse gas emissions in Washington State. ► A carbon tax is however more effective if implemented nationwide.

  14. Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States?

    Science.gov (United States)

    Chevrette, Marianne; Abenhaim, Haim Arie

    2015-10-01

    The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates. We carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates. The state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different-for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. While teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. Planned home birth in the United States and professionalism: a critical assessment.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Grünebaum, Amos; Arabin, Birgit; Levene, Malcolm I; Brent, Robert L

    2013-01-01

    Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one's training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a "professional." Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth.The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and

  16. [Birth weight and frozen embryo transfer: State of the art].

    Science.gov (United States)

    Anav, M; Ferrières-Hoa, A; Gala, A; Fournier, A; Zaragoza, S; Vintejoux, E; Vincens, C; Hamamah, S

    2018-04-18

    The aim of this study was to update our acknowledgment if there is a link between assisted embryo cryopreservation and epigenetics in human? Animal studies have demonstrated epigenetics consequence and especially imprinting disorders due to in vitro culture. In human, it is important to note that after frozen embryo transfer birth weight is significantly increased by 81 to 250g. But these studies cannot identify the reasons of such difference. This review strongly suggests that embryo cryopreservation is responsible for birth weight variations but mechanisms not yet elucidated. Epigenetics is probably one of these but to date, none study is able to prove it. We have to be attentive on a possible link between assisted reproductive technology (ART) and epigenetics reprogrammation. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  17. Cost Effectiveness of ASHRAE Standard 90.1-2013 for the State of Washington

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Philip R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Xie, YuLong [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhuge, Jing Wei [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Halverson, Mark A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Loper, Susan A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rosenberg, Michael I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Richman, Eric E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-12-01

    Moving to the ASHRAE Standard 90.1-2013 (ASHRAE 2013) edition from Standard 90.1-2010 (ASHRAE 2010) is cost-effective for the State of Washington. The table below shows the state-wide economic impact of upgrading to Standard 90.1-2013 in terms of the annual energy cost savings in dollars per square foot, additional construction cost per square foot required by the upgrade, and life-cycle cost (LCC) per square foot. These results are weighted averages for all building types in all climate zones in the state, based on weightings shown in Table 4. The methodology used for this analysis is consistent with the methodology used in the national cost-effectiveness analysis. Additional results and details on the methodology are presented in the following sections. The report provides analysis of two LCC scenarios: Scenario 1, representing publicly-owned buildings, considers initial costs, energy costs, maintenance costs, and replacement costs—without borrowing or taxes. Scenario 2, representing privately-owned buildings, adds borrowing costs and tax impacts.

  18. Epidemiologic Surveillance of Teenage Birth Rates in the United States, 2006-2012.

    Science.gov (United States)

    Amin, Raid; Decesare, Julie Zemaitis; Hans, Jennifer; Roussos-Ross, Kay

    2017-06-01

    To investigate the geographic variation in the average teenage birth rates by county in the contiguous United States. Data from the National Center for Health Statistics were used in this retrospective cohort to count the total number of live births to females aged 15-19 years by county between 2006 and 2012. Software for disease surveillance and spatial cluster analysis was used to identify clusters of high or low teenage births in counties or areas of greater than 100,000 teenage females. The analysis was then adjusted for percentage of poverty and high school diploma achievement. The unadjusted analysis identified the top 10 clusters of teenage births. The cluster with the highest rate was a city and the surrounding 40 counties, demonstrating an average teen birth rate of 67 per 1,000 females in the age range, 87% higher than the rate in the contiguous United States. Adjustments for poverty rates and high school diploma achievement shifted the top clusters to other areas. Despite an overall national decline in the teenage birth rate, clusters of elevated teenage birth rates remain. These clusters are not random and remain higher than expected when adjusted for poverty and education. This data set provides a framework to focus targeted interventions to reduce teenage birth rates in this high-risk population.

  19. 75 FR 39325 - Notice of Draft Finding of No Significant Impact for the Washington State Portion of the Pacific...

    Science.gov (United States)

    2010-07-08

    ... Washington State is to improve intercity passenger rail service by reducing travel times, achieving greater... intercity travel demand. To achieve these goals WSDOT applied for federal funding through the High Speed Intercity Passenger Rail Program (HSIPR Program) administered by the FRA and funded by the American Recovery...

  20. Crooked Calf Syndrome: Managing Lupines on Rangelands of the Channel Scablands of East-Central Washington State

    Science.gov (United States)

    “Crooked calf syndrome”, the contracture-type skeletal defects and cleft palate caused by velvet lupine (Lupinus leucophyllus) on the channel Scablands of east-central Washington State are the same as those defects induced by Conium maculatum (poison-hemlock) and Nicotiana spp. (wild tobacco) in rum...

  1. Constructing Relationships between Science and Practice in the Written Science Communication of the Washington State Wine Industry

    Science.gov (United States)

    Szymanski, Erika Amethyst

    2016-01-01

    Even as deficit model science communication falls out of favor, few studies question how written science communication constructs relationships between science and industry. Here, I investigate how textual microprocesses relate scientific research to industry practice in the Washington State wine industry, helping (or hindering) winemakers and…

  2. Being safe: making the decision to have a planned home birth in the United States.

    Science.gov (United States)

    Lothian, Judith A

    2013-01-01

    Although there is evidence that supports the safety of planned home birth for healthy women, less than 1 percent of women in the United States choose to have their baby at home. An ethnographic study of the experience of planned home birth provided rich descriptions of women's experiences planning, preparing for, and having a home birth.This article describes findings related to how women make the decision to have a planned home birth. For these women, being safe emerged as central in making the decision. For them, being safe included four factors: avoiding technological birth interventions, knowing the midwife and the midwife knowing them, feeling comfortable and protected at home, and knowing that backup hospital medical care was accessible if needed.

  3. An exploratory study of boarding home sanctions and compliance in Washington State.

    Science.gov (United States)

    Graf Schaffner, Mindy L

    2011-01-01

    States vary in enforcement systems that monitor the quality of care in residential boarding homes. The growing number of people seeking long-term care services in boarding homes requires regulatory systems that are effective in quality assurance enforcement. This 6 year retrospective study describes the characteristics of 601 sanctioned and nonsanctioned homes in the state of Washington and evaluates the effectiveness of enforcement actions such as intermediate sanctions on future boarding home compliance. The intermediate sanctions evaluated are stop placement of admissions, civil fines, and conditions placed on licenses. Boarding homes that were sanctioned tended to be homes that were for-profit and had governmental contracts for Medicaid services. Homes that remained sanctioned throughout the 6 year study tended to be homes that were individual ownership corporations, had smaller numbers of licensed beds, and did not provide nursing services. Intermediate sanctions were found to vary in effectiveness. Conditions placed on licenses were the most effective intermediate sanction, and civil fines the least effective. Higher citation numbers and the most severe level of complaint types were found to be predictors of becoming a sanctioned boarding home. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Promoting Breastfeeding-Friendly Hospital Practices: A Washington State Learning Collaborative Case Study.

    Science.gov (United States)

    Freney, Emily; Johnson, Donna; Knox, Isabella

    2016-05-01

    Hospital breastfeeding support practices can affect breastfeeding outcomes. Learning collaboratives are an increasingly common strategy to improve practices in health care and have been applied to breastfeeding in many cases. The aims of this study of the Evidence-Based Hospital Breastfeeding Support Learning Collaborative (EBBS LC) were to describe the perceptions of participants regarding the process and effectiveness of the EBBS LC, describe perceived barriers and facilitators to implementing the Ten Steps to Successful Breastfeeding, and identify additional actions and resources needed in future learning collaboratives. Qualitative, semistructured telephone interviews were conducted with 13 key staff who represented 16 of the 18 participating hospitals. The learning collaborative was perceived positively by participants, meeting the expectations of 9 and exceeding the expectations of 4 persons interviewed. The most beneficial aspect of the program was its collaborative nature, and the most difficult aspect was the time required to participate as well as technological difficulties. The key barriers were staff time, staff changes, cost, and the difficulty of changing the existing practices of hospitals and communities. The key facilitating factors were supportive management, participation in multiple breastfeeding quality improvement projects, collecting data on breastfeeding outcomes, tangible resources regarding the Ten Steps, and positive community response. Participants in the EBBS LC stated that they would like to see the Washington State Department of Health create a resource-rich, centralized source of information for participants. This learning collaborative approach was valued by participants. Future efforts can be guided by these evaluation findings. © The Author(s) 2015.

  5. Device evaluation and coverage policy in workers' compensation: examples from Washington State.

    Science.gov (United States)

    Franklin, G M; Lifka, J; Milstein, J

    1998-09-25

    Workers' compensation health benefits are broader than general health benefits and include payment for medical and rehabilitation costs, associated indemnity (lost time) costs, and vocational rehabilitation (return-to-work) costs. In addition, cost liability is for the life of the claim (injury), rather than for each plan year. We examined device evaluation and coverage policy in workers' compensation over a 10-year period in Washington State. Most requests for device coverage in workers' compensation relate to the diagnosis, prognosis, or treatment of chronic musculoskeletal conditions. A number of specific problems have been recognized in making device coverage decisions within workers' compensation: (1) invasive devices with a high adverse event profile and history of poor outcomes could significantly increase both indemnity and medical costs; (2) many noninvasive devices, while having a low adverse event profile, have not proved effective for managing chronic musculoskeletal conditions relevant to injured workers; (3) some devices are marketed and billed as surrogate diagnostic tests for generally accepted, and more clearly proven, standard tests; (4) quality oversight of technology use among physicians may be inadequate; and (5) insurers' access to efficacy data adequate to make timely and appropriate coverage decisions in workers' compensation is often lacking. Emerging technology may substantially increase the costs of workers' compensation without significant evidence of health benefit for injured workers. To prevent ever-rising costs, we need to increase provider education and patient education and consent, involve the state medical society in coverage policy, and collect relevant outcomes data from healthcare providers.

  6. Teen Birth Rates for Urban and Rural Areas in the United States, 2007-2015.

    Science.gov (United States)

    Hamilton, Brady E; Rossen, Lauren M; Branum, Amy M

    2016-11-01

    Data from the National Vital Statistics System •Birth rates for teenagers aged 15-19 declined in urban and rural counties from 2007 through 2015, with the largest declines in large urban counties and the smallest declines in rural counties. •From 2007 through 2015, the teen birth rate was lowest in large urban counties and highest in rural counties. •Declines in teen birth rates in all urban counties between 2007 and 2015 were largest in Arizona, Massachusetts, Connecticut, Minnesota, and Colorado, with 17 states experiencing a decline of 50% or more. •Declines in teen birth rates in all rural counties between 2007 and 2015 were largest (50% or more) in Colorado and Connecticut. •In 2015, teen birth rates were highest in rural counties and lowest in large urban counties for non-Hispanic white, non-Hispanic black, and Hispanic females. Teen birth rates have demonstrated an unprecedented decline in the United States since 2007 (1). Declines occurred in all states and among all major racial and Hispanic-origin groups, yet disparities by both geography and demographic characteristics persist (2,3). Although teen birth rates and related declines have been described by state, patterns by urban-rural location have not yet been examined. This report describes trends in teen birth rates in urban (metropolitan) and rural (nonmetropolitan) areas in the United States overall and by state from 2007 through 2015 and by race and Hispanic origin for 2015. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  7. Location, location, location: Assessing the spatial patterning between marijuana licenses, alcohol outlets and neighborhood characteristics within Washington state.

    Science.gov (United States)

    Tabb, Loni Philip; Fillmore, Christina; Melly, Steven

    2018-04-01

    The availability of marijuana products is becoming increasingly prevalent across the United States (US), many states are allowing for the production, processing, and retailing of these products for medical and/or recreational use. The purpose of this study is to: (1) examine the spatial patterning of marijuana licenses, and (2) examine the impact of alcohol outlets in addition to other neighborhood characteristics on marijuana licenses within the state of Washington. This cross-sectional observational study examined 1458 census tracts in Washington state from 2017, using marijuana and alcohol data from the Washington State Liquor and Cannabis Board as well as neighborhood characteristics data from the American Community Survey 2011-2015 5-year estimates. We used exploratory and formal spatial regression methods, including integrated nested Laplace approximation within a Bayesian statistical framework, to address the study aims. Our results indicate there is significant spatial patterning of marijuana producers and processors across the state. We also found that all marijuana licenses are located in poorer census tracts, and marijuana retailers are co-located in census tracts with off-premises alcohol outlets. Our study provides empirical evidence of the relationship between marijuana licenses, alcohol outlets, and neighborhood characteristics, and has important implications for policymakers in other states currently considering legalizing marijuana-products for medical and/or recreational use. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

    2014-10-01

    We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Trends and characteristics of home and other out-of-hospital births in the United States, 1990-2006.

    Science.gov (United States)

    MacDorman, Marian F; Menacker, Fay; Declercq, Eugene

    2010-03-03

    This report examines trends and characteristics of out-of-hospital and home births in the United States. Descriptive tabulations of data are presented and interpreted. In 2006, there were 38,568 out-of-hospital births in the United States, including 24,970 home births and 10,781 births occurring in a freestanding birthing center. After a gradual decline from 1990 to 2004, the percentage of out-of-hospital births increased by 3% from 0.87% in 2004 to 0.90% in 2005 and 2006. A similar pattern was found for home births. After a gradual decline from 1990 to 2004, the percentage of home births increased by 5% to 0.59% in 2005 and remained steady in 2006. Compared with the U.S. average, home birth rates were higher for non-Hispanic white women, married women, women aged 25 and over, and women with several previous children. Home births were less likely than hospital births to be preterm, low birthweight, or multiple deliveries. The percentage of home births was 74% higher in rural counties of less than 100,000 population than in counties with a population size of 100,000 or more. The percentage of home births also varied widely by state; in Vermont and Montana more than 2% of births in 2005-2006 were home births, compared with less than 0.2% in Louisiana and Nebraska. About 61% of home births were delivered by midwives. Among midwife-delivered home births, one-fourth (27%) were delivered by certified nurse midwives, and nearly three-fourths (73%) were delivered by other midwives. Women may choose home birth for a variety of reasons, including a desire for a low-intervention birth in a familiar environment surrounded by family and friends and cultural or religious concerns. Lack of transportation in rural areas and cost factors may also play a role.

  10. Birth Defects

    Science.gov (United States)

    A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of ... in the United States is born with a birth defect. A birth defect may affect how the ...

  11. Evaluation of PCB sources and releases for identifying priorities to reduce PCBs in Washington State (USA).

    Science.gov (United States)

    Davies, Holly; Delistraty, Damon

    2016-02-01

    Polychlorinated biphenyls (PCBs) are ubiquitously distributed in the environment and produce multiple adverse effects in humans and wildlife. As a result, the purpose of our study was to characterize PCB sources in anthropogenic materials and releases to the environment in Washington State (USA) in order to formulate recommendations to reduce PCB exposures. Methods included review of relevant publications (e.g., open literature, industry studies and reports, federal and state government databases), scaling of PCB sources from national or county estimates to state estimates, and communication with industry associations and private and public utilities. Recognizing high associated uncertainty due to incomplete data, we strived to provide central tendency estimates for PCB sources. In terms of mass (high to low), PCB sources include lamp ballasts, caulk, small capacitors, large capacitors, and transformers. For perspective, these sources (200,000-500,000 kg) overwhelm PCBs estimated to reside in the Puget Sound ecosystem (1500 kg). Annual releases of PCBs to the environment (high to low) are attributed to lamp ballasts (400-1500 kg), inadvertent generation by industrial processes (900 kg), caulk (160 kg), small capacitors (3-150 kg), large capacitors (10-80 kg), pigments and dyes (0.02-31 kg), and transformers (PCB distribution and decrease exposures include assessment of PCBs in buildings (e.g., schools) and replacement of these materials, development of Best Management Practices (BMPs) to contain PCBs, reduction of inadvertent generation of PCBs in consumer products, expansion of environmental monitoring and public education, and research to identify specific PCB congener profiles in human tissues.

  12. Trends and characteristics of home vaginal birth after cesarean delivery in the United States and selected States.

    Science.gov (United States)

    Macdorman, Marian F; Declercq, Eugene; Mathews, T J; Stotland, Naomi

    2012-04-01

    To examine trends and characteristics of home vaginal birth after cesarean delivery (VBAC) in the United States and selected states from 1990-2008. Birth certificate data were used to track trends in home and hospital VBACs from 1990-2008. Data on planned home VBAC were analyzed by sociodemographic and medical characteristics for the 25 states reporting this information in 2008 and compared with hospital VBAC data. In 2008, there were approximately 42,000 hospital VBACs and approximately 1,000 home VBACs in the United States, up from 664 in 2003 and 656 in 1990. The percentage of home births that were VBACs increased from less than 1% in 1996 to 4% in 2008, whereas the percentage of hospital births that were VBACs decreased from 3% in 1996 to 1% in 2008. Planned home VBACs had a lower risk profile than hospital VBACs with fewer births to teenagers, unmarried women, or smokers; fewer preterm or low-birth-weight deliveries; and higher maternal education levels. Recent increases in the proportion of U.S. women with a prior cesarean delivery mean that an increasing number of women are faced with the choice and associated risks of either VBAC or repeat cesarean delivery. Recent restrictions in hospital VBAC availability have coincided with increases in home VBACs; however, home VBAC remains rare, with approximately 1,000 occurrences in 2008. II.

  13. A practical framework for regulating for-profit recreational marijuana in US States: Lessons from Colorado and Washington.

    Science.gov (United States)

    Carnevale, John T; Kagan, Raanan; Murphy, Patrick J; Esrick, Josh

    2017-04-01

    Despite the federal prohibition against marijuana, state-level recreational use appears to be moving forward. Public opinion is shifting. Following well-publicized state-legalization in Washington and Colorado, states across the US have begun considering similar measures. Since the 2016 election, over 21% of Americans now live in places where recreational marijuana is state-legal, and over 63% of the country permits medical or recreational use at the state level. This paper does not consider whether states should legalize marijuana nor does it weigh all regulatory options available to states. Instead, it considers how states can create a practical framework to regulate recreational marijuana, particularly in a climate of federal uncertainty where marijuana remains illegal. We draw lessons from Colorado and Washington-assuming that other states will adopt similar models and employ commercial, for-profit systems. Considering both the variety of goals that states could adopt and how they interact, we offer recommendations in five areas: cultivation, production, and processing; sale, consumption, and possession; taxes and finance; public health and safety; and governance. We recommend that states implement a relatively restrictive regulatory approach, with a single market for recreational and medical marijuana, if appropriate. This should make marijuana laws easier to enforce, help reduce diversion, and satisfy federal guidance. Moreover, drawing from Colorado and Washington's experience, we suggest a flexible system with robust data collection and performance monitoring that supports a thorough evaluation. This should allow states to "learn as they go"-a must, given the uncertainty surrounding such policy shifts. Of course, a tightly regulated approach will have drawbacks-including a significant illegal market. But political experience teaches that states will be better off loosening a tight market than attempting to tighten a loose one. We also consider a potential

  14. The inner state differences of preterm birth rates in Brazil: a time series study.

    Science.gov (United States)

    de Oliveira, Rosana Rosseto; Melo, Emiliana Cristina; Fujimori, Elizabeth; Mathias, Thais Aidar de Freitas

    2016-05-17

    Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality. The prevalence of premature births has increased worldwide, with regional differences. The objective of this study was to analyze the trend of preterm births in the state of Paraná, Brazil, according to Macro-regional and Regional Health Offices (RHOs). This is an ecological time series study using preterm births records from the national live birth registry system of Brazil's National Health Service - Live Birth Information System (Sinasc), for residents of the state of Paraná, Brazil, between 2000 and 2013. The preterm birth rates was calculated on a yearly basis and grouped into three-year periods (2000-2002, 2003-2005, 2006-2008, 2009-2011) and one two-year period (2012-2013), according to gestational age and mother's Regional Health Office of residence. The polynomial regression model was used for trend analysis. The predominance of preterm birth rate increased from 6.8 % in 2000 to 10.5 % in 2013, with an average increase of 0.20 % per year (r(2) = 0.89), and a greater share of moderate preterm births (32 to rate of prematurity and average annual growth during that period (7.55 % and 0.35 %, respectively). The trend analysis of preterm birth rates according to RHO showed a growing trend for almost all RHOs - except for the 7(th) RHO where a declining trend was observed (-0.95 a year); and in the 20(th), 21(st) and 22(nd) RHOs which remained unchanged. In the last three-year of the study period (2011-2013), no RHO showed preterm birth rates below 7.3 % or prevalence of moderate preterm birth below 9.4 %. The results show an increase in preterm births with differences among Macro-regional and RHOs, which indicate the need to improve actions during the prenatal period according to the specificities of each region.

  15. The inner state differences of preterm birth rates in Brazil: a time series study

    Directory of Open Access Journals (Sweden)

    Rosana Rosseto de Oliveira

    2016-05-01

    Full Text Available Abstract Background Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality. The prevalence of premature births has increased worldwide, with regional differences. The objective of this study was to analyze the trend of preterm births in the state of Paraná, Brazil, according to Macro-regional and Regional Health Offices (RHOs. Methods This is an ecological time series study using preterm births records from the national live birth registry system of Brazil’s National Health Service - Live Birth Information System (Sinasc, for residents of the state of Paraná, Brazil, between 2000 and 2013. The preterm birth rates was calculated on a yearly basis and grouped into three-year periods (2000–2002, 2003–2005, 2006–2008, 2009–2011 and one two-year period (2012–2013, according to gestational age and mother’s Regional Health Office of residence. The polynomial regression model was used for trend analysis. Results The predominance of preterm birth rate increased from 6.8 % in 2000 to 10.5 % in 2013, with an average increase of 0.20 % per year (r2 = 0.89, and a greater share of moderate preterm births (32 to <37 weeks, which increased from 5.8 % to 9 %. The same pattern was observed for all Macro-regional Health Offices, with highlight to the Northern Macro-Regional Office, which showed the highest average rate of prematurity and average annual growth during that period (7.55 % and 0.35 %, respectively. The trend analysis of preterm birth rates according to RHO showed a growing trend for almost all RHOs – except for the 7th RHO where a declining trend was observed (−0.95 a year; and in the 20th, 21st and 22nd RHOs which remained unchanged. In the last three-year of the study period (2011–2013, no RHO showed preterm birth rates below 7.3 % or prevalence of moderate preterm birth below 9.4 %. Conclusions The results show an increase in preterm births

  16. 75 FR 434 - Notice of Intent to Repatriate Cultural Items: Thomas Burke Memorial Washington State Museum...

    Science.gov (United States)

    2010-01-05

    ... bone handle. The funerary objects were removed from the area surrounding Lake Washington primarily on... the 1870s, as the City of Seattle developed, the Lake people were pushed out to other areas, including...

  17. 78 FR 59955 - Notice of Inventory Completion: Thomas Burke Memorial Washington State Museum, University of...

    Science.gov (United States)

    2013-09-30

    ... responsibilities under NAGPRA, 25 U.S.C. 3003(d)(3). The determinations in this notice are the sole responsibility... Reservation, Washington) that this notice has been published. Dated: August 20, 2013. Sherry Hutt, Manager...

  18. Smoke-free law associated with higher-than-expected taxable retail sales for bars and taverns in Washington State.

    Science.gov (United States)

    Boles, Myde; Dilley, Julia; Maher, Julie E; Boysun, Michael J; Reid, Terry

    2010-07-01

    Continued progress in implementing smoke-free laws throughout the United States would benefit from documenting positive economic effects, particularly for the hospitality industry. This study describes changes in sales revenue in bars and taverns since December 2005, when a statewide smoke-free law in Washington State went into effect. Using 24 quarters of inflation-adjusted taxable retail sales data from 2002 through 2007, we fitted a regression model to estimate the effect of the smoke-free law on sales revenue, controlling for seasonality and other economic factors. We found no immediate change in bar revenues in the first quarter of 2006, but taxable retail sales grew significantly through the fourth quarter of 2007. In the 2 years after the smoke-free law was implemented, sales revenues were $105.5 million higher than expected for bars and taverns in Washington State. The higher-than-expected revenue from taxable sales in bars and taverns after the implementation of smoke-free laws in Washington State provided extra funds to the state general fund. Potential increases in revenue in other jurisdictions that implement smoke-free indoor air policies could provide funds to benefit residents of those jurisdictions.

  19. The effects of maternity leave on children's birth and infant health outcomes in the United States.

    Science.gov (United States)

    Rossin, Maya

    2011-03-01

    This paper evaluates the impacts of unpaid maternity leave provisions of the 1993 Family and Medical Leave Act (FMLA) on children's birth and infant health outcomes in the United States. My identification strategy uses variation in pre-FMLA maternity leave policies across states and variation in which firms are covered by FMLA provisions. Using Vital Statistics data and difference-in-difference-in-difference methodology, I find that maternity leave led to small increases in birth weight, decreases in the likelihood of a premature birth, and substantial decreases in infant mortality for children of college-educated and married mothers, who were most able to take advantage of unpaid leave. My results are robust to the inclusion of numerous controls for maternal, child, and county characteristics, state, year, and month fixed effects, and state-year interactions, as well as across several different specifications. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. ''How clean is clean'' in the United States federal and Washington State cleanup regulations

    International Nuclear Information System (INIS)

    Landau, H.G.

    1993-01-01

    The enactment of legislation and promulgation of implementing regulations generally involves the resolution of conflicting goals. Defining ''How Clean is Clean?'' in federal and state cleanup laws, regulations, and policies is no exception. Answering the ''How Clean is Clean?'' question has resulted in the identification of some important and sometimes conflicting goals. Continuing resolution of the following conflicting goals is the key to effect cleanup of hazardous waste sites: Expediency vs. Fairness; Flexibility vs. Consistency; Risk Reduction vs. Risk Causation; and Permanence vs. Cost Effectiveness

  1. Trends and characteristics of home births in the United States by race and ethnicity, 1990-2006.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Menacker, Fay

    2011-03-01

    After a gradual decline from 1990 to 2004, the percentage of births occurring at home in the United States increased by 5 percent in 2005 and that increase was sustained in 2006. The purpose of the study was to analyze trends and characteristics in home births in United States by race and ethnicity from 1990 to 2006. U.S. birth certificate data on home births were analyzed and compared with hospital births for a variety of demographic and medical characteristics. From 1990 to 2006, both the number and percentage of home births increased for non-Hispanic white women, but declined for all other race and ethnic groups. In 2006, non-Hispanic white women were three to four times more likely to have a home birth than women of other race and ethnic groups. Home births were more likely than hospital births to occur to older, married women with singleton pregnancies and several previous children. For non-Hispanic white women, fewer home births than hospital births were born preterm, whereas for other race and ethnic groups a higher percentage of home births than hospital births were born preterm. For non-Hispanic white women, two-thirds of home births were delivered by midwives. In contrast, for other race and ethnic groups, most home births were delivered by either physicians or "other" attendants, suggesting that a higher proportion of these births may be unplanned home births because of emergency situations. Differences in the risk profile of home births by race and ethnicity are consistent with previous research, suggesting that, compared with non-Hispanic white women, a larger proportion of non-Hispanic black and Hispanic home births represent unplanned, emergency situations. © 2010, Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc.

  2. Partner support and impact on birth outcomes among teen pregnancies in the United States.

    Science.gov (United States)

    Shah, Monisha K; Gee, Rebekah E; Theall, Katherine P

    2014-02-01

    Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  3. Practice patterns among male and female general dentists in a Washington State population.

    Science.gov (United States)

    del Aguila, Michael A; Leggott, Penelope J; Robertson, Paul B; Porterfield, Denise L; Felber, Gene D

    2005-06-01

    Women make up about 14 percent of general dentists in the United States, and the proportion is projected to exceed 29 percent by 2020. The authors obtained dental benefits claims data from the Washington Dental Service (WDS), Seattle, and used them to examine the practice patterns of 265 women and 1,947 men engaged in general dentistry for at least 26 days in 2001. Practice variables of interest included age, days worked, procedures performed and total income from WDS reimbursements and patient copayments. The number, age and sex of patients treated also were obtained. Using productivity data, the authors also estimated the potential impact of an increase in the percentage of female dentists in the state. The authors found no differences between male and female dentists in the number of procedures per patient, income per patient or income per day of work. Frequency distributions of various services were highly similar for both groups. Multiple regression models showed no influence of dentist's sex on total income. However, the mean and median numbers of days worked were about 10 percent lower for female dentists than for male dentists. This difference was consistent with the finding that female dentists treated approximately 10 percent fewer patients, performed about 10 percent fewer procedures and had a combined income of about 10 percent less than that of male dentists. Practice patterns of male and female dentists generally were equivalent in this WDS population. Female and male dentists provided a similar range of services and earned an equal income per patient treated and per day worked. However, women worked fewer days per year than did men, irrespective of age. If the dental work force and practice patterns remain unchanged otherwise, the total number of patients treated per dentist will decrease slightly as women make up an increasing proportion of dentists.

  4. Variations in teenage birth rates, 1991-98: national and state trends.

    Science.gov (United States)

    Ventura, S J; Curtin, S C; Mathews, T J

    2000-04-24

    This report presents national birth rates for teenagers for 1991-98 and the percent change, 1991-98. State-specific teenage birth rates by age, race, and Hispanic origin for 1991 and 1998 and the percent change, 1991 to 1998, are also presented. Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin of the mother, are discussed. Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age and race and Hispanic origin populations, with the steepest declines recorded for black teenagers. State-specific rates fell significantly in all States for ages 15-19 years; declines ranged from 10 to 38 percent. In general, rates by State fell more for younger than for older teenagers, ranging by State from 10 to 46 percent for ages 15-17 years. Statistically significant reductions for older teenagers ranged from 3 to 39 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 30 percent or more in 15 States. Among the factors accounting for these declines are decreased sexual activity, increases in condom use, and the adoption of the implant and injectable contraceptives.

  5. Maternal Fish Consumption and Infant Birth Size and Gestation: New York State Angler Cohort Study

    Directory of Open Access Journals (Sweden)

    Weiner John M

    2003-06-01

    Full Text Available Abstract Background The scientific literature poses a perplexing dilemma for pregnant women with respect to the consumption of fish from natural bodies of water. On one hand, fish is a good source of protein, low in fat and a rich source of other nutrients all of which have presumably beneficial effects on developing embryos and fetuses. On the other hand, consumption of fish contaminated with environmental toxicants such as polychlorinated biphenyls (PCBs has been associated with decrements in gestation and birth size. Methods 2,716 infants born between 1986–1991 to participants of the New York State Angler Cohort Study were studied with respect to duration of maternal consumption of contaminated fish from Lake Ontario and its tributaries and gestation and birth size. Hospital delivery records (maternal and newborn were obtained for 92% of infants for the ascertainment of gestation (weeks, birth size (weight, length, chest, and head circumference and other known determinants of fetal growth (i.e., maternal parity, history of placental infarction, uterine bleeding, pregnancy loss or cigarette smoking and infant's race, sex and presence of birth defect. Duration of maternal fish consumption prior to the index infant's birth was categorized as: none; 1–2, 3–7, 8+ years, while birth weight (in grams, birth length (in centimeters, and head and chest circumference (in centimeters were left as continuous variables in multiple linear regression models. Birth size percentiles, ponderal indices and head to chest circumference ratios were computed to further assess proportionality and birth size in relation to gestational age. Results Analysis of variance failed to identify significant mean differences in gestation or any measure of birth size in relation to duration of maternal lifetime fish consumption. Multiple linear regressions identified gestational age, male sex, number of daily cigarettes, parity and placental infarction, as significant

  6. Washington State recreational marijuana legalization: parent and adolescent perceptions, knowledge, and discussions in a sample of low-income families.

    Science.gov (United States)

    Mason, W A; Hanson, Koren; Fleming, Charles B; Ringle, Jay L; Haggerty, Kevin P

    2015-04-01

    In November 2012, Washington State and Colorado became the first states in the United States to legalize recreational marijuana use for adults, and Uruguay became the first country to allow the cultivation, distribution, possession, and use of marijuana. One possible consequence of these changes is increased adolescent marijuana use. Parents may mitigate this adverse consequence; however, whether parents and adolescents have accurate knowledge about the laws and are discussing marijuana use in light of the law changes is unknown. We examine perceptions, knowledge, and parent-child discussions about Washington State's recreational marijuana law in a sample of low-income families. Participants were a subset of families (n = 115) in an ongoing study that originally recruited parents and adolescents from middle schools in Tacoma, Washington. In summer 2013, when students were entering the 11(th) grade, students and their parents were asked questions about the recreational marijuana law. Participants perceived that their marijuana-related attitudes and behaviors changed little as a result of the law, and displayed uncertainty about what is legal and illegal. Most parents reported discussing the new law with their children but only occasionally, and conversations emphasized household rules, particularly among parent lifetime marijuana users compared to non-users. Conclusions/Importance: Results suggest that there should be a public health campaign focused on families that provides clear information about the recreational marijuana laws.

  7. Nursing, social contexts, and ideologies in the early United States birth control movement.

    Science.gov (United States)

    Lagerwey, M D

    1999-12-01

    Using historical discourse analysis, this study provides a thematic analysis of writings of nursing and birth control as found in The Birth Control Review from 1917 to 1927. The author contrasts this publication with the official journal of the American Nurses Association, the American Journal of Nursing from the same years to explore nursing voices and silences in early birth control stories. In dialogue with social contexts, nursing endeavors and inactivity have played important yet conflicting roles in the birth control movement in the United States. Nursing writings from the early twentieth century reflect eugenic beliefs, national fears of immigrants, and ambivalence about women's roles in society and the home. Nurses simultaneously empowered women to choose when to become pregnant and reinforced nativist and paternalistic views of the poor.

  8. Program and curriculum development in radiochemistry at Washington State University to educate the next generation of radiochemists in the US

    International Nuclear Information System (INIS)

    Clark, S.B.; Nash, K.; Benny, P.; Elliston, J.; Buckely, P.

    2005-01-01

    Washington State University (WSU) has -been the recipient of grant funds from the U.S. Department of Energy's Office of Nuclear Science and Technology to enhance its curriculum and service activities in radiochemistry. These funds have been used to hire new faculty, redesign undergraduate and graduate courses in radiochemistry, and initiate summer programs in radiochemistry for regional college faculty and high school teachers. The funds received from the federal government were matched by investments from the state of Washington. These investments have resulted in many positive changes in the Chemistry Department and the Nuclear Radiation Center at WSU. The number of students graduating from our radiochemistry programs has increased markedly, and the level of additional extra mural funding for our programs has also increased. These activities will be described, and feedback from employers of our radiochemistry graduates will be provided. Plans for future radiochemistry program development will also be discussed.

  9. Metrics, Dollars, and Systems Change: Learning from Washington State's Student Achievement Initiative to Design Effective Postsecondary Performance Funding Policies. A State Policy Brief

    Science.gov (United States)

    Jenkins, Davis; Shulock, Nancy

    2013-01-01

    The Student Achievement Initiative (SAI), adopted by the Washington State Board for Community and Technical Colleges in 2007, is one of a growing number of performance funding programs that have been dubbed "performance funding 2.0." Unlike previous performance funding models, the SAI rewards colleges for students' intermediate…

  10. Psychometric Properties of the Persian Version of the Padua Inventory: Washington State University Revision (PI-WSUR)

    OpenAIRE

    Shams, Giti; Kaviani, Hosein; Esmaili, Yaghob; Ebrahimkhani, Narges; Manesh, Alireza Amin

    2011-01-01

    Objective The psychometric properties and factor structure of the Persian Padua Inventory Washington State University Revision (PI-WSUR), a measure of obsessive- compulsive phenomena, was examined in a non-clinical sample of 348 Iranian university students. Method The PI-WSUR was translated into Persian, and its back translation was controlled by the author inventory. A pilot study based on cultural differences was carried out on twenty students. The study subjects consisted of 348 university...

  11. Assessing the Thermal Environmental Impacts of an Groundwater Heat Pump in Southeastern Washington State

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, Vicky L.; Waichler, Scott R.; Mackley, Rob D.; Horner, Jacob A.

    2012-04-01

    A thermal analysis of a large-scale (e.g., 1900 gpm), open-loop ground source heat pump (GSHP) installed on the Pacific Northwest National Laboratory (PNNL) campus in southeastern Washington State has been performed using a numerical modeling approach. Water temperature increases at the upgradient extraction wells in the system and at the downgradient Columbia River are potential concerns, especially since heat rejection to the subsurface will occur year-round. Hence, thermal impacts of the open-loop GSHP were investigated to identify operational scenarios that minimized downgradient environmental impacts at the river, and upgradient temperature drift at the production wells. Simulations examined the sensitivity of the system to variations in pumping rates and injected water temperatures, as well as to hydraulic conductivity estimates of the aquifer. Results demonstrated that both downgradient and upgradient thermal impacts were more sensitive to injection flow rates than estimates of hydraulic conductivity. Higher injection rates at lower temperatures resulted in higher temperature increases at the extraction wells but lower increases at the river. Conversely, lower pumping rates and higher injected water temperatures resulted in a smaller temperature increase at the extraction wells, but higher increases at the river. The scenario with lower pumping rates is operationally more efficient, but does increase the likelihood of a thermal plume discharging into the Columbia River. However, this impact would be mitigated by mixing within the hyporheic zone and the Columbia River. The impact under current operational conditions is negligible, but future increases in heat rejection could require a compromise between maximizing operational efficiency and minimizing temperature increases at the shoreline.

  12. Occupational determinants of serum cholinesterase inhibition among organophosphate-exposed agricultural pesticide handlers in Washington State

    Science.gov (United States)

    Hofmann, Jonathan N; Keifer, Matthew C; De Roos, Anneclaire J; Fenske, Richard A; Furlong, Clement E; van Belle, Gerald; Checkoway, Harvey

    2010-01-01

    Objective To identify potential risk factors for serum cholinesterase (BuChE) inhibition among agricultural pesticide handlers exposed to organophosphate (OP) and N-methyl-carbamate (CB) insecticides. Methods We conducted a longitudinal study among 154 agricultural pesticide handlers who participated in the Washington State cholinesterase monitoring program in 2006 and 2007. BuChE inhibition was analyzed in relation to reported exposures before and after adjustment for potential confounders using linear regression. Odds ratios estimating the risk of ‘BuChE depression’ (>20% from baseline) were also calculated for selected exposures based on unconditional logistic regression analyses. Results An overall decrease in mean BuChE activity was observed among study participants at the time of follow-up testing during the OP/CB spray season relative to pre-season baseline levels (mean decrease of 5.6%, P < 0.001). Score for estimated cumulative exposure to OP/CB insecticides in the past 30 days was a significant predictor of BuChE inhibition (β = −1.74, P < 0.001). Several specific work practices and workplace conditions were associated with greater BuChE inhibition, including mixing/loading pesticides and cleaning spray equipment. Factors that were protective against BuChE inhibition included full-face respirator use, wearing chemical-resistant boots, and storing personal protective equipment in a locker at work. Conclusions Despite existing regulations, agricultural pesticide handlers continue to be exposed to OP/CB insecticides at levels resulting in BuChE inhibition. These findings suggest that modifying certain work practices could potentially reduce BuChE inhibition. Replication from other studies will be valuable. PMID:19819864

  13. Mapping Precipitation Patterns from the Stable Isotopic Composition of Surface Waters: Olympic Peninsula, Washington State

    Science.gov (United States)

    Anders, A. M.; Brandon, M. T.

    2008-12-01

    Available data indicate that large and persistent precipitation gradients are tied to topography at scales down to a few kilometers, but precipitation patterns in the majority of mountain ranges are poorly constrained at scales less than tens of kilometers. A lack of knowledge of precipitation patterns hampers efforts to understand the processes of orographic precipitation and identify the relationships between geomorphic evolution and climate. A new method for mapping precipitation using the stable isotopic composition of surface waters is tested in the Olympic Mountains of Washington State. Measured δD and δ18O of 97 samples of surface water are linearly related and nearly inseparable from the global meteoric water line. A linear orographic precipitation model extended to include in effects of isotopic fractionation via Rayleigh distillation predicts precipitation patterns and isotopic composition of surface water. Seven parameters relating to the climate and isotopic composition of source water are used. A constrained random search identifies the best-fitting parameter set. Confidence intervals for parameter values are defined and precipitation patterns are determined. Average errors for the best-fitting model are 4.8 permil in δD. The difference between the best fitting model and other models within the 95% confidence interval was less than 20%. An independent high-resolution precipitation climatology documents precipitation gradients similar in shape and magnitude to the model derived from surface water isotopic composition. This technique could be extended to other mountain ranges, providing an economical and fast assessment of precipitation patterns requiring minimal field work.

  14. Occupational carbon monoxide poisoning in the State of Washington, 1994-1999.

    Science.gov (United States)

    Lofgren, Don J

    2002-04-01

    Carbon monoxide poisonings continue to be significant and preventable for a number of work operations. This study assesses occupational carbon monoxide morbidity and mortality for the state of Washington based on a review of workers' compensation records for the years 1994-1999. The study characterizes sources, industries, and causative factors, and further attempts to identify work operations most at risk. Records were identified by both injury source and diagnostic codes. The study limits itself to non-fire-related carbon monoxide poisonings and primarily those from acute exposure. A decline in the number of claims was not evident, but the number of incidents per year showed a slight decline. Carbon monoxide poisonings were found to occur throughout all types of industries. The greatest number of claims was found in agriculture, followed by construction and wholesale trade, with these three accounting for more than half the claims and nearly half of the incidents. The more severe poisonings did not necessarily occur in industries with the greatest number of incidents. The major source for carbon monoxide poisoning was forklift trucks, followed by auto/truck/bus, portable saws, and more than 20 other sources. Fruit packing and storage had the highest number of incidents mostly due to fuel-powered forklift activity, with nearly half of the incidents occurring in cold rooms. Adverse health effects as measured by carboxyhemoglobin, hyperbaric oxygen treatment, unconsciousness, and number and cost of claims were indexed by source. Though several specific work operations were identified, the episodic nature of carbon monoxide poisonings, as well as the diverse industries and sources, and the opportunity for a severe poisoning in any number of operations, poses challenges for effective intervention.

  15. Nitrogen deposition effects on diatom communities in lakes from three National Parks in Washington State

    Science.gov (United States)

    Sheibley, Richard W.; Enache, Mihaela; Swarzenski, Peter W.; Moran, Patrick W.; Foreman, James R.

    2014-01-01

    The goal of this study was to document if lakes in National Parks in Washington have exceeded critical levels of nitrogen (N) deposition, as observed in other Western States. We measured atmospheric N deposition, lake water quality, and sediment diatoms at our study lakes. Water chemistry showed that our study lakes were ultra-oligotrophic with ammonia and nitrate concentrations often at or below detection limits with low specific conductance (−1 year−1 and were variable both within and across the parks. Diatom assemblages in a single sediment core from Hoh Lake (Olympic National Park) displayed a shift to increased relative abundances of Asterionella formosa and Fragilaria tenera beginning in the 1969–1975 timeframe, whereas these species were not found at the remaining (nine) sites. These diatom species are known to be indicative of N enrichment and were used to determine an empirical critical load of N deposition, or threshold level, where changes in diatom communities were observed at Hoh Lake. However, N deposition at the remaining nine lakes does not seem to exceed a critical load at this time. At Milk Lake, also in Olympic National Park, there was some evidence that climate change might be altering diatom communities, but more research is needed to confirm this. We used modeled precipitation for Hoh Lake and annual inorganic N concentrations from a nearby National Atmospheric Deposition Program station, to calculate elevation-corrected N deposition for 1980–2009 at Hoh Lake. An exponential fit to this data was hindcasted to the 1969–1975 time period, and we estimate a critical load of 1.0 to 1.2 kg N ha−1 year−1 for wet deposition for this lake.

  16. Precipitation, landsliding, and erosion across the Olympic Mountains, Washington State, USA

    Science.gov (United States)

    Smith, Stephen G.; Wegmann, Karl W.

    2018-01-01

    In the Olympic Mountains of Washington State, landsliding is the primary surface process by which bedrock and hillslope regolith are delivered to river networks. However, the relative importance of large earthquakes versus high magnitude precipitation events to the total volume of landslide material transported to valley bottoms remains unknown in part due to the absence of large historical earthquakes. To test the hypothesis that erosion is linked to precipitation, approximately 1000 landslides were mapped from Google Earth imagery between 1990 and 2015 along a 15 km-wide × 85 km-long (1250 km2) swath across the range. The volume of hillslope material moved by each slide was calculated using previously published area-volume scaling relationships, and the spatial distribution of landslide volume was compared to mean annual precipitation data acquired from the PRISM climate group for the period 1981-2010. Statistical analysis reveals a significant correlation (r = 0.55; p landslide volume and mean annual precipitation, with 98% of landslide volume occurring along the windward, high-precipitation side of the range during the 25-year interval. Normalized to area, this volume yields a basin-wide erosion rate of 0.28 ± 0.11 mm yr- 1, which is similar to previous time-variable estimates of erosion throughout the Olympic Mountains, including those from river sediment yield, cosmogenic 10Be, fluvial terrace incision, and thermochronometry. The lack of large historic earthquakes makes it difficult to assess the relative contributions of precipitation and seismic shaking to total erosion, but our results suggest that climate, and more specifically a sharp precipitation gradient, plays an important role in controlling erosion and landscape evolution over both short and long timescales across the Olympic Mountains.

  17. The force awakens: Birth of national surveillance state

    Directory of Open Access Journals (Sweden)

    Avramović Dragutin S.

    2016-01-01

    Full Text Available University of Yale professor of Constitutional Law Jack Balkin convincingly declared emergence of a new sort of the state called 'national surveillance state'. Although the very name announces quite clearly an Orwellian scenario, Balkin is in doubt which path that kind of state will follow - the authoritarian or the democratic one. Nevertheless quite optimistic approaches of J. Balkin, O. Kerr and other authors considering democratic type of the national surveillance state the author of this paper holds the opposite opinion. Taking as a starting point an anthropological feature that 'passion warps the rule even of the best men' (Aristotle, 1287a, the author doubts in democratic character of the national surveillance state. He criticizes Balkin's explanations that the problem could be solved by 'control of the controllers' or 'observation of the observers'. One who has supreme right to dispose over information (no matter which state body could it be, can always, or most often will abuse that right having in mind some interest, particularly when the interest can be vested within socially and politically acceptable tune, like the fight against terrorism, national interest or similar. Proper and firm normative framework could contribute to successful balance between privacy and security of citizens and eventually diminish potential misuse of surveillance of citizens. However, many people provide information for the 'Big Brother' by sacrificing their own privacy voluntarily, forming their own 'digital database' through different social networking. Balkin's generous but native belief that democratic national surveillance state is possible could hardly survive the test of the coming time and challenges. It is quite evident that, particularly the most developed states, fairly fast incline towards repressive national surveillance state. Maybe the process could be only decelerated by activities of NGOs, by developing awareness of every single citizen of

  18. Cesarean Delivery in Women With Genital Herpes in Washington State, 1989–1991

    Directory of Open Access Journals (Sweden)

    Jeanne M. Marrazzo

    1997-01-01

    Full Text Available Objective: The purpose of this study was to determine whether the proportion of cesarean deliveries in pregnant women with a history of genital herpes and no active lesions at birth is higher than that in women with no history of genital herpes, and to determine whether this risk was modified by birth facilities' underlying prevalence of cesarean delivery.

  19. Area racism and birth outcomes among Blacks in the United States.

    Science.gov (United States)

    Chae, David H; Clouston, Sean; Martz, Connor D; Hatzenbuehler, Mark L; Cooper, Hannah L F; Turpin, Rodman; Stephens-Davidowitz, Seth; Kramer, Michael R

    2018-02-01

    There is increasing evidence that racism is a cause of poor health outcomes in the United States, including adverse birth outcomes among Blacks. However, research on the health consequences of racism has faced measurement challenges due to the more subtle nature of contemporary racism, which is not necessarily amenable to assessment through traditionally used survey methods. In this study, we circumvent some of these limitations by examining a previously developed Internet query-based proxy of area racism (Stephens-Davidowitz, 2014) in relation to preterm birth and low birthweight among Blacks. Area racism was measured in 196 designated market areas as the proportion of total Google searches conducted between 2004 and 2007 containing the "n-word." This measure was linked to county-level birth data among Blacks between 2005 and 2008, which were compiled by the National Center for Health Statistics; preterm birth and low birthweight were defined as racism was associated with relative increases of 5% in the prevalence of preterm birth and 5% in the prevalence of low birthweight among Blacks. Our study provides evidence for the utility of an Internet query-based measure as a proxy for racism at the area-level in epidemiologic studies, and is also suggestive of the role of racism in contributing to poor birth outcomes among Blacks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Dacthal and chlorophenoxy herbicides and chlorothalonil fungicide in eggs of osprey (Pandion haliaetus) from the Duwamish-Lake Washington-Puget Sound area of Washington state, USA

    International Nuclear Information System (INIS)

    Chu Shaogang; Henny, Charles J.; Kaiser, James L.; Drouillard, Ken G.; Haffner, G. Douglas; Letcher, Robert J.

    2007-01-01

    Current-use chlorophenoxy herbicides including 2,4-dichlorophenoxyacetic acid, dicamba, triclopyr, dicamba, dimethyl tetrachloroterephthalate (DCPA or dacthal), and the metabolite of pyrethroids, 3-phenoxybenzoic acid (3-PBA), and the fungicide, chlorothalonil, were investigated in the eggs of osprey (Pandion haliaetus) that were collected from 15 sites from five study areas Puget Sound/Seattle area of Washington State, USA. DCPA differs from acidic chlorophenoxy herbicides, and is not readily hydrolyzed to free acid or acid metabolites, and thus we developed a new method. Of the 12 chlorophenoxy herbicides and chlorothalonil analyzed only DCPA could be quantified at six of these sites (2.0 to 10.3 pg/g fresh weight). However, higher levels (6.9 to 85.5 pg/g fresh weight) of the unexpected DCPA structural isomer, dimethyl tetrachlorophthalate (diMe-TCP) were quantified in eggs from all sites. diMe-TCP concentrations tended to be higher in eggs from the Everett Harbor area. As diMe-TCP is not an industrial product, and not commercially available, the source of diMe-TCP is unclear. Regardless, these findings indicate that DCPA and diMe-TCP can be accumulated in the food chain of fish-eating osprey, and transferred in ovo to eggs, and thus may be of concern to the health of the developing chick and the general reproductive health of this osprey population. - Osprey eggs from the Puget Sound area contain the herbicide dacthal and its analogue

  1. Plastic in surface waters of the Inside Passage and beaches of the Salish Sea in Washington State.

    Science.gov (United States)

    Davis, Wallace; Murphy, Anne G

    2015-08-15

    We summarize results of two independent studies on plastic pollution in the marine environment that overlap in time and space. One study evaluated the abundance of anthropogenic debris on 37 sandy beaches bordering the Salish Sea in Washington State while the other characterized plastic debris in surface waters of the Salish Sea and the Inside Passage to Skagway, Alaska. Both studies concluded that foam, primarily expanded polystyrene was the dominant pollutant. Plastic was found in surface waters the full length of the Inside Passage but was concentrated near harbors. At the wrack line, an average square meter of Washington's 1180km of sandy beaches in the Salish Sea had 61 pieces of anthropogenic debris weighing approximately 5g. The total loading for the entire 1m wide band is estimated to be 72,000,000 pieces and 5.8metric tons. Most anthropogenic debris on beaches is generated within the region. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Male scarcity is associated with higher prevalence of premature gestation and low birth weight births across the United States.

    Science.gov (United States)

    Kruger, Daniel J; Clark, Jillian; Vanas, Sarah

    2013-01-01

    Modern adverse birth outcomes may partially result from mechanisms evolved to evaluate environmental conditions and regulate maternal investment trade-offs. Male scarcity in a population is associated with a cluster of characteristics related to higher mating effort and lower paternal investment. We predicted that modern populations with male scarcity would have shorter gestational times and lower birth weights on average. We compared US Centers for Disease Control and Prevention county-aggregated year 2000 birth records with US Decennial Census data. We combined these data in a path model with the degree of male scarcity and known socio-economic predictors of birth outcomes as exogenous predictors of prematurity and low birth weight, with single mother households as a proportion of families with children as a mediator (N = 450). Male scarcity was directly associated with higher rates of low birth weight. Male scarcity made significant indirect predictions of rates of prematurity and low birth weight, as mediated by the proportion of families headed by single mothers. Aggregate socio-economic status also indirectly predicted birth outcomes, as mediated by the proportion of families headed by single mothers, whereas the proportion African American retained both direct and indirect predictions of adverse birth outcomes. Male scarcity influences life history tradeoffs, with consequences for important social and public health issues such as adverse birth outcomes. Copyright © 2013 Wiley Periodicals, Inc.

  3. Educational Preparation for the Role of the School Nurse: Perceptions of School Nurses in Washington State

    Science.gov (United States)

    Newell, Mary E.

    2013-01-01

    The purpose of this quantitative research study was to identify the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and determine if they felt adequately prepared to effectively practice in the role of a school nurse. A descriptive, quantitative on-line survey was conducted of Washington State…

  4. 75 FR 34674 - Washington: Proposed Authorization of State Hazardous Waste Management Program Revisions

    Science.gov (United States)

    2010-06-18

    ... comment includes information claimed to be Confidential Business Information (CBI) or other information....gov or in hard copy. You may view and copy the Washington application, during normal business hours...(7)(c) Clarify that 261/5(c) Intro. counting exclusion applies to permit- by-rule (PBR), not to...

  5. Travel costs associated with flood closures of state highways near Centralia/Chehalis, Washington.

    Science.gov (United States)

    2014-09-01

    This report discusses the travel costs associated with the closure of roads in the greater : Centralia/Chehalis, Washington region due to 100-year flood conditions starting on the Chehalis River. The costs : were computed for roadway closures on I-5,...

  6. School Transitions: A Qualitative Study of the Supports Provided by Washington State Special Education Administrators

    Science.gov (United States)

    Lewinsohn, Kari

    2013-01-01

    This study investigated the role of special education administrators in the transition planning process for children with disabilities ages 3-21 in selected Washington school districts. A basic qualitative study was selected to construct meaning from a described phenomenon. The study sought to identify and explain how special education…

  7. 75 FR 12718 - United States Navy Restricted Area, Puget Sound, Naval Station Everett, Washington

    Science.gov (United States)

    2010-03-17

    ... . Follow the instructions for submitting comments. E-mail: david.b.olson@usace.army.mil . Include the..., Attn: CECW-CO (David B. Olson), 441 G Street, NW., Washington, DC 20314-1000. Hand Delivery/Courier... copy form. FOR FURTHER INFORMATION CONTACT: Mr. David Olson, Headquarters, Operations and Regulatory...

  8. 78 FR 14951 - State of Washington; Underground Injection Control (UIC) Program Revision

    Science.gov (United States)

    2013-03-08

    ... EPA Docket Center homepage at http://www.epa.gov/epahome/dockets.htm or the SUPPLEMENTARY INFORMATION... Agency, Region 10, Library, 10th Floor, 1200 Sixth Avenue, Seattle, WA 98101. The Library is open from 9... telephone number for the Library is (206) 553-1289. (2) Washington Department of Ecology, Water Quality...

  9. Data from monitoring of shellfish for Paralytic Shellfish Poisoning (PSP) and Domoic Acid Poisoning (DAP) by the Washington State Department of Health, 1989-1999 (NODC Accession 0000580)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The state of Washington routinely experiences seasonal restrictions on commercial and recreational shellfish harvest due to two toxic phytoplankton syndromes,...

  10. Sampling for Paralytic Shellfish Poisoning in commercial and recreational shellfish areas in Washington state marine waters, 1957 - 1988 (NODC Accession 0000597)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The state of Washington routinely experiences seasonal restrictions on commercial and recreational shellfish harvest due to two toxic phytoplankton syndromes,...

  11. Sampling for Paralytic Shellfish Poisoning in commercial and recreational shellfish areas in Washington state marine waters, January - December 2000 (NODC Accession 0000559)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The state of Washington routinely experiences seasonal restrictions on commercial and recreational shellfish harvest due to two toxic phytoplankton syndromes,...

  12. The Impact of ART on Live Birth Outcomes: Differing Experiences across Three States.

    Science.gov (United States)

    Luke, Sabrina; Sappenfield, William M; Kirby, Russell S; McKane, Patricia; Bernson, Dana; Zhang, Yujia; Chuong, Farah; Cohen, Bruce; Boulet, Sheree L; Kissin, Dmitry M

    2016-05-01

    Research has shown an association between assisted reproductive technology (ART) and adverse birth outcomes. We identified whether birth outcomes of ART-conceived pregnancies vary across states with different maternal characteristics, insurance coverage for ART services, and type of ART services provided. CDC's National ART Surveillance System data were linked to Massachusetts, Florida, and Michigan vital records from 2000 through 2006. Maternal characteristics in ART- and non-ART-conceived live births were compared between states using chi-square tests. We performed multivariable logistic regression analyses and calculated adjusted odds ratios (aOR) to assess associations between ART use and singleton preterm delivery (birth. ART use in Massachusetts was associated with significantly lower odds of twins as well as triplets and higher order births compared to Florida and Michigan (aOR 22.6 vs. 30.0 and 26.3, and aOR 37.6 vs. 92.8 and 99.2, respectively; Pinteraction order gestations per cycle was lower in Massachusetts, which may be due to the availability of insurance coverage for ART in Massachusetts. © 2016 John Wiley & Sons Ltd.

  13. Safety evaluation report related to the renewal of the operating license for the Washington State University TRIGA reactor. Docket No. 50-27

    International Nuclear Information System (INIS)

    1982-05-01

    This Safety Evaluation Report for the application filed by the Washington State University (WSU) for a renewal of operating license number R-76 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Washington State University and is located on the WSU campus in Pullman, Whitman County, Washington. The staff concludes that the TRIGA reactor facility can continue to be operated by WSU without endangering the health and safety of the public

  14. Country of Birth of Children With Diagnosed HIV Infection in the United States, 2008-2014.

    Science.gov (United States)

    Nesheim, Steven R; Linley, Laurie; Gray, Kristen M; Zhang, Tianchi; Shi, Jing; Lampe, Margaret A; FitzHarris, Lauren F

    2018-01-01

    Diagnoses of HIV infection among children in the United States have been declining; however, a notable percentage of diagnoses are among those born outside the United States. The impact of foreign birth among children with diagnosed infections has not been examined in the United States. Using the Centers for Disease Control and Prevention National HIV Surveillance System, we analyzed data for children aged United States (reported from 50 states and the District of Columbia) during 2008-2014, by place of birth and selected characteristics. There were 1516 children [726 US born (47.9%) and 676 foreign born (44.6%)]. US-born children accounted for 70.0% in 2008, declining to 32.3% in 2013, and 40.9% in 2014. Foreign-born children have exceeded US-born children in number since 2011. Age at diagnosis was younger for US-born than foreign-born children (0-18 months: 72.6% vs. 9.8%; 5-12 years: 16.9% vs. 60.3%). HIV diagnoses in mothers of US-born children were made more often before pregnancy (49.7% vs. 21.4%), or during pregnancy (16.6% vs. 13.9%), and less often after birth (23.7% vs. 41%). Custodians of US-born children were more often biological parents (71.9% vs. 43.2%) and less likely to be foster or nonrelated adoptive parents (10.4% vs. 55.1%). Of 676 foreign-born children with known place of birth, 65.5% were born in sub-Saharan Africa and 14.3% in Eastern Europe. The top countries of birth were Ethiopia, Ukraine, Uganda, Haiti, and Russia. The increasing number of foreign-born children with diagnosed HIV infection in the United States requires specific considerations for care and treatment.

  15. BIRTH DEFECTS IN FOUR U.S. WHEAT-PRODUCING STATES

    Science.gov (United States)

    Birth Defects in Four U.S. Wheat - Producing StatesDina M. Schreinemachers, National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711Wheat agriculture in Mi...

  16. Occupational carbon monoxide violations in the State of Washington, 1994-1999.

    Science.gov (United States)

    Lofgren, Don J

    2002-07-01

    Occupational exposure to carbon monoxide continues to cause a number of injuries and deaths. This study reviewed the State of Washington OSHA inspection records for occupational safety or health violations related to carbon monoxide for the time period 1994-1999 to assess the agency's efforts and further identify and characterize causative factors. Inspection data were also compared with carbon monoxide claims data from a companion study to determine if the agency was visiting the most at risk work operations. Inspections were identified by searching computerized violation texts for "carbon monoxide" or "CO." The study found 142 inspections with one or more carbon monoxide violations. Inspections were spread over 84 different 4-digit Standard Industrial Classification codes. Most inspections were initiated as a result of a complaint or other informant. Inspections were predominantly in construction and manufacturing, whereas carbon monoxide claims were mores evenly distributed between the major industries. Inspections also may have failed to find violations for some types of equipment responsible for carbon monoxide claims. Forklifts were the source of carbon monoxide most often associated with a violation, followed by compressors for respirators, auto/truck/bus, and temporary heating devices. Inspections in response to poisonings found common factors associated with lack of recognition and failure to use or maintain equipment and ventilation. Some work sites with one or more poisonings were not being inspected. Only 10 of the 51 incidents with industrial insurance claim reports of carboxyhemoglobin at or above 20 percent were inspected. Further, it was found more preventive efforts should be targeted at cold storage operations and certain warehouse and construction activities. It is proposed that more specific standards, both consensus and regulatory, would provide additional risk reduction. Reliance upon safe work practices as a primary method of control in the

  17. Home Birth Midwifery in the United States : Evolutionary Origins and Modern Challenges.

    Science.gov (United States)

    Dunham, Bria

    2016-12-01

    Human childbirth is distinct in requiring-or at least strongly profiting from-the assistance of a knowledgeable attendant to support the mother during birth. With economic modernization, the role of that attendant is transformed, and increased access to obstetric interventions may bring biomedicine into conflict with anatomical, physiological, and behavioral adaptations for childbirth. This article provides an overview of the role of midwifery in human evolution and ways in which this evolutionary heritage is reflected in home birth in the contemporary United States. Opportunities remain for evolutionary scholars to apply their knowledge and skills to strengthen culturally consonant, evolutionarily grounded maternity care within a complex, multilevel, pluralistic medical system.

  18. Vital signs: births to teens aged 15-17 years--United States, 1991-2012.

    Science.gov (United States)

    Cox, Shanna; Pazol, Karen; Warner, Lee; Romero, Lisa; Spitz, Alison; Gavin, Lorrie; Barfield, Wanda

    2014-04-11

    Teens who give birth at age 15-17 years are at increased risk for adverse medical and social outcomes of teen pregnancy. To examine trends in the rate and proportion of births to teens aged 15-19 years that were to teens aged 15-17 years, CDC analyzed 1991-2012 National Vital Statistics System data. National Survey of Family Growth (NSFG) data from 2006-2010 were used to examine sexual experience, contraceptive use, and receipt of prevention opportunities among female teens aged 15-17 years. During 1991-2012, the rate of births per 1,000 teens declined from 17.9 to 5.4 for teens aged 15 years, 36.9 to 12.9 for those aged 16 years, and 60.6 to 23.7 for those aged 17 years. In 2012, the birth rate per 1,000 teens aged 15-17 years was higher for Hispanics (25.5), non-Hispanic blacks (21.9), and American Indians/Alaska Natives (17.0) compared with non-Hispanic whites (8.4) and Asians/Pacific Islanders (4.1). The rate also varied by state, ranging from 6.2 per 1,000 teens aged 15-17 years in New Hampshire to 29.0 in the District of Columbia. In 2012, there were 86,423 births to teens aged 15-17 years, accounting for 28% of all births to teens aged 15-19 years. This percentage declined from 36% in 1991 to 28% in 2012 (pteens aged 15-17 years received formal sex education on birth control or how to say no to sex, 24% had not spoken with parents about either topic; among sexually experienced female teens, 83% reported no formal sex education before first sex. Among currently sexually active female teens (those who had sex within 3 months of the survey) aged 15-17 years, 58% used clinical birth control services in the past 12 months, and 92% used contraception at last sex; however, only 1% used the most effective reversible contraceptive methods. Births to teens aged 15-17 years have declined but still account for approximately one quarter of births to teens aged 15-19 years. These data highlight opportunities to increase younger teens exposure to interventions that delay

  19. Collection, use, and protection of population-based birth defects surveillance data in the united states.

    Science.gov (United States)

    Mai, Cara T; Law, David J; Mason, Craig A; McDowell, Bradley D; Meyer, Robert E; Musa, Debra

    2007-12-01

    Birth defects surveillance systems collect population-based birth defects data from multiple sources to track trends in prevalence, identify risk factors, refer affected families to services, and evaluate prevention efforts. Strong state and federal public health and legal mandates are in place to govern the collection and use of these data. Despite the prima facie appeal of "opt-in" and similar strategies to those who view data collection as a threat to privacy, the use of these strategies in lieu of population-based surveillance can severely limit the ability of public health agencies to accurately access the health status of a group within a defined geographical area. With the need for population-based data central to their mission, birth defects programs around the country take their data stewardship role seriously, recognizing both moral and legal obligations to protect the data by employing numerous safeguards. Birth defects surveillance systems are shaped by the needs of the community they are designed to serve, with the goal of preventing birth defects or alleviating the burdens associated with them. (c) 2007 Wiley-Liss, Inc.

  20. Paleodrainage of the Columbia River system on the Columbia Plateau of Washington State: a summary

    International Nuclear Information System (INIS)

    Fecht, K.R.; Reidel, S.P.; Tallman, A.M.

    1985-12-01

    The evolution of the Columbia River drainage system on the Columbia Plateau of Washington in the last 17 My reflects the geologic history of the plateau. We have updated an interpretation of the evolution of the Columbia River system and defined the geomorphic and structural features that have controlled the position of ancestral streams. The sequence of geologic events and the resulting drainage system for various time intervals in the last 17 My are summarized below. 121 refs., 14 figs

  1. Resettlement and Birth Rates

    African Journals Online (AJOL)

    GB

    The Relationship between Resettlement and Birth Rates: The Case of ... statistical software. SAS is used. RESULTS: In a univariate analysis of Gambella's ..... World Bank Conference on Land And. Poverty. Washington DC, World Bank, April.

  2. Work-related falls among union carpenters in Washington State before and after the Vertical Fall Arrest Standard.

    Science.gov (United States)

    Lipscomb, Hester J; Li, Leiming; Dement, John

    2003-08-01

    Washington State enacted a change in their fall standard for the construction industry in 1991, preceding the Safety Standard for Fall Protection in the Construction Industry promulgated by Federal OSHA in 1994. We evaluated changes in the rate of falls from elevations and measures of severity among a large cohort of union carpenters after the fall standard change in Washington State, taking into account the temporal trends in their overall injury rates. There was a significant decrease in the rate of falls from height after the standard went into effect, even after adjusting for the overall decrease in work-related injuries among this cohort. Much of the decrease was immediate, likely representing the publicity surrounding fatal falls and subsequent promulgation of the standard. The greatest decrease was seen between 3 and 3(1/2) years after the standard went into effect. There was a significant reduction in mean paid lost days per event after the standard change and there was a significant reduction in mean cost per fall when adjusting for age and the temporal trend for costs among non-fall injuries. Through the use of observational methods we have demonstrated significant effects of the Washington State Vertical Fall Arrest Standard among carpenters in the absence of a control or comparison group. Without controlling for the temporal trend in overall injury rates, the rate of decline in falls appeared significantly greater, but the more pronounced, but delayed, decline was not seen. The analyses demonstrate potential error in failing to account for temporal patterns or assuming that a decline after an intervention is related to the intervention. Copyright 2003 Wiley-Liss, Inc.

  3. Factors associated with low birth weight in Goiás State

    Directory of Open Access Journals (Sweden)

    Ruth Minamisava

    2006-12-01

    Full Text Available ABSTRACT: Low birth weight (LBW is public health problem, because they are associated with increased risk of morbidity and mortality. No previous studies on factors associated with LBW carried out in central Brazil were found in the literature. The main aims of this study were to determine the prevalence and the factors associated with LBW in children born alive in the State of Goiás, Brazil. A cross-sectional analysis was performed using data from the Live Births Information System from the Brazilian Health Ministry. All 92.745 singleton births in the State of Goiás during the year of 2000 were examined. Logistic regression analysis was used to examine the factors associated with LBW (< 2500 g. In Goiás, the prevalence of LBW was 5.96% and the most important factors associated with LBW were: prematurity, young and older mothers, unmarried women, mother illiteracy, mothers who had less than seven prenatal care visits, non-hospital delivery, and female infants. Local public health actions are necessary to reduce inequalities in infant and maternal care. KEYWORDS: newborn, birth weight, prenatal care.

  4. The Great Recession of 2007 in the United States and the male: female ratio at birth.

    Science.gov (United States)

    Grech, Victor

    2015-01-01

    Male live births slightly exceed female live births by approximately 3%. The ratio of male to total live births is conventionally represented as M/F. Many factors have been shown to affect M/F, mainly privation, toxins, and stress, all of which reduce M/F. Population stress may be engendered by natural phenomena such as earthquakes and man-made events such as short wars, terrorist attacks, and contracting economies. This study was conducted to ascertain whether the onset of the "Great Recession" (2007) was associated with changes in M/F in the United States (US). Annual monthly live births by gender for January 2006 to December 2008 were obtained from United States Centres for Disease Control and Prevention. In 2007, there were 4316233 live births [M/F: 0.51157; 95% confidence intervals: 0.51110-0.51205). M/F rose between January and June, and then fell sharply between August and December. M/F was statistically significantly lower in the second half of 2007 (p=0.007). The dip in M/F from June to July was also significant (p=0.02). These findings were not replicated in the amalgamated data for 2006 and 2008. The United States housing boom of the mid-2000s was fueled by rising house prices and cheap mortgages given to credit-poor buyers. A halt in rising house prices resulted in defaults and foreclosures, triggering the worst financial crisis since the Great Depression. The associated stress appears to have decreased M/F in the US.

  5. Birth in the United States: an overview of trends past and present.

    Science.gov (United States)

    McCool, William F; Simeone, Sara A

    2002-12-01

    The picture of birth in the United States today is complex and, as the data above indicates, difficult to describe in simplistic terms. Though many women today have come to believe that there are choices surrounding pregnancy and birth, the beliefs and practices of providers, insurers, and hospital administrators play a major role in either influencing those choices or dictating how they will be manifested. On one hand, technological advances have given women greater options with regard to the outcomes of pregnancy and birth. On the other hand, these very same technological advances place limits on the choices available to the individual. For example, increased efficiency in the placement and use of epidural anesthesia has made this a pain-control option for most of the childbearing women in the United States. The use of an epidural, however, puts limits on the choice of an institution at which to give birth and on the movements/activities of the woman during labor. Twentieth-century developments led to the almost complete demise of midwifery practice in the United States, thus taking birth away from the control of the individual woman and her close, matriarchal support system, and placing it in the hands of the patriarchal world of medicine and the institutions (i.e., hospitals) at which this approach to health care is practiced. Most births went from being normal, home-based events to becoming illness-oriented, hospital-based procedures. Just as some steps were being taken in the latter part of the twentieth century to return some of the control of birth back to pregnant women (e.g., childbirth education classes, the modern home-birth movement, increases in the number of midwifery-tended births), technological advances contributed to continued control by physicians and the hospitals of their practice (e.g., fetal monitoring, epidural anesthesia). Advances in technology have made birth possible for many individuals who otherwise would not have had the opportunity

  6. Limited percentages of adults in Washington State meet the Dietary Guidelines for Americans recommended intakes of fruits and vegetables.

    Science.gov (United States)

    Ta, Myduc L; VanEenwyk, Juliet; Bensley, Lillian

    2012-05-01

    Nutritious diets that include sufficient intake of fruits and vegetables promote health and reduce risk for chronic diseases. The 2005 Dietary Guidelines for Americans recommend four to 13 servings of fruits and vegetables daily for energy intake levels of 1,000 to 3,200 kcal, including seven to 13 servings for 1,600 to 3,000 kcal/day as recommended for adults aged ≥25 years. The 2006-2007 Washington Adult Health Survey, a cross-sectional study designed to measure risk factors for cardiovascular disease among a representative sample of Washington State residents aged ≥25 years, included a food frequency questionnaire (FFQ). The FFQ included approximately 120 food items and summary questions for fruits and vegetables that were used to compute energy intake and two measures of fruit and vegetable intake. Measure 1 was computed as the sum of intake of individual FFQ fruit and vegetable items; Measure 2 combined the summary questions with selected individual FFQ fruit and vegetable items. Depending on the measure used, approximately 14% to 22% of 519 participants with complete information met the guidelines for fruits, 11% to 15% for vegetables, and 5% to 6% for both fruits and vegetables. Participants aged ≥65 years and women were more likely to meet recommendations, compared with younger participants and men. Despite decades of public health attention, the vast majority of Washington State residents do not consume the recommended amount of fruits or vegetables daily. These findings underscore the need for developing and evaluating new approaches to promote fruit and vegetable consumption. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. The Relationships between the Iowa Test of Basic Skills and the Washington Assessment of Student Learning in the State of Washington. Technical Report.

    Science.gov (United States)

    Joireman, Jeff; Abbott, Martin L.

    This report examines the overlap between student test results on the Iowa Test of Basic Skills (ITBS) and the Washington Assessment of Student Learning (WASL). The two tests were compared and contrasted in terms of content and measurement philosophy, and analyses studied the statistical relationship between the ITBS and the WASL. The ITBS assesses…

  8. Projected health impacts of heat events in Washington State associated with climate change.

    Science.gov (United States)

    Isaksen, Tania Busch; Yost, Michael; Hom, Elizabeth; Fenske, Richard

    2014-01-01

    Climate change is predicted to increase the frequency and duration of extreme-heat events and associated health outcomes. This study used data from the historical heat-health outcome relationship, and a unique prediction model, to estimate mortality for 2025 and 2045. For each one degree change in humidex above threshold, we find a corresponding 1.83% increase in mortality for all ages, all non-traumatic causes of death in King County, Washington. Mortality is projected to increase significantly in 2025 and 2045 for the 85 and older age group (2.3-8.0 and 4.0-22.3 times higher than baseline, respectively).

  9. Use of attorneys and appeal filing in the Washington State workers' compensation program: does patient satisfaction matter?

    Science.gov (United States)

    Wickizer, Thomas M; Franklin, Gary; Turner, Judith; Fulton-Kehoe, Deborah; Mootz, Robert; Smith-Weller, Terri

    2004-04-01

    Specify the frequency with which injured workers in Washington State's compensation system retained an attorney or filed an appeal, and the personal and job-related correlates of these actions. Analyze the relationship between workers' legal actions and their satisfaction in two domains: how well the claim was managed administratively, and how well the worker and claim manager communicated with one another. Characterize the relationship between retaining an attorney and long-term disability. Little is known about how often injured workers retain attorneys or file appeals in the workers' compensation system. We conducted a population-based study to examine the frequency of attorney retention and appeal filing in the Washington State workers' compensation program and the factors related to this event. Data for the study were provided by a survey conducted on 804 injured workers who were interviewed an average of 159 days after claim receipt. Attorney retention and appeal filing were examined up to 28 months later. Seven percent of the workers either retained an attorney or filed an appeal. Workers who were less satisfied with claims administration procedures were more likely to retain an attorney or file an appeal (Pclaim receipt to attorney retention (368 days) suggests that retaining an attorney is a correlate rather than a predictor of long-term disability.

  10. Washington State Spirits Privatization: How Satisfied were Liquor Purchasers Before and After, and by Type of Retail Store in 2014?

    Science.gov (United States)

    Greenfield, Thomas K; Williams, Edwina; Kerr, William C; Subbaraman, Meenakshi S; Ye, Yu

    2017-11-27

    In 2012 Washington State ended a wholesale/retail monopoly on liquor, permitting sale of spirits in stores with > 10,000 square feet. Implementation resulted in average price increases, but also five times the stores selling liquor. As part of a privatization evaluation, we studied pre-post and between-store-type purchase experiences. A 2010 Washington State Liquor Control Board (LCB) survey of liquor purchasers (n = 599), and the 2014 baseline of a repeated telephone survey (1,202 residents; n = 465 purchasers), each included 10 LCB questions on satisfaction with purchase experiences, each attribute with graded response scale A = 4 to D = 1 and F (0 = fail). Analyses used t-tests for satisfaction differences by time and analysis of variance (ANOVA) for 2014 between-store satisfaction-level differences. Five purchase features were rated more favorably after privatization (ps convenience, store hours, and prices (though price rated lowest both times); selection offered, courtesy, and checkout speed were unaltered, and number of staff and staff knowledge declined (both p convenience favored grocery and drug stores, and price satisfaction favored wholesale (Costco) stores, with staff knowledge highest at liquor stores. Satisfaction with liquor purchases increased after privatization for half the consumer experiences. Availability (location convenience and store hours) was important to liquor purchasers. Such results are relevant to sustained support for the policy of privatizing spirits retail monopolies.

  11. Lead exposure in radiator repair workers: a survey of Washington State radiator repair shops and review of occupational lead exposure registry data.

    Science.gov (United States)

    Whittaker, Stephen G

    2003-07-01

    Radiator repair workers in Washington State have the greatest number of very elevated (> or =60 microg/dL) blood lead levels of any other worker population. The goals of this study were to determine the number of radiator repair workers potentially exposed to lead; estimate the extent of blood lead data underreporting to the Occupational Lead Exposure Registry; describe current safety and health practices in radiator repair shops; and determine appropriate intervention strategies to reduce exposure and increase employer and worker awareness. Lead exposure in Washington State's radiator repair workers was assessed by reviewing Registry data and conducting a statewide survey of radiator repair businesses. This study revealed that a total of 226 workers in Washington State (including owner-operators and all employees) conduct repair activities that could potentially result in excessive exposures to lead. Approximately 26% of radiator repair workers with elevated blood lead levels (> or =25 microg/dL) were determined to report to Washington State's Registry. This study also revealed a lack of awareness of lead's health effects, appropriate industrial hygiene controls, and the requirements of the Lead Standard. Survey respondents requested information on a variety of workplace health and safety issues and waste management; 80% requested a confidential, free-of-charge consultation. Combining data derived from an occupational health surveillance system and a statewide mail survey proved effective at characterizing lead exposures and directing public health intervention in Washington State.

  12. Placentophagy among women planning community births in the United States: Frequency, rationale, and associated neonatal outcomes.

    Science.gov (United States)

    Benyshek, Daniel C; Cheyney, Melissa; Brown, Jennifer; Bovbjerg, Marit L

    2018-05-02

    Limited systematic research on maternal placentophagy is available to maternity care providers whose clients/patients may be considering this increasingly popular practice. Our purpose was to characterize the practice of placentophagy and its attendant neonatal outcomes among a large sample of women in the United States. We used a medical records-based data set (n = 23 242) containing pregnancy, birth, and postpartum information for women who planned community births. We used logistic regression to determine demographic and clinical predictors of placentophagy. Finally, we compared neonatal outcomes (hospitalization, neonatal intensive unit admission, or neonatal death in the first 6 weeks) between placenta consumers and nonconsumers, and participants who consumed placenta raw vs cooked. Nearly one-third (31.2%) of women consumed their placenta. Consumers were more likely to have reported pregravid anxiety or depression compared with nonconsumers. Most (85.7%) placentophagic mothers consumed their placentas in encapsulated form, and nearly half (49.1%) consumed capsules containing dehydrated, uncooked placenta. Placentophagy was not associated with any adverse neonatal outcomes. Women with home births were more likely to engage in placentophagy than women with birth center births. The most common reason given (58.6%) for engaging in placentophagy was to prevent postpartum depression. The majority of women consumed their placentas in uncooked/encapsulated form and hoping to avoid postpartum depression, although no evidence currently exists to support this strategy. Preparation technique (cooked vs uncooked) did not influence adverse neonatal outcomes. Maternity care providers should discuss the range of options available to prevent/treat postpartum depression, in addition to current evidence with respect to the safety of placentophagy. © 2018 Wiley Periodicals, Inc.

  13. Changing concepts of geologic structure and the problem of siting nuclear reactors: examples from Washington State

    International Nuclear Information System (INIS)

    Tabor, R.W.

    1986-01-01

    The conflict between regulation and healthy evolution of geological science has contributed to the difficulties of siting nuclear reactors. On the Columbia Plateau in Washington, but for conservative design of the Hanford reactor facility, the recognition of the little-understood Olympic-Wallowa lineament as a major, possibly still active structural alignment might have jeopardized the acceptability of the site for nuclear reactors. On the Olympic Peninsula, evolving concepts of compressive structures and their possible recent activity and the current recognition of a subducting Juan de Fuca plate and its potential for generating great earthquakes - both concepts little-considered during initial site selection - may delay final acceptance of the Satsop site. Conflicts of this sort are inevitable but can be accommodated if they are anticipated in the reactor-licensing process. More important, society should be increasing its store of geologic knowledge now, during the current recess in nuclear reactor siting

  14. Information Needs Assessment for K-12 School Nurses in Rural Eastern Washington State.

    Science.gov (United States)

    Vela, Kathryn

    2017-01-01

    School nurses are an often-overlooked population of health care professionals who have great importance in rural communities where access to health care is limited. In order to better serve school nurses in rural eastern Washington, an assessment was conducted to determine their information needs, behaviors, and perceptions. Results indicated this population of school nurses searches for multiple types of health information on a daily basis and navigates obstacles to information access using a variety of resources. While largely confident in their searching ability, they are open to learning more about how to find reliable health information to support their daily responsibilities. These results will guide the development of a workshop for school nurses about using reliable health information resources to improve health care in their rural communities.

  15. Interventions during labor and birth in the United States: a qualitative analysis of women's experiences.

    Science.gov (United States)

    Bibeau, Alana M

    2014-12-01

    To explore and describe hospital-birthing women's understandings of and experiences with interventions during labor and birth. Qualitative data was collected as part of a larger ethnographic study of childbirth in the United States. The grounded theory method was employed to analyze interviews with 59 women from three states who had recently given birth in hospitals with physicians or certified nurse-midwives in attendance. Four themes emerged from the data. The themes safety/risk and provider match, described women's expectations regarding intervention and their interactions with providers. A third theme addressed how women experienced interventions and their perceptions of control over decision-making. A final theme characterized women's satisfaction with maternity care. Women who received interventions expressed varying levels of comfort or apprehension associated with both expectations of maternity care and provider match. Women whose expectations matched those of the provider reported more positive experiences. Regardless of provider match, women expressed ambivalence about the use of interventions and confusion over their appropriate place. Women's ability to make sense of interventions was related to how well they navigated a complicated and bureaucratic maternity system. Increasing attention needs to be paid to the impact of these factors on women's perceptions of care during pregnancy and childbirth. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Accredited Birth Centers

    Science.gov (United States)

    ... Danbury, CT 06810 203-748-6000 Accredited Since March 1998 Corvallis Birth & Women's Health Center Accredited 2314 NW Kings Blvd, Suite ... Washington, DC 20002 202-398-5520 Accredited Since March 2001 Flagstaff Birth and Women's Center Accredited 401 West Aspen Avenue Flagstaff, AZ ...

  17. Innovative States: Emerging Family Support and Education Programs. Arkansas, Iowa, Oregon, Vermont, Washington. Second Edition.

    Science.gov (United States)

    Harvard Family Research Project, Cambridge, MA.

    The five states featured in this second edition of "Innovative States" were chosen because they reflect crucial elements in an emerging understanding of state policy making in family support and education. Creative state partnerships involving program development and funding are a key ingredient to successful endeavors. States rely on…

  18. Vital Signs: Births to Teens Aged 15–17 Years — United States, 1991–2012

    Science.gov (United States)

    Cox, Shanna; Pazol, Karen; Warner, Lee; Romero, Lisa; Spitz, Alison; Gavin, Lorrie; Barfield, Wanda

    2014-01-01

    Background Teens who give birth at age 15–17 years are at increased risk for adverse medical and social outcomes of teen pregnancy. Methods To examine trends in the rate and proportion of births to teens aged 15–19 years that were to teens aged 15–17 years, CDC analyzed 1991–2012 National Vital Statistics System data. National Survey of Family Growth (NSFG) data from 2006–2010 were used to examine sexual experience, contraceptive use, and receipt of prevention opportunities among female teens aged 15–17 years. Results During 1991–2012, the rate of births per 1,000 teens declined from 17.9 to 5.4 for teens aged 15 years, 36.9 to 12.9 for those aged 16 years, and 60.6 to 23.7 for those aged 17 years. In 2012, the birth rate per 1,000 teens aged 15–17 years was higher for Hispanics (25.5), non-Hispanic blacks (21.9), and American Indians/Alaska Natives (17.0) compared with non-Hispanic whites (8.4) and Asians/Pacific Islanders (4.1). The rate also varied by state, ranging from 6.2 per 1,000 teens aged 15–17 years in New Hampshire to 29.0 in the District of Columbia. In 2012, there were 86,423 births to teens aged 15–17 years, accounting for 28% of all births to teens aged 15–19 years. This percentage declined from 36% in 1991 to 28% in 2012 (pteens aged 15–17 years received formal sex education on birth control or how to say no to sex, 24% had not spoken with parents about either topic; among sexually experienced female teens, 83% reported no formal sex education before first sex. Among currently sexually active female teens (those who had sex within 3 months of the survey) aged 15–17 years, 58% used clinical birth control services in the past 12 months, and 92% used contraception at last sex; however, only 1% used the most effective reversible contraceptive methods. Conclusions Births to teens aged 15–17 years have declined but still account for approximately one quarter of births to teens aged 15–19 years. Implications for public health

  19. Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state.

    Science.gov (United States)

    Smart, Rosanna; Caulkins, Jonathan P; Kilmer, Beau; Davenport, Steven; Midgette, Greg

    2017-12-01

    To (1) assess trends and variation in the market share of product types and potency sold in a legal cannabis retail market and (2) estimate how potency and purchase quantity influence price variation for cannabis flower. Secondary analysis of publicly available data from Washington State's cannabis traceability system spanning 7 July 2014 to 30 September 2016. Descriptive statistics and linear regressions assessed variation and trends in cannabis product variety and potency. Hedonic regressions estimated how purchase quantity and potency influence cannabis flower price variation. Washington State, USA. (1) A total of 44 482 176 million cannabis purchases, including (2) 31 052 123 cannabis flower purchases after trimming price and quantity outliers. Primary outcome measures were (1) monthly expenditures on cannabis, total delta-9-tetrahydrocannabinol (THC) concentration and cannabidiol (CBD) concentration by product type and (2) excise tax-inclusive price per gram of cannabis flower. Key covariates for the hedonic price regressions included quantity purchased, THC and CBD. Traditional cannabis flowers still account for the majority of spending (66.6%), but the market share of extracts for inhalation increased by 145.8% between October 2014 and September 2016, now comprising 21.2% of sales. The average THC-level for cannabis extracts is more than triple that for cannabis flowers (68.7% compared to 20.6%). For flower products, there is a statistically significant relationship between price per gram and both THC [coefficient = 0.012; 95% confidence interval (CI) = 0.011-0.013] and CBD (coefficient = 0.017; CI = 0.015-0.019). The estimated discount elasticity is -0.06 (CI = -0.07 to -0.05). In the state of Washington, USA, the legal cannabis market is currently dominated by high-THC cannabis flower, and features growing expenditures on extracts. For cannabis flower, both THC and CBD are associated with higher per-gram prices, and there are small but

  20. Estimated number of preterm births and low birth weight children born in the United States due to maternal binge drinking.

    Science.gov (United States)

    Truong, Khoa D; Reifsnider, Odette S; Mayorga, Maria E; Spitler, Hugh

    2013-05-01

    The objective of this study was to estimate the aggregate burden of maternal binge drinking on preterm birth (PTB) and low birth weight (LBW) across American sociodemographic groups in 2008. To estimate the aggregate burden of maternal binge drinking on preterm birth (PTB) and low birth weight (LBW) across American sociodemographic groups in 2008. A simulation model was developed to estimate the number of PTB and LBW cases due to maternal binge drinking. Data inputs for the model included number of births and rates of preterm and LBW from the National Center for Health Statistics; female population by childbearing age groups from the U.S. Census; increased relative risks of preterm and LBW deliveries due to maternal binge drinking extracted from the literature; and adjusted prevalence of binge drinking among pregnant women estimated in a multivariate logistic regression model using Behavioral Risk Factor Surveillance System survey. The most conservative estimates attributed maternal binge drinking to 8,701 (95% CI: 7,804-9,598) PTBs (1.75% of all PTBs) and 5,627 (95% CI 5,121-6,133) LBW deliveries in 2008, with 3,708 (95% CI: 3,375-4,041) cases of both PTB and LBW. The estimated rate of PTB due to maternal binge drinking was 1.57% among all PTBs to White women, 0.69% among Black women, 3.31% among Hispanic women, and 2.35% among other races. Compared to other age groups, women ages 40-44 had the highest adjusted binge drinking rate and highest PTB rate due to maternal binge drinking (4.33%). Maternal binge drinking contributed significantly to PTB and LBW differentially across sociodemographic groups.

  1. Dual Sarcocystis neurona and Toxoplasma gondii infection in a northern sea otter from Washington state, USA

    Science.gov (United States)

    Lindsay, D.S.; Thomas, N.J.; Rosypal, A.C.; Dubey, J.P.

    2001-01-01

    Dual Sarcocystis neurona and Toxoplasma gondii infection was observed in a Northern sea otter from Washington, USA. The animal was found stranded, convulsed, and died shortly thereafter. Encephalitis caused by both S. neurona and T. gondii was demonstrated in histological sections of brain. Immunohistochemical examination of sections with S. neurona specific antisera demonstrated developmental stages that divided by endopolygeny and produced numerous merozoites. PCR of brain tissue from the sea otter using primer pairs JNB33/JNB54 resulted in amplification of a 1100 bp product. This PCR product was cut in to 884 and 216 bp products by Dra I but was not cut by Hinf I indicating that it was S. neurona [J. Parasitol. 85 (1999) 221]. No PCR product was detected in the brain of a sea otter which had no lesions of encephalitis. Examination of brain sections using T. gondii specific antisera demonstrated tachyzoites and tissue cysts of T. gondii. The lesions induced by T. gondii suggested that the sea otter was suffering from reactivated toxoplasmosis. T. gondii was isolated in mice inoculated with brain tissue. A cat that was fed infected mouse brain tissue excreted T. gondii oocysts which were infective for mice. This is apparently the first report of dual S. neurona and T. gondii in a marine mammal.

  2. Charity care in nonprofit urban hospitals: analysis of the role of size and ownership type in Washington State for 2011.

    Science.gov (United States)

    Coyne, Joseph S; Ogle, Natalie M; McPherson, Sterling; Murphy, Sean; Smith, Gary J; Davidson, Gregg Agustín

    2014-01-01

    Nonprofit hospitals are expected to serve their communities as charitable organizations in exchange for the tax exemption benefits they receive. With the passage into law of the Affordable Care Act, additional guidelines were generated in 2010 to ensure nonprofit hospitals are compliant. Nonetheless, the debate continues on whether nonprofit hospitals provide adequate charity care to their patient population. In this study, charity care provided by 29 Washington State nonprofit urban hospitals was examined for 2011 using financial data from the Washington State Department of Health. Charity care levels were compared to both income tax savings and gross revenues to generate two financial ratios that were analyzed according to hospital bed size and nonprofit ownership type. For the first ratio, 97% of the hospitals (28 of 29) were providing charity care in greater amounts than the tax savings they accrued. The average ratio value using total charity care and total income tax savings of all the hospitals in the study was 6.10, and the median value was 3.46. The nonparametric Kruskal-Wallis test results by bed size and nonprofit ownership type indicate that ownership type has a significant effect on charity care to gross revenue ratios (p = .020). Our analysis indicates that church-owned hospitals had higher ratios of charity care to gross revenues than did the other two ownership types--government and voluntary--in this sample. Policy implications are offered and further studies are recommended to analyze appropriate levels of charity care in nonprofit hospitals given new requirements for maintaining a hospital's tax-exempt status.

  3. Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State

    Directory of Open Access Journals (Sweden)

    Reed Peter

    2012-12-01

    Full Text Available Abstract Background Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance. Methods We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets

  4. Evaluation of Progesterone Utilization and Birth Outcomes in a State Medicaid Plan.

    Science.gov (United States)

    Hydery, Tasmina; Price, Mylissa K; Greenwood, Bonnie C; Takeshita, Mito; Kunte, Parag S; Mauro, Rose P; Lenz, Kimberly; Jeffrey, Paul L

    2017-10-01

    Progesterone (hydroxyprogesterone caproate injection and vaginal progesterone) has been shown to reduce preterm birth (PTB) rates by a third among pregnant women at high risk. The purpose of this analysis is to report birth outcomes and medication adherence among Massachusetts Medicaid (MassHealth) members receiving progesterone, evaluate the association between member characteristics and birth outcomes and medication adherence, and compare cost of care with a prior preterm pregnancy. This retrospective cohort study used medical claims, pharmacy claims, and prior authorization (PA) request data for MassHealth members who had a PA submitted for progesterone between January 1, 2011, and March 31, 2015. Members were excluded due to breaks in coverage, progesterone was not indicated for prevention of PTB, and if current gestational week or date of delivery was unavailable. A total of 418 members were screened for inclusion of whom 190 met criteria and 169 filled progesterone. Mean age was 29.2 years (SD = 5.23), and clinical comorbidities were identified in 90.5% of members. Consistent with clinical trials on progesterone effectiveness, 62.1% of members had a term delivery (37 wks of gestation). Among members with prior gestational age at delivery available, the average difference in gestational age between pregnancies was 8.25 weeks (SD = 6.11). In addition, 66.3% of members were adherent to progesterone based on proportion of days covered (PDC) of 0.8 or higher. The overall mean PDC was 0.79 (SD = 0.26). Despite similar birth outcomes in clinical trials and national trends, medication adherence is low in this state Medicaid program. Therefore, members may benefit from adherence support. © 2017 Pharmacotherapy Publications, Inc.

  5. Effect of placental malaria on birth weight of babies in Nnewi, Anambra state, Nigeria.

    Science.gov (United States)

    Oraneli, Boniface U; Okeke, Ogochukwu C; Ubachukwu, Patience O

    2013-03-01

    In malaria-endemic countries, one adverse consequence of placental malaria on infants is low birth weight (LBW) caused by intra-uterine growth retardation and pre-term delivery. The effect of placental malaria on birth weight of babies was investigated in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra state, Nigeria. Placental blood was collected from 364 women who gave birth in NAUTH. Thin and thick placental blood smears were made and checked for the presence of malaria parasites. Plasmodium falciparum antigen rapid kit was used to confirm the presence of P. falciparum. New-borns were weighed and classified as normal birth weight (≥2500 g) or LBW (<2500 g). Analysis of variance (ANOVA), Student's t and Pearson chi-square tests were used to compare means and percentages. Risk factors for LBW were also determined. Placental malaria was found in 55.2% (n = 201) of the women. Placental malaria was associated with gravidity while age was not. In all the age groups, primigravidae and secundigravidae were mostly infected. Women with placental malaria delivered more LBW babies (32.1%) than their uninfected counterparts (5.5%), with primigravidae having more LBW babies. Similarly, weight of babies born by infected women was significantly different from that of uninfected women (p <0.0001). In multivariate analysis, placental malaria was associated with LBW (OR 0.1, 95% CI 0.06-0.17, p <0.0001). The result suggests a high prevalence of placental malaria and its close association with LBW in pregnant women attending antenatal clinic in NAUTH. It was also found that the percentage of LBW was highest in primigravidae.

  6. Rural community birth: Maternal and neonatal outcomes for planned community births among rural women in the United States, 2004-2009.

    Science.gov (United States)

    Nethery, Elizabeth; Gordon, Wendy; Bovbjerg, Marit L; Cheyney, Melissa

    2017-11-13

    Approximately 22% of women in the United States live in rural areas with limited access to obstetric care. Despite declines in hospital-based obstetric services in many rural communities, midwifery care at home and in free standing birth centers is available in many rural communities. This study examines maternal and neonatal outcomes among planned home and birth center births attended by midwives, comparing outcomes for rural and nonrural women. Using the Midwives Alliance of North America Statistics Project 2.0 dataset of 18 723 low-risk, planned home, and birth center births, rural women (n = 3737) were compared to nonrural women. Maternal outcomes included mode of delivery (cesarean and instrumental delivery), blood transfusions, severe events, perineal lacerations, or transfer to hospital and a composite (any of the above). The primary neonatal outcome was a composite of early neonatal intensive care unit or hospital admissions (longer than 1 day), and intrapartum or neonatal deaths. Analysis involved multivariable logistic regression, controlling for sociodemographics, antepartum, and intrapartum risk factors. Rural women had different risk profiles relative to nonrural women and reduced risk of adverse maternal and neonatal outcomes in bivariable analyses. However, after adjusting for risk factors and confounders, there were no significant differences for a composite of maternal (adjusted odds ratio [aOR] 1.05 [95% confidence interval {CI} 0.93-1.19]) or neonatal (aOR 1.13 [95% CI 0.87-1.46]) outcomes between rural and nonrural pregnancies. Among this sample of low-risk women who planned midwife-led community births, no increased risk was detected by rural vs nonrural status. © 2017 Wiley Periodicals, Inc.

  7. The Impact of School Tobacco Policies on Student Smoking in Washington State, United States and Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Richard F. Catalano

    2010-02-01

    Full Text Available This paper measures tobacco polices in statewide representative samples of secondary and mixed schools in Victoria, Australia and Washington, US (N = 3,466 students from 285 schools and tests their association with student smoking. Results from confounder-adjusted random effects (multi-level regression models revealed that the odds of student perception of peer smoking on school grounds are decreased in schools that have strict enforcement of policy (odds ratio (OR = 0.45; 95% CI: 0.25 to 0.82; p = 0.009. There was no clear evidence in this study that a comprehensive smoking ban, harsh penalties, remedial penalties, harm minimization policy or abstinence policy impact on any of the smoking outcomes.

  8. Seismic amplification within the Seattle Basin, Washington State: Insights from SHIPS seismic tomography experiments

    Science.gov (United States)

    Snelson, C.M.; Brocher, T.M.; Miller, K.C.; Pratt, T.L.; Trehu, A.M.

    2007-01-01

    Recent observations indicate that the Seattle sedimentary basin, underlying Seattle and other urban centers in the Puget Lowland, Washington, amplifies long-period (1-5 sec) weak ground motions by factors of 10 or more. We computed east-trending P- and S-wave velocity models across the Seattle basin from Seismic Hazard Investigations of Puget Sound (SHIPS) experiments to better characterize the seismic hazard the basin poses. The 3D tomographic models, which resolve features to a depth of 10 km, for the first time define the P- and S-wave velocity structure of the eastern end of the basin. The basin, which contains sedimentary rocks of Eocene to Holocene, is broadly symmetric in east-west section and reaches a maximum thickness of 6 km along our profile beneath north Seattle. A comparison of our velocity model with coincident amplification curves for weak ground motions produced by the 1999 Chi-Chi earthquake suggests that the distribution of Quaternary deposits and reduced velocity gradients in the upper part of the basement east of Seattle have significance in forecasting variations in seismic-wave amplification across the basin. Specifically, eastward increases in the amplification of 0.2- to 5-Hz energy correlate with locally thicker unconsolidated deposits and a change from Crescent Formation basement to pre-Tertiary Cascadia basement. These models define the extent of the Seattle basin, the Seattle fault, and the geometry of the basement contact, giving insight into the tectonic evolution of the Seattle basin and its influence on ground shaking.

  9. CDC WONDER: Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Births (Natality) online databases in CDC WONDER report birth rates, fertility rates and counts of live births occurring within the United States to U.S....

  10. Sudden birth versus sudden death of entanglement for the extended Werner-like state in a dissipative environment

    International Nuclear Information System (INIS)

    Chuan-Jia, Shan; Tao, Chen; Ji-Bing, Liu; Wei-Wen, Cheng; Tang-Kun, Liu; Yan-Xia, Huang; Hong, Li

    2010-01-01

    In this paper, we investigate the dynamical behaviour of entanglement in terms of concurrence in a bipartite system subjected to an external magnetic field under the action of dissipative environments in the extended Werner-like initial state. The interesting phenomenon of entanglement sudden death as well as sudden birth appears during the evolution process. We analyse in detail the effect of the purity of the initial entangled state of two qubits via Heisenberg XY interaction on the apparition time of entanglement sudden death and entanglement sudden birth. Furthermore, the conditions on the conversion of entanglement sudden death and entanglement sudden birth can be generalized when the initial entangled state is not pure. In particular, a critical purity of the initial mixed entangled state exists, above which entanglement sudden birth vanishes while entanglement sudden death appears. It is also noticed that stable entanglement, which is independent of different initial states of the qubits (pure or mixed state), occurs even in the presence of decoherence. These results arising from the combination of the extended Werner-like initial state and dissipative environments suggest an approach to control and enhance the entanglement even after purity induced sudden birth, death and revival. (general)

  11. A Brief History of the Resting State: the Washington University Perspective

    Science.gov (United States)

    Snyder, Abraham Z.; Raichle, Marcus E.

    2012-01-01

    We present a history of the concepts and developments that have led us to focus on the resting state as an object of study. We then discuss resting state research performed in our laboratory since 2005 with an emphasis on papers of particular interest. PMID:22266172

  12. Washington state--British Columbia international mobility and trade corridor (IMTC) : ITS-CVO border crossing deployment, evaluation draft report : executive summary

    Science.gov (United States)

    2003-10-01

    The Washington state-British Columbia international mobility and trade corridor (IMTC) ITS-CVO Border Crossing Deployment is allowing for the completion of a bi-national freight border crossing ITS system at the border, and is a follow-on effort t...

  13. Assessing the suitability of a partial water reuse system for rearing juvenile Chinook salmon Oncorhynchus tshawytscha for stocking in Washington State

    Science.gov (United States)

    Health and welfare of juvenile Chinook salmon Oncorhynchus tshawytsha reared in a pilot circular tank-based partial water reuse system in Washington State were evaluated in comparison to fish from the same spawn reared in a flow-through raceway, in order to assess the suitability of using water reus...

  14. Ideal citizens: the birthing of state truths and fictions in Quintana Roo.

    Science.gov (United States)

    Williams, Sarah A

    2016-12-01

    Reducing the maternal mortality rate (MMR) is an important part of Mexico's commitment to the Millennium Development Goals, and the country has made great strides towards achieving this goal. However, researchers have questioned to what extent the focus on improved MMR and other indices of maternal health has contributed to an emphasis on improved statistics rather than quality care, and the effect this has had on the quality of reporting. While public health officials and hospital administrators alike agree that improved obstetric reporting is necessary, there is little discussion regarding the accuracy of the data that are submitted and the institutional pressures that may contribute to the production of inaccurate data. Using ethnographic research collected in Tulum, Quintana Roo, this paper explores how biomedical childbirth functions as a source of legitimization for the state while simultaneously providing the means for the presentation of an ideal subjecthood, one that situates birthing women and healthcare personnel as properly attenuated to the norms and needs of the modern Mexican state. By highlighting the point of disjuncture between women's experiences and the formal 'reality' created through hospital texts, this paper explores the place of biomedical birth as a producer of and legitimization for Mexican public health policy.

  15. 75 FR 33736 - Tart Cherries Grown in the States of Michigan, New York, Pennsylvania, Oregon, Utah, Washington...

    Science.gov (United States)

    2010-06-15

    ...., Stop 0237, Washington, DC 20250-0237; telephone: (202) 720-2491, Fax: (202) 720-8938, or E-mail: Laurel... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service 7 CFR Part 930 [Doc. No. AO-370-A8; AMS..., Oregon, Utah, Washington, and Wisconsin; Withdrawal of Proposed Rule AGENCY: Agricultural Marketing...

  16. Racial and ethnic differences in the transition to a teenage birth in the United States.

    Science.gov (United States)

    Manlove, Jennifer; Steward-Streng, Nicole; Peterson, Kristen; Scott, Mindy; Wildsmith, Elizabeth

    2013-06-01

    Rates of teenage childbearing are high in the United States, and they differ substantially by race and ethnicity and nativity status. Data from the National Longitudinal Survey of Youth 1997 cohort were used to link characteristics of white, black, U.S.-born Hispanic and foreign-born Hispanic adolescents to teenage childbearing. Following a sample of 3,294 females aged 12-16 through age 19, discrete-time logistic regression analyses were used to examine which domains of teenagers' lives were associated with the transition to a teenage birth for each racial and ethnic group, and whether these associations help explain racial and ethnic and nativity differences in this transition. In a baseline multivariate analysis controlling for age, compared with whites, foreign-born Hispanics had more than three times the odds of a teenage birth (odds ratio, 3.5), while blacks and native-born Hispanics had about twice the odds (2.1 and 1.9, respectively). Additional controls (for family environments; individual, peer and dating characteristics; characteristics of first sexual relationships; and subsequent sexual experience) reduced the difference between blacks and whites, and between foreign-born Hispanics and whites, and eliminated the difference between U.S.-born Hispanics and whites. Further, if racial or ethnic minority adolescents had the same distribution as did white teenagers across all characteristics, the predicted probability of a teenage birth would be reduced by 40% for blacks and 35% for U.S.-born Hispanics. Differences in the context of adolescence may account for a substantial portion of racial, ethnic and nativity differences in teenage childbearing. Copyright © 2013 by the Guttmacher Institute.

  17. Foreign-born care givers in Washington State nursing homes: characteristics, associations with quality of care, and views of administrators.

    Science.gov (United States)

    Acker, Katherine; Pletz, Anna Maria; Katz, Aaron; Hagopian, Amy

    2015-06-01

    Following national trends, Washington State relies heavily on foreign-born workers to provide long-term care. Our study assesses state nursing facility characteristics, quality ratings, and the views of facility administrators about the implications of an increasing number of foreign-born employees. We used independently available data to supplement a survey of nursing home administrators. Nearly half of the administrators reported difficulty hiring U.S.-born job applicants. Three in four administrators reported problems related to language differences, and just more than a third reported challenges related to cultural and/or religious differences. Nonetheless, the proportion of foreign-born employees was positively associated with independent facility quality ratings. Almost half of the administrators reported discrimination by patients/clients toward their foreign-born workers. Quality ratings were negatively associated with for-profit, chain, or multi-ownership status. The proportion of foreign-born employees in nursing facilities may be associated with improved performance. © The Author(s) 2014.

  18. Cost inefficiency under financial strain: a stochastic frontier analysis of hospitals in Washington State through the Great Recession.

    Science.gov (United States)

    Izón, Germán M; Pardini, Chelsea A

    2017-06-01

    The importance of increasing cost efficiency for community hospitals in the United States has been underscored by the Great Recession and the ever-changing health care reimbursement environment. Previous studies have shown mixed evidence with regards to the relationship between linking hospitals' reimbursement to quality of care and cost efficiency. Moreover, current evidence suggests that not only inherently financially disadvantaged hospitals (e.g., safety-net providers), but also more financially stable providers, experienced declines to their financial viability throughout the recession. However, little is known about how hospital cost efficiency fared throughout the Great Recession. This study contributes to the literature by using stochastic frontier analysis to analyze cost inefficiency of Washington State hospitals between 2005 and 2012, with controls for patient burden of illness, hospital process of care quality, and hospital outcome quality. The quality measures included in this study function as central measures for the determination of recently implemented pay-for-performance programs. The average estimated level of hospital cost inefficiency before the Great Recession (10.4 %) was lower than it was during the Great Recession (13.5 %) and in its aftermath (14.1 %). Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased cost inefficiency.

  19. Washington State Retail Marijuana Legalization: Parent and Adolescent Preferences for Marijuana Messages in a Sample of Low-Income Families.

    Science.gov (United States)

    Hanson, Koren; Haggerty, Kevin P; Fleming, Charles B; Skinner, Martie L; Casey-Goldstein, Mary; Mason, W Alex; Thompson, Ronald W; Redmond, Cleve

    2018-03-01

    As legalization of nonmedical retail marijuana increases, states are implementing public health campaigns designed to prevent increases in youth marijuana use. This study investigated which types of marijuana-related messages were rated most highly by parents and their teens and whether these preferences differed by age and marijuana use. Nine marijuana-focused messages were developed as potential radio, newspaper, or television announcements. The messages fell into four categories: information about the law, general advice/conversation starters, consequences of marijuana use/positive alternatives, and information on potential harmful effects of teen marijuana use. The messages were presented through an online survey to 282 parent (84% female) and 283 teen (54% female) participants in an ongoing study in Washington State. Both parents and youth rated messages containing information about the law higher than other types of messages. Messages about potential harms of marijuana use were rated lower than other messages by both generations. Parents who had used marijuana within the past year (n = 80) rated consequence/positive alternative messages lower than parent nonusers (n = 199). Youth marijuana users (n = 77) and nonusers (n = 202) both rated messages containing information about the law higher than other types of messages. Youth users and nonusers were less likely than parents to believe messages on the harmful effects of marijuana. The high ratings for messages based on information about the marijuana law highlight the need for informational health campaigns to be established as a first step in the marijuana legalization process.

  20. Finding Common Ground in Pension Reform: Lessons from the Washington State Pension System

    Science.gov (United States)

    Goldhaber, Dan; Grout, Cyrus

    2014-01-01

    As states and localities across the nation consider the tradeoffs between defined benefit (DB) and defined contribution (DC) pension systems, it is important to gain insight into what implications pension reforms might have on workforce composition and teachers' retirement savings behavior. Moreover, it is also important to consider that…

  1. GED Test Changes and Attainment: Overview of 2014 GED Test Changes and Attainment in Washington State

    Science.gov (United States)

    Larson, Kara; Gaeta, Cristina; Sager, Lou

    2016-01-01

    In January 2014, the GED Testing Service significantly redesigned the GED test to incorporate the Common Core State Standards and the College and Career Readiness Standards for Adult Education. The purpose of this study was to examine the significant changes made to the test in 2014, examine the impact of the changes on Washingtonians, and make…

  2. Outcomes of care for 16,924 planned home births in the United States: the Midwives Alliance of North America Statistics Project, 2004 to 2009.

    Science.gov (United States)

    Cheyney, Melissa; Bovbjerg, Marit; Everson, Courtney; Gordon, Wendy; Hannibal, Darcy; Vedam, Saraswathi

    2014-01-01

    Between 2004 and 2010, the number of home births in the United States rose by 41%, increasing the need for accurate assessment of the safety of planned home birth. This study examines outcomes of planned home births in the United States between 2004 and 2009. We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth. Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes. © 2014 by the American College of Nurse-Midwives.

  3. Epidemiology of Infectious Disease-Related Death After Release from Prison, Washington State, United States, and Queensland, Australia: A Cohort Study.

    Science.gov (United States)

    Binswanger, Ingrid A; Blatchford, Patrick J; Forsyth, Simon J; Stern, Marc F; Kinner, Stuart A

    2016-01-01

    People in prison may be at high risk for infectious diseases and have an elevated risk of death immediately after release compared with later; their risk of death is elevated for at least a decade after release. We compared rates, characteristics, and prison-related risk factors for infectious disease-related mortality among people released from prisons in Queensland, Australia, and Washington State, United States, regions with analogous available data. We analyzed data from retrospective cohort studies of people released from prison in Queensland (1997-2007, n=37,180) and Washington State (1999-2009, n=76,208) and linked identifiers from each cohort to its respective national death index. We estimated infectious disease-related mortality rates (deaths per person-years in community) and examined associations using Cox proportional hazard models. The most frequent infectious disease-related underlying cause of death after release from prison was pneumonia (43%, 23/54 deaths) in the Australian cohort and viral hepatitis (40%, 69/171 deaths) in the U.S. cohort. The infectious disease-related mortality rate was significantly higher in the U.S. cohort than in the Australian cohort (51.2 vs. 26.5 deaths per 100,000 person-years; incidence rate ratio = 1.93, 95% confidence interval 1.42, 2.62). In both cohorts, increasing age was strongly associated with mortality from infectious diseases. Differences in the epidemiology of infectious disease-related mortality among people released from prison may reflect differences in patterns of community health service delivery in each region. These findings highlight the importance of preventing and treating hepatitis C and other infectious diseases during the transition from prison to the community.

  4. Statement at NRC International Regulators Conference on Nuclear Security, 4 December 2012, Washington, United States

    International Nuclear Information System (INIS)

    Amano, Y.

    2012-01-01

    I would like to begin by thanking NRC Chairman Allison Macfarlane for hosting this first regulatory Conference on nuclear security involving regulators, law enforcement agencies and the IAEA. The United States has been a very important partner in the IAEA's nuclear security activities right from the start. It is by far the largest donor to our Nuclear Security Fund. It has actively supported our programmes and has been generous in providing funding, equipment and training to other Member States. When President Obama hosted the first Nuclear Security Summit in April 2010, he said it was important that that event should be part of a ''serious and sustained effort'' to improve nuclear security throughout the world. Since then, a growing number of governments have given high-level attention to this vitally important issue. This is very encouraging. Today, I am especially pleased to see regulators coming together to focus on this subject. I am confident that your meeting will make a valuable contribution to strengthening global nuclear security. I would like to share with you some important recent milestones in the IAEA's nuclear security work. As you know, primary responsibility for ensuring nuclear security lies with national governments. However, governments have recognized that international cooperation is vital. Terrorists and other criminals do not respect international borders and no country can respond effectively on its own to the threat which they pose. In September, our Member States - there are now 158 - reaffirmed the central role of the IAEA in e nsuring coordination of international activities in the field of nuclear security, while avoiding duplication and overlap . Our central role reflects the Agency's extensive membership, our mandate, our unique expertise and our long experience of providing technical assistance and specialist, practical guidance to countries. To put it simply, our work focuses on helping to minimize the risk of nuclear and other

  5. Perspectives on risk: Assessment of risk profiles and outcomes among women planning community birth in the United States.

    Science.gov (United States)

    Bovbjerg, Marit L; Cheyney, Melissa; Brown, Jennifer; Cox, Kim J; Leeman, Lawrence

    2017-09-01

    There is little agreement on who is a good candidate for community (home or birth center) birth in the United States. Data on n=47 394 midwife-attended, planned community births come from the Midwives Alliance of North America Statistics Project. Logistic regression quantified the independent contribution of 10 risk factors to maternal and neonatal outcomes. Risk factors included: primiparity, advanced maternal age, obesity, gestational diabetes, preeclampsia, postterm pregnancy, twins, breech presentation, history of cesarean and vaginal birth, and history of cesarean without history of vaginal birth. Models controlled additionally for Medicaid, race/ethnicity, and education. The independent contributions of maternal age and obesity were quite modest, with adjusted odds ratios (AOR) less than 2.0 for all outcomes: hospital transfer, cesarean, perineal trauma, postpartum hemorrhage, low/very-low Apgar, maternal or neonatal hospitalization, NICU admission, and fetal/neonatal death. Breech was strongly associated with morbidity and fetal/neonatal mortality (AOR 8.2, 95% CI, 3.7-18.4). Women with a history of both cesarean and vaginal birth fared better than primiparas across all outcomes; however, women with a history of cesarean but no prior vaginal births had poor outcomes, most notably fetal/neonatal demise (AOR 10.4, 95% CI, 4.8-22.6). Cesarean births were most common in the breech (44.7%), preeclampsia (30.6%), history of cesarean without vaginal birth (22.1%), and primipara (11.0%) groups. The outcomes of labor after cesarean in women with previous vaginal deliveries indicates that guidelines uniformly prohibiting labor after cesarean should be reconsidered for this subgroup. Breech presentation has the highest rate of adverse outcomes supporting management of vaginal breech labor in a hospital setting. © 2017 Wiley Periodicals, Inc.

  6. Groundwater remediation of hexavalent chromium along the Columbia River at the Hanford site in Washington state, USA - 59030

    International Nuclear Information System (INIS)

    Foss, Dyan L.; Charboneau, Briant L.

    2012-01-01

    The U.S. Department of Energy Hanford Site, formerly used for nuclear weapons production, encompasses 1500 square kilometers in southeast Washington State along the Columbia River. A principle threat to the river are the groundwater plumes of hexavalent chromium (Cr(VI)), which affect approximately 9.8 square kilometers, and 4.1 kilometers of shoreline. Cleanup goals are to stop Cr(VI) from entering the river by the end of 2012 and remediate the groundwater plumes to the drinking water standards by the end of 2020. Five groundwater pump-and-treat systems are currently in operation for the remediation of Cr(VI). Since the 1990's, over 13.6 billion L of groundwater have been treated; over 1, 435 kg of Cr(VI) have been removed. This paper describes the unique aspects of the site, its environmental setting, hydrogeology, groundwater-river interface, riverine hydraulic effects, remediation activities completed to date, a summary of the current and proposed pump-and-treat operations, the in situ redox manipulation barrier, and the effectiveness of passive barriers, resins, and treatability testing results of calcium polysulfide, bio-stimulation, and electrocoagulation, currently under evaluation. (authors)

  7. Effectiveness of OSHA Outreach Training on carpenters' work-related injury rates, Washington State 2000-2008.

    Science.gov (United States)

    Schoenfisch, Ashley L; Lipscomb, Hester; Sinyai, Clayton; Adams, Darrin

    2017-01-01

    Despite the size and breadth of OSHA's Outreach Training program for construction, information on its impact on work-related injury rates is limited. In a 9-year dynamic cohort of 17,106 union carpenters in Washington State, the effectiveness of OSHA Outreach Training on workers' compensation claims rate was explored. Injury rates were calculated by training status overall and by carpenters' demographic and work characteristics using Poisson regression. OSHA Outreach Training resulted in a 13% non-significant reduction in injury claims rates overall. The protective effect was more pronounced for carpenters in their apprenticeship years, drywall installers, and with increasing time since training. In line with these observed effects and prior research, it is unrealistic to expect OSHA Outreach Training alone to have large effects on union construction workers' injury rates. Standard construction industry practice should include hazard awareness and protection training, coupled with more efficient approaches to injury control. Am. J. Ind. Med. 60:45-57, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. Going from Microbial Ecology to Genome Data and Back: Studies on a Haloalkaliphilic Bacterium Isolated from Soap Lake, Washington State

    Directory of Open Access Journals (Sweden)

    Melanie R. Mormile

    2014-11-01

    Full Text Available Soap Lake is a meromictic, alkaline (~pH 9.8 and saline (~14 to 140 g liter-1 lake located in the semiarid area of eastern Washington State. Of note is the length of time it has been meromictic (at least 2000 years and the extremely high sulfide level (~140 mM in its monimolimnion. As expected, the microbial ecology of this lake is greatly influenced by these conditions. A bacterium, Halanaerobium hydrogeniformans, was isolated from the mixolimnion region of this lake. H. hydrogeniformans is a haloalkaliphilic bacterium capable of forming hydrogen from 5- and 6-carbon sugars derived from hemicellulose and cellulose. Due to its ability to produce hydrogen under saline and alkaline conditions, in amounts that rival genetically modified organisms, its genome was sequenced. This sequence data provides an opportunity to explore the unique metabolic capabilities of this organism, including the mechanisms for tolerating the extreme conditions of both high salinity and alkalinity of its environment.

  9. Health-hazard-evaluation report HETA 87-376-2018, US Department of Justice, United States Marshals Service, Washington, DC

    Energy Technology Data Exchange (ETDEWEB)

    Reh, C.M.; Klein, M.K.

    1990-03-01

    In response to a request from the United States Marshals Service (SIC-9221) in Washington, D.C. for assistance in testing the effect of renovations to the ventilation system of their indoor firing range, lead (7439921) exposures were measured during handgun qualifying sessions. Each qualifying session of firing consisted of 60 rounds fired in 10 to 12 minutes. Personal breathing zone air samples were taken from three shooters and the range officer. Lead exposure concentrations measured were 2073, 1786, 172, and 142 micrograms of lead per cubic meter of air (microg/cu m). Eight hour time weighted average concentrations were calculated to be 194, 167, 101, and 13microg/cu m, respectively. The three shooters were therefore overexposed to lead. Bulk sampling of the sand from the bullet trap indicated it to be contaminated, containing 41% lead by weight. The authors concluded that a health hazard existed from exposure to lead. The authors recommended changes to improve the ventilation system. Following modification of the system, tests were again conducted and 11 of the 12 samples taken were below the limits of detection for the method used. The authors conclude that after modification, a hazard did not exist during qualifying sessions. The authors recommend specific measures to protect personnel from exposure to lead.

  10. Energy Code Enforcement Training Manual : Covering the Washington State Energy Code and the Ventilation and Indoor Air Quality Code.

    Energy Technology Data Exchange (ETDEWEB)

    Washington State Energy Code Program

    1992-05-01

    This manual is designed to provide building department personnel with specific inspection and plan review skills and information on provisions of the 1991 edition of the Washington State Energy Code (WSEC). It also provides information on provisions of the new stand-alone Ventilation and Indoor Air Quality (VIAQ) Code.The intent of the WSEC is to reduce the amount of energy used by requiring energy-efficient construction. Such conservation reduces energy requirements, and, as a result, reduces the use of finite resources, such as gas or oil. Lowering energy demand helps everyone by keeping electricity costs down. (It is less expensive to use existing electrical capacity efficiently than it is to develop new and additional capacity needed to heat or cool inefficient buildings.) The new VIAQ Code (effective July, 1991) is a natural companion to the energy code. Whether energy-efficient or not, an homes have potential indoor air quality problems. Studies have shown that indoor air is often more polluted than outdoor air. The VIAQ Code provides a means of exchanging stale air for fresh, without compromising energy savings, by setting standards for a controlled ventilation system. It also offers requirements meant to prevent indoor air pollution from building products or radon.

  11. New records of nematomorph parasites (Nematomorpha: Gordiida) of ground beetles (Coleoptera: Carabidae) and camel crickets (Orthoptera: Rhaphidophoridae) in Washington State.

    Science.gov (United States)

    Looney, Chris; Hanelt, Ben; Zack, Richard S

    2012-06-01

    From 1998 to 2003, beetles and crickets infected with hairworms were collected from 4 localities within the Hanford Nuclear Site and the Hanford Reach National Monument, located in a shrub-steppe region of Washington State along the Columbia River. Infected hosts comprised 6 species of carabid beetles within 5 genera and 2 camel crickets within 1 genus; all are newly documented insect-nematomorph associations. A large proportion of the infected hosts (48%) were collected from a single site during a single collecting period. Of the 38 infected hosts, 32 contained a single worm, 4 hosts contained 2 worms, and 2 hosts contained 3 worms. Five of the hosts with multiple infections contained at least 1 male and 1 female worm. Camel crickets were infected with Neochordodes occidentalis while carabids were infected with an undescribed species of Gordionus . As the majority of hairworms are collected in the post-parasitic adult phase, host data and hairworm-arthropod associations remain poorly documented and our work adds new data to this area of nematomorph biology.

  12. Characteristics of construction firms at risk for future workers' compensation claims using administrative data systems, Washington State.

    Science.gov (United States)

    Marcum, Jennifer L; Foley, Michael; Adams, Darrin; Bonauto, Dave

    2018-06-01

    Construction is high-hazard industry, and continually ranks among those with the highest workers' compensation (WC) claim rates in Washington State (WA). However, not all construction firms are at equal risk. We tested the ability to identify those construction firms most at risk for future claims using only administrative WC and unemployment insurance data. We collected information on construction firms with 10-50 average full time equivalent (FTE) employees from the WA unemployment insurance and WC data systems (n=1228). Negative binomial regression was used to test the ability of firm characteristics measured during 2011-2013 to predict time-loss claim rates in the following year, 2014. Claim rates in 2014 varied by construction industry groups, ranging from 0.7 (Land Subdivision) to 4.6 (Foundation, Structure, and Building Construction) claims per 100 FTE. Construction firms with higher average WC premium rates, a history of WC claims, increasing number of quarterly FTE, and lower average wage rates during 2011-2013 were predicted to have higher WC claim rates in 2014. We demonstrate the ability to leverage administrative data to identify construction firms predicted to have future WC claims. This study should be repeated to determine if these results are applicable to other high-hazard industries. Practical Applications: This study identified characteristics that may be used to further refine targeted outreach and prevention to construction firms at risk. Published by Elsevier Ltd.

  13. Reduced sleep duration and history of work-related injuries among Washington State adolescents with a history of working.

    Science.gov (United States)

    Graves, Janessa M; Miller, Mary E

    2015-04-01

    The relationship between sleep and occupational injury risk has not been adequately explored for working adolescents. Data were analyzed from the 2010 Washington State Healthy Youth Survey of 8th, 10th, and 12th grade public school students. Teens reported average school and weekend night sleep hours and history of work-related injury that received medical treatment. Multivariable logistic regression evaluated the association between sleep duration and occupational injury. Of 4,144 working teens, 6.4% reported ever having an occupational injury. Teens who sleep ≤5 hr/school night had greater odds of a history of occupational injury than those sleeping 8 hr (OR:2.91, 95% CI:1.85-4.57). No significant association was observed for weekend night sleep duration. Reduced school night sleep was associated with increased odds of work-related injury in adolescents. Long hours and late night schedules may contribute to decreased sleep time and potentially have other health and developmental impacts for youth. © 2015 Wiley Periodicals, Inc.

  14. AFSC/NMML/CCEP: Capture and resight data of California sea lions in Washington State, 1989 to 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset contains data from the capture and recapture of over 1500 male California sea lions (Zalophus californianus) from Washington between 1989-2006. The data...

  15. Basalt alteration and basalt-waste interaction in the Pasco Basin of Washington State. Final report

    International Nuclear Information System (INIS)

    Benson, L.V.; Carnahan, C.L.; Apps, J.A.; Mouton, C.A.; Corrigan, D.J.; Frisch, C.J.; Shomura, L.K.

    1978-09-01

    A study was conducted to determine the nature of the minerals which coat vesicle and fracture surfaces in the Grande Ronde Basalt Formation, simulate the mass transfer which led to their precipitation, and predict the mass transfer associated with the dissolution of spent unreprocessed fuel (SURF). Scanning electron microscopy (SEM), petrographic, x-ray diffraction (XRD), and electron microprobe (EMP) analyses have been made on a series of samples taken from 1100 ft (335.3 m) of core from core hole DC2. Preliminary simulations of the mass transfer associated with basalt dissolution in a thermodynamically closed system have been accomplished. In addition two mass transfer codes have been modified to facilitate data base changes. Thermochemical data for uranium and plutonium have been collected and converted to standard state conditions. These data will be critically evaluated and input to the mass transfer data base in the near future

  16. Out-of-hospital births in the United States 2009-2014.

    Science.gov (United States)

    Grunebaum, Amos; Chervenak, Frank A

    2016-10-01

    To evaluate recent trends of out-of-hospital births in the US from 2009 to 2014. We accessed data for all live births occurring in the US from the National Vital Statistics System, Natality Data Files for 2009-2014 through the interactive data tool, VitalStats. Out-of-hospital (OOH) births in the US increased from 2009 to 2014 by 80.2% from 32,596 to 58,743 (0.79%-1.47% of all live births). Home births (HB) increased by 77.3% and births in freestanding birthing centers (FBC) increased by 79.6%. In 2014, 63.8% of OOH births were HB, 30.7% were in FBC, and 5.5% were in other places, physicians offices, or clinics. The majority of women who had an OOH birth in 2014 were non-Hispanic White (82.3%). About in one in 47 non-Hispanic White women had an OOH in 2014, up from 1 in 87 in 2009. Women with a HB were older compared to hospital births (age ≥35: 21.5% vs. 15.4%), had a higher live birth order(≥5: 18.9% vs. 4.9%), 3.48% had infants home and in freestanding birthing centers has significantly increased in the US making it the country with the most out of hospital births among all developed countries. The root cause of the increase in planned OOH births should be identified and addressed by the medical community.

  17. Student and school factors associated with school suspension: A multilevel analysis of students in Victoria, Australia and Washington State, United States

    Science.gov (United States)

    Sheryl, A. Hemphill; Stephanie, M. Plenty; Herrenkohl, Todd I.; Toumbourou, John W.; Catalano, Richard F.

    2014-01-01

    One of the common issues schools face is how best to handle challenging student behaviors such as violent behavior, antisocial behavior, bullying, school rule violations, and interrupting other students’ learning. School suspension may be used to remove students engaging in challenging behaviors from the school for a period of time. However, the act of suspending students from school may worsen rather than improve their behavior. Research shows that suspensions predict a range of student outcomes, including crime, delinquency, and drug use. It is therefore crucial to understand the factors associated with the use of school suspension, particularly in sites with different policy approaches to problem behaviors. This paper draws on data from state-representative samples of 3,129 Grade 7 and 9 students in Washington State, United States and Victoria, Australia sampled in 2002. Multilevel modeling examined student and school level factors associated with student-reported school suspension. Results showed that both student (being male, previous student antisocial and violent behavior, rebelliousness, academic failure) and school (socioeconomic status of the school, aggregate measures of low school commitment) level factors were associated with school suspension and that the factors related to suspension were similar in the two states. The implications of the findings for effective school behavior management policy are that, rather than focusing only on the student, both student and school level factors need to be addressed to reduce the rates of school suspension. PMID:24860205

  18. Workplace health and safety regulations: Impact of enforcement and consultation on workers' compensation claims rates in Washington State.

    Science.gov (United States)

    Baggs, James; Silverstein, Barbara; Foley, Michael

    2003-05-01

    There has been considerable debate in the public policy arena about the appropriate mix of regulatory enforcement and consultation in achieving desired health and safety behavior across industries. Recently there has been a shift in federal policy toward voluntary approaches and constraining the scope of enforcement programs, although there is little evidence that this might improve health and safety outcomes. To address this, we examined changes in lost time workers compensation claims rates for Washington State employers who had (1) no OSHA State Plan (WISHA) activity, (2) enforcement, (3) consultation, and (4) both types of visits. Compensable claims rates, hours, and WISHA activity were determined for each employer account with a single business location that had payroll hours reported for every quarter from 1997-2000 and more than 10 employees. We used a generalized estimating equations (GEE) approach to Poisson regression to model the association between WISHA activity and claims rate controlling for other external factors. Controlling for previous claims rate and average size, claims rates for employers with WISHA enforcement activity declined 22.5% in fixed site industry SIC codes compared to 7% among employers with no WISHA activity (P 0.10). WISHA consultation activity was not associated with a greater decline in compensable claims rates (-2.3% for fixed sites and +3.5% for non-fixed sites). WISHA activity did not adversely affect worksite survivability through the study period. Enforcement inspections are significantly associated with decreasing compensable workers compensation claims rates especially for fixed site employers. We were unable to identify an association between consultation activities and decreasing claims rates. Copyright 2003 Wiley-Liss, Inc.

  19. Preventable health and cost burden of adverse birth outcomes associated with pregestational diabetes in the United States.

    Science.gov (United States)

    Peterson, Cora; Grosse, Scott D; Li, Rui; Sharma, Andrea J; Razzaghi, Hilda; Herman, William H; Gilboa, Suzanne M

    2015-01-01

    Preconception care for women with diabetes can reduce the occurrence of adverse birth outcomes. We aimed to estimate the preconception care (PCC)-preventable health and cost burden of adverse birth outcomes associated with diagnosed and undiagnosed pregestational diabetes mellitus (PGDM) in the United States. Among women of reproductive age (15-44 years), we estimated age- and race/ethnicity-specific prevalence of diagnosed and undiagnosed diabetes. We applied age and race/ethnicity-specific pregnancy rates, estimates of the risk reduction from PCC for 3 adverse birth outcomes (preterm birth, major birth defects, and perinatal mortality), and lifetime medical and lost productivity costs for children with those outcomes. Using a probabilistic model, we estimated the reduction in adverse birth outcomes and costs associated with universal PCC compared with no PCC among women with PGDM. We did not assess maternal outcomes and associated costs. We estimated 2.2% of US births are to women with PGDM. Among women with diagnosed diabetes, universal PCC might avert 8397 (90% prediction interval [PI], 5252-11,449) preterm deliveries, 3725 (90% PI, 3259-4126) birth defects, and 1872 (90% PI, 1239-2415) perinatal deaths annually. Associated discounted lifetime costs averted for the affected cohort of children could be as high as $4.3 billion (90% PI, 3.4-5.1 billion) (2012 US dollars). PCC among women with undiagnosed diabetes could yield an additional $1.2 billion (90% PI, 951 million-1.4 billion) in averted cost. Results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care. Published by Elsevier Inc.

  20. Collaborative effort in Washington state slashes non-essential use of the ED by Medicaid patients, delivering millions in projected savings.

    Science.gov (United States)

    2013-04-01

    Early data suggest a coordinated, state-wide effort has reduced non-essential use of the ED by 10% among Medicaid recipients in Washington state, and is projected to save the state an estimated $31 million in the first year of the approach. The effort includes the adoption of seven best practices by hospitals across the state.These include the creation of an Emergency Department Information Exchange, so that EDs can immediately access a patient's utilization history, strict narcotic prescribing guidelines, and regular feedback reports to hospitals regarding ED utilization patterns. The effort was prompted by threats by the state legislature to limit Medicaid payments for ED visits deemed not medically necessary in the emergency setting. The legislature backed down when emergency physicians in the state countered with their own proposal to reduce nonessential use of the ED. They worked with other health care groups in the state to develop the plan. Data on the first six months of the effort are included in a report to the state legislature by the Washington State Health Care Authority. Among the findings are a 23% reduction in ED visits among Medicaid recipients with five or more visits, a 250% increase in providers who have registered with the state's Prescription Monitoring Program, aimed at identifying patients with narcotic-seeking behavior, and a doubling in the number of shared care plans, intended to improve care coordination. Emergency providers say big challenges remain, including a need for more resources for patients with mental health and dental care needs.

  1. Vital Signs: Repeat Births Among Teens — United States, 2007–2010

    OpenAIRE

    Gavin, Lorrie; Warner, Lee; O’Neil, Mary Elizabeth; Duong, Linh M.; Marshall, Cassondra; Hastings, Philip A.; Harrison, Ayanna T.; Barfield, Wanda

    2013-01-01

    Background Teen childbearing has potential negative health, economic, and social consequences for mother and child. Repeat teen childbearing further constrains the mother’s education and employment possibilities. Rates of preterm and low birth weight are higher in teens with a repeat birth, compared with first births. Methods To assess patterns of repeat childbearing and postpartum contraceptive use among teens, CDC analyzed natality data from the National Vital Statistics System (NVSS) and t...

  2. Partners in immunization: 2010 survey examining differences among H1N1 vaccine providers in Washington state.

    Science.gov (United States)

    Seib, Katherine; Gleason, Cindy; Richards, Jennifer L; Chamberlain, Allison; Andrews, Tracey; Watson, Lin; Whitney, Ellen; Hinman, Alan R; Omer, Saad B

    2013-01-01

    Emergency response involving mass vaccination requires the involvement of traditional vaccine providers as well as other health-care providers, including pharmacists, obstetricians, and health-care providers at correctional facilities. We explored differences in provider experiences administering pandemic vaccine during a public health emergency. We conducted a cross-sectional survey of H1N1 vaccine providers in Washington State, examining topics regarding pandemic vaccine administration, participation in preparedness activities, and communication with public health agencies. We also examined differences among provider types in responses received (n=619, 80.9% response rate). Compared with other types of vaccine providers (e.g., family practitioners, obstetricians, and specialists), pharmacists reported higher patient volumes as well as higher patient-to-practitioner ratios, indicating a broad capacity for community reach. Pharmacists and correctional health-care providers reported lower staff coverage with seasonal and H1N1 vaccines. Compared with other vaccine providers, pharmacists were also more likely to report relying on public health information from federal sources. They were less likely to report relying on local health departments (LHDs) for pandemic-related information, but indicated a desire to be included in LHD communications and plans. While all provider types indicated a high willingness to respond to a public health emergency, pharmacists were less likely to have participated in training, actual emergency response, or surge capacity initiatives. No obstetricians reported participating in surge capacity initiatives. Results from this survey suggest that efforts to increase communication and interaction between public health agencies and pharmacy, obstetric, and correctional health-care vaccine providers may improve future preparedness and emergency response capability and reach.

  3. Using the global positioning system in support of environmental characterization at the Hanford Site in Washington State

    International Nuclear Information System (INIS)

    Peterson, L.B.; Tzemos, S.; Dietz, L.A.

    1993-10-01

    The US Department of Energy's 1,450 km 2 Hanford Site in southeastern Washington State accumulated hazardous wastes for more than 50 years. To support the Site's mission of environmental restoration and cleanup, the Global Positioning System (GPS) is being used to verify waste site locations and provide location information for field samples. Collected GPS data are stored for use in the Hanford Geographic Information System (HGIS). The NAVSTAR GPS is a space-based electronic navigation and positioning system designed and operated by the US Department of Defense (DOD). The system consists of three major components: (1) the space segment, comprising 24 earth-orbiting satellites; (2) the control segment, made up of 5 control and monitoring stations placed around the globe; and (3) the user segment, which includes users worldwide. When declared fully operational by the DOD, the NAVSTAR GPS will allow users to identify their geographical position anywhere on earth at any time. There are no user fees for the service and anyone with a GPS receiver may use the system worldwide. The one major hindrance to the system is the DOD policy concerning a security option called Selective Availability (SA). Selective Availability affects the usability of the system by intentional manipulation of the GPS signals to degrade the accuracy of the user's positions. The period and magnitude of degradation is solely a DOD privilege. The DOD policy on SA is to vary the error in position calculated from the Standard Positioning Service code to approximately 100 m root-mean squared (RMS). With SA on and other possible errors included, users may know their location to within a few hundred meters. While this accuracy is good for many applications, it is too inaccurate for others

  4. An Alexandrium Spp. Cyst Record from Sequim Bay, Washington State, USA, and its Relation to Past Climate Variability(1).

    Science.gov (United States)

    Feifel, Kirsten M; Moore, Stephanie K; Horner, Rita A

    2012-06-01

    Since the 1970s, Puget Sound, Washington State, USA, has experienced an increase in detections of paralytic shellfish toxins (PSTs) in shellfish due to blooms of the harmful dinoflagellate Alexandrium. Natural patterns of climate variability, such as the Pacific Decadal Oscillation (PDO), and changes in local environmental factors, such as sea surface temperature (SST) and air temperature, have been linked to the observed increase in PSTs. However, the lack of observations of PSTs in shellfish prior to the 1950s has inhibited statistical assessments of longer-term trends in climate and environmental conditions on Alexandrium blooms. After a bloom, Alexandrium cells can enter a dormant cyst stage, which settles on the seafloor and then becomes entrained into the sedimentary record. In this study, we created a record of Alexandrium spp. cysts from a sediment core obtained from Sequim Bay, Puget Sound. Cyst abundances ranged from 0 to 400 cysts · cm(-3) and were detected down-core to a depth of 100 cm, indicating that Alexandrium has been present in Sequim Bay since at least the late 1800s. The cyst record allowed us to statistically examine relationships with available environmental parameters over the past century. Local air temperature and sea surface temperature were positively and significantly correlated with cyst abundances from the late 1800s to 2005; no significant relationship was found between PDO and cyst abundances. This finding suggests that local environmental variations more strongly influence Alexandrium population dynamics in Puget Sound when compared to large-scale changes. © 2012 Phycological Society of America.

  5. Knowledge, Practices, and Barriers to HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Among Washington State Medical Providers.

    Science.gov (United States)

    Wood, Brian R; McMahan, Vanessa M; Naismith, Kelly; Stockton, Jonathan B; Delaney, Lori A; Stekler, Joanne D

    2018-01-04

    We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. Of 735 eligible providers, 64.8% had heard of PrEP. Younger providers and providers with a Doctor of Medicine (MD) degree were more likely to be aware of PrEP compared to older providers (p=0.0001) and providers of other training backgrounds (Advanced Registered Nurse Practitioner [ARNP], Doctor of Osteopathic Medicine [DO], or Physician Assistant [PA]) (p=0.04). Among providers aware of PrEP, most frequent reported concerns about prescribing were adherence (46.0%) and costs (42.9%). Providers felt very (20.1%) or somewhat (33.8%) comfortable discussing PrEP overall, but very (26.8%) or somewhat (44.7%) uncomfortable discussing cost and insurance issues. The 124 PrEP prescribers reported a median of 2 (range 1-175, total 1,142) patients prescribed PrEP. Prior authorizations and insurance denials had prevented prescriptions for 28.7% and 12.1% of prescribers, respectively. Interventions to improve PrEP access should include education to inform medical providers about PrEP, with particular attention to provider types less likely to be aware. Continued efforts to eliminate cost and insurance barriers and educate providers regarding financial resources would help improve PrEP access.

  6. Fossil plotopterid seabirds from the Eo-Oligocene of the Olympic Peninsula (Washington State, USA: descriptions and functional morphology.

    Directory of Open Access Journals (Sweden)

    Gareth J Dyke

    Full Text Available The plotopterids (Aves, Plotopteridae were a group of extinct wing-propelled marine birds that are known from Paleogene-aged sediments (Eocene to Miocene, mostly around the Pacific Rim (especially Japan and the northwest coast of North America. While these birds exhibit a strikingly similar wing morphology to penguins (Spheniscidae, they also share derived characters with pelecaniform birds that are absent in penguins and exhibit apparently superficial similarities with auks (Alcidae: Charadriiformes. Despite quite an abundant fossil record, these birds have been little studied, and in particular their functional morphology remains little understood. Here we present osteological overviews of specimens from the northwest coast of Washington state (USA. We give an amended diagnosis for the well-represented North American genus, Tonsala Olson, 1980, describe a new large species, and examine the functional morphology of plotopterids showing that the ratio of humeral strength to femoral strength is quite low in one well-represented species Tonsala buchanani sp.nov., relative to both extant penguins and alcids. While the femoral strength of Tonsala buchanani is 'penguin-grade', its humeral strength is more 'alcid-grade'. These results have implications for understanding the mode-of-locomotion of these extinct marine birds. Although not related to Spheniscidae, our descriptions and functional results suggest that Tonsala buchanani sustained similar loads in walking, but slightly lower humeral loads during swimming, than a modern penguin. This suggests a swimming mode that is more similar to living alcids, than to the highly-specialised locomotor strategy of living and fossil penguins.

  7. Impacts of Landuse Management and Climate Change on Landslides Susceptibility over the Olympic Peninsula of Washington State

    Science.gov (United States)

    Barik, M. G.; Adam, J. C.

    2009-12-01

    The commercial forests on the western side of the Olympic Mountains in Washington State are a region of steep slopes and high annual rainfall (2500-6000 mm/year) and are therefore highly susceptible to landslides. Potential climatic change (more intense and frequent winter storms) may exacerbate landslide susceptibility unless forest management practices are changed. As this area is a critical habitat for numerous organisms, including salmon, this may result in potentially severe consequences to riparian habitat due to increased sediment loads. Therefore, there is a need to investigate potential forest management plans to promote the economic viability of timber extraction while protecting the natural habitat, particularly in riparian areas. The objective of this study is to predict the long term effects of forest management decisions under projected climate change on slope stability. We applied the physically-based Distributed Hydrology Soil Vegetation Model (DHSVM) with its sediment module to simulate mass wasting and sediment delivery under different vegetation and climate scenarios. Sub-basins were selected and classified according to elevation, slope, land cover and soil type. Various land management practices (such as clear-cutting in riparian areas, logging under short rotations, varying amount of timbers left intact in riparian areas) were applied to each of the selected sub-basins. DHSVM was used to simulate landslide volume, frequency, and sediment loads for each of the land cover applications under various future climate scenarios. We comment on the suitability of various harvesting techniques for different parts of the forest to minimize landslide-induced sediment loading to streams in an altered climate. This approach can be developed as a decision making tool that can be used by forest managers to make long-term planning decisions.

  8. Marine vessel air emissions in B.C. and Washington State outside the GVRD and FVRD for the year 2000

    International Nuclear Information System (INIS)

    Quan, R.G.; Trask, T.C.; Cheng, K.C.

    2002-01-01

    Emissions inventories are used by government agencies as a tool for policy development and air quality management. Marine vessels have been identified as a major source of anthropogenic pollution in British Columbia. This report presents estimates of emissions from marine vessels in coastal areas in British Columbia outside of the Greater Vancouver Regional District (GVRD), the Fraser Valley Regional District (FVRD), and in Washington State for the year 2000. The project includes an update of emission estimates for each marine vessel category and an update of emission estimates for pollutants of interest, including carbon monoxide (CO), nitrogen oxides (NOx), particulate matter (PM), sulphur oxides (SOx), volatile organic compounds (VOCs), as well as inhalable fine particulates (PM10 and PM2.5) and greenhouse gases such as carbon dioxide, methane, nitrous oxide and ammonia. This report presented emissions results for both the Canadian and U.S. portions. It also includes both spatial and temporal allocation of emissions. Results indicate that ocean-going vessels are the major contributor to emissions of NOx, SOx, PM and greenhouse gases, accounting for 56, 93, 83, and 51 per cent of the total marine vessel emissions respectively. They also contribute 30 and 33 per cent to the marine totals for CO and VOCs. Harbour vessels contribute 22 and 24 per cent of NOx and greenhouse gases and 17 per cent of both CO and VOCs. Ferries contribute between 15 per cent and 23 per cent for CO, VOC, NOx and GHGs, but less than 9 per cent for SOx and PM. Fishing vessels contribute 1 per cent or less of all contaminants. Although recreational vessels are major contributors for CO and VOC, they contribute less than 2 per cent for all other contaminants. A comparison of 1995 and 2000 marine vessel inventory for British Columbia was presented and recommendations for improvements were presented. refs., tabs., figs.

  9. Promoting Employee Health Through an American Cancer Society Program, The CEOs Challenge, Washington State, 2013-2015.

    Science.gov (United States)

    Harris, Jeffrey R; Parrish, Amanda T; Kohn, Marlana; Hammerback, Kristen; McMillan, Becca; Hannon, Peggy A

    2015-12-17

    Evidence-based practices in the workplace can increase levels of healthy eating, cancer screening, physical activity, and tobacco cessation but are underused, even in large workplaces. This report summarizes an evaluation of the first year of The CEOs Challenge, a program developed by the American Cancer Society to promote implementation and maintenance of health-promoting, evidence-based workplace practices by large companies. Use of 17 evidence-based practices by 17 companies in the Washington State Chapter of the American Cancer Society's CEOs Against Cancer network was assessed via survey and scored from 0 to 100. Companies received a written report of their baseline performance, followed by at least quarterly consultations with American Cancer Society staff members trained to assist in implementation of these practices. Follow-up performance was measured at 1 year. At baseline, implementation scores were 54.8 for cancer screening, 46.5 for healthy eating, 59.8 for physical activity, and 68.2 for tobacco cessation. At follow-up, scores increased by 19.6 for cancer screening, 19.4 for healthy eating, 16.0 for physical activity, and 9.4 points for tobacco cessation. The CEOs Challenge is a promising approach to chronic disease prevention via the workplace. It brings together one of the nation's largest health-promoting voluntary agencies with the nation's largest employers to promote evidence-based practices targeted at the most common causes of disease and death. The program increased the adoption of these practices and was well-accepted.

  10. Why is the teen birth rate in the United States so high and why does it matter?

    Science.gov (United States)

    Kearney, Melissa S; Levine, Phillip B

    2012-01-01

    Teens in the United States are far more likely to give birth than in any other industrialized country in the world. U.S. teens are two and a half times as likely to give birth as compared to teens in Canada, around four times as likely as teens in Germany or Norway, and almost 10 times as likely as teens in Switzerland. Among more developed countries, Russia has the next highest teen birth rate after the United States, but an American teenage girl is still around 25 percent more likely to give birth than her counterpart in Russia. Moreover, these statistics incorporate the almost 40 percent fall in the teen birth rate that the United States has experienced over the past two decades. Differences across U.S. states are quite dramatic as well. A teenage girl in Mississippi is four times more likely to give birth than a teenage girl in New Hampshire--and 15 times more likely to give birth as a teen compared to a teenage girl in Switzerland. This paper has two overarching goals: understanding why the teen birth rate is so high in the United States and understanding why it matters. Thus, we begin by examining multiple sources of data to put current rates of teen childbearing into the perspective of cross-country comparisons and recent historical context. We examine teen birth rates alongside pregnancy, abortion, and "shotgun" marriage rates as well as the antecedent behaviors of sexual activity and contraceptive use. We seek insights as to why the rate of teen childbearing is so unusually high in the United States as a whole, and in some U.S. states in particular. We argue that explanations that economists have tended to study are unable to account for any sizable share of the variation in teen childbearing rates across place. We describe some recent empirical work demonstrating that variation in income inequality across U.S. states and developed countries can explain a sizable share of the geographic variation in teen childbearing. To the extent that income inequality

  11. Plurality of Birth and Infant Mortality Due to External Causes in the United States, 2000-2010.

    Science.gov (United States)

    Ahrens, Katherine A; Thoma, Marie E; Rossen, Lauren M; Warner, Margaret; Simon, Alan E

    2017-03-01

    Risk of death during the first year of life due to external causes, such as unintentional injury and homicide, may be higher among twins and higher-order multiples than among singletons in the United States. We used national birth cohort linked birth-infant death data (2000-2010) to evaluate the risk of infant mortality due to external causes in multiples versus singletons in the United States. Risk of death from external causes during the study period was 3.6 per 10,000 live births in singletons and 5.1 per 10,000 live births in multiples. Using log-binomial regression, the corresponding unadjusted risk ratio was 1.40 (95% confidence interval (CI): 1.30, 1.50). After adjustment for maternal age, marital status, race/ethnicity, and education, the risk ratio was 1.68 (95% CI: 1.56, 1.81). Infant deaths due to external causes were most likely to occur between 2 and 7 months of age. Applying inverse probability weighting and assuming a hypothetical intervention where no infants were low birth weight, the adjusted controlled direct effect of plurality on infant mortality due to external causes was 1.64 (95% CI: 1.39, 1.97). Twins and higher-order multiples were at greater risk of infant mortality due to external causes, particularly between 2 and 7 months of age, and this risk appeared to be mediated largely by factors other than low-birth-weight status. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  12. Franciscana strandings on the north coast of Santa Catarina State and insights into birth period

    Directory of Open Access Journals (Sweden)

    Marta Jussara Cremer

    2013-08-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2013v26n4p133 Franciscana, Pontoporia blainvillei, is the most threatened small cetacean in the South Atlantic. Accidental captures in fishing nets is the main problem for this species throughout its distribution. Dead franciscanas found along the coast are an important source of information. This work aimed to analyze the records of dead franciscanas found on the northern coast of Santa Catarina, including Babitonga Bay. Between January 2001 and November 2012, 54 franciscana carcasses were recorded, with the highest number (8 individuals in 2011. Fifty-four percent (n=28 of the carcasses were recorded between August and October. Taking into account that this information was not obtained from a systematic effort, it was not possible to consider this as an estimation of mortality. The largest animal was a female, with a total length of 142 cm. Ten recovered animals (18.5% were smaller than 80 cm, and were considered fetuses or calves. These records indicate that the main birthing period for franciscanas in Santa Catarina is between October and January. The findings presented here contribute to our knowledge of franciscana ecology in the state of Santa Catarina.

  13. Franciscana strandings on the north coast of Santa Catarina State and insights into birth period

    Directory of Open Access Journals (Sweden)

    Renan Lopes Paitach

    2013-11-01

    Full Text Available Franciscana, Pontoporia blainvillei, is the most threatened small cetacean in the South Atlantic. Accidental captures in fishing nets is the main problem for this species throughout its distribution. Dead franciscanas found along the coast are an important source of information. This work aimed to analyze the records of dead franciscanas found on the northern coast of Santa Catarina, including Babitonga Bay. Between January 2001 and November 2012, 54 franciscana carcasses were recorded, with the highest number (8 individuals in 2011. Fifty-two percent (n=28 of the carcasses were recorded between August and October. Taking into account that this information was not obtained from a systematic effort, it was not possible to consider this as an estimation of mortality. The largest animal was a female, with a total length of 142 cm. Ten recovered animals (18.5% were smaller than 80 cm, and were considered fetuses or calves. These records indicate that the main birthing period for franciscanas in Santa Catarina is between October and January. The findings presented here contribute to our knowledge of franciscana ecology in the state of Santa Catarina.

  14. The Great Recession of 2007 in the United States and the male: female ratio at birth

    OpenAIRE

    Grech, Victor

    2015-01-01

    OBJECTIVE: Male live births slightly exceed female live births by approximately 3%. The ratio of male to total live births is conventionally represented as M/F. Many factors have been shown to affect M/F, mainly privation, toxins, and stress, all of which reduce M/F. Population stress may be engendered by natural phenomena such as earthquakes and man-made events such as short wars, terrorist attacks, and contracting economies. This study was conducted to ascertain whether the onset of the "Gr...

  15. Residential segregation and birth weight among racial and ethnic minorities in the United States.

    Science.gov (United States)

    Walton, Emily

    2009-12-01

    Racial and ethnic minorities are often residentially segregated from whites in urban settings, a fact which has important health consequences. Research on the relationship between residential segregation and health outcomes lacks national-level investigation of racial and ethnic minority groups other than African Americans. I use multilevel analyses to examine the associations of residential isolation and clustering with birth weight among Asian, black, and Latino Americans using data from the National Center for Health Statistics' Natality Files and the U.S. Census. Findings indicate that segregation has a negative effect on the likelihood of having a low birth weight baby among Asian Americans, suggesting a possible concentration of social and structural resources in highly-segregated communities. On the contrary, segregation marginally increases the odds of low birth weight among African Americans, but only in the presence of higher poverty rates. Segregation does not affect birth weight among Latino Americans.

  16. LPRS by State, County, Country of Birth and Major Class of Admission 2015

    Data.gov (United States)

    Department of Homeland Security — These tables offer county-level data for the top 200 counties of residence of new LPRs by major class of admission and by country of birth. OIS assigns county of...

  17. Effects of posted point-of-sale warnings on alcohol consumption during pregnancy and on birth outcomes.

    Science.gov (United States)

    Cil, Gulcan

    2017-05-01

    In 23 states and Washington D.C., alcohol retailers are required by law to post alcohol warning signs (AWS) that warn against the risks of drinking during pregnancy. Using the variation in the adoption of these laws across states and within states over time, I find a statistically significant reduction in prenatal alcohol use associated with AWS. I then use this plausibly exogenous change in drinking behavior to establish a causal link between prenatal alcohol exposure and birth outcomes. I find that AWS laws are associated with decreases in the odds of very low birth weight and very pre-term birth. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Impact of police-reported intimate partner violence during pregnancy on birth outcomes.

    Science.gov (United States)

    Lipsky, Sherry; Holt, Victoria L; Easterling, Thomas R; Critchlow, Cathy W

    2003-09-01

    To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes. We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20-36 weeks' gestation), very preterm birth (20-31 weeks), and neonatal death (before discharge). Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50). Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

  19. Reasons for and challenges of recent increases in teen birth rates: a study of family planning service policies and demographic changes at the state level.

    Science.gov (United States)

    Yang, Zhou; Gaydos, Laura M

    2010-06-01

    After declining for over a decade, the birth rate in the United States for adolescents aged 15-19 years increased by 3% in 2006 and 1% again in 2007. We examined demographic and policy reasons for this trend at state level. With data merged from multiple sources, descriptive analysis was used to detect state-level trends in birth rate and policy changes from 2000 to 2006, and variations in the distribution of teen birth rates, sex education, and family planning service policies, and demographic features across each state in 2006. Regression analysis was then conducted to estimate the effect of several reproductive health policies and demographic features on teen birth rates at the state level. Instrument variable was used to correct possible bias in the regression analysis. Medicaid family planning waivers were found to reduce teen birth rates across all ages and races. Abstinence-only education programs were found to cause an increase in teen birth rates among white and black teens. The increasing Hispanic population is another driving force for high teen birth rates. Both demographic factors and policy changes contributed to the increase in teen birth rates between 2000 and 2006. Future policy and behavioral interventions should focus on promoting and increasing access to contraceptive use. Family planning policies should be crafted to address the special needs of teens from different cultural backgrounds, especially Hispanics. Copyright 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Psychological resilience: the impact of affectivity and coping on state anxiety and positive emotions during and after the Washington, DC sniper killings.

    Science.gov (United States)

    Moore, Philip J; Chrabaszcz, Jeffrey S; Peterson, Rolf A; Rohrbeck, Cynthia A; Roemer, Enid C; Mercurio, Andrea E

    2014-01-01

    This research examined the impact of affectivity and coping on state anxiety and positive emotions among young adults living in the Washington, DC metro area both during and after the Washington, DC sniper killings. Participants completed questionnaires during three waves of data collection: (1) during the sniper attacks (n=92); (2) within two weeks after the snipers were captured (n=45); and (3) six months later (n=43). Affectivity (measured by neuroticism) was significantly associated with state anxiety and positive emotions during all three time periods. Coping (measured by constructive thinking) predicted state anxiety and positive emotions during the shootings, but was unrelated to either outcome immediately after the attacks, and marginally related to them six months later. Consistent with the Dynamic Model of Affect, state anxiety and positive emotions were more strongly (and negatively) correlated with each other during the killings than they were after the snipers were apprehended. Taken together, these results support transactional models of stress that emphasize the interaction between dispositional and situational influences, and they suggest that affectivity reflects a fundamental set of reactions to one's environment, while coping dispositions result in more stress-specific responses. Additional theoretical and practical implications of these findings are also discussed.

  1. Interpretation of ambiguities by schoolchildren with low birth weight from Embu das Artes, São Paulo state, Brazil.

    Science.gov (United States)

    Pessoa, Rebeca Rodrigues; Araújo, Sarah Cueva Cândido Soares de; Isotani, Selma Mie; Puccini, Rosana Fiorini; Perissinoto, Jacy

    To assess the development of language regarding the ability to recognize and interpret lexical ambiguity in low-birth-weight schoolchildren enrolled at the school system in the municipality of Embu das Artes, Sao Paulo state, compared with that of schoolchildren with normal birth weight. A case-control, retrospective, cross-sectional study conducted with 378 schoolchildren, both genders, aged 5 to 9.9 years, from the municipal schools of Embu das Artes. Study Group (SG) comprising 210 schoolchildren with birth weight Control Group (CG) composed of 168 school children with birth weight ≥ 2500 g. Participants of both groups were compared with respect to the skills of recognition and verbal interpretation of sentences containing lexical ambiguity using the Test of Language Competence. Variables of interest: Age and gender of children; age and schooling of mothers. Statistical analysis: Descriptive analysis to characterize the sample and score per group; Student's t test for comparison between the total scores of each skill/subtest; Chi-square test to compare items within each subtest; multiple regression analysis for the intervening variables. Participants of the SG presented lower scores for ambiguous sentences compared with those of participants of the CG. Multiple regression analysis showed that child's current age was a predictor for all metalinguistic skills regarding interpretation of ambiguities in both groups. Participants of the SG presented lower specific and total scores than those of participants of the CG for ambiguity skills. The child's current age factor positively influenced the ambiguity skills in both groups.

  2. Characteristics of home care workers who leave their jobs: a cross-sectional study of job satisfaction and turnover in Washington State.

    Science.gov (United States)

    Banijamali, Sahar; Jacoby, Daniel; Hagopian, Amy

    2014-01-01

    Attracting and retaining a stable and motivated home care workforce has become a top policy priority. We surveyed 402 former home care workers in Washington State. We compared these "leavers" to current home care workers recently surveyed. Those who left the profession were more highly educated, had higher household income, and were more likely to be White. Those newly employed have better benefits, wages, hours, and career mobility than in their home care jobs. The low status and poor pay of home care workers may result in the inability of the profession to retain those who face better prospects.

  3. Corrections Education. Washington's Community and Technical Colleges

    Science.gov (United States)

    Washington State Board for Community and Technical Colleges, 2015

    2015-01-01

    The Washington State Department of Corrections contracts with community colleges to provide basic education and job training at each of the state's 12 adult prisons so upon release, individuals are more likely to get jobs and less likely to return. Washington State community colleges build a bridge for offenders to successfully re-enter…

  4. Rainfall and runoff Intensity-Duration-Frequency Curves for Washington State considering the change and uncertainty of observed and anticipated extreme rainfall and snow events

    Science.gov (United States)

    Demissie, Y. K.; Mortuza, M. R.; Li, H. Y.

    2015-12-01

    The observed and anticipated increasing trends in extreme storm magnitude and frequency, as well as the associated flooding risk in the Pacific Northwest highlighted the need for revising and updating the local intensity-duration-frequency (IDF) curves, which are commonly used for designing critical water infrastructure. In Washington State, much of the drainage system installed in the last several decades uses IDF curves that are outdated by as much as half a century, making the system inadequate and vulnerable for flooding as seen more frequently in recent years. In this study, we have developed new and forward looking rainfall and runoff IDF curves for each county in Washington State using recently observed and projected precipitation data. Regional frequency analysis coupled with Bayesian uncertainty quantification and model averaging methods were used to developed and update the rainfall IDF curves, which were then used in watershed and snow models to develop the runoff IDF curves that explicitly account for effects of snow and drainage characteristic into the IDF curves and related designs. The resulted rainfall and runoff IDF curves provide more reliable, forward looking, and spatially resolved characteristics of storm events that can assist local decision makers and engineers to thoroughly review and/or update the current design standards for urban and rural storm water management infrastructure in order to reduce the potential ramifications of increasing severe storms and resulting floods on existing and planned storm drainage and flood management systems in the state.

  5. Evaluating the content and quality of intrapartum care in vaginal births: An example of a state hospital.

    Science.gov (United States)

    Karaçam, Zekiye; Arslan Kurnaz, Döndü; Güneş, Gizem

    2017-03-01

    The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital. This cross-sectional study was conducted between January 1 st , 2013 and December 31 st , 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling. Research data were collected with a questionnaire created by the researchers and assessed using the Bologna score. Numbers and percentages were assessed in the data analysis. The mean age of the women was 25.14±5.37 years and 40.5% had given one live birth. Of the women, 45.2% were admitted to hospital in the latent phase, 76.6% were administered an enema, 3.3% had epidural anesthesia, 2.6% delivered using vacuum extraction, and 54.1% underwent an episiotomy. Some 23.8% of the women experienced spontaneous laceration that needed sutures. The babies of two women exhibited an Apgar score below 7 in the fifth minute. When the quality of the intrapartum care given to the women was assessed with the Bologna score, it was found that 92.7% went into labor spontaneously, 100% of the births were supervised by midwives and doctors, 97.7% of the women had no supporting companion, and the nonsupine position was only used in 0.3% of the women. A partogram was used to follow up on the birth process in 72.6% of the women, and 82.5% achieved contact with their babies within the first hour after birth. Induction was applied in 76.6% of the women and fundal pressure in 27.4%. The study revealed that the quality of intrapartum care in vaginal births was inadequate. Reformulating the guidelines regarding intrapartum care in accordance with World Health Organization recommendations and evidence-based practices may contribute to improving mother and infant health.

  6. Geomorphic response of the North Fork Stillaguamish River to the State Route 530 landslide near Oso, Washington

    Science.gov (United States)

    Anderson, Scott W.; Keith, Mackenzie K.; Magirl, Christopher S.; Wallick, J. Rose; Mastin, Mark C.; Foreman, James R.

    2017-08-03

    On March 22, 2014, the State Route 530 Landslide near Oso, Washington mobilized 8 million cubic meters of unconsolidated Pleistocene material, creating a valley‑spanning deposit that fully impounded the North Fork Stillaguamish River. The river overtopped the 8-meter high debris impoundment within 25 hours and began steadily incising a new channel through the center of the deposit. Repeat topographic surveys, sediment transport measurements, bedload transport models, and observations of downstream channel change were used to document the establishment of that new channel through the landslide and assess the potential for downstream aggradation or channel change that might increase downstream flood hazards.Efficient erosion of the landslide deposit, associated with the steep knickzone formed by the downstream edge of the deposit, resulted in the re-establishment of a 20–40 meters wide, deeply inset channel through the entire deposit by May 2014, 2 months after the landslide. The mean water-surface elevation of the channel through the landslide decreased 7 meters during that 2-month period, and was about 1 meter above the pre-landslide profile in July 2014. The 2014–15 flood season, which included flows near the 0.5 annual exceedance probability discharge (2-year flood), widened the channel tens of meters, and further lowered the water-surface profile 0.5 meter. The planform position evolved slowly as a result of 5–20-meter high banks predominantly composed of clay-rich, cohesive lacustrine material. Erosion of the landslide deposit delivered a total of 820 thousand metric tons of sediment to the North Fork Stillaguamish River over the 18 months following the landslide. The sediment delivery from the deposit was predominantly fine grained: 77 percent (by mass) of the eroded material was silt or clay (less than 0.063 millimeter [mm]), 19 percent sand (0.063–2 mm), and 4 percent pebbles and cobbles (greater than 2 mm).Over the 18 months following the

  7. How the pill became a lifestyle drug: the pharmaceutical industry and birth control in the United States since 1960.

    Science.gov (United States)

    Watkins, Elizabeth Siegel

    2012-08-01

    Marketing decisions, rather than scientific innovations, have guided the development and positioning of contraceptive products in recent years. I review the stalled progress in contraceptive development in the decades following the advent of the Pill in 1960 and then examine the fine-tuning of the market for oral contraceptives in the 1990s and 2000s. Although birth control has been pitched in the United States as an individual solution, rather than a public health strategy, the purpose of oral contraceptives was understood by manufacturers, physicians, and consumers to be the prevention of pregnancy, a basic health care need for women. Since 1990, the content of that message has changed, reflecting a shift in the drug industry's view of the contraception business. Two factors contributed to bring about this change: first, the industry's move away from research and development in birth control and second, the growth of the class of medications known as lifestyle drugs.

  8. Reduced Disparities in Birth Rates Among Teens Aged 15-19 Years - United States, 2006-2007 and 2013-2014.

    Science.gov (United States)

    Romero, Lisa; Pazol, Karen; Warner, Lee; Cox, Shanna; Kroelinger, Charlan; Besera, Ghenet; Brittain, Anna; Fuller, Taleria R; Koumans, Emilia; Barfield, Wanda

    2016-04-29

    Teen childbearing can have negative health, economic, and social consequences for mothers and their children (1) and costs the United States approximately $9.4 billion annually (2). During 1991-2014, the birth rate among teens aged 15-19 years in the United States declined 61%, from 61.8 to 24.2 births per 1,000, the lowest rate ever recorded (3). Nonetheless, in 2014, the teen birth rate remained approximately twice as high for Hispanic and non-Hispanic black (black) teens compared with non-Hispanic white (white) teens (3), and geographic and socioeconomic disparities remain (3,4), irrespective of race/ethnicity. Social determinants associated with teen childbearing (e.g., low parental educational attainment and limited opportunities for education and employment) are more common in communities with higher proportions of racial and ethnic minorities (4), contributing to the challenge of further reducing disparities in teen births. To examine trends in births for teens aged 15-19 years by race/ethnicity and geography, CDC analyzed National Vital Statistics System (NVSS) data at the national (2006-2014), state (2006-2007 and 2013-2014), and county (2013-2014) levels. To describe socioeconomic indicators previously associated with teen births, CDC analyzed data from the American Community Survey (ACS) (2010-2014). Nationally, from 2006 to 2014, the teen birth rate declined 41% overall with the largest decline occurring among Hispanics (51%), followed by blacks (44%), and whites (35%). The birth rate ratio for Hispanic teens and black teens compared with white teens declined from 2.9 to 2.2 and from 2.3 to 2.0, respectively. From 2006-2007 to 2013-2014, significant declines in teen birth rates and birth rate ratios were noted nationally and in many states. At the county level, teen birth rates for 2013-2014 ranged from 3.1 to 119.0 per 1,000 females aged 15-19 years; ACS data indicated unemployment was higher, and education attainment and family income were lower in

  9. Cesarean Birth

    Science.gov (United States)

    ... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...

  10. Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State

    OpenAIRE

    Nicolaidis, Christina; Ko, Cynthia W; Saha, Somnath; Koepsell, Thomas D

    2004-01-01

    Abstract Background The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups. Methods We conducted a retrospective population-bas...

  11. Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight

    Directory of Open Access Journals (Sweden)

    Karen J. Mathewson PhD

    2015-03-01

    Full Text Available Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST. Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood.

  12. To Be a Slave: The Boyhood of Booker T. Washington.

    Science.gov (United States)

    National Park Service (Dept. of Interior), Washington, DC.

    The Booker T. Washington National Monument preserves and protects the birth site and childhood home of Booker T. Washington, while interpreting his life experiences and significance in U.S. history as the most powerful African American between 1895 and 1915. The park provides a resource for public education and a focal point for continuing…

  13. [The influence of birth modus on the emotional state of the mother, bonding, and the newborn's neurobehavioural state].

    Science.gov (United States)

    Pilch, Dorota

    2015-01-01

    Childbirth is an important event, both in a woman's, and in her family's lives, an event which carries a huge emotional charge and influences the functioning of a triad. Labour is a physiological process which may have health (somatic, psychological, mental) and economic consequences. Irrespective of the reasons why it is performed; caesarean section involves surgical, obstetric and anaesthesiological intervention, as well as the necessity for pharmacological agents. Bonding between parents and their children serves as a basis for optimal psychomotor development, and the first year is important for the rest of life. The aim of the study was to assess the influence of the labour mode on the mother's emotional state, mother-child bonding, and the infant's neurobehavioural state. The plan of this study was approved by the Bioethical Commission of the Pomeranian Medical University in Szczecin (BN-001/108/08). The research material comprised 200 women and their children. The following instruments were used in this study: an original questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), the Mother-Child Relationship FIRST score (MCR FIRST score), the Brazelton Scale, also known as the Neonatal Behavioural Assessment Scale (NBAS). The umbilical blood was used to determine the level of cortisol as a stress marker. Statistical analysis was performed using the Shapiro-Wilk test, the χ2 test, the Mann-Whitney U-test, the Fisher test, and the Spearman rank correlation coefficient. The accepted significance level (p) was equal to 0.05 (the acceptable type I error). Around 35% of the women took part in prenatal education, and 59% of them declared the intention to participate in postnatal education. The respondents wanted someone close to be with them during delivery (65.5%), although only 35% had such a possibility. Women giving birth naturally were more often accompanied by their partners (p = 0.00005). Less than half of the women (35%) had skin-to-skin contact with

  14. Washington Conference

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    The 1981 Particle Accelerator Conference was held in Washington from 11-13 March. It was the ninth in the series of meetings organized in the USA which differ from the 'International' meetings in their coverage of the full range of accelerator engineering and technology, including applications outside e field of high energy physics. The Conference took place under the cloud of further budget cuts for Fiscal Year 1982 in the USA which the Department of Energy has applied in line with the financial policy of the new administration. Coming on top of many years of budget trimming which have reduced the number of high energy physics Laboratories funded by the DOE to three (Brookhaven, Fermilab, Stanford - Cornell is funded by the National Science Foundation) and reduced the exploitation of these Laboratories to less than half of their potential, the new cuts did not exactly help to boost morale. Nevertheless, the huge amount of tailed work in accelerator physics and technology which was presented at the Conference showed how alive the field is

  15. Atrazine and nitrate in drinking water and the risk of preterm delivery and low birth weight in four Midwestern states.

    Science.gov (United States)

    Stayner, Leslie Thomas; Almberg, Kirsten; Jones, Rachael; Graber, Judith; Pedersen, Marie; Turyk, Mary

    2017-01-01

    Atrazine and nitrate are common contaminants in water, and there is limited evidence that they are associated with adverse birth outcomes. The objective of this study was to examine whether atrazine and nitrate in water are associated with an increased risk of preterm delivery (PTD) and term low birth weight (LBW). The study included a total of 134,258 singletons births born between January 1, 2004 and December 31, 2008 from 46 counties in four Midwestern states with public water systems that were included in the U.S. Environmental Protection Agency (EPA)'s atrazine monitoring program (AMP). Counties with a population of >300,000 were eliminated from the analyses in order to avoid confounding by urbanicity. Monthly child's sex, race and Hispanic ethnicity specific data were obtained from the states for estimating rates of PTD (nitrate in finished water. Multivariable negative binomial models were fitted to examine the association between the exposures and the adverse birth outcomes. Models were fitted with varying restrictions on the percentage of private well usage in the counties in order to limit the degree of exposure misclassification. Estimated water concentrations of atrazine (mean=0.42 ppb) and nitrate (mean=0.95ppm) were generally low. Neither contaminant was associated with an increased risk of term LBW. Atrazine exposure was associated with a significant increased rate of PTD when well use was restricted to 10% and the exposure was averaged over 4-6 months prior to birth (Rate Ratio for 1ppm increase [RR 1ppm ]=1.08, 95%CI=1.05,1.11) or over 9 months prior to birth (RR 1ppm =1.10, 95%CI=1.01,1.20). Atrazine exposure was also associated with an increased rate of VPTD when when well use was restricted to 10% and the exposure was averaged over 7-9 months prior to birth (RR 1ppm =1.19, 95%CI=1.04,1.36). Exposure to nitrate was significantly associated with an increased rate of VPTD (RR 1ppm =1.08, 95%CI=1.02,1.15) and VLBW (RR 1ppm =1.17, 95%CI=1

  16. Expanded public notice: Washington State notice of intent for corrective action management unit, Hanford Environmental Restoration Disposal

    International Nuclear Information System (INIS)

    1994-01-01

    This document is to serve notice of the intent to operate an Environmental Restoration Disposal Facility (ERDF), adjacent to the 200 West Area of the Hanford Facility, Richland, Washington, as a Corrective Action Management Unit (CAMU), in accordance with 40 Code of Federal Regulation (CFR) 264.552. The ERDF CAMU will serve as a management unit for the majority of waste (primarily soil) excavated during remediation of waste management sites on the Hanford Facility. Only waste that originates from the Hanford Facility can be accepted in this ERDF CAMU. The waste is expected to consist of dangerous waste, radioactive waste, and mixed waste. Mixed waste contains radioactive and dangerous components. The primary features of the ERDF could include the following: one or more trenches, rail and tractor/trailer container handling capability, railroads, an inventory control system, a decontamination building, and operational offices

  17. Consumer use and understanding of labelling information on edible marijuana products sold for recreational use in the states of Colorado and Washington.

    Science.gov (United States)

    Kosa, Katherine M; Giombi, Kristen C; Rains, Caroline B; Cates, Sheryl C

    2017-05-01

    In 2014, the states of Colorado and Washington began allowing retail sales of marijuana for recreational use. The regulatory agencies in these states have implemented specific labelling requirements for edible marijuana products sold for recreational use to help address concerns such as delayed activation time, accidental ingestion, and proper dosing. We conducted 12 focus groups with 94 adult consumers and nonconsumers of edibles in Denver and Seattle to collect information on their use and understanding of labelling information on edible marijuana products sold for recreational use. Specifically, we asked participants about the usefulness, attractiveness, ease of comprehension, relevancy, and acceptability of the label information. Some focus group participants look for and read specific information, such as the potency profile and serving size statement, but do not read or were unfamiliar with other labelling features. The focus groups revealed that participants have some concerns about the current labelling of edibles. In particular, participants were concerned that there is too much information on the labels so consumers may not read the label, there is no obvious indication that the product contains marijuana (e.g., a Universal Symbol), and the information on consumption advice is not clear. Participants in both locations suggested that education in a variety of formats, such as web- and video-based education, would be useful in informing consumers about the possible risks of edibles. The focus group findings suggest that improvements are needed in the labelling of edibles to prevent unintentional ingestion among adult nonusers and help ensure proper dosing and safe consumption among adult users. These findings, along with lessons learned from Colorado and Washington, can help inform the labelling of edibles as additional states allow the sale of edibles for recreational use. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Use of Marijuana and Other Substances Among Pregnant and Parenting Women With Substance Use Disorders: Changes in Washington State After Marijuana Legalization.

    Science.gov (United States)

    Grant, Therese M; Graham, J Christopher; Carlini, Beatriz H; Ernst, Cara C; Brown, Natalie Novick

    2018-01-01

    In 2012, possession of marijuana for nonmedical use was legalized in Washington State. This study examined how legalization affected alcohol and drug use in a sample of pregnant and parenting women with substance use disorders. Study participants from nine counties in Washington State (N = 1,359) were questioned about their substance use after completing a 3-year case management intervention program. The sample was divided into two cohorts based on whether participants had completed the program before or after legalization. Most study participants reported complete abstinence from alcohol and nonprescription drugs at program exit. Among those who were still using substances, women who completed the intervention after marijuana legalization were significantly more likely to report marijuana use at program exit compared with women who completed the intervention before marijuana legalization. Across both cohorts (pre- and post-legalization), we found a positive association of exit marijuana use with alcohol, illegal methadone, other opioids, amphetamines, and cocaine use; even when we controlled for historical period, the association with some of these substances with marijuana use remained evident. Independent of marijuana use, we saw increased use during the post-legalization period of alcohol, illicit methadone, and other opioids. Marijuana use at exit from the Parent-Child Assistance Program (PCAP) increased significantly after marijuana legalization in the state. Women who were not abstinent from marijuana at program exit were likely to report use of other substances as well. Our study design demonstrates an association but does not allow us to conclude that marijuana use leads to other substance use among this sample of women with a history of polysubstance use.

  19. Why Is the Teen Birth Rate in the United States so High and Why Does It Matter? NBER Working Paper No. 17965

    Science.gov (United States)

    Kearney, Melissa Schettini; Levine, Phillip B.

    2012-01-01

    This paper examines two aspects of teen childbearing in the United States. First, it reviews and synthesizes the evidence on the reasons why teen birth rates are so uniquely high in the United States and especially in some states. Second, it considers why and how it matters. We argue that economists' typical explanations are unable to account for…

  20. 75 FR 14462 - Notice of Inventory Completion: Central Washington University, Department of Anthropology...

    Science.gov (United States)

    2010-03-25

    ... Washington University, Department of Anthropology, Ellensburg, WA, and Thomas Burke Memorial Washington State... Washington University, Department of Anthropology, Ellensburg, WA, and the Thomas Burke Memorial Washington... Anthropology, Central Washington University, Ellensburg, WA 98926-7544, telephone (509) 963-2671 or Dr. Peter...

  1. Estimating Aquifer Storage and Recovery (ASR Regional and Local Suitability: A Case Study in Washington State, USA

    Directory of Open Access Journals (Sweden)

    Maria T. Gibson

    2018-01-01

    Full Text Available Developing aquifers as underground water supply reservoirs is an advantageous approach applicable to meeting water management objectives. Aquifer storage and recovery (ASR is a direct injection and subsequent withdrawal technology that is used to increase water supply storage through injection wells. Due to site-specific hydrogeological quantification and evaluation to assess ASR suitability, limited methods have been developed to identify suitability on regional scales that are also applicable at local scales. This paper presents an ASR site scoring system developed to qualitatively assess regional and local suitability of ASR using 9 scored metrics to determine total percent of ASR suitability, partitioned into hydrogeologic properties, operational considerations, and regulatory influences. The development and application of a qualitative water well suitability method was used to assess the potential groundwater response to injection, estimate suitability based on predesignated injection rates, and provide cumulative approximation of statewide and local storage prospects. The two methods allowed for rapid assessment of ASR suitability and its applicability to regional and local water management objectives at over 280 locations within 62 watersheds in Washington, USA. It was determined that over 50% of locations evaluated are suitable for ASR and statewide injection potential equaled 6400 million liters per day. The results also indicate current limitations and/or potential benefits of developing ASR systems at the local level with the intent of assisting local water managers in strategic water supply planning.

  2. 76 FR 377 - Land Acquisitions; Cowlitz Indian Tribe of Washington

    Science.gov (United States)

    2011-01-04

    ... State of Washington by Auditor's File Nos. G 450664 and G 147358. Parcel II That portion of the... thereof acquired by the State of Washington by deed recorded under Auditor's File Nos. G 140380 and D... recorded under Auditor's File No. F 38759, records of Clark County, Washington, described as follows...

  3. Maternal Pre-pregnancy BMI, Gestational Weight Gain, and Infant Birth Weight: A Within-Family Analysis in the United States

    OpenAIRE

    Ji Yan

    2014-01-01

    In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline regression controlling for mother fixed effects indic...

  4. Multi-hazard Non-regulatory Risk Maps for Resilient Coastal Communities of Washington State in Pacific Northwest Region of the United States

    Science.gov (United States)

    Cakir, R.; Walsh, T. J.; Zou, Y.; Gufler, T.; Norman, D. K.

    2015-12-01

    Washington Department of Natural Resources - Division of Geology and Earth Resources (WADNR-DGER) partnered with FEMA through the FEMA Cooperating Technical Partners (CTP) program to assess annualized losses from flood and other hazards and prepare supportive risk related data for FEMA's coastal RiskMAP projects. We used HAZUS-MH analysis to assess losses from earthquake, flood and other potential hazards such as landslide and tsunami in the project areas; on shorelines of the Pacific Ocean and Puget Sound of Washington Grays Harbor, Pacific, Skagit, Whatcom, Island, Mason, Clallam, Jefferson and San Juan counties. The FEMA's Hazus-MH tool was applied to estimate losses and damages for each building due to floods and earthquakes. User-defined facilities (UDF) inventory data were prepared and used for individual building damage estimations and updating general building stocks. Flood depth grids were used to determine which properties are most impacted by flooding. For example, the HAZUS-MH (flood model) run based on the 1% annual chance event (or 100 year flood) for Grays Harbor County, resulted in a total of 161 million in losses to buildings including residential, commercial properties, and other building and occupancy types. A likely M9 megathrust Cascadia earthquake scenario USGS-ShakeMap was used for the HAZUS-MH earthquake model. For example, the HAZUS-MH (earthquake model) run based on the Cascadia M9 earthquake for Grays Harbor County, resulted in a total of 1.15 billion in losses to building inventory. We produced GIS-based overlay maps of properties exposed to tsunami, landslide, and liquefaction hazards within the communities. This multi-hazard approach is an essential component to produce non-regulatory maps for FEMA's RiskMAP project, and they help further improve local and regional mitigation efforts and emergency response plans, and overall resiliency plan of the communities in and around the coastal communities in western Washington.

  5. Producing a satellite-derived map and modelling Spartina alterniflora expansion for Willapa Bay in Washington State

    Science.gov (United States)

    Berlin, Cynthia Jane

    1998-12-01

    This research addresses the identification of the areal extent of the intertidal wetlands of Willapa Bay, Washington, and the evaluation of the potential for exotic Spartina alterniflora (smooth cordgrass) expansion in the bay using a spatial geographic approach. It is hoped that the results will address not only the management needs of the study area but provide a research design that may be applied to studies of other coastal wetlands. Four satellite images, three Landsat Multi-Spectral (MSS) and one Thematic Mapper (TM), are used to derive a map showing areas of water, low, middle and high intertidal, and upland. Two multi-date remote sensing mapping techniques are assessed: a supervised classification using density-slicing and an unsupervised classification using an ISODATA algorithm. Statistical comparisons are made between the resultant derived maps and the U.S.G.S. topographic maps for the Willapa Bay area. The potential for Spartina expansion in the bay is assessed using a sigmoidal (logistic) growth model and a spatial modelling procedure for four possible growth scenarios: without management controls (Business-as-Usual), with moderate management controls (e.g. harvesting to eliminate seed setting), under a hypothetical increase in the growth rate that may reflect favorable environmental changes, and under a hypothetical decrease in the growth rate that may reflect aggressive management controls. Comparisons for the statistics of the two mapping techniques suggest that although the unsupervised classification method performed satisfactorily, the supervised classification (density-slicing) method provided more satisfactory results. Results from the modelling of potential Spartina expansion suggest that Spartina expansion will proceed rapidly for the Business-as-Usual and hypothetical increase in the growth rate scenario, and at a slower rate for the elimination of seed setting and hypothetical decrease in the growth rate scenarios, until all potential

  6. A floating bridge disrupts seaward migration and increases mortality of steelhead smolts in Hood Canal, Washington state.

    Directory of Open Access Journals (Sweden)

    Megan Moore

    Full Text Available Habitat modifications resulting from human transportation and power-generation infrastructure (e.g., roads, dams, bridges can impede movement and alter natural migration patterns of aquatic animal populations, which may negatively affect survival and population viability. Full or partial barriers are especially problematic for migratory species whose life histories hinge on habitat connectivity.The Hood Canal Bridge, a floating structure spanning the northern outlet of Hood Canal in Puget Sound, Washington, extends 3.6 meters underwater and forms a partial barrier for steelhead migrating from Hood Canal to the Pacific Ocean. We used acoustic telemetry to monitor migration behavior and mortality of steelhead smolts passing four receiver arrays and several single receivers within the Hood Canal, Puget Sound, and Strait of Juan de Fuca. Twenty-seven mortality events were detected within the vicinity of the Hood Canal Bridge, while only one mortality was recorded on the other 325 receivers deployed throughout the study area. Migrating steelhead smolts were detected at the Hood Canal Bridge array with greater frequency, on more receivers, and for longer durations than smolts migrating past three comparably configured arrays. Longer migration times and paths are likely to result in a higher density of smolts near the bridge in relation to other sites along the migration route, possibly inducing an aggregative predator response to steelhead smolts.This study provides strong evidence of substantial migration interference and increased mortality risk associated with the Hood Canal Bridge, and may partially explain low early marine survival rates observed in Hood Canal steelhead populations. Understanding where habitat modifications indirectly increase predation pressures on threatened populations helps inform potential approaches to mitigation.

  7. A floating bridge disrupts seaward migration and increases mortality of steelhead smolts in Hood Canal, Washington state.

    Science.gov (United States)

    Moore, Megan; Berejikian, Barry A; Tezak, Eugene P

    2013-01-01

    Habitat modifications resulting from human transportation and power-generation infrastructure (e.g., roads, dams, bridges) can impede movement and alter natural migration patterns of aquatic animal populations, which may negatively affect survival and population viability. Full or partial barriers are especially problematic for migratory species whose life histories hinge on habitat connectivity. The Hood Canal Bridge, a floating structure spanning the northern outlet of Hood Canal in Puget Sound, Washington, extends 3.6 meters underwater and forms a partial barrier for steelhead migrating from Hood Canal to the Pacific Ocean. We used acoustic telemetry to monitor migration behavior and mortality of steelhead smolts passing four receiver arrays and several single receivers within the Hood Canal, Puget Sound, and Strait of Juan de Fuca. Twenty-seven mortality events were detected within the vicinity of the Hood Canal Bridge, while only one mortality was recorded on the other 325 receivers deployed throughout the study area. Migrating steelhead smolts were detected at the Hood Canal Bridge array with greater frequency, on more receivers, and for longer durations than smolts migrating past three comparably configured arrays. Longer migration times and paths are likely to result in a higher density of smolts near the bridge in relation to other sites along the migration route, possibly inducing an aggregative predator response to steelhead smolts. This study provides strong evidence of substantial migration interference and increased mortality risk associated with the Hood Canal Bridge, and may partially explain low early marine survival rates observed in Hood Canal steelhead populations. Understanding where habitat modifications indirectly increase predation pressures on threatened populations helps inform potential approaches to mitigation.

  8. Birth Control

    Science.gov (United States)

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  9. Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States.

    Science.gov (United States)

    Yan, Ji

    2015-07-01

    In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline analysis controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, respectively, by 1.3, 3 and 3.9 percentage points, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence by 1.4 and 2 percentage points. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on one's health, education, and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. A Cluster Analytic Examination of Acculturation and Health Status among Asian Americans in the Washington DC Metropolitan Area, United States

    Science.gov (United States)

    Lee, Sunmin; Chen, Lu; He, Xin; Miller, Matthew J.; Juon, Hee-Soon

    2013-01-01

    Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups. A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range: −1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score. Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the

  11. Birth Defects in Newborns: Spina Bifida Index at Rio Grande Do Norte State in Brazil

    Directory of Open Access Journals (Sweden)

    Arnaldo CM Junior

    2014-08-01

    Conclusion: Northeast region is the one that has the major incidence of SB in Brazil country, but RN state has a number lower than others states from its region. It was made an update about therapeutic options to minimize the morbidity and mortality in newborn with SB congenital defects. [J Interdiscipl Histopathol 2014; 2(4.000: 217-223

  12. Federal/State cooperation in the licensing of a nuclear power project. A joint licensing process between the US Nuclear Regulatory Commission and the Washington State Energy Facility Site Evaluation Council

    International Nuclear Information System (INIS)

    1984-05-01

    This report summarizes and documents a joint environmental review and licensing process established between the US Nuclear Regulatory Commission (NRC) and the Washington State Energy Facility Site Evaluation Council (EFSEC) in 1980-1983 for the Skagit/Hanford Nuclear Project (S/HNP). It documents the agreements made between the agencies to prepare a joint environmental impact statement responsive to the requirements of the National Environmental Policy Act of 1969 (NEPA) and the Washington State Environmental Policy Act. These agreements also established protocol to conduct joint public evidentiary hearings on matters of mutual jurisdiction, thereby reducing the duplication of effort and increasing the efficiency of the use of resources of federal and state governments and other entities involved in the process. This report may provide guidance and rationale to licensing bodies that may wish to adopt some of the procedures discussed in the report in the event that they become involved in the licensing of a nuclear power plant project. The history of the S/HNP and of the agreement processes are discussed. Discussions are provided on implementing the joint review process. A separate section is included which presents independent evaluations of the process by the applicant, NRC, and EFSEC

  13. Access and Diversity in the Running Start Program: A Comparison of Washington's Running Start Program to Other State Level Dual Enrollment Programs Hosted on a College Campus

    Science.gov (United States)

    Smith, Karl

    2014-01-01

    Since 1990, high school students in Washington have had the choice of earning college credit through the Running Start program. Running start is a dual enrollment and dual credit program that allows eleventh and twelfth grade high school students to take college courses at any of Washington's 34 community and technical colleges, Central Washington…

  14. Spatially varying predictors of teenage birth rates among counties in the United States

    Directory of Open Access Journals (Sweden)

    Carla Shoff

    2012-09-01

    Full Text Available BACKGROUND Limited information is available about teenage pregnancy and childbearing in rural areas, even though approximately 20 percent of the nation's youth live in rural areas. Identifying whether there are differences in the teenage birth rate (TBR across metropolitan and nonmetropolitan areas is important because these differences may reflect modifiable ecological-level influences such as education, employment, laws, healthcare infrastructure, and policies that could potentially reduce the TBR. OBJECTIVE The goals of this study are to investigate whether there are spatially varying relationships between the TBR and the independent variables, and if so, whether these associations differ between metropolitan and nonmetropolitan counties. METHODS We explore the heterogeneity within metropolitan/nonmetropolitan county groups separately using geographically weighted regression (GWR, and investigate the difference between metropolitan/nonmetropolitan counties using spatial regime models with spatial errors. These analyses were applied to county-level data from the National Center for Health Statistics and the US Census Bureau. RESULTS GWR results suggested that non-stationarity exists in the associations between TBR and determinants within metropolitan/nonmetropolitan groups. The spatial regime analysis indicated that the effect of socioeconomic disadvantage on TBR significantly varied by the metropolitan status of counties. CONCLUSIONS While the spatially varying relationships between the TBR and independent variables were found within each metropolitan status of counties, only the magnitude of the impact of the socioeconomic disadvantage index is significantly stronger among metropolitan counties than nonmetropolitan counties. Our findings suggested that place-specific policies for the disadvantaged groups in a county could be implemented to reduce TBR in the US.

  15. Reconciling State Aid and Property Tax Relief for Urban Schools: Birthing a New STAR in New York State

    Science.gov (United States)

    Eom, Tae Ho; Killeen, Kieran M.

    2007-01-01

    Similar to many property tax relief programs, New York State's School Tax Relief (STAR) program has been shown to exacerbate school resource inequities across urban, suburban, and rural schools. STAR's inherent conflict with the wealth equalization policies of New York State's school finance system are highlighted in a manner that effectively…

  16. VSRR - State and National Provisional Counts for Live Births, Deaths, and Infant Deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — NOTES: Figures include all revisions received from the states and, therefore, may differ from those previously published. Data are provisional and are subject to...

  17. An mHealth Framework to Improve Birth Outcomes in Benue State, Nigeria: A Study Protocol.

    Science.gov (United States)

    Ezeanolue, Echezona Edozie; Gbadamosi, Semiu Olatunde; Olawepo, John Olajide; Iwelunmor, Juliet; Sarpong, Daniel; Eze, Chuka; Ogidi, Amaka; Patel, Dina; Onoka, Chima

    2017-05-26

    The unprecedented coverage of mobile technology across the globe has led to an increase in the use of mobile health apps and related strategies to make health information available at the point of care. These strategies have the potential to improve birth outcomes, but are limited by the availability of Internet services, especially in resource-limited settings such as Nigeria. Our primary objective is to determine the feasibility of developing an integrated mobile health platform that is able to collect data from community-based programs, embed collected data into a smart card, and read the smart card using a mobile phone-based app without the need for Internet access. Our secondary objectives are to determine (1) the acceptability of the smart card among pregnant women and (2) the usability of the smart card by pregnant women and health facilities in rural Nigeria. We will leverage existing technology to develop a platform that integrates a database, smart card technology, and a mobile phone-based app to read the smart cards. We will recruit 300 pregnant women with one of the three conditions-HIV, hepatitis B virus infection, and sickle cell trait or disease-and four health facilities in their community. We will use Glasgow's Reach, Effectiveness, Adoption, Implementation, and Maintenance framework as a guide to assess the implementation, acceptability, and usability of the mHealth platform. We have recruited four health facilities and 300 pregnant women with at least one of the eligible conditions. Over the course of 3 months, we will complete the development of the mobile health platform and each participant will be offered a smart card; staff in each health facility will receive training on the use of the mobile health platform. Findings from this study could offer a new approach to making health data from pregnant women available at the point of delivery without the need for an Internet connection. This would allow clinicians to implement evidence

  18. Public Pension Reform and Teacher Turnover: Evidence from Washington State. CEDR Policy Brief. WP #2015-8

    Science.gov (United States)

    Goldhaber, Dan; Grout, Cyrus; Holden, Kristian

    2015-01-01

    Traditional defined benefit (DB) pension systems in many states face large funding shortfalls. Movement toward defined contribution (DC) pension structures may reduce the likelihood of future shortfalls, but there is concern that such reforms may have the undesirable effect of increasing employee turnover. In studying patterns of employee turnover…

  19. 75 FR 74131 - Notice of Finding of No Significant Impact for the Washington State Portion of the Pacific...

    Science.gov (United States)

    2010-11-30

    ... Environmental Assessment AGENCY: Federal Railroad Administration (FRA), United States Department of... Transportation (WSDOT) prepared a Tier-1 Environmental Assessment (Tier-1 EA) that evaluates the impacts of a... have a significant impact on the quality of the human or natural environment and has issued a Finding...

  20. Evaluation of the product ratio coherent model in forecasting mortality rates and life expectancy at births by States

    Science.gov (United States)

    Shair, Syazreen Niza; Yusof, Aida Yuzi; Asmuni, Nurin Haniah

    2017-05-01

    Coherent mortality forecasting models have recently received increasing attention particularly in their application to sub-populations. The advantage of coherent models over independent models is the ability to forecast a non-divergent mortality for two or more sub-populations. One of the coherent models was recently developed by [1] known as the product-ratio model. This model is an extension version of the functional independent model from [2]. The product-ratio model has been applied in a developed country, Australia [1] and has been extended in a developing nation, Malaysia [3]. While [3] accounted for coherency of mortality rates between gender and ethnic group, the coherency between states in Malaysia has never been explored. This paper will forecast the mortality rates of Malaysian sub-populations according to states using the product ratio coherent model and its independent version— the functional independent model. The forecast accuracies of two different models are evaluated using the out-of-sample error measurements— the mean absolute forecast error (MAFE) for age-specific death rates and the mean forecast error (MFE) for the life expectancy at birth. We employ Malaysian mortality time series data from 1991 to 2014, segregated by age, gender and states.

  1. SECULAR TRENDS AND LATITUDE GRADIENTS IN THE MALE-FEMALE RATIO AT BIRTH IN YUGOSLAVIA AND THE EX-YUGOSLAVIAN STATES

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2013-01-01

    Full Text Available Background: Latitude gradients and secular trends in Europe and North America have been found in the male-female ratio at birth (M/F: male births divided by total births which approximates 0.515. Methods: Annual national data for Yugoslavia and the post-Yugoslavia States for male and female live births were obtained from the World Health Organisation and analysed with contingency tables. Results: This study analysed 22,020,729 live births. There was a increasing trend in M/F prior to the breakup of the former Yugoslavia (1950–1990, p = 0.002, followed by a decreasing trend after 1990 (p = 0.02. A latitude gradient was also noted, with more males being born in southern, warmer latitudes (p < 0.0001. There was an overall excess of 42,753 male births based on an anticipated M/F of 0.515. Conclusion: M/F is decreasing in this region, similar to the rest of Europe and North America. A latitude gradient is also present with more males being born in warmer (more Southern latitudes (p < 0.0001, even in this small region and over the short time-frame studied.

  2. From 50 Years Ago, the Birth of Modern Liquid-State Science.

    Science.gov (United States)

    Chandler, David

    2017-05-05

    The story told in this autobiographical perspective begins 50 years ago, at the 1967 Gordon Research Conference on the Physics and Chemistry of Liquids. It traces developments in liquid-state science from that time, including contributions from the author, and especially in the study of liquid water. It emphasizes the importance of fluctuations and the challenges of far-from-equilibrium phenomena.

  3. Russian Bank Database : Birth and Death, Location, Mergers, Deposit Insurance Participation, State and Foreign Ownership

    NARCIS (Netherlands)

    Karas, A.O.|info:eu-repo/dai/nl/411259393; Vernikov, Andrei

    For every Russian bank we collect records of its registration, license withdrawal, liquidation, location changes, mergers and acquisitions, entrance to and exit from the Deposit Insurance System as well as state and foreign ownership. We describe our sources and the resulting database.

  4. Secular Trends and Latitude Gradients in Sex Ratios at Birth in Czechoslovakia and the Post-Czechoslovakian States

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2012-01-01

    Full Text Available Latitude gradients and secular trends in Europe and North America have been found in the male-female ratio at birth (M/F: male births divided by total births which is expected to be 0.515. Annual national data for Czechoslovakia and the post-Czechoslovakian (Czech Republic and Slovakia countries for male and female live births were obtained from the World Health Organisation and analysed with contingency tables. This study analysed 13,123,538 live births. An overall decreasing trend in M/F was found (p < 00001. No latitude gradient was noted. There was an overall deficit of 15,232 male births based on an M/F of 0.515. M/F is declining in this region, despite well developing economies that have resisted the worldwide slowdown. An interplay of several poorly understood factors is likely.

  5. Willapa Bay, Washington Benthic Habitats 1995 Biotic

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In June 1995, the Columbia River Estuary Study Taskforce (CREST) acquired 295 true color aerial photographs (1:12,000) of Willapa Bay, Washington, from the State of...

  6. Willapa Bay, Washington Benthic Habitats 1995 Geoform

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In June 1995, the Columbia River Estuary Study Taskforce (CREST) acquired 295 true color aerial photographs (1:12,000) of Willapa Bay, Washington, from the State of...

  7. Willapa Bay, Washington Benthic Habitats 1995 Substrate

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In June 1995, the Columbia River Estuary Study Taskforce (CREST) acquired 295 true color aerial photographs (1:12,000) of Willapa Bay, Washington, from the State of...

  8. From 32 ounces to zero: a medical geographic study of dispensing a cultivated batch of "plum" cannabis flowers to medical marijuana patients in Washington State.

    Science.gov (United States)

    Aggarwal, Sunil K; Carter, Gregory T; Zumbrunnen, Craig; Morrill, Richard; Sullivan, Mark; Mayer, Jonathan D

    2013-01-01

    The medicinal use of cannabis is a growing phenomenon in the U.S. predicated on the success of overcoming specific spatial challenges and establishing particular human-environment relationships. This article takes a medical geographic "snapshot" of an urban site in Washington State where qualifying chronically ill and debilitated patients are delivered locally produced botanical cannabis for medical use. Using interview, survey, and observation, this medical geographic research project collected information on the social space of the particular delivery site and tracked the production cost, reach, and health value of a 32-ounce batch of strain-specific medical cannabis named "Plum" dispensed over a four-day period. A convenience sample of 37 qualifying patients delivered this batch of cannabis botanical medicine was recruited and prospectively studied with survey instruments. Results provide insight into patients' self-rated health, human-plant relationships, and travel-to-clinic distances. An overall systematic geographic understanding of the medical cannabis delivery system gives a grounded understanding of the lengths that patients and care providers go, despite multiple hurdles, to receive and deliver treatment with botanical cannabis that relieves diverse symptoms and improves health-related quality-of-life.

  9. Evaluating the effectiveness of Washington state repeated job search services on the employment rate of prime-age female welfare recipients☆

    Science.gov (United States)

    Hsiao, Cheng; Shen, Yan; Wang, Boqing; Weeks, Greg

    2014-01-01

    This paper uses an unbalanced panel dataset to evaluate how repeated job search services (JSS) and personal characteristics affect the employment rate of the prime-age female welfare recipients in the State of Washington. We propose a transition probability model to take into account issues of sample attrition, sample refreshment and duration dependence. We also generalize Honoré and Kyriazidou’s [Honoré, B.E., Kyriazidou, E., 2000. Panel data discrete choice models with lagged dependent variables. Econometrica 68 (4), 839–874] conditional maximum likelihood estimator to allow for the presence of individual-specific effects. A limited information test is suggested to test for selection issues in non-experimental data. The specification tests indicate that the (conditional on the set of the confounding variables considered) assumptions of no selection due to unobservables and/or no unobserved individual-specific effects are not violated. Our findings indicate that the first job search service does have positive and significant impacts on the employment rate. However, providing repeated JSS to the same client has no significant impact. Further, we find that there are significant experience-enhancing effects. These findings suggest that providing one job search services training to individuals may have a lasting impact on raising their employment rates. PMID:26052178

  10. Prevalence at birth of congenital malformations in communities near the Hanford site

    International Nuclear Information System (INIS)

    Sever, L.E.; Hessol, N.A.; Gilbert, E.S.; McIntyre, J.M.

    1988-01-01

    The authors examined the prevalence of congenital malformations among births in Benton and Franklin counties, in southeastern Washington State, from 1968 through 1980. The Hanford Site is in this area and serves as a major employer. In addition, various agriculturally and chemically related activities are in the area. Hospital and vital records were used to identify 454 malformation cases among 23,319 births; this yielded a malformation rate of 19.6 per 1000 births, a rate similar to those reported in other studies. The rates of specific malformations ascertained during the first year of life were compared with combined rates from the states of Washington, Oregon, and Idaho from the Birth Defects Monitoring Program. Among defects that would be expected to be comparably ascertained, a statistically significant elevated rate of neural tube defects was observed (1.72 per 1000 births vs. 0.99 per 1000). Rates of cleft lip were significantly lower in Benton and Franklin counties than in the Birth Defects Monitoring Program (0.59 per 1,000 vs. 1.17 per 1000). For congenital heart defects, pyloric stenosis, and Down syndrome, which are often not diagnosed in the newborn period, Birth Defects Monitoring Program data did not offer appropriate comparisons. The rates of these defects did not appear to be elevated in relation to rates found in other relevant populations. When rates of neural tube defects were compared with those in populations other than the Birth Defects Monitoring Program, the Benton and Franklin county rates were still considered to be elevated. The increased bicounty rate cannot be explained by employment of the parents at Hanford or by the impact of plant emissions on the local population

  11. Capture and resight data of California sea lions in Washington State, 1989-02-15 to 2006-06-01 (NCEI Accession 0146259)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset contains data from the capture and recapture of over 1500 male California sea lions (Zalophus californianus) from Washington between 1989-2006. The data...

  12. Clash of the Titans: Booker T. Washington and W. E. B. Du Bois. Curriculum Based Education Program, Grade 11.

    Science.gov (United States)

    National Park Service (Dept. of Interior), Washington, DC.

    The Booker T. Washington National Monument preserves and protects the birth site and childhood home of Booker T. Washington while interpreting his life experiences and significance in U.S. history as the most powerful African American between 1895 and 1915. The programs and activities included in this guide about the Booker T. Washington and W. E.…

  13. Access road from State Route 240 to the 200 West Area, Hanford Site, Richland, Washington: Environmental assessment

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    The US Department of Energy (DOE) proposes to construct an access road on the Hanford Site, from State Route (SR) 240 to Beloit Avenue in the 200 West Area. Traffic volume during shift changes creates an extremely serious congestion and safety problem on Route 4S from the Wye barricade to the 200 Areas. A Risk Evaluation (Trost 1992) indicated that there is a probability of 1.53 fatal accidents on Route 4S within 2 years. To help alleviate this danger, a new 3.5-kilometer (2.2-mile)-long access road would be constructed from Beloit Avenue in the 200 West Area to SR 240. In addition, administrative controls such as redirecting traffic onto alternate routes would be used to further reduce traffic volume. The proposed access road would provide an alternative travel-to-work route for many outer area personnel, particularly those with destinations in the 200 West Area. This proposal is the most reasonable alternative to reduce the problem. While traffic safety would be greatly improved, a small portion of the shrub-steppe habitat would be disturbed. The DOE would offset any habitat damage by re-vegetation or other appropriate habitat enhancement activities elsewhere on the Hanford Site. This Environmental Assessment (EA) provides information about the environmental impacts of the proposed action, so a decision can be made to either prepare an Environmental Impact Statement or issue a Finding of No Significant Impact.

  14. The absolute power of relative risk in debates on repeat cesareans and home birth in the United States.

    Science.gov (United States)

    Declercq, Eugene

    2013-01-01

    Changes in policies and practices related to repeat cesareans and home birth in the U.S. have been influenced by different interpretations of the risk of poor outcomes. This article examines two cases-vaginal birth after cesarean (VBAC) and home birth to illustrate how an emphasis on relative over absolute risk has been used to characterize outcomes associated with these practices. The case studies will rely on reviews of the research literature and examination of data on birth trends and outcomes. Childbirth involves some unique challenges in assessing health risks, specifically the issues of: (1) timing of risks (lowering health risk in a current birth can increase it in subsequent births); (2) the potential weighing of risks to the mother's versus the infant's health; (3) the fact that birth is a condition of health and many of the feared outcomes (for example, symptomatic uterine rupture) involve very low absolute risk of occurrence; and (4) a malpractice environment that seizes upon those rare poor outcomes in highly publicized lawsuits that receive widespread attention in the clinical community. In the cases of VBAC and home birth, the result has been considerable emphasis on relative risks, typically an adjusted odds ratio, with little consideration of absolute risks. Assessments of the safety of interventions in childbirth should involve careful consideration and communication of the multiple dimensions of risk, particularly a balancing of relative and absolute risks of poor health outcomes.

  15. Breech birth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000623.htm Breech birth To use the sharing features on this page, ... safer for your baby to pass through the birth canal. In the last weeks of pregnancy, your ...

  16. Physical Activity Practices, Policies and Environments in Washington State Child Care Settings: Results of a Statewide Survey.

    Science.gov (United States)

    Tandon, Pooja S; Walters, Kelly M; Igoe, Bridget M; Payne, Elizabeth C; Johnson, Donna B

    2017-03-01

    Objectives Child care is an important setting for the promotion of physical activity (PA) in early childhood. The purpose of this study was to examine the associations between specific PA environments and recommended practices in child care settings as well as the degree to which child care settings met recommended standards for total PA time. Methods In 2013, all programs licensed to care for children ages 2-5 in WA state were surveyed about their PA related practices. Logistic regression was used to determine odds of meeting best-practice standards for outdoor time and PA. Results The response rate was 45.8 % from centers (692/1511) and 32.1 % from homes (1281/3991). Few programs reported meeting best-practice standards for the amount of time children spend being physically active (centers: 12.1 %, homes: 20.1 %) and outdoor time (centers: 21.8 %, homes: 21.7 %). Programs where children go outside regardless of weather and those reporting more adult-led PA had higher odds of meeting best-practice standards for both PA and outdoor time. Meeting best-practice standards for outdoor time was the strongest predictor of meeting best-practice standards for total PA time [centers: OR 15.9 (9.3-27.2), homes: OR 5.2 (3.8-7.1)]. Conclusions for Practice There is considerable room for improvement in licensed child care settings in WA to meet best-practice standards for young children's outdoor and PA time. Initiatives that create policies and environments encouraging outdoor play and adult-led PA in child care have the potential to increase physical activity in substantial numbers of young children.

  17. Prevalence of Hospitalized Live Births Affected by Alcohol and Drugs and Parturient Women Diagnosed with Substance Abuse at Liveborn Delivery: United States, 1999–2008

    Science.gov (United States)

    Pan, I-Jen; Yi, Hsiao-ye

    2015-01-01

    Objective To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. Methods This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. Results From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. Conclusions The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births. PMID:22688539

  18. Prevalence of hospitalized live births affected by alcohol and drugs and parturient women diagnosed with substance abuse at liveborn delivery: United States, 1999-2008.

    Science.gov (United States)

    Pan, I-Jen; Yi, Hsiao-ye

    2013-05-01

    To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births.

  19. Auditing Access to Outpatient Rehabilitation Services for Children With Traumatic Brain Injury and Public Insurance in Washington State.

    Science.gov (United States)

    Fuentes, Molly M; Thompson, Leah; Quistberg, D Alex; Haaland, Wren L; Rhodes, Karin; Kartin, Deborah; Kerfeld, Cheryl; Apkon, Susan; Rowhani-Rahbar, Ali; Rivara, Frederick P

    2017-09-01

    To identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. Audit study with paired calls, where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury and public or private insurance. Outpatient rehabilitation clinics. Sample of rehabilitation clinics (N=287): 195 physical therapy (PT) clinics, 109 occupational therapy (OT) clinics, 102 speech therapy (ST) clinics, and 11 rehabilitation medicine clinics. Not applicable. Acceptance of public insurance and the number of business days until the next available appointment. Therapy clinics were more likely to accept private insurance than public insurance (relative risk [RR] for PT clinics, 1.33; 95% confidence interval [CI], 1.22-1.44; RR for OT clinics, 1.40; 95% CI, 1.24-1.57; and RR for ST clinics, 1.42; 95% CI, 1.25-1.62), with no significant difference for rehabilitation medicine clinics (RR, 1.10; 95% CI, 0.90-1.34). The difference in median wait time between clinics that accepted public insurance and those accepting only private insurance was 4 business days for PT clinics and 15 days for ST clinics (P≤.001), but the median wait time was not significantly different for OT clinics or rehabilitation medicine clinics. When adjusting for urban and multidisciplinary clinic statuses, the wait time at clinics accepting public insurance was 59% longer for PT (95% CI, 39%-81%), 18% longer for OT (95% CI, 7%-30%), and 107% longer for ST (95% CI, 87%-130%) than that at clinics accepting only private insurance. Distance to clinics varied by discipline and area within the state. Therapy clinics were less likely to accept public insurance than private insurance. Therapy clinics accepting public insurance had longer wait times than did clinics that accepted only private insurance. Rehabilitation professionals should attempt to implement policy and practice changes to promote equitable access to care. Copyright © 2017

  20. University of Washington

    Data.gov (United States)

    Federal Laboratory Consortium — The theme of the University of Washington based Center for Child Environmental Health Risks Research (CHC) is understanding the biochemical, molecular and exposure...

  1. [The impact of low birth weight related to gestational depression on federal funding of public health: a study in Pelotas, Rio Grande do Sul State, Brazil].

    Science.gov (United States)

    Menezes, Leticia Oliveira de; Pinheiro, Ricardo Tavares; Quevedo, Luciana de Avila; Oliveira, Sandro Schreiber de; Silva, Ricardo Azevedo da; Pinheiro, Karen Amaral Tavares; Santo, Graciela Coelho Espírito; Jansen, Karen

    2012-10-01

    Low birth weight is related to morbidity and mortality and sequelae during infant development, thereby impacting health system costs. It is thus important to evaluate factors that influence low birth weight and to estimate their impact on the Brazilian Unified National Health System (SUS). This was a nested prospective study in a cohort of pregnant women who received prenatal care and gave birth in the National Health System in hospitals with ICUs in the city of Pelotas, Rio Grande do Sul State, Brazil. Gestational depression was associated with a fourfold risk of low birth weight (PR = 3.94; CI: 1.49-10.36). Based on the population-attributable fraction, in the overall population an estimated 36.17% of low birth weight infants are born to mothers with an episode of depression during pregnancy, with an estimated cost of more than R$76 million (U$38 million) in Brazil. The study recommends the expansion of preventive and therapeutic mental health care measures for pregnant women and the adequate use of resources in the Unified National Health System to improve neonatal outcomes.

  2. The effect of air pollutants on birth weight in medium-sized towns in the state of São Paulo

    Directory of Open Access Journals (Sweden)

    Veridiana de Paula Santos

    2014-12-01

    Full Text Available OBJECTIVE: To investigate the effect of air pollution on birth weight in a medium-sized town in the State of São Paulo, Southeast Brazil.METHODS: Cross-sectional study using data from live births of mothers residing in São José dos Campos from 2005 to 2009. Data was obtained from the Department of Information and Computing of the Brazilian Unified Health System. Air pollutant data (PM10, SO2, and O3 and daily averages of their concentrations were obtained from the Environmental Sanitation & Technology Company. Statistical analysis was performed by linear and logistic regressions using the Excel and STATA v.7 software programs.RESULTS: Maternal exposure to air pollutants was not associated with low birth weight, with the exception of exposure to SO2 within the last month of pregnancy (OR=1.25; 95% CI=1.00-1.56. Maternal exposure to PM10 and SO2 during the last month of pregnancy led to lower weight at birth (0.28g and 3.15g, respectively for each 1mg/m3 increase in the concentration of these pollutants, but without statistical significance.CONCLUSIONS: This study failed to identify a statistically significant association between the levels of air pollutants and birth weight, with the exception of exposure to SO2 within the last month of pregnancy.

  3. Causes of death and infant mortality rates among full-term births in the United States between 2010 and 2012: An observational study.

    Science.gov (United States)

    Bairoliya, Neha; Fink, Günther

    2018-03-01

    While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. Linked birth and death records for the period 2010-2012 were used to identify the state- and cause-specific burden of infant mortality among full-term infants (born at 37-42 weeks of gestation). Multivariable logistic models were used to assess the extent to which state-level differences in full-term infant mortality (FTIM) were attributable to observed differences in maternal and birth characteristics. Random effects models were used to assess the relative contribution of state-level variation to FTIM. Hypothetical mortality outcomes were computed under the assumption that all states could achieve the survival rates of the best-performing states. A total of 10,175,481 infants born full-term in the US between January 1, 2010, and December 31, 2012, were analyzed. FTIM rate (FTIMR) was 2.2 per 1,000 live births overall, and ranged between 1.29 (Connecticut, 95% CI 1.08, 1.53) and 3.77 (Mississippi, 95% CI 3.39, 4.19) at the state level. Zero states reached the rates reported in the 6 low-mortality European countries analyzed (FTIMR 2.75. Sudden unexpected death in infancy (SUDI) accounted for 43% of FTIM; congenital malformations and perinatal conditions accounted for 31% and 11.3% of FTIM, respectively. The largest mortality differentials between states with good and states with poor FTIMR were found for SUDI, with particularly large risk differentials for deaths due to sudden infant death syndrome (SIDS) (odds ratio [OR] 2.52, 95% CI 1.86, 3.42) and suffocation (OR 4.40, 95% CI 3.71, 5.21). Even though these mortality differences

  4. Science Technology Engineering and Math (STEM) Education MUST Begin in Early Childhood Education: A Systematic Analysis of Washington State Guidelines Used to Gauge the Development and Learning of Young Learners

    Science.gov (United States)

    Briseno, Luis Miguel

    This paper reflects future direction for early Science Technology Engineering and Mathematics (STEM) education, science in particular. Washington State stakeholders use guidelines including: standards, curriculums and assessments to gauge young children's development and learning, in early childhood education (ECE). Next Generation Science Standards (NGSS), and the Framework for K-12 programs (National Research Council, 2011) emphasizes the need for reconfiguration of standards: "Too often standards are a long list of detailed and disconnected facts... this approach alienates young people, it also leaves them with fragments of knowledge and little sense of the inherent logic and consistency of science and of its universality." NGSS' position elevates the concern and need for learners to experience teaching and learning from intentionally designed cohesive curriculum units, rather than as a series of unrelated and isolated lessons. To introduce the argument the present study seeks to examine Washington State early learning standards. To evaluate this need, I examined balance and coverage/depth. Analysis measures the level of continuum in high-quality guidelines from which Washington State operates to serve its youngest citizens and their families.

  5. A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network.

    Science.gov (United States)

    Devine, Emily Beth; Alfonso-Cristancho, Rafael; Devlin, Allison; Edwards, Todd C; Farrokhi, Ellen T; Kessler, Larry; Lavallee, Danielle C; Patrick, Donald L; Sullivan, Sean D; Tarczy-Hornoch, Peter; Yanez, N David; Flum, David R

    2013-08-01

    To describe the inaugural comparative effectiveness research (CER) cohort study of Washington State's Comparative Effectiveness Research Translation Network (CERTAIN), which compares invasive with noninvasive treatments for peripheral artery disease, and to focus on the patient centeredness of this cohort study by describing it within the context of a newly published conceptual framework for patient-centered outcomes research (PCOR). The peripheral artery disease study was selected because of clinician-identified uncertainty in treatment selection and differences in desired outcomes between patients and clinicians. Patient centeredness is achieved through the "Patient Voices Project," a CERTAIN initiative through which patient-reported outcome (PRO) instruments are administered for research and clinical purposes, and a study-specific patient advisory group where patients are meaningfully engaged throughout the life cycle of the study. A clinician-led research advisory panel follows in parallel. Primary outcomes are PRO instruments that measure function, health-related quality of life, and symptoms, the latter developed with input from the patients. Input from the patient advisory group led to revised retention procedures, which now focus on short-term (3-6 months) follow-up. The research advisory panel is piloting a point-of-care, patient assessment checklist, thereby returning study results to practice. The cohort study is aligned with the tenets of one of the new conceptual frameworks for conducting PCOR. The CERTAIN's inaugural cohort study may serve as a useful model for conducting PCOR and creating a learning health care network. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Interaction between aggrading geomorphic surfaces and the formation of a late pleistocene paleosol in the palouse loess of eastern Washington state

    Science.gov (United States)

    McDonald, Eric V.; Busacca, Alan J.

    1990-09-01

    Variable rates of loess deposition contributed to dramatic regional variation in a soil-stratigraphic unit, the Washtucna Soil, in the Palouse loess deposits in the Channeled Scabland of eastern Washington state. Throughout most of the Channeled Scabland, the morphology of the Washtucna Soil is that of a single buried soil, but it bifurcates into two well-developed and pedologically distinct buried soils in areas immediately downwind of the major source of loessial sediment. Regional loess stratigraphy confirms that the two well-developed soils formed during the same interval of time during which only one soil formed in areas that are distal to loess source areas. The variable and perhaps rapid rates of soil formation suggested by the stratigraphy resulted from an interaction between variable rates of loess deposition and the formation of superimposed calcic soils. Petrocalcic horizons with weak Stage IV morphology formed as the zone of carbonate accumulation moved up into former A and cambic horizons that had been profusely burrowed by cicadas. The development of cicada burrows in one phase of soil development that were subsequently engulfed by pedogenic carbonate under a rising land surface seems to have greatly accelerated the development of the petrocalcic horizons. Accelerated rates of formation of the petrocalcic horizons occurred when extrinsic (pulses of loess deposition) and intrinsic (engulfment of burrowed horizons) thresholds were exceeded. Stratigraphic evidence suggests that the soil formation that accompanied the rise in the land surface due to additional loess deposition may have occurred during the late Wisconsin glaciation when giant glacial outburst floods in the channeled Scabland triggered a new cycle of loess deposition.

  7. Preliminary assessment of aggradation potential in the North Fork Stillaguamish River downstream of the State Route 530 landslide near Oso, Washington

    Science.gov (United States)

    Magirl, Christopher S.; Keith, Mackenzie K.; Anderson, Scott W.; O'Connor, Jim; Robert Aldrich,; Mastin, Mark C.

    2015-12-28

    On March 22, 2014, the State Route 530 Landslide near Oso, Washington, traveled almost 2 kilometers (km), destroyed more than 40 structures, and impounded the North Fork Stillaguamish River to a depth of 8 meters (m) and volume of 3.3×106 cubic meters (m3). The landslide killed 43 people. After overtopping and establishing a new channel through the landslide, the river incised into the landslide deposit over the course of 10 weeks draining the impoundment lake and mobilizing an estimated 280,000±56,000 m3 of predominantly sand-sized and finer sediment. During the first 4 weeks after the landslide, this eroded sediment caused downstream riverbed aggradation of 1–2 m within 1 km of the landslide and 0.4 m aggradation at Whitman Road Bridge, 3.5 km downstream. Winter high flows in 2014–15 were anticipated to mobilize an additional 220,000±44,000 m3 of sediment, potentially causing additional aggradation and exacerbating flood risk downstream of the landslide. Analysis of unit stream power and bed-material transport capacity along 35 km of the river corridor indicated that most fine-grained sediment will transport out of the North Fork Stillaguamish River, although some localized additional aggradation was possible. This new aggradation was not likely to exceed 0.1 m except in reaches within a few kilometers downstream of the landslide, where additional aggradation of up to 0.5 m is possible. Alternative river response scenarios, including continued mass wasting from the landslide scarp, major channel migration or avulsion, or the formation of large downstream wood jams, although unlikely, could result in reaches of significant local aggradation or channel change.

  8. The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007.

    Science.gov (United States)

    Fan, Z Joyce; Anderson, Naomi J; Foley, Michael; Rauser, Eddy; Silverstein, Barbara A

    2011-01-01

    We examined the disparities in health-care coverage between low- and high-income workers in Washington State (WA) to provide support for possible policy decisions for uninsured workers. We examined data from the WA Behavioral Risk Factor Surveillance System 2003-2007 and compared workers aged 18-64 years of low income (annual household income income (annual household income ≥$35,000) on proportions and sources of health-care coverage. We conducted multivariable logistic regression analyses on factors that were associated with the uninsured. Of the 54,536 survey respondents who were working-age adults in WA, 13,922 (25.5%) were low-income workers. The proportions of uninsured were 38.2% for low-income workers and 6.3% for high-income workers. While employment-based health benefits remained a dominant source of health insurance coverage, they covered only 40.2% of low-income workers relative to 81.5% of high-income workers. Besides income, workers were more likely to be uninsured if they were younger; male; Hispanic; less educated; not married; current smokers; self-employed; or employed in agriculture/forestry/fisheries, construction, and retail. More low-income workers (28.7%) reported cost as an issue in paying for health services than did their high-income counterparts (6.7%). A persistent gap in health-care coverage exists between low- and high-income workers. The identified characteristics of these workers can be used to implement policies to expand health insurance coverage.

  9. Washington Tsunami Hazard Mitigation Program

    Science.gov (United States)

    Walsh, T. J.; Schelling, J.

    2012-12-01

    Washington State has participated in the National Tsunami Hazard Mitigation Program (NTHMP) since its inception in 1995. We have participated in the tsunami inundation hazard mapping, evacuation planning, education, and outreach efforts that generally characterize the NTHMP efforts. We have also investigated hazards of significant interest to the Pacific Northwest. The hazard from locally generated earthquakes on the Cascadia subduction zone, which threatens tsunami inundation in less than hour following a magnitude 9 earthquake, creates special problems for low-lying accretionary shoreforms in Washington, such as the spits of Long Beach and Ocean Shores, where high ground is not accessible within the limited time available for evacuation. To ameliorate this problem, we convened a panel of the Applied Technology Council to develop guidelines for construction of facilities for vertical evacuation from tsunamis, published as FEMA 646, now incorporated in the International Building Code as Appendix M. We followed this with a program called Project Safe Haven (http://www.facebook.com/ProjectSafeHaven) to site such facilities along the Washington coast in appropriate locations and appropriate designs to blend with the local communities, as chosen by the citizens. This has now been completed for the entire outer coast of Washington. In conjunction with this effort, we have evaluated the potential for earthquake-induced ground failures in and near tsunami hazard zones to help develop cost estimates for these structures and to establish appropriate tsunami evacuation routes and evacuation assembly areas that are likely to to be available after a major subduction zone earthquake. We intend to continue these geotechnical evaluations for all tsunami hazard zones in Washington.

  10. PLANNED HOME BIRTH: A REVIEW

    Directory of Open Access Journals (Sweden)

    Tamara Serdinšek

    2016-05-01

    Full Text Available Background: Home birth is as old as humanity, but still most middle- and high-income countries consider hospitals as the safest birth settings, as complications regarding birth are highly unpredictable. Despite this there are a few countries in which home birth in integrated into official healthcare system (the Netherlands, United Kingdom, Canada etc.. Home births can be divided into unplanned and planned, and the latter can be further categorized by the presence of the birth attendants. This review focuses on planned home births, which are differently represented throughout the world. In the United States 0.6-1.0% of all children are born at home, in the United Kingdom 2-3%, in Canada 1.6% and in the Netherlands 20-30%. For Slovenia, the number of planned home births is unknown; however, in 2010 0.1% of children were born outside medical facilities.Conclusions: The safety of home birth in still under the debate. While research confirms smaller number of obstetric interventions and some complications in mothers who give birth at home, the data regarding the neonatal and perinatal mortality and morbidity is still conflicting. This confirms the need for large multicentric trials in this field. Current home birth guidelines emphasize that women should be well informed regarding the possible advantages and disadvantages of home births. In addition, the emphasis is on definition of selection criteria for home birth, indications for intrapartal transfer to the hospital and appropriate education of birth attendants. 

  11. Home birth integration into the health care systems of eleven international jurisdictions.

    Science.gov (United States)

    Comeau, Amanda; Hutton, Eileen K; Simioni, Julia; Anvari, Ella; Bowen, Megan; Kruegar, Samantha; Darling, Elizabeth K

    2018-02-13

    The purpose of this study was to develop assessment criteria that could be used to examine the level of integration of home birth within larger health care systems in developed countries across 11 international jurisdictions. An expert panel developed criteria and a definition to assess home birth integration within health care systems. We selected jurisdictions based on the publications that were eligible for inclusion in our systematic review and meta-analysis on planned place of birth. We sent the authors of the included publications a questionnaire about home birth practitioners and practices in their respective health care system at the time of their studies. We searched published peer-reviewed, non-peer-reviewed, and gray literature, and the websites of professional bodies to document information about home birth integration in each jurisdiction based on our criteria. Where information was lacking, we contacted experts in the field from the relevant jurisdiction. Home birth is well integrated into the health care system in British Columbia (Canada), England, Iceland, the Netherlands, New Zealand, Ontario (Canada), and Washington State (USA). Home birth is less well integrated into the health care system in Australia, Japan, Norway, and Sweden. This paper is the first to propose criteria for the evaluation of home birth integration within larger maternity care systems. Application of these criteria across 11 international jurisdictions indicates differences in the recognition and training of home birth practitioners, in access to hospital facilities, and in the supplies and equipment available at home births, which give rise to variation in the level of integration across different settings. Standardized criteria for the evaluation of systems integration are essential for interpreting planned home birth outcomes that emerge from contextual differences. © 2018 Wiley Periodicals, Inc.

  12. Grand multiparae's evolving experiences of birthing and technology in U.S. hospitals.

    Science.gov (United States)

    Fleming, Susan E; Vandermause, Roxanne

    2011-01-01

    To explore the nature of birthing in United States (U.S.) hospitals from 1973-2007 and to explicate and interpret common, often overlooked, birthing experiences and nursing care. A Heideggerian phenomenological approach utilizing in-depth interviews. Participants' homes in Washington, Idaho, and Oregon. A purposive sample of grand multiparaes (N = 14). Data were collected via open conversational interviews of 60-90 minutes recorded on digital media and completion of a demographic and birth attribute form. Field notes and interpretive commentary were used as additional data sources and were analyzed using an established Heideggerian approach. The participants came from diverse religious and ethical backgrounds and experienced 116 births (8.29 births per woman, 79% unmedicated), a Cesarean rate of 6%, and a breastfeeding rate of 99% with a mean duration of 12 months. Two overarching patterns emerged: pursuing the "'good birth": a safe passage for baby and being in-and-out of control: body, technology, others. Each pattern subsumed several overlapping themes. The first pattern revealed that women often desire a good birth in the safety of a hospital by navigating their options prior to and during the birth. The second pattern revealed a common, yet often unachievable, desire by all of those involved in the process to control birth. Harmonizing an exchange of ideas in a technologically advanced environment prevalent in hospitals today can increase the quality of intrapartum care. Encouraging anchored companions and promoting normal physiological birth will make hospitals places where women can experience a good birth and feel safe. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  13. Abundance, Distribution and Estimated Consumption (kg fish) of Piscivorous Birds Along the Yakima River, Washington State; Implications for Fisheries Management, 2002 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Major, III, Walter; Grassley, James M.; Ryding, Kristen E. (University of Washington, Quantitive Ecology Program, Seattle, WA)

    2003-05-01

    This report is divided into two chapters. The abstract for chapter one is--Understanding of the abundance and spatial and temporal distributions of piscivorous birds and their potential consumption of fish is an increasingly important aspect of fisheries management. During 1999-2002, we determined the abundance and distribution and estimated the maximum consumption (kg biomass) of fish-eating birds along the length of the Yakima River in Washington State. Sixteen different species were observed during the 4-yr study, but only half of those were observed during all years. Abundance and estimated consumption of fish within the upper and middle sections of the river were dominated by common mergansers (Mergus merganser) which are known to breed in those reaches. Common mergansers accounted for 78 to 94% of the estimated total fish take for the upper river or approximately 28,383 {+-} 1,041 kg over the 4 yrs. A greater diversity of avian piscivores occurred in the lower river and potential impacts to fish populations was more evenly distributed among the species. In 1999-2000, great blue herons potentially accounted for 29 and 36% of the fish consumed, whereas in 2001-2002 American white pelicans accounted for 53 and 55%. We estimated that approximately 75,878 {+-} 6,616 kg of fish were consumed by piscivorous birds in the lower sections of the river during the study. Bird assemblages differed spatially along the river with a greater abundance of colonial nesting species within the lower sections of the river, especially during spring and the nesting season. The abundance of avian piscivores and consumption estimates are discussed within the context of salmonid supplementation efforts on the river and juvenile out-migration. The abstract for chapter two is--Consumption of fish by piscivorous birds may be a significant constraint on efforts to enhance salmonid populations within tributaries to the Columbia River in Washington State. During 1999-2002, we determined the

  14. Regeneration in United States Department of Agriculture Forest Service mixed conifer partial cuttings in the Blue Mountains of Oregon and Washington.

    Science.gov (United States)

    K.W. Seidel; S. Conrade. Head

    1983-01-01

    A survey in the Blue Mountains of north-eastern Oregon and southeastern Washington showed that, on the average, partial cuts in the grand fir/big huckleberry community were well stocked with a mixture of advance, natural post-harvest, and planted reproduction of a number of species. Partial cuts in the mixed conifer/pinegrass community had considerably fewer seedlings...

  15. Development and Evaluation of an On-Line Educational Module for Volunteer Leaders on Bio-Security in Washington State 4-H Livestock Projects

    Science.gov (United States)

    Stevenson, Jill L.; Moore, Dale A.; Newman, Jerry; Schmidt, Janet L.; Smith, Sarah M.; Smith, Jean; Kerr, Susan; Wallace, Michael; BoyEs, Pat

    2011-01-01

    An on-line module on disease prevention was created for 4-H volunteer leaders who work with livestock projects in Washington to better prepare them to teach youth about bio-security and its importance in 4-H livestock projects. Evaluation of the module and usage statistics since the module's debut were collected and evaluated. The module increases…

  16. Facilities for Study and Research in the Offices of the United States Government at Washington. Bulletin, 1909, No. 1. Whole Number 398

    Science.gov (United States)

    Hadley, Arthur Twining

    1909-01-01

    This bulletin contains a report prepared by President Hadley of Yale University on the facilities for advanced study and research in the offices of the National Government at Washington. Especial interest attaches to this publication. It sets forth, in compact form, information which has frequently been sought by institutions and individuals…

  17. The impact of the State Children's Health Insurance Program's unborn child ruling expansions on foreign-born Latina prenatal care and birth outcomes, 2000-2007.

    Science.gov (United States)

    Drewry, Jonathan; Sen, Bisakha; Wingate, Martha; Bronstein, Janet; Foster, E Michael; Kotelchuck, Milton

    2015-07-01

    The 2002 "unborn child ruling" resulted in State Children's Health Insurance Program (SCHIP) expansion for states to cover prenatal care for low-income women without health insurance. Foreign-born Latinas who do not qualify for Medicaid coverage theoretically should have benefited most from the policy ruling given their documented low rates of prenatal care utilization. This study compares prenatal care utilization and subsequent birth outcomes among foreign-born Latinas in six states that used the unborn child ruling to expand coverage to those in ten states that did not implement the expansion. This policy analysis examines cross-sectional pooled US natality data from the pre-enactment years (2000-2003) versus post-enactment years (2004-2007) to estimate the effect of the UCR on prenatal care utilization and birth outcome measures for foreign-born Latinas. Then using a difference-in-difference estimator, we assessed these differences across time for states that did or did not enact the unborn child ruling. Analyses were then replicated on a high-risk subset of the population (single foreign-born Latinas with lower levels of education). The SCHIP unborn child ruling policy expansion increased PNCU over time in the six enacting states. Foreign-born Latinas in expansion enacting states experienced increases in prenatal care utilization though only the high-risk subset were statistically significant. Birth outcomes did not change. The SCHIP unborn child ruling policy was associated with enhanced PNC for a subset of high-risk foreign-born Latinas.

  18. Atrazine and nitrate in drinking water and the risk of preterm delivery and low birth weight in four Midwestern states

    DEFF Research Database (Denmark)

    Stayner, Leslie Thomas; Almberg, Kirsten; Jones, Rachael

    2017-01-01

    Background: Atrazine and nitrate are common contaminants in water, and there is limited evidence that they are associated with adverse birth outcomes. The objective of this study was to examine whether atrazine and nitrate in water are associated with an increased risk of preterm delivery (PTD...... weeks), term LBW (nitrate in finished water. Multivariable negative binomial models were fitted to examine the association...... between the exposures and the adverse birth outcomes. Models were fitted with varying restrictions on the percentage of private well usage in the counties in order to limit the degree of exposure misclassification. Results: Estimated water concentrations of atrazine (mean=0.42 ppb) and nitrate (mean=0...

  19. Birthing Classes

    Science.gov (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  20. Birth Control

    Science.gov (United States)

    ... even if you aren’t going for birth control. What doesn’t work to prevent pregnancy? top It’s ... and taking care of a baby’s many needs. What if I need birth control in an emergency? top Emergency contraception (EC) is ...

  1. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  2. Profile and birthing practices of Maranao traditional birth attendants

    Directory of Open Access Journals (Sweden)

    Maghuyop-Butalid R

    2015-10-01

    Full Text Available Roselyn Maghuyop-Butalid, Norhanifa A Mayo, Hania T Polangi College of Nursing, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines Abstract: This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents’ modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents’ personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn. Keywords: intrapartum and newborn care, modern birthing practices, traditional birthing practices 

  3. Constitutional osteochondrodysplasias identifiable a birth. A short review on the state of the art in radiodiagnostic in the late 20. century

    International Nuclear Information System (INIS)

    Gugliantini, P.; Maragliano, G.; Piscione, M.; Licata, G.

    1999-01-01

    The value of a systematic radiologic analysis in constitutional osteochondrodysplasias remains underestimated by both neonatologists and radiologists. The authors report the clinical experience of the Department of Neonatology and Neonatal Intensive Cure Unit of St. John Hospital in Rome with constitutional osteochondrodysplasias identifiable at birth. The authors justify the relatively high incidence of constitutional osteochondrodysplasias in this study (66% versus an average incidence of 0,076% reported in the world population) on the basis of: a) an increasing number of high-risk newborns in the intensive cure; b) an improvement in our clinical and radiologic diagnostic skill. They conclude that the state of the art of diagnostic of constitutional osteochondrodysplasiasin still based on the first plain X-ray examination performed at birth because of cardiorespiratory and/or abdominal diseases in the newborn [it

  4. Births: preliminary data for 2005.

    Science.gov (United States)

    Hamilton, Brady E; Martin, Joyce A; Ventura, Stephanie J

    2006-12-28

    This report presents preliminary data for 2005 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. Data in this report are based on 99.2 percent of births for 2005. The records are weighted to independent control counts of all births received in state vital statistics offices in 2005. Comparisons are made with 2004 data. The crude birth rate in 2005 was 14.0 births per 1,000 total population, unchanged from 2004. The general fertility rate, however, rose to 66.7 births per 1,000 women aged 15-44 years in 2005, the highest level since 1993. The birth rate for teenagers declined by 2 percent in 2005, falling to 40.4 births per 1,000 women aged 15-19 years, the lowest ever recorded in the 65 years for which a consistent series of rates are available. The rate declined for teenagers 15-17 years to 21.4 births per 1,000, but was essentially stable for older teenagers 18-19 years. The birth rate for women aged 20-24 years rose in 2005, whereas the rate for women aged 25-29 years was essentially unchanged. The birth rates for women aged 30 years and over rose to levels not seen in almost 40 years. Childbearing by unmarried women increased to record levels for the Nation in 2005. The birth rate rose 3 percent to 47.6 births per 1,000 unmarried women aged 15-44 years; the proportion of all births to unmarried women increased to 36.8 percent. The cesarean delivery rate rose by 4 percent in 2005 to 30.2 percent of all births, another record high for the Nation. The preterm birth rate continued to rise (to 12.7 percent in 2005) as did the rate for LBW births (8.2 percent).

  5. Preterm Birth

    Science.gov (United States)

    ... for Health Care Providers For Health Care Providers: Electronic Nicotine Delivery Systems and Pregnancy CDC Activities Resources ... births and improving neonatal outcomes. View the archived presentation and publication Related Links Is It Worth It? ...

  6. Plasma Science and Innovation Center at Washington, Wisconsin, and Utah State: Final Scientific Report for the University of Wisconsin-Madison

    Energy Technology Data Exchange (ETDEWEB)

    Sovinec, Carl R. [Univ. of Wisconsin, Madison, WI (United States)

    2016-11-28

    The University of Wisconsin-Madison component of the Plasma Science and Innovation Center (PSI Center) contributed to modeling capabilities and algorithmic efficiency of the Non-Ideal Magnetohydrodynamics with Rotation (NIMROD) Code, which is widely used to model macroscopic dynamics of magnetically confined plasma. It also contributed to the understanding of direct-current (DC) injection of electrical current for initiating and sustaining plasma in three spherical torus experiments: the Helicity Injected Torus-II (HIT-II), the Pegasus Toroidal Experiment, and the National Spherical Torus Experiment (NSTX). The effort was funded through the PSI Center's cooperative agreement with the University of Washington and Utah State University over the period of March 1, 2005 - August 31, 2016. In addition to the computational and physics accomplishments, the Wisconsin effort contributed to the professional education of four graduate students and two postdoctoral research associates. The modeling for HIT-II and Pegasus was directly supported by the cooperative agreement, and contributions to the NSTX modeling were in support of work by Dr. Bickford Hooper, who was funded through a separate grant. Our primary contribution to model development is the implementation of detailed closure relations for collisional plasma. Postdoctoral associate Adam Bayliss implemented the temperature-dependent effects of Braginskii's parallel collisional ion viscosity. As a graduate student, John O'Bryan added runtime options for Braginskii's models and Ji's K2 models of thermal conduction with magnetization effects and thermal equilibration. As a postdoctoral associate, O'Bryan added the magnetization effects for ion viscosity. Another area of model development completed through the PSI-Center is the implementation of Chodura's phenomenological resistivity model. Finally, we investigated and tested linear electron parallel viscosity, leveraged by support from

  7. 77 FR 37317 - Drawbridge Operation Regulation; Lake Washington, Seattle, WA

    Science.gov (United States)

    2012-06-21

    ..., 2012. The deviation allows the floating draw span of the SR 520 Lake Washington Bridge to remain in the... schedule that governs the State Route 520 (SR 520) Bridge across Lake Washington at Seattle, WA. This... allows the bridge to remain in the closed position to allow safe movement of event participants. DATES...

  8. 75 FR 71139 - Land Acquisitions; Puyallup Tribe of Washington

    Science.gov (United States)

    2010-11-22

    ... Auditor, in Pierce County, Washington. Except that portion of Lot 3 conveyed to the State of Washington by Deeds recorded under Auditor's file number 689865 and 689858. Together with the East half of the... amendment of Short Plat Nos. 8502210395 and 8403080186, filed with the Pierce County Auditor, in Pierce...

  9. Births and deaths including fetal deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...

  10. Women's preference for traditional birth attendants and modern health care practitioners in Akpabuyo community of Cross River State, Nigeria.

    Science.gov (United States)

    Akpabio, Idongesit I; Edet, Olaide B; Etifit, Rita E; Robinson-Bassey, Grace C

    2014-01-01

    The proportion of women who patronized traditional birth attendants (TBAs) or modern health care practitioners (MHCPs) was compared, including reasons for their choices. A comparative design was adopted to study 300 respondents selected through a multistage systematic random sampling technique. The instrument for data collection was a validated 21-item structured questionnaire. We observed that 75 (25%) patronized and 80 (27%) preferred TBAs, and 206 (69%) patronized and 220 (75%) preferred MHCPs, while 19 (6%) patronized both. The view that TBAs prayed before conducting deliveries was supported by a majority 75 (94%) of the respondents who preferred them. Factors associated with preference for TBAs should be addressed.

  11. Precipitous Birth

    Directory of Open Access Journals (Sweden)

    Jennifer Yee

    2017-09-01

    Full Text Available Audience: This scenario was developed to educate emergency medicine residents on the management of a precipitous birth in the emergency department (ED. The case is also appropriate for teaching of medical students and advanced practice providers, as well as reviewing the principles of crisis resource management, teamwork, and communication. Introduction: Patients with precipitous birth require providers to manage two patients simultaneously with limited time and resources. Crisis resource management skills will be tested once baby is delivered, and the neonate will require assessment for potential neonatal resuscitation. Objectives: At the conclusion of the simulation session, learners will be able to manage women who have precipitous deliveries, as well as perform neonatal assessment and management. Method: This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on precipitous birth management and neonatal evaluation.

  12. How Can Improvements Be Made to the United States Metrorail System (With a Focus on the Washington Metropolitan Area Transit Authority Metrorail System) to Enhance Safety for Its Riders

    Science.gov (United States)

    2016-06-10

    on the rail system, and recommended improvements to improve the safety of the Metrorail system. These three influences show a holistic view of the...due to special events in the area to include Washington Redskins football , Washington National baseball, and other events held in the Washington, D.C...Station in Washington, DC. The accident resulted in nine people including the train operator were killed. Emergency response agencies reported

  13. Washington Schools Learn from Value Engineering.

    Science.gov (United States)

    Doleae, Michael L.; Childs, Harvey C.

    1983-01-01

    Results of two value engineering studies have shown that a review early in the design process can help save costs in school construction, maintenance, operation, and replacement. The value engineering concepts and technical manual are being presented throughout the state of Washington. (MLF)

  14. Natural phenomena hazards, Hanford Site, Washington

    International Nuclear Information System (INIS)

    Conrads, T.J.

    1998-01-01

    This document presents the natural phenomena hazard loads for use in implementing DOE Order 5480.28, Natural Phenomena Hazards Mitigation, and supports development of double-shell tank systems specifications at the Hanford Site in south-central Washington State. The natural phenomena covered are seismic, flood, wind, volcanic ash, lightning, snow, temperature, solar radiation, suspended sediment, and relative humidity

  15. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

    Directory of Open Access Journals (Sweden)

    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  16. Birth Cohort Differences in Sexual Identity Development Milestones among HIV-Negative Gay and Bisexual Men in the United States.

    Science.gov (United States)

    Grov, Christian; Rendina, H Jonathon; Parsons, Jeffrey T

    2017-10-12

    The coming-out process for gay and bisexual men (GBM) involves crossing sexual identity development (SID) milestones: (1) self-awareness of sexual attraction to the same sex, (2) self-acceptance of an identity as gay or bisexual, (3) disclosure of this sexual identity to others, and (4) having sex with someone of the same sex. We examined trends in SID milestones by birth cohort in a 2015 U.S. national sample of GBM (n = 1,023). Birth cohort was independent of when men first felt sexually attracted to someone of the same sex (median age 11 to 12). However, with the exception of age of first same-sex attraction, older cohorts tended to pass other milestones at later ages than younger cohorts. Latent class analysis (LCA) of SID milestone patterns identified three subgroups. The majority (84%) began sexual identity development with same-sex attraction around the onset of puberty (i.e., around age 10) and progressed to self-identification, same-sex sexual activity, and coming out-in that order. The other two classes felt same-sex attraction during teen years (ages 12.5 to 18.0) but achieved the remaining SID milestones later in life. For 13% of men, this was during early adulthood; for 3% of men, this was in middle adulthood. Findings highlight the need to monitor ongoing generational differences in passing SID milestones.

  17. Getting a piece of the pie? The economic boom of the 1990s and declining teen birth rates in the United States.

    Science.gov (United States)

    Colen, Cynthia G; Geronimus, Arline T; Phipps, Maureen G

    2006-09-01

    In the United States, the 1990s was a decade of dramatic economic growth as well as a period characterized by substantial declines in teenage childbearing. This study examines whether falling teen fertility rates during the 1990s were responsive to expanding employment opportunities and whether the implementation of the Personal Responsibility and Work Opportunities Act (PRWORA), increasing rates of incarceration, or restrictive abortion policies may have affected this association. Fixed-effects Poisson regression models were estimated to assess the relationship between age-specific birth rates and state-specific unemployment rates from 1990 to 1999 for Black and White females aged 10-29. Falling unemployment rates in the 1990s were associated with decreased childbearing among African-American women aged 15-24, but were largely unrelated to declines in fertility for Whites. For 18-19 year-old African-Americans, the group for whom teen childbearing is most normative, our model accounted for 85% of the decrease in rates of first births. Young Black women, especially older teens, may have adjusted their reproductive behavior to take advantage of expanded labor market opportunities.

  18. QuickStats: Birth Rates Among Teens Aged 15-19 Years, by Race/Hispanic Ethnicity* - National Vital Statistics System, United States,(†) 2007 and 2015(§).

    Science.gov (United States)

    2016-08-19

    From 2007 to 2015, the birth rate for female teens aged 15-19 years declined 46%, from 41.5 to 22.3 births per 1,000, the lowest rate ever recorded for this population in the United States. In 2015, rates declined to record lows for all racial/ethnic populations, with declines ranging from 41% for non-Hispanic white teens to 54% for Hispanic teens. Despite the declines, teen birth rates by race/Hispanic ethnicity continued to reflect wide disparities, with rates ranging from 6.9 per 1,000 for Asian or Pacific Islander teens to 34.9 for Hispanic teens in 2015.

  19. 78 FR 53235 - 50th Anniversary of the March on Washington for Jobs and Freedom

    Science.gov (United States)

    2013-08-28

    ... Anniversary of the March on Washington for Jobs and Freedom By the President of the United States of America A... waters of the reflecting pool, to the proud base of the Washington Monument. They were men and women..., and justice for all. The March on Washington capped off a summer of discontent, a time when the...

  20. Recent developments: Washington focus

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    November was a quiet month in Washington. Although Congress has recessed until 1991, the Senate filled vacancies in party leadership positions created by November's elections. The House is expected to proceed with its changes in early December. The Nuclear Energy Forum was held in Washington, DC on November 11-14 to discuss the status of the nuclear industry in the USA. The Forum, held in conjunction with the American Nuclear Society's annual meeting, assembled a large number of CEO's from US, European, and Far Eastern utilities and vendors. The meeting concluded with an announcement by Philip Bayne, President of NYPA and chairman of the Nuclear Power Oversight Committee (NPOC), of the results of a year-long NPOC study entitled a open-quotes Strategic Plan for Building New Nuclear Power Plants.close quotes

  1. Predicting the effect of maternal docosahexaenoic acid (DHA) supplementation to reduce early preterm birth in Australia and the United States using results of within country randomized controlled trials

    Science.gov (United States)

    Yelland, LN; Gajewski, BJ; Colombo, J; Gibson, RA; Makrides, M; Carlson, SE

    2016-01-01

    SUMMARY The DHA to Optimize Mother Infant Outcome (DOMInO) and Kansas DHA Outcomes Study (KUDOS) were randomized controlled trials that supplemented mothers with 800 and 600 mg DHA/day, respectively, or a placebo during pregnancy. DOMInO was conducted in Australia and KUDOS in the United States. Both trials found an unanticipated and statistically significant reduction in early preterm birth (ePTB; i.e., birth before 34 weeks gestation). However, in each trial, the number of ePTBs were small. We used a novel Bayesian approach and an arbitrary sample of 120,000 pregnancies to estimate statistically derived low, moderate or high risk for ePTB, and to test for differences between the DHA and placebo groups. In both trials, the model predicted DHA would significantly reduce the expected proportion of deliveries in the high risk group under the trial conditions of the parent studies. From these proportions we estimated the number of ePTB that could be prevented. PMID:27637340

  2. Utilization of the state led public private partnership program "Chiranjeevi Yojana" to promote facility births in Gujarat, India: a cross sectional community based study.

    Science.gov (United States)

    Yasobant, Sandul; Vora, Kranti Suresh; Shewade, Hemant Deepak; Annerstedt, Kristi Sidney; Isaakidis, Petros; Mavalankar, Dileep V; Dholakia, Nishith B; De Costa, Ayesha

    2016-07-15

    "Chiranjeevi Yojana (CY)", a state-led large-scale demand-side financing scheme (DSF) under public-private partnership to increase institutional delivery, has been implemented across Gujarat state, India since 2005. The scheme aims to provide free institutional childbirth services in accredited private health facilities to women from socially disadvantaged groups (eligible women). These services are paid for by the state to the private facility with the intention of service being free to the user. This community-based study estimates CY uptake among eligible women and explores factors associated with non-utilization of the CY program. This was a community-based cross sectional survey of eligible women who gave birth between January and July 2013 in 142 selected villages of three districts in Gujarat. A structured questionnaire was administered by trained research assistant to collect information on socio-demographic details, pregnancy details, details of childbirth and out-of-pocket (OOP) expenses incurred. A multivariable inferential analysis was done to explore the factors associated with non-utilization of the CY program. Out of 2,143 eligible women, 559 (26 %) gave birth under the CY program. A further 436(20 %) delivered at free public facilities, 713(33 %) at private facilities (OOP payment) and 435(20 %) at home. Eligible women who belonged to either scheduled tribe or poor [aOR = 3.1, 95 % CI:2.4 - 3.8] or having no formal education [aOR = 1.6, 95 % CI:1.1, 2.2] and who delivered by C-section [aOR = 2.1,95 % CI: 1.2, 3.8] had higher odds of not utilizing CY program. Of births at CY accredited facilities (n = 924), non-utilization was 40 % (n = 365) mostly because of lack of required official documentation that proved eligibility (72 % of eligible non-users). Women who utilized the CY program overall paid more than women who delivered in the free public facilities. Uptake of the CY among eligible women was low after almost a decade

  3. Seismic imaging beneath an InSAR anomaly in eastern Washington State: Shallow faulting associated with an earthquake swarm in a low-hazard area

    Science.gov (United States)

    Stephenson, William J.; Odum, Jackson K.; Wicks, Chuck; Pratt, Thomas L.; Blakely, Richard J.

    2016-01-01

    In 2001, a rare swarm of small, shallow earthquakes beneath the city of Spokane, Washington, caused ground shaking as well as audible booms over a five‐month period. Subsequent Interferometric Synthetic Aperture Radar (InSAR) data analysis revealed an area of surface uplift in the vicinity of the earthquake swarm. To investigate the potential faults that may have caused both the earthquakes and the topographic uplift, we collected ∼3  km of high‐resolution seismic‐reflection profiles to image the upper‐source region of the swarm. The two profiles reveal a complex deformational pattern within Quaternary alluvial, fluvial, and flood deposits, underlain by Tertiary basalts and basin sediments. At least 100 m of arching on a basalt surface in the upper 500 m is interpreted from both the seismic profiles and magnetic modeling. Two west‐dipping faults deform Quaternary sediments and project to the surface near the location of the Spokane fault defined from modeling of the InSAR data.

  4. Comparison of under-pressure and over-pressure pulse tests conducted in low-permeability basalt horizons at the Hanford Site, Washington State

    International Nuclear Information System (INIS)

    Thorne, P.D.; Spane, F.A. Jr.

    1984-10-01

    Over-pressure pulse tests (pressurized slug tests have been widely used by others for hydraulic characterization of low-permeability ( -8 m/sec) rock formations. Recent field studies of low-permeability basalt horizons at the Hanford Site, Washington, indicate that the under-pressure pulse technique is also a viable test method for hydraulic characterization studies. For over-pressure pulse tests, fluid within the test system is rapidly pressurized and the associated pressure decay is monitored as compressed fluid within the test system expands and flows into the test formation. Under-pressure pulse tests are conducted in a similar manner by abruptly decreasing the pressure of fluid within the test system, and monitoring the associated increase in pressure as fluid flows from the formation into the test system. Both pulse test methods have been used in conjunction with other types of tests to determine the hydraulic properties of selected low-permeability basalt horizons at Hanford test sites. Results from both pulse test methods generally provide comparable estimates of hydraulic properties and are in good agreement with those from other tests

  5. Analysis of the reduction in waste volumes received for disposal at the low-level radioactive waste site in the State of Washington

    International Nuclear Information System (INIS)

    Ko, S.

    1988-01-01

    The commercial low-level radioactive waste (LLRW) disposal site at Richland, Washington has been receiving waste from generators nationwide since 1965 and is one of the three sites in the nation currently receiving commercial LLRW for disposal. In the past, volumes of LLRW have been increasing steadily, however, this trend has reversed since 1986. This paper addresses waste volume and activity of the waste disposed, factors which have caused this dramatic reduction in LLRW volume, and regulatory concerns regarding environmental protection, and public and occupational health and safety. Future volumes of LLRW that are disposed at the Richland site depend on economic, technological, political and regulatory variables. Provided there is a continual increase in industrial growth, and a demand for medical research and diagnosis, the volume of LLRW increases. However, this volume also offsets by an increase in demand for volume reduction due to economic and institutional pressures. Yet, if all generators continue to volume reduce their LLRW, some time in future, a limit will be reached when the facility site operator needs to increase the unit disposal cost to cover the fixed cost and maintain a profit margin in order to operate the site

  6. The Impact of Interstate Migration on Human Capital Development in Washington

    Science.gov (United States)

    Spaulding, Randy

    2010-01-01

    Washington State is a leader in the innovation economy largely due to the combination of aerospace, software, and biomedical industries centered in the greater Seattle area; and, the state's high level of international trade. Despite Washington's national ranking, the state is overly reliant on importing educated workers from other states and…

  7. HIV infection and testing among Latino men who have sex with men in the United States: the role of location of birth and other social determinants.

    Directory of Open Access Journals (Sweden)

    Alexandra M Oster

    Full Text Available BACKGROUND: In the United States, Latino men who have sex with men (MSM are disproportionately affected by HIV. Latino MSM are a diverse group who differ culturally based on their countries or regions of birth and their time in the United States. We assessed differences in HIV prevalence and testing among Latino MSM by location of birth, time since arrival, and other social determinants of health. METHODS: For the 2008 National HIV Behavioral Surveillance System, a cross-sectional survey conducted in large US cities, MSM were interviewed and tested for HIV infection. We used generalized estimating equations to test associations between various factors and 1 prevalent HIV infection and 2 being tested for HIV infection in the past 12 months. RESULTS: Among 1734 Latino MSM, HIV prevalence was 19%. In multivariable analysis, increasing age, low income, and gay identity were associated with HIV infection. Moreover, men who were U.S.-born or who arrived ≥5 years ago had significantly higher HIV prevalence than recent immigrants. Among men not reporting a previous positive HIV test, 63% had been tested for HIV infection in the past 12 months; recent testing was most strongly associated with having seen a health care provider and disclosing male-male attraction/sexual behavior to a health care provider. CONCLUSIONS: We identified several social determinants of health associated with HIV infection and testing among Latino MSM. Lower HIV prevalence among recent immigrants contrasts with higher prevalence among established immigrants and suggests a critical window of opportunity for HIV prevention, which should prioritize those with low income, who are at particular risk for HIV infection. Expanding health care utilization and encouraging communication with health care providers about sexual orientation may increase testing.

  8. Births: preliminary data for 2000.

    Science.gov (United States)

    Martin, J A; Hamilton, B E; Ventura, S J

    2001-07-24

    This report presents preliminary data for 2000 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Data in this report are based on more than 96 percent of births for 2000. The records are weighted to independent control counts of births received in State vital statistics offices in 2000. Comparisons are made with 1999 final data. The number of births rose 3 percent between 1999 and 2000. The crude birth rate increased to 14.8 per 1,000 population in 2000, 2 percent higher than the 1999 rate. The fertility rate rose 3 percent to 67.6 per 1,000 women aged 15-44 years between 1999 and 2000. The birth rate for teenagers, which has been falling since 1991, declined 2 percent in 2000 to 48.7 births per 1,000 females aged 15-19 years, another historic low. The rate for teenagers 15-17 years fell 4 percent, and the rate for 18-19 year olds was down 1 percent. Since 1991, rates have fallen 29 percent for teenagers 15-17 years and 16 percent for teenagers 18-19 years. Birth rates for all of the older age groups increased for 1999-2000: 1 percent among women aged 20-24 years, 3 percent for women aged 25-29 years, and 5 percent for women in their thirties. Rates for women aged 40-54 years were also up for 2000. The birth rate for unmarried women increased 2 percent to 45.2 births per 1,000 unmarried women aged 15-44 years in 2000, but was still lower than the peak reached in 1994. The number of births to unmarried women was up 3 percent, the highest number ever reported in the United States. However, the number of births to unmarried teenagers declined. The proportion of women who began prenatal care in the first trimester of pregnancy (83.2 percent) did not improve for 2000, nor did the rate of low birthweight (7.6 percent). The total cesarean rate rose for the fourth consecutive year to 22.9 percent, the result of both a

  9. Black Carbon, Dust and Organic Matter at South Cascade Glacier in Washington State, USA: A Comprehensive Characterization of Temporal (1865-2014) and Spatial Variability

    Science.gov (United States)

    Kaspari, S.; Pittenger, D.; Swick, M.; Skiles, M.; Perez, A.; Sethi, H.; Sevier, E.

    2017-12-01

    Rising temperatures are a widely recognized cause of glacial retreat in Washington, however light absorbing aerosols (LAA, including black carbon (BC), dust and organic matter) can also contribute to increased melt by reducing snow albedo. We present updated results of BC and dust variability at South Cascade (SOCAS) glacier spanning 1865-1994 using a 158 m ice core. Peak BC deposition occurred between 1940-1958, when median BC concentrations were 25 times higher than background levels. Post 1958 BC concentrations decrease, followed by an increase post 1980 associated with melt consolidation and/or trans-Pacific aerosol transport. Dust deposition at SOCAS is dominated by local sources. Albedo reductions from LAA are dominated by dust deposition, except during high BC deposition events from wildfires, and during the 1940-1958 period when BC contributes equally to albedo reductions. Results from a 2014 field campaign that included collection of 3 shallow ice cores, surface snow, and snow albedo measurements allow the 1865-1994 ice core record to be extended toward present, and spatial variability in LAA to be characterized. Snow albedo transects were measured using a spectrometer. BC concentrations were measured using a Single Particle Soot Photometer (SP2). Gravimetric filtration was used to determine the total LAA, and a thermal gravimetric technique was used to partition the LAA between dust and organic matter. The organic matter was partitioned into organic and elemental carbon using a thermal optical method. These methods allow LAA abundances be measured, but to partition the contribution of the LAA to albedo reductions requires characterization of LAA optical properties. This was accomplished using a Hyperspectral Imaging Microscope Spectrometer method that allows particle reflectance to be measured at 138 nm2 pixel resolution. By combining these methods, we provide a comprehensive characterization of spatial and temporal LAA variability at SOCAS.

  10. Profile and birthing practices of Maranao traditional birth attendants

    OpenAIRE

    Maghuyop-Butalid, Roselyn; Mayo, Norhanifa A; Polangi, Hania T

    2015-01-01

    Roselyn Maghuyop-Butalid, Norhanifa A Mayo, Hania T Polangi College of Nursing, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines Abstract: This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs) in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A quest...

  11. Whole genome sequencing analyses of Listeria monocytogenes that persisted in a milkshake machine for a year and caused illnesses in Washington State

    OpenAIRE

    Li, Zhen; P?rez-Osorio, Ailyn; Wang, Yu; Eckmann, Kaye; Glover, William A.; Allard, Marc W.; Brown, Eric W.; Chen, Yi

    2017-01-01

    Background In 2015, in addition to a United States multistate outbreak linked to contaminated ice cream, another outbreak linked to ice cream was reported in the Pacific Northwest of the United States. It was a hospital-acquired outbreak linked to milkshakes, made from contaminated ice cream mixes and milkshake maker, served to patients. Here we performed multiple analyses on isolates associated with this outbreak: pulsed-field gel electrophoresis (PFGE), whole genome single nucleotide polymo...

  12. Preterm birth

    Science.gov (United States)

    2010-01-01

    Introduction Preterm birth occurs in about 5% to 10% of all births in resource-rich countries, but in recent years the incidence seems to have increased in some countries, particularly in the USA. We found little reliable evidence for incidence in resource-poor countries. The rate in northwestern Ethiopia has been reported to vary from 11% to 22%, depending on the age group of mothers studied, and is highest in teenage mothers. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in women at high risk of preterm delivery? What are the effects of interventions to improve neonatal outcome after preterm rupture of membranes? What are the effects of treatments to stop contractions in preterm labour? What are the effects of elective compared with selective caesarean delivery for women in preterm labour? What are the effects of interventions to improve neonatal outcome in preterm delivery? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 58 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: amnioinfusion for preterm rupture of membranes; antenatal corticosteroids; antibiotic treatment; bed rest; beta mimetics; calcium-channel blockers; elective caesarean; enhanced antenatal care programmes; magnesium sulphate; oxytocin receptor antagonists (atosiban); progesterone

  13. A national study of socioeconomic status and tuberculosis rates by country of birth, United States, 1996–2005

    Directory of Open Access Journals (Sweden)

    Olson Nicole A

    2012-05-01

    Full Text Available Abstract Background Tuberculosis (TB in developed countries has historically been associated with poverty and low socioeconomic status (SES. In the past quarter century, TB in the United States has changed from primarily a disease of native-born to primarily a disease of foreign-born persons, who accounted for more than 60% of newly-diagnosed TB cases in 2010. The purpose of this study was to assess the association of SES with rates of TB in U.S.-born and foreign-born persons in the United States, overall and for the five most common foreign countries of origin. Methods National TB surveillance data for 1996–2005 was linked with ZIP Code-level measures of SES (crowding, unemployment, education, and income from U.S. Census 2000. ZIP Codes were grouped into quartiles from low SES to high SES and TB rates were calculated for foreign-born and U.S.-born populations in each quartile. Results TB rates were highest in the quartiles with low SES for both U.S.-born and foreign-born populations. However, while TB rates increased five-fold or more from the two highest to the two lowest SES quartiles among the U.S.-born, they increased only by a factor of 1.3 among the foreign-born. Conclusions Low SES is only weakly associated with TB among foreign-born persons in the United States. The traditional associations of TB with poverty are not sufficient to explain the epidemiology of TB among foreign-born persons in this country and perhaps in other developed countries. TB outreach and research efforts that focus only on low SES will miss an important segment of the foreign-born population.

  14. A national study of socioeconomic status and tuberculosis rates by country of birth, United States, 1996-2005.

    Science.gov (United States)

    Olson, Nicole A; Davidow, Amy L; Winston, Carla A; Chen, Michael P; Gazmararian, Julie A; Katz, Dolores J

    2012-05-18

    Tuberculosis (TB) in developed countries has historically been associated with poverty and low socioeconomic status (SES). In the past quarter century, TB in the United States has changed from primarily a disease of native-born to primarily a disease of foreign-born persons, who accounted for more than 60% of newly-diagnosed TB cases in 2010. The purpose of this study was to assess the association of SES with rates of TB in U.S.-born and foreign-born persons in the United States, overall and for the five most common foreign countries of origin. National TB surveillance data for 1996-2005 was linked with ZIP Code-level measures of SES (crowding, unemployment, education, and income) from U.S. Census 2000. ZIP Codes were grouped into quartiles from low SES to high SES and TB rates were calculated for foreign-born and U.S.-born populations in each quartile. TB rates were highest in the quartiles with low SES for both U.S.-born and foreign-born populations. However, while TB rates increased five-fold or more from the two highest to the two lowest SES quartiles among the U.S.-born, they increased only by a factor of 1.3 among the foreign-born. Low SES is only weakly associated with TB among foreign-born persons in the United States. The traditional associations of TB with poverty are not sufficient to explain the epidemiology of TB among foreign-born persons in this country and perhaps in other developed countries. TB outreach and research efforts that focus only on low SES will miss an important segment of the foreign-born population.

  15. Births: final data for 2004.

    Science.gov (United States)

    Martin, Joyce A; Hamilton, Brady E; Sutton, Paul D; Ventura, Stephanie J; Menacker, Fay; Kirmeyer, Sharon

    2006-09-29

    This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise

  16. A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United States.

    Science.gov (United States)

    Phillips, Julie A

    2014-08-01

    The increases in suicide among middle-aged baby boomers (born between 1946 and 1964) in the United States since 1999 suggest a changing epidemiology of suicide. Using data from 1935 to 2010, this paper conducts age-period-cohort analyses to determine the impact of cohorts in shaping temporal patterns of suicide in the United States. The analysis demonstrates that age, period and cohort effects are all important in determining suicide trends. Net of age and period effects, the cohort pattern of suicide rates is U-shaped, with cohorts born between 1915 and 1945 possessing among the very lowest suicide rates. Suicide rates begin to rise with boomers and subsequent cohorts exhibit increasingly higher rates of suicide. The general pattern exists for both men and women but is especially pronounced among males. The average suicide rate over the entire period for males is about 28 per 100,000, 95% CI [27.4, 28.7]. For males born in 1930-34, the suicide rate is estimated to be 17.4 per 100,000, 95% CI [15.9, 18.8]; for males born between 1955 and 1959, the rate is essentially the same as the average for the period while for males born between 1985 and 1989, the suicide rate is estimated to be 37.8 per 100,000, 95% CI [33.1, 43.4]. The results dispute popular claims that boomers exhibit an elevated suicide rate relative to other generations, but boomers do appear to have ushered in new cohort patterns of suicide rates over the life course. These patterns are interpreted within a Durkheimian framework that suggests weakened forms of social integration and regulation among postwar cohorts may be producing increased suicide rates. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  18. Facts about Birth Defects

    Science.gov (United States)

    ... label> Information For… Media Policy Makers Facts about Birth Defects Language: English (US) Español (Spanish) Recommend on ... having a baby born without a birth defect. Birth Defects Are Common Every 4 ½ minutes, a ...

  19. Birth control pills - combination

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000655.htm Birth control pills - combination To use the sharing features on ... both progestin and estrogen. What Are Combination Birth Control Pills? Birth control pills help keep you from ...

  20. Essure Permanent Birth Control

    Science.gov (United States)

    ... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  1. Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection - 15 States and U.S. Territories, 2016.

    Science.gov (United States)

    Delaney, Augustina; Mai, Cara; Smoots, Ashley; Cragan, Janet; Ellington, Sascha; Langlois, Peter; Breidenbach, Rebecca; Fornoff, Jane; Dunn, Julie; Yazdy, Mahsa; Scotto-Rosato, Nancy; Sweatlock, Joseph; Fox, Deborah; Palacios, Jessica; Forestieri, Nina; Leedom, Vinita; Smiley, Mary; Nance, Amy; Lake-Burger, Heather; Romitti, Paul; Fall, Carrie; Prado, Miguel Valencia; Barton, Jerusha; Bryan, J Michael; Arias, William; Brown, Samara Viner; Kimura, Jonathan; Mann, Sylvia; Martin, Brennan; Orantes, Lucia; Taylor, Amber; Nahabedian, John; Akosa, Amanda; Song, Ziwei; Martin, Stacey; Ramlal, Roshan; Shapiro-Mendoza, Carrie; Isenburg, Jennifer; Moore, Cynthia A; Gilboa, Suzanne; Honein, Margaret A

    2018-01-26

    Zika virus infection during pregnancy can cause serious birth defects, including microcephaly and brain abnormalities (1). Population-based birth defects surveillance systems are critical to monitor all infants and fetuses with birth defects potentially related to Zika virus infection, regardless of known exposure or laboratory evidence of Zika virus infection during pregnancy. CDC analyzed data from 15 U.S. jurisdictions conducting population-based surveillance for birth defects potentially related to Zika virus infection.* Jurisdictions were stratified into the following three groups: those with 1) documented local transmission of Zika virus during 2016; 2) one or more cases of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents; and 3) less than one case of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents. A total of 2,962 infants and fetuses (3.0 per 1,000 live births; 95% confidence interval [CI] = 2.9-3.2) (2) met the case definition. † In areas with local transmission there was a non-statistically significant increase in total birth defects potentially related to Zika virus infection from 2.8 cases per 1,000 live births in the first half of 2016 to 3.0 cases in the second half (p = 0.10). However, when neural tube defects and other early brain malformations (NTDs) § were excluded, the prevalence of birth defects strongly linked to congenital Zika virus infection increased significantly, from 2.0 cases per 1,000 live births in the first half of 2016 to 2.4 cases in the second half, an increase of 29 more cases than expected (p = 0.009). These findings underscore the importance of surveillance for birth defects potentially related to Zika virus infection and the need for continued monitoring in areas at risk for Zika.

  2. Analysis of birth-death fluid queues

    NARCIS (Netherlands)

    van Doorn, Erik A.; Scheinhardt, Willem R.W.

    1996-01-01

    We present a survey of techniques for analysing the performance of a reservoir which receives and releases fluid at rates which are determined by the state of a background birth-death process. The reservoir is assumed to be infinitely large, but the state space of the modulating birth-death process

  3. Catholics vs. Protestants - Birth and Tax

    DEFF Research Database (Denmark)

    Gøtze, Michael

    2008-01-01

    Danish Supreme Court Decision, Protestant State Church, Religious Minority, Birth Registration, Family Law, Taxation System, Discrimination, European Human Rights Law, Constitutional Law, Law and Religion Udgivelsesdato: 28. July......Danish Supreme Court Decision, Protestant State Church, Religious Minority, Birth Registration, Family Law, Taxation System, Discrimination, European Human Rights Law, Constitutional Law, Law and Religion Udgivelsesdato: 28. July...

  4. Analysis of birth-death fluid queues

    OpenAIRE

    van Doorn, Erik A.; Scheinhardt, Willem R.W.

    1996-01-01

    We present a survey of techniques for analysing the performance of a reservoir which receives and releases fluid at rates which are determined by the state of a background birth-death process. The reservoir is assumed to be infinitely large, but the state space of the modulating birth-death process may be finite or infinite.

  5. Congress in Washington

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Full text: Over 1200 accelerator physicists and engineers gathered in Washington mid-May for the 15th in the series of biennial Particle Accelerator Conferences (PAC) - the major US forum for accelerator physics and technology. For the first time since their inception, actual attendance declined, however the number of contributed papers stayed around 1500. CERN Director General designate Chris Llewellyn Smith spelled out the challenges with an opening talk underlining the deficiencies in today's Standard Model. From many directions comes the message that collision in the 1 TeV range must tell us something new - wherefore art thou SSC and LHC? The secondary shock waves of last year's (fortunately overturned) bid to cancel the SSC Superconducting Supercollider project still ripple around the USA, while progress towards authorization of CERN's LHC Large Hadron Collider has been slower than initially hoped. The new US administration has indicated a constant rate of SSC funding over the next four years; the figure is higher than the present budget but considerably below the originally proposed budget profile, implying that completion will be retarded by some three years beyond the end of the decade. The SSC Laboratory will clearly have problems to fight increased overall cost and sustain enthusiasm. CERN hopes for LHC blessing in time to allow machine completion by the year 2000. Pride of place at Washington went to DESY's HERA electron-proton collider - the major new facility since the previous PAC. Commissioning has been impressive and physics is well underway, with luminosity climbing towards the design figure. The varied user community of the ubiquitous synchrotron radiation facilities is now considerably larger than that of particle physics and has extensive industrial involvement. Three such machines have come into operation since the previous PAC - the 6 GeV European Synchrotron Radiation Facility at Grenoble, the 1.5 GeV Advanced Light Source

  6. Washington Accelerator Conference

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Highlights of the 1993 Particle Accelerator Conference, held in Washington in May, were picked out in the previous issue (page 18). Talks on the big hadron colliders reflected the sea-change in the accelerator world where the scale, complexity and cost of the front-line projects has slowed the pace of developments (not unlike the scene in particle physics itself). Speaking before the anti-SSC vote in the House of Representatives in June, Dick Briggs reviewed the situation at the SSC Superconducting Supercollider in Ellis County, Texas. The linac building is near completion and the Low Energy Booster will be ready to receive components early next year. Tunnelling for the Main Ring is advancing rapidly with four boring machines in action. Five miles of tunnel have been completed since January and the pace has now stepped up to nearly a mile each week. The superconducting magnet news is good. Following the successful initial string test of a half cell of the magnet lattice, a two-ring full cell with all associated services is being assembled. The mechanical robustness of the magnet design was confirmed when a dipole was taken to 9.7 T when cooled to 1.8 K. In the Magnet Test Lab itself, ten test stands are installed and equipped

  7. Recent developments: Washington focus

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    Congress reconvened on January 23, but most of Washington's January new involves the Administration. DOE sent two letters to USEC customers, awarded a contract for the independent financial review of the enrichment program, and released a plan for demonstrating AVLIS by 1992. A General Accounting Office (GAO) report investigating the impact of imports of Soviet EUP into the US was made public. Both Congress and the administration are reportedly considering a full-scope US-Soviet Agreement for Nuclear Cooperation. Finally, published reports indicate Congress may consider ending the customs user fee which levies a charge of 0.17% on the value of all imported goods. The fee is felt to violate the General Agreement on Tariffs and Trade (GATT) and is not based on recovering actual Customs costs for processing a good. The fee brings the Treasury over $700 million per year, but the business community plans to lobby hard for its outright elimination or a change in authority to collect the fee based on actual costs

  8. Washington Accelerator Conference

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1993-09-15

    Highlights of the 1993 Particle Accelerator Conference, held in Washington in May, were picked out in the previous issue (page 18). Talks on the big hadron colliders reflected the sea-change in the accelerator world where the scale, complexity and cost of the front-line projects has slowed the pace of developments (not unlike the scene in particle physics itself). Speaking before the anti-SSC vote in the House of Representatives in June, Dick Briggs reviewed the situation at the SSC Superconducting Supercollider in Ellis County, Texas. The linac building is near completion and the Low Energy Booster will be ready to receive components early next year. Tunnelling for the Main Ring is advancing rapidly with four boring machines in action. Five miles of tunnel have been completed since January and the pace has now stepped up to nearly a mile each week. The superconducting magnet news is good. Following the successful initial string test of a half cell of the magnet lattice, a two-ring full cell with all associated services is being assembled. The mechanical robustness of the magnet design was confirmed when a dipole was taken to 9.7 T when cooled to 1.8 K. In the Magnet Test Lab itself, ten test stands are installed and equipped.

  9. A Partnership for Modeling the Marine Environment of Puget Sound, Washington

    Science.gov (United States)

    2009-03-30

    Northwest National Marine Renewable Energy Center, a joint University of Washington - Oregon State project funded by the U.S. Department of Energy. e. A... Marine Renewable Energy Center (NNMREC), a joint Washington - Oregon State project to investigate extraction of wave and tidal energy sponsored by

  10. Improving Immunization Coverage in a Rural School District in Pierce County, Washington

    Science.gov (United States)

    Peterson, Robin M.; Cook, Carolyn; Yerxa, Mary E.; Marshall, James H.; Pulos, Elizabeth; Rollosson, Matthew P.

    2012-01-01

    Washington State has some of the highest percentages of school immunization exemptions in the country. We compared school immunization records in a rural school district in Pierce County, Washington, to immunization records in the state immunization information system (IIS) and parent-held records. Correcting school immunization records resulted…

  11. 12 CFR 4.4 - Washington office.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Washington office. 4.4 Section 4.4 Banks and... EXAMINERS Organization and Functions § 4.4 Washington office. The Washington office of the OCC is the main office and headquarters of the OCC. The Washington office directs OCC policy, oversees OCC operations...

  12. Building Astronomy Curriculum to Include the Sight Impaired: Week long summer camp activities for Middle School Students adherent to Washington State Curriculum Standards (EALR's)

    Science.gov (United States)

    Ramien, Natalie; Loebman, S. R.; Player, V.; Larson, A.; Torcolini, N. B.; Traverse, A.

    2011-01-01

    Currently astronomy learning is heavily geared towards visual aids; however, roughly 10 million people in North America are sight impaired. Every student should have access to meaningful astronomy curriculum; an understanding of astronomy is an expectation of national and state science learning requirements. Over the last ten years, Noreen Grice has developed Braille and large print astronomy text books aimed at sight impaired learners. We build upon Grice's written work and present here a five day lesson plan that integrates 2D reading with 3D activities. Through this curriculum, students develop an intuitive understanding of astronomical distance, size, composition and lifetimes. We present five distinct lesson modules that can be taught individually or in a sequential form: the planets, our sun, stars, stellar evolution and galaxies. We have tested these modules on sight impaired students and report the results here. Overall, we find the work presented here lends itself equally well to a week long science camp geared toward middle school sight impaired taught by astronomers or as supplemental material integrated into a regular classroom science curriculum. This work was made possible by a 2007 Simple Effective Education and Dissemination (SEED) Grant For Astronomy Researchers, Astronomical Society of the Pacific through funds provided by the Planck Mission, Jet Propulsion Laboratory, California Institute of Technology.

  13. Trends in characteristics of women choosing contraindicated home births.

    Science.gov (United States)

    Zafman, Kelly B; Stone, Joanne L; Factor, Stephanie H

    2018-04-12

    To characterize the American College of Obstetricians and Gynecologists (ACOG) contraindicated home births and the women who are receiving these births in hopes of identifying venues for intervention. The National Center for Health Statistics (NCHS) birth certificate records from 1990 to 2015 were used. "Planned home births" were defined as those births in which birthplace was coded as "residence" and birth attendant was coded as "certified nurse midwife (CNM)" or "other midwife". Contraindicated home births were defined as "planned home births" from 1990 to 2015 that had one or more of the ACOG risk factors for home births, which include vaginal birth after prior cesarean delivery (VBAC), breech presentation and multiple gestations. A review of trends in contraindicated home births from 1990 to 2015 suggests that they are increasing in number (481-1396) and as a percentage of total births (0.01%-0.04%, P95%), which is most frequently initiated in the first trimester. The majority of home births were paid out-of-pocket (65%-69%). The increasing number of contraindicated home births in the United States requires public health action. Home births are likely a matter of choice rather than a lack of resources. It is unclear if women choose home births while knowing the risk or due to a lack of information. Prenatal education about contraindicated home births is possible, as almost all women receive prenatal care.

  14. A Pleasing Birth

    NARCIS (Netherlands)

    Vries, De Raymond

    2005-01-01

    Women have long searched for a pleasing birth-a birth with a minimum of fear and pain, in the company of supportive family, friends, and caregivers, a birth that ends with a healthy mother and baby gazing into each other's eyes. For women in the Netherlands, such a birth is defined as one at home

  15. Beating Birth Defects

    Centers for Disease Control (CDC) Podcasts

    Each year in the U.S., one in 33 babies is affected by a major birth defect. Women can greatly improve their chances of giving birth to a healthy baby by avoiding some of the risk factors for birth defects before and during pregnancy. In this podcast, Dr. Stuart Shapira discusses ways to improve the chances of giving birth to a healthy baby.

  16. 78 FR 46258 - Drawbridge Operation Regulation Lake Washington, Seattle, WA

    Science.gov (United States)

    2013-07-31

    ... that governs the Evergreen Point Floating Bridge (State Route 520 across Lake Washington) at Seattle... Department of Transportation has requested that the draw span of the Evergreen Point Floating Bridge (State... this time, which would divert road traffic onto the Evergreen Point Floating Bridge. The closure of the...

  17. Birth Order, Family Size and Educational Attainment

    OpenAIRE

    Monique de Haan

    2005-01-01

    This paper investigates the effect of sibship size and birth order on educational attainment, for the United States and the Netherlands. An instrumental variables approach is used to identify the effect of sibship size. Instruments for the number of children are twins at last birth and the sex mix of the first two children. The effect of birth order is identified, by examining the relation with years of education for different family sizes separately; this avoids the problem that estimated ef...

  18. Controllable entanglement sudden birth of Heisenberg spins

    International Nuclear Information System (INIS)

    Zheng Qiang; Zhi Qijun; Zhang Xiaoping; Ren Zhongzhou

    2011-01-01

    We investigate the Entanglement Sudden Birth (ESB) of two Heisenberg spins A and B. The third controller, qutrit C is introduced, which only has the Dzyaloshinskii-Moriya (DM) spin-orbit interaction with qubit B. We find that the DM interaction is necessary to induce the Entanglement Sudden Birth of the system qubits A and B, and the initial states of the system qubits and the qutrit C are also important to control its Entanglement Sudden Birth. (authors)

  19. Comparative effectiveness of skin antiseptic agents in reducing surgical site infections: a report from the Washington State Surgical Care and Outcomes Assessment Program.

    Science.gov (United States)

    Hakkarainen, Timo W; Dellinger, E Patchen; Evans, Heather L; Farjah, Farhood; Farrokhi, Ellen; Steele, Scott R; Thirlby, Richard; Flum, David R

    2014-03-01

    Surgical site infections (SSI) are an important source of morbidity and mortality. Chlorhexidine in isopropyl alcohol is effective in preventing central venous-catheter associated infections, but its effectiveness in reducing SSI in clean-contaminated procedures is uncertain. Surgical studies to date have had contradictory results. We aimed to further evaluate the relationship of commonly used antiseptic agents and SSI, and to determine if isopropyl alcohol has a unique effect. We performed a prospective cohort analysis to evaluate the relationship of commonly used skin antiseptic agents and SSI for patients undergoing mostly clean-contaminated surgery from January 2011 through June 2012. Multivariate regression modeling predicted expected rates of SSI. Risk adjusted event rates (RAERs) of SSI were compared across groups using proportionality testing. Among 7,669 patients, the rate of SSI was 4.6%. The RAERs were 0.85 (p = 0.28) for chlorhexidine (CHG), 1.10 (p = 0.06) for chlorhexidine in isopropyl alcohol (CHG+IPA), 0.98 (p = 0.96) for povidone-iodine (PVI), and 0.93 (p = 0.51) for iodine-povacrylex in isopropyl alcohol (IPC+IPA). The RAERs were 0.91 (p = 0.39) for the non-IPA group and 1.10 (p = 0.07) for the IPA group. Among elective colorectal patients, the RAERs were 0.90 (p = 0.48) for CHG, 1.04 (p = 0.67) for CHG+IPA, 1.04 (p = 0.85) for PVI, and 1.00 (p = 0.99) for IPC+IPA. For clean-contaminated surgical cases, this large-scale state cohort study did not demonstrate superiority of any commonly used skin antiseptic agent in reducing the risk of SSI, nor did it find any unique effect of isopropyl alcohol. These results do not support the use of more expensive skin preparation agents. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Historical changes to Lake Washington and route of the Lake Washington Ship Canal, King County, Washington

    Science.gov (United States)

    Chrzastowski, Michael J.

    1983-01-01

    Lake Washington, in the midst of the greater Seattle metropolitan area of the Puget Sound region (fig. 1), is an exceptional commercial, recreational, and esthetic resource for the region . In the past 130 years, Lake Washington has been changed from a " wild " lake in a wilderness setting to a regulated lake surrounded by a growing metropolis--a transformation that provides an unusual opportunity to study changes to a lake's shoreline and hydrologic characteristics -resulting from urbanization.

  1. Incomplete childhood immunization with new and old vaccines and associated factors: BRISA birth cohort, São Luís, Maranhão State, Northeast Brazil.

    Science.gov (United States)

    Silva, Francelena de Sousa; Barbosa, Yonna Costa; Batalha, Mônica Araújo; Ribeiro, Marizélia Rodrigues Costa; Simões, Vanda Maria Ferreira; Branco, Maria Dos Remédios Freitas Carvalho; Thomaz, Érika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; Araújo, Waleska Regina Machado; Silva, Antônio Augusto Moura da

    2018-03-12

    This study estimated the percentages of incomplete immunization with new vaccines and old vaccines and associated factors in children 13 to 35 months of age belonging to a birth cohort in São Luís, the capital of Maranhão State, Brazil. The sample was probabilistic, with 3,076 children born in 2010. Information on vaccination was obtained from the Child's Health Card. The new vaccines, namely those introduced in 2010, were meningococcal C and 10-valent pneumococcal, and the old vaccines, or those already on the childhood immunization schedule, were BCG, hepatitis B, human rotavirus, polio, tetravalent (diphtheria, tetanus, pertussis, Haemophilus influenzae b), yellow fever, and triple viral (measles, mumps, rubella). The study used hierarchical modeling and Poisson regression with robust variance. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated. Incomplete immunization was higher with new vaccines (51.1%) than with old vaccines (33.2%). Children 25 to 35 months of age (PR = 1.27; 95%CI: 1.14-1.41) and those in economic classes D/E (PR = 1.20; 95%CI: 1.06-1.35) were only significantly associated with new vaccines; low maternal schooling (PR = 1.58; 95%CI: 1.21-2.06), unavailability of outpatient and/or hospital care for the child (PR = 1.20; 95%CI: 1.04-1.38), and unavailability of the vaccine in health services (PR: 1.28; 95%CI: 1.12-1.46) were only associated with old vaccines. Immunization strategies should consider the vulnerability of older preschool-age children and those belonging to classes D and E, especially when new vaccines are introduced, as well as children of mothers with low schooling. Strategies should also address problems with the availability of health services and vaccines.

  2. The distribution of clinical phenotypes of preterm birth syndrome: implications for prevention.

    Science.gov (United States)

    Barros, Fernando C; Papageorghiou, Aris T; Victora, Cesar G; Noble, Julia A; Pang, Ruyan; Iams, Jay; Cheikh Ismail, Leila; Goldenberg, Robert L; Lambert, Ann; Kramer, Michael S; Carvalho, Maria; Conde-Agudelo, Agustin; Jaffer, Yasmin A; Bertino, Enrico; Gravett, Michael G; Altman, Doug G; Ohuma, Eric O; Purwar, Manorama; Frederick, Ihunnaya O; Bhutta, Zulfiqar A; Kennedy, Stephen H; Villar, José

    2015-03-01

    Preterm birth has been difficult to study and prevent because of its complex syndromic nature. To identify phenotypes of preterm delivery syndrome in the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. A population-based, multiethnic, cross-sectional study conducted at 8 geographically demarcated sites in Brazil, China, India, Italy, Kenya, Oman, the United Kingdom, and the United States. A total of 60,058 births over a 12-month fixed period between April 27, 2009, and March 2, 2014. Of these, 53,871 had an ultrasonography estimate of gestational age, among which 5828 were preterm births (10.8%). Pregnancies were prospectively studied using a standardized data collection and online data management system. Newborns had anthropometric and clinical examinations using standardized methods and identical equipment and were followed up until hospital discharge. The main study outcomes were clusters of preterm phenotypes and for each cluster, we analyzed signs of presentation at hospital admission, admission rates for neonatal intensive care for 7 days or more, and neonatal mortality rates. Twelve preterm birth clusters were identified using our conceptual framework. Eleven consisted of combinations of conditions known to be associated with preterm birth, 10 of which were dominated by a single condition. However, the most common single cluster (30.0% of the total preterm cases; n = 1747) was not associated with any severe maternal, fetal, or placental condition that was clinically detectable based on the information available; within this cluster, many cases were caregiver initiated. Only 22% (n = 1284) of all the preterm births occurred spontaneously without any of these severe conditions. Maternal presentation on hospital admission, newborn anthropometry, and risk for death before hospital discharge or admission for 7 or more days to a neonatal intensive care unit, none of which were used to construct the clusters, also differed according to the identified

  3. The rising home birth trend in America

    OpenAIRE

    Nurlan Aliyev; Chastidy Roldan; Bulent Cakmak

    2015-01-01

    In recent years home birth rates are increased in the whole world, mainly in the United States (US). Between 2004-2012, non-hospital births increasing rate is 89% in the US. Home birth increased especially among the married, non-Hispanic, over 35 years of age, multipar and singleton pregnancies. However the high rate of cesarean birth did not increase in recent years in the US, now it has been stable at 32%. It is reported that the stability of the cesarean rate is related to rising rate of h...

  4. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ebuehi OM

    2012-02-01

    Full Text Available Olufunke M Ebuehi, IA AkintujoyeReproductive and International Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, NigeriaBackground: In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptions and utilization of traditional birth attendant (TBA services in a rural Local Government Area (LGA in Ogun State, southwest Nigeria.Methods: A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1 statistical software.Results: Almost half (48.8% of the respondents were in the age group 26–35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6% of the respondents had been pregnant 2–4 times before. TBA functions, as identified by respondents, were: “taking normal delivery” (56.7%, “providing antenatal services” (16.5%, “performing caesarean section” (13.0%, “providing family planning services” (8.2%, and “performing gynaecological surgeries” (5.6%. About 6/10 (61.0% respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7% respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%, normal delivery (36.1%, “special maternal bath to ward off evil spirits” (1.9%, “concoctions for mothers to drink to make baby strong” (15.1%, and family planning services (1.9%. Reasons for using TBA services were: “TBA services are cheaper” (50.9%, “TBA services are more culturally acceptable in my environment” (34.0%,

  5. Twins: prevalence, problems, and preterm births.

    Science.gov (United States)

    Chauhan, Suneet P; Scardo, James A; Hayes, Edward; Abuhamad, Alfred Z; Berghella, Vincenzo

    2010-10-01

    The rate of twin pregnancies in the United States has stabilized at 32 per 1000 births in 2006. Aside from determining chorionicity, first-trimester screening and second-trimester ultrasound scanning should ascertain whether there are structural or chromosomal abnormalities. Compared with singleton births, genetic amniocentesis-related loss at births is higher (0.9% vs 2.9%, respectively). Selective termination for an anomalous fetus is an option, although the pregnancy loss rate is 7% at experienced centers. For singleton and twin births for African American and white women, approximately 50% of preterm births are indicated; approximately one-third of these births are spontaneous, and 10% of the births occur after preterm premature rupture of membranes. From 1989-2000, the rate of preterm twin births increased, for African American and white women alike, although the perinatal mortality rate has actually decreased. As with singleton births, tocolytics should be used judiciously and only for a limited time (births. Administration of antenatal corticosteroids is an evidence-based recommendation. Copyright © 2010 Mosby, Inc. All rights reserved.

  6. State of Washington Aquatic Plant Management Program

    Science.gov (United States)

    1979-10-01

    endothall (DMA salt); and herbivorous fish, insects , and pathogens. 4. Comments Received from Public Review of the Draft Environmental Impact Statement...SNYIAOWMNWAL MANWULATION UIONOGC SSUCTION DREDGE HAND RUMOVA HOTTON SHADING WATER LEVEL FLUCTUATIONS HERBIVOROUS FIS1H INSECTS , PAT1OGIENS, ETC. set...the control of acuatic plants. 52 4. PROBABLE IMPACTS OF THE PROPOSED ACTION ON~ THE ENVIRON4MENT 4.01 Impacts on Air Quality, Noise and Traffic. 4.01.1

  7. Reactor console replacement at Washington State University

    International Nuclear Information System (INIS)

    Lovas, Thomas A.

    1978-01-01

    A replacement reactor console was installed in 1977 at the W.S.U. 1 MW TRIGA-fueled reactor as the final step in an instrumentation upgrade program. The program was begun circa 1972 with the design, construction and installation of various systems and equipment. Major instruments were installed in the existing console and tested in the course of reactor operation. The culmination of the program was the installation of a cubicle designed and constructed to house the updated instrumentation. (author)

  8. Planned home birth: the professional responsibility response.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit

    2013-01-01

    This article addresses the recrudescence of and new support for midwife-supervised planned home birth in the United States and the other developed countries in the context of professional responsibility. Advocates of planned home birth have emphasized patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and identify professionally appropriate responses of obstetricians and other concerned physicians to planned home birth. We start with patient safety and show that planned home birth has unnecessary, preventable, irremediable increased risk of harm for pregnant, fetal, and neonatal patients. We document that the persistently high rates of emergency transport undermines patient safety and satisfaction, the raison d'etre of planned home birth, and that a comprehensive analysis undermines claims about the cost-effectiveness of planned home birth. We then argue that obstetricians and other concerned physicians should understand, identify, and correct the root causes of the recrudescence of planned home birth; respond to expressions of interest in planned home birth by women with evidence-based recommendations against it; refuse to participate in planned home birth; but still provide excellent and compassionate emergency obstetric care to women transported from planned home birth. We explain why obstetricians should not participate in or refer to randomized clinical trials of planned home vs planned hospital birth. We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital. Copyright © 2013 Mosby, Inc. All rights reserved.

  9. Planned hospital birth versus planned home birth

    DEFF Research Database (Denmark)

    Olsen, O.; Clausen, J.A.

    2012-01-01

    Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998....

  10. The pre-history of the University of Washington Astronomy Department: 1891-1965

    Science.gov (United States)

    Sullivan, Woodruff T.

    2015-01-01

    The University of Washington (UW) created its first Professor of Astronomy (within the Mathematics Department) in 1891, only two years after Washington itself became a state. Joseph Taylor bought a Warner & Swasey refractor with a 6-inch John Brashear lens, and installed it in a dome in 1895 when the university moved to a new campus outside of downtown Seattle. The small observatory became only the second building on the present campus, and is listed on the State Register of Historical Buildings. Over succeeding decades, Taylor was followed, amongst others, by Samuel Boothroyd (who after nine years left for Cornell in 1921) and for two years by Herman Zanstra (of "Zanstra method" fame). In 1928 Theodor Jacobsen joined the faculty after having obtained his Ph.D. at the University of California (Berkeley) and spending two years as a staff member at Lick Observatory. Jacobsen's research over the years focused on the spectra and motions of variable stars, especially of the Cepheid type. In the 1970s Jacobsen published a paper about secular changes in one particular Cepheid variable still using his own data extending as far back as the 1920s. For 42 years until his retirement, Jacobsen taught courses in astronomy (although there never was an astronomy major and only two graduate degrees were ever awarded), navigation, and a variety of mathematical topics. In the decade following Sputnik and the birth of NASA, UW astronomy ceased to be a one-man effort with the creation of a modern department, founding of a graduate program, and hiring of two new faculty members: George Wallerstein and Paul Hodge came from Berkeley in 1965 and are both still engaged in research 50 years later.

  11. 78 FR 19298 - Notice of Inventory Completion: University of Washington, Department of Anthropology, Seattle, WA

    Science.gov (United States)

    2013-03-29

    ...-PPWOCRADN0] Notice of Inventory Completion: University of Washington, Department of Anthropology, Seattle, WA..., Department of Anthropology, has completed an inventory of human remains, in consultation with the appropriate... Washington, Department of Anthropology. Disposition of the human remains to the Indian tribes stated below...

  12. An annotated checklist of the vascular flora of Washington County Mississippi

    Science.gov (United States)

    Field explorations have yielded 257 species new to Washington County, Mississippi and Calandrinia ciliata (Ruiz & Pav.) DC. and Ruellia nudiflora (Engelm. & Gray) Urban new to the state. An annotated list of 796 taxa for Washington County is provided and excludes 62 species that were reported from ...

  13. Integrated Digital English Acceleration (I-DEA). Washington's Community and Technical Colleges

    Science.gov (United States)

    Washington State Board for Community and Technical Colleges, 2015

    2015-01-01

    Washington state has a large and rapidly growing foreign-born population. In 2011, immigrants made up 16.5 percent of Washington's civilian employed workforce, up from 7.1 percent in 1990. These new arrivals create jobs by forming businesses, spending income in local economies and raising employers' productivity. Thanks to project I-DEA…

  14. 76 FR 18001 - Irish Potatoes Grown in Washington; Decreased Assessment Rate

    Science.gov (United States)

    2011-04-01

    ... IR] Irish Potatoes Grown in Washington; Decreased Assessment Rate AGENCY: Agricultural Marketing... rate established for the State of Washington Potato Committee (Committee) for the 2011-2012 and subsequent fiscal periods from $0.0035 to $0.003 per hundredweight of potatoes handled. The Committee locally...

  15. 78 FR 48285 - Irish Potatoes Grown in Washington; Decreased Assessment Rate

    Science.gov (United States)

    2013-08-08

    ...; FV13-946-1 FIR] Irish Potatoes Grown in Washington; Decreased Assessment Rate AGENCY: Agricultural... established for the State of Washington Potato Committee (Committee) for the 2013-2014 fiscal year and all subsequent fiscal periods from $0.003 to $0.0025 per hundredweight of potatoes handled. The Committee locally...

  16. 76 FR 41589 - Irish Potatoes Grown in Washington; Decreased Assessment Rate

    Science.gov (United States)

    2011-07-15

    ... FIR] Irish Potatoes Grown in Washington; Decreased Assessment Rate AGENCY: Agricultural Marketing... established for the State of Washington Potato Committee (Committee) for the 2011-2012 and subsequent fiscal periods from $0.0035 to $0.003 per hundredweight of potatoes handled. The Committee locally administers...

  17. Booker T. Washington's Educational Contributions to Contemporary Practices of Sustainable Development

    Science.gov (United States)

    Grant, Brett G.

    2014-01-01

    This article discusses Booker T. Washington's educational contributions to contemporary practices of sustainable development. In particular, the article looks at Washington's contributions in the areas of economic sustainability and entrepreneurship, character development, and aesthetics. As states continue to contemplate and evaluate the value of…

  18. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

    The birth of a baby is a family experience. However, in the United Kingdom birth often occurs outside the family environment, in hospital. Both home and hospital births have risks and benefits, but research shows that, for most women, it is as safe to give birth at home as it is in hospital. Women report home-birth to be satisfying with lowered risks of intervention and less likelihood of being separated from their family. It is also more cost effective for the National Health Service. Yet, whilst midwives are working hard to promote home birth as an option, it remains controversial. The aim of this paper is to raise awareness of the safety of home birth and the needs of women and midwives when a home birth is chosen. It provides an overview of care required and the role of the midwife in the ensuring care is woman-centred and personalised.

  19. Preterm Labor and Birth

    Science.gov (United States)

    ... Facebook Twitter Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about ... is called preterm labor (or premature labor). A birth that occurs before 37 weeks is considered a ...

  20. Birth Control Shot

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Shot KidsHealth / For Teens / Birth Control Shot What's ...