Association of Marijuana Legalization with Marijuana Use among US High School Students, 1993-2019

Dr Anderson acknowledges partial support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NIH) (research infrastructure grant No. R24 HD042828), to the Center for Studies in Demography and Ecology at the University of Washington. Dr Sabia and Mr Safford acknowledge partial support from the Center for Health Economics & Policy Studies at San Diego State University, including grant funding received from the Charles Koch Foundation

Multiple uncontrolled conditions and blood pressure medication intensification: an observational study

Abstract Background Multiple uncontrolled medical conditions may act as competing demands for clinical decision making. We hypothesized that multiple uncontrolled cardiovascular risk factors would decrease blood pressure (BP) medication intensification among uncontrolled hypertensive patients. Methods We observed 946 encounters at two VA primary care clinics from May through August 2006. After each encounter, clinicians recorded BP medication intensification (BP medication was added or titrated). Demographic, clinical, and laboratory information were collected from the medical record. We examined BP medication intensification by presence and control of diabetes and/or hyperlipidemia. 'Uncontrolled' was defined as hemoglobin A1c ≥ for diabetes, BP ≥ 140/90 mmHg (≥ 130/80 mmHg if diabetes present) for hypertension, and low density lipoprotein cholesterol (LDL-c) ≥ 130 mg/dl (≥ 100 mg/dl if diabetes present) for hyperlipidemia. Hierarchical regression models accounted for patient clustering and adjusted medication intensification for age, systolic BP, and number of medications. Results Among 387 patients with uncontrolled hypertension, 51.4% had diabetes (25.3% were uncontrolled) and 73.4% had hyperlipidemia (22.7% were uncontrolled). The BP medication intensification rate was 34.9% overall, but higher in individuals with uncontrolled diabetes and uncontrolled hyperlipidemia: 52.8% overall and 70.6% if systolic BP ≥ 10 mmHg above goal. Intensification rates were lowest if diabetes or hyperlipidemia were controlled, lower than if diabetes or hyperlipidemia were not present. Multivariable adjustment yielded similar results. Conclusions The presence of uncontrolled diabetes and hyperlipidemia was associated with more guideline-concordant hypertension care, particularly if BP was far from goal. Efforts to understand and improve BP medication intensification in patients with controlled diabetes and/or hyperlipidemia are warranted.http://deepblue.lib.umich.edu/bitstream/2027.42/78266/1/1748-5908-5-55.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78266/2/1748-5908-5-55.pdfPeer Reviewe

Assessing Students\u27 Acquisition of Scientific Reasoning in an Experimental Psychology Class

This pilot study is an initial exploration of a theoretical rubric proposed to describe the progress of students’ acquisition of scientific inquiry (Halonen et al., 2003, p. 196), and an application of the utility of the rubric. Twenty-two undergraduates from a woman’s college participated in two sections of experimental psychology. Students consisted of sophomores, juniors, and seniors who completed general psychology courses. Consistent with the Halonen et al. (2003) model, results indicated that authentic research experiences in the first phase of the course were positively correlated with changes in scientific thinking in a second phase. In turn, experiences in the second phase were positively correlated with evidence of advanced thinking skills in a third phase. The findings suggest that much of the basic skill knowledge acquired in the beginning lectures, textbook readings, and writing instruction of the course enhanced students’ ability to apply that knowledge in later classes and the lab components. Further, the authentic learning experiences were instrumental in fine-tuning the skills learned from the lectures and textbooks readings. As a result, the current authors advocate the use of authentic experiences in teaching research methods, as a way for teachers to transform such classes in a beneficial and systematic way, in order to enhance acquisition of scientific thinking skills and to examine changes in scientific thinking as explicated in the Halonen et al. (2003) model

Beliefs about Development Versus Environmental Tradeoffs in the Puget Sound Region

Policymakers face difficult decisions as they attempt to balance competing calls for increased developmentand environmental protection. In the Puget Sound region of Washington State, population growth and the needfor housing and energy have brought these types of tradeoffs to the forefront. Using data from a phone survey of 1,980 residents, researchers from the Carsey Institute and the National Oceanic and Atmospheric Administration (NOAA) Fisheries investigated public perceptions of environmental concerns across Puget Sound. This fact sheet outlines residents' views about the importance of environmental protection as well as their opinions about energy development, protection of wild salmon, and land use regulation

National variation in United States sepsis mortality: a descriptive study

<p>Abstract</p> <p>Background</p> <p>The regional distribution of a disease may provide important insights regarding its pathophysiology, risk factors and clinical care. While sepsis is a prominent cause of death in the United States (US), few studies have examined regional variations with this malady. We identified the national variation in sepsis deaths in the US. We conducted a descriptive analysis of 1999-2005 national vital statistics data from the National Center for Health Statistics summarized at the state-level. We defined sepsis deaths as deaths attributed to an infection, classified according to the International Classification of Diseases, Version 10. We calculated national and state age-adjusted sepsis-attributed mortality rates.</p> <p>Results</p> <p>National age-adjusted sepsis mortality was 65.5 per 100,000 persons (95% CI: 65.8 - 66.0). State level sepsis mortality varied more than two-fold (range 41 to 88.6 per 100,000 persons; median 60.8 per 100,000, IQR 53.9-74.4 per 100,000). A cluster extending from the Southeastern to the mid-Atlantic US encompassed states with the highest sepsis mortality.</p> <p>Conclusions</p> <p>Sepsis mortality varies across the US. The states with highest sepsis mortality form a contiguous cluster in the Southeastern and mid-Atlantic US. These observations highlight unanswered questions regarding the characteristics and care of sepsis.</p

Application of statistical process control and process capability analysis procedures in orbiter processing activities at the Kennedy Space Center

Successful ground processing at KSC requires that flight hardware and ground support equipment conform to specifications at tens of thousands of checkpoints. Knowledge of conformance is an essential requirement for launch. That knowledge of conformance at every requisite point does not, however, enable identification of past problems with equipment, or potential problem areas. This paper describes how the introduction of Statistical Process Control and Process Capability Analysis identification procedures into existing shuttle processing procedures can enable identification of potential problem areas and candidates for improvements to increase processing performance measures. Results of a case study describing application of the analysis procedures to Thermal Protection System processing are used to illustrate the benefits of the approaches described in the paper

Vigilance problems in orbiter processing

A pilot experiment was done to determine what factors influence potential performance errors related to vigilance in Orbiter processing activities. The selected activities include post flight inspection for burned gap filler material and pre-rollout inspection for tile processing shim material. It was determined that the primary factors related to performance decrement were the color of the target and the difficulty of the target presentation

Intended and Unintended Effects of E-cigarette Taxes on Youth Tobacco Use

Over the past decade, rising youth use of e-cigarettes and other electronic nicotine delivery systems (ENDS) has prompted aggressive regulation by state and local governments. Between 2010 and 2019, ten states and two large counties adopted ENDS taxes. Applying a continuous treatment difference-in-differences approach to data from two large national datasets (Monitoring the Future and the Youth Risk Behavior Surveillance System), this study explores the impact of ENDS taxes on youth tobacco use. We find that ENDS taxes reduce youth e-cigarette consumption, with estimated e-cigarette tax elasticities of -0.06 to -0.21. However, we estimate sizable positive cigarette cross-tax elasticities, suggesting economic substitution between cigarettes and e-cigarettes for youth. These substitution effects are particularly large for frequent cigarette smoking. We conclude that the unintended effects of ENDS taxation may more than fully offset any public health gains

Association of Prediabetes and Diabetes With Stroke Symptoms The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

OBJECTIVE Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms. RESEARCH DESIGN AND METHODS This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported no history of stroke or transient ischemic attack at baseline (2003–2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire. RESULTS The prevalence of any stroke symptom was higher among participants with diabetes (22.7%) compared with those with prediabetes (15.6%) or normal glycemia (14.9%). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95% CI 1.18–1.39]) and two or more stroke symptoms (1.26 [1.12–1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03–1.29]), vision loss (1.52 [1.31–1.76]), half-vision loss (1.54 [1.30–1.84]), and lost ability to understand people (1.34 [1.12–1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms. CONCLUSIONS In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted