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PubMed2004

Distribution of Ochlerotatus togoi along the Pacific coast of Washington.

Before this study, the mosquito Ochlerotatus (Finlaya) togoi (Theobald) had been reported from only 2 locations within the continental United States, both of which were documented in Washington State. This study used active and passive surveillance to determine the current distribution of Oc. togoi along the Pacific Coast of Washington. Results of the study show that small, but stable, populations of Oc. togoi exist in the northern San Juan Island region of Puget Sound. Geological formations in this region are conducive to rock holes and support populations of Oc. togoi. No members of Oc. togoi were found on the southwestern Washington coast, the coast of the Olympic Peninsula, or in the lower Puget Sound.

Animals↗
PubMedDate not supplied

Cervical cytology quality assurance in Washington State.

The objectives of this study were to establish a profile of cervical cytology laboratories in Washington State, identify quality assurance problems amenable to correction through education or legislation, and describe differences between large and small cytology laboratories. All 43 Washington laboratories that perform cervical cytology were surveyed by mail during 1989. Completed surveys were returned by 37 (86%) of the laboratories. Nearly half (43%) of the respondents reported processing less than 10,000 Papanicolaou smears annually. Only one-third (35%) of the respondents reported participating in relevant proficiency programs. A proportion of smaller cytology laboratories were compensating their cytotechnologists on the basis of the number of slides read and allowing Papanicolaou smears to be read outside the confines of the laboratory. The results of this study suggest that cytotechnologists in some larger Washington laboratories have been exceeding work load limits recommended by professional associations. Recent legislation includes regulations that address cervical cytology quality assurance. However, continued efforts will need to be made to encourage voluntary adoption of quality control measures not addressed by this legislation.

Female↗
PubMed2003

Dr. Jekyll's waiver of Mr. Hyde's right to refuse medical treatment: Washington's new law authorizing mental health care advance directives needs additional protection.

Mental health care advance directives are gaining popularity nationwide. Following a growing trend, the Washington State Legislature has recently passed a law allowing patients to draft mental health care advance directives that could be irrevocable. Patients who sign an irrevocable directive essentially waive their fundamental right to refuse treatment in the future. The United States Supreme Court has held that waivers of fundamental rights must be made knowingly, voluntarily, and intelligently. However, as passed, Washington's new law contains insufficient safeguards to guarantee such a waiver. This Comment proposes that the Washington State Legislature amend this law the require two additional protections: a "rights advocate" to explain the potential waiver of rights, and a written warning in the advance directive form. These safeguards will help ensure that patients make knowing and intelligent waivers of their fundamental right to refuse treatment.

Advance Directives↗
PubMed2006

The University of Washington Health Sciences Library BioCommons: an evolving Northwest biomedical research information support infrastructure.

SETTING: The University of Washington Health Sciences Libraries and Information Center BioCommons serves the bioinformatics needs of researchers at the university and in the vibrant for-profit and not-for-profit biomedical research sector in the Washington area and region. PROGRAM COMPONENTS: The BioCommons comprises services addressing internal University of Washington, not-for-profit, for-profit, and regional and global clientele. The BioCommons is maintained and administered by the BioResearcher Liaison Team. The BioCommons architecture provides a highly flexible structure for adapting to rapidly changing resources and needs. EVALUATION MECHANISMS: BioCommons uses Web-based pre- and post-course evaluations and periodic user surveys to assess service effectiveness. Recent surveys indicate substantial usage of BioCommons services and a high level of effectiveness and user satisfaction. NEXT STEPS/FUTURE DIRECTIONS: BioCommons is developing novel collaborative Web resources to distribute bioinformatics tools and is experimenting with Web-based competency training in bioinformation resource use.

Academic Medical Centers↗
PubMed1991

Lower extremity amputations among persons with diabetes mellitus--Washington, 1988.

Diabetes mellitus is the leading cause of lower extremity amputations (LEAs) in the United States, accounting for approximately 50% of all nontraumatic LEAs. To assist public health programs in preventing diabetes-related LEAs in Washington state, the diabetes-control program of the Washington Department of Health characterizes LEAs. This report summarizes an analysis of the incidence of LEAs during 1988 among Washington residents with and without diabetes.

Adult↗
PubMed1991

Differences in the obstetric practices of obstetricians and family physicians in Washington State.

In response to the obstetric malpractice crisis, both obstetrician-gynecologists and family physicians have raised their fees and preferentially selected lower risk patients. In addition, large numbers of general and family physicians have left obstetric practice altogether. The impact of these responses was explored by examining the differences in the demographic and clinical profile of patients served by these two disciplines in the State of Washington. Eighty-five percent (45,540) of all complete records from 1983 births attended by physicians in the State of Washington were matched to physician specialty information. These births represent 67% of the total deliveries in Washington State in 1983. Although twice as many general and family physicians as obstetricians were practicing obstetrics, obstetricians delivered 2.5 times as many infants as did general and family physicians. Obstetricians served an older patient population with more low-birthweight infants, multiple births, and complications of pregnancy than family physicians. General and family physicians were more likely to care for minorities, teenagers, and unmarried and rural mothers. Obstetricians cared for patients with higher medical risks, whereas general and family physicians provided care to more socially vulnerable and geographically isolated populations. To the extent that general and family physicians are differentially abandoning obstetric practice because of the current malpractice crisis, access to care for rural and socially vulnerable groups may deteriorate rapidly.

Adolescent↗
PubMed1990

A separate department of health in Washington State: four years before the mast.

This paper reviews the recent experience in Washington State which resulted in creation of a separate state Department of Health. Until the 1989 legislation was passed, Washington was one of 19 states in which public health was organizationally housed in a superagency. The Institute of Medicine, in its 1988 report on The Future of Public Health, recommended that states organize core functions under a separate department of health. The effort in Washington State was led by local public health officials. Success followed four years of hard work during which mistakes were made, coalitions were built, and legislative process was learned.

Forecasting↗
PubMed1989

A brief history of graduate medical education in Washington, Alaska, Montana, and Idaho.

Internships and hospital-based medical education preceded by more than 40 years the beginnings of a medical school in Washington State. Just after the turn of the 20th century, a few internships were begun by hospitals in Seattle and Spokane to help with the care of their sicker patients in the tradition of Eastern teaching hospitals. In the 1920s and 1930s, the number of hospitals with internship programs grew steadily as part of a nationwide effort at hospital standardization. Experiences in developing these programs and problems with intern recruitment contributed to the beginning of the University of Washington School of Medicine after World War II. Since the 1960s, intern and resident training has progressively become a cooperative effort of the school with many hospitals and clinics in Washington, Alaska, Montana, and Idaho contributing to the development of graduate medical education in this region.

Alaska↗
PubMed1978

Factors influencing the location of rural general practitioners. A study in Washington state.

Data on (1) personal background, (2) place of medical education and training, (3) reasons for selecting the present place of practice and (4) previous practice location were gathered and analyzed from 41 general practitioners in rural Washington state. The analysis was done to isolate factors influencing the choice of location by physicians. Results show that most of the physicians had spent at least some of their preadulthood years in small communities and that most had some exposure to the state of Washington before establishing their practices in the state. In addition to the apparent importance of previous exposure to small communities and Washington state, the physicians were also influenced in their locational choice by (1) the professional advantages or appeal of the community, (2) recruitment efforts by persons within the community and (3) economic reasons. The physicians were rather immobile. Most had never practiced in another community and only two of the 41 physicians planned to move to another community.

Economics↗
PubMedDate not supplied

Correctness of racial coding of American Indians and Alaska Natives on the Washington State death certificate.

Underestimation of death rates for specific races can obscure health problems and impair the ability of public programs to prevent premature death and disability. For accurate race-specific death rates, the racial classification of both the population at risk and the decreased population must be accurately ascertained. However, studies suggest that the American Indian (AI) and Alaska Native (AN) races may be not be accurately recorded on the death certificate. We performed a computerized linkage between the Indian Health Service (IHS) patient registry and the 1985-1990 computerized Washington State death certificate data. The deceased was correctly identified as AI or AN on the death certificate for 1,088 (87.2%) of 1,248 matched deaths. The majority (93%) of deceased persons identified on the death certificate as not AI or AN were listed as white. The percentage of American Indian ancestry was strongly associated with correct racial classification on the death certificate (P < .001). Birth in Washington State, membership in a large Washington State tribe, and death from an alcohol condition independently added to the likelihood of correct AI or AN racial classification. Persons who died from cancer were significantly less likely to be correctly coded as AI or AN on the death certificate.

Alaska↗
PubMedDate not supplied

Family planning service provision in rural areas: a survey in Washington State.

CONTEXT: Women in rural areas are highly dependent on public clinics for family planning services, yet little information has been collected on rural family planning providers, especially on their funding and operation. METHODS: All 31 family planning clinic sites in rural Washington State were surveyed about their sponsorship, staffing, service provision and population coverage. RESULTS: Clinic sites were located in 25 of the 53 discrete rural health service areas of Washington State. While the three wealthiest areas had clinics, eight of the poorest areas had no clinics. Eight clinics were Planned Parenthood affiliates, eight were private freestanding clinics and 15 were local health department sites. Clinic sites were small (with the equivalent of 2.4 full-time staff members, on average) and offered a mean of 18 of 43 potential reproductive and women's health care services; general primary care services were rarely provided. Only one clinic offered abortions. CONCLUSION: Family planning clinics in rural Washington State offer an important but limited number of services. Many rural areas have no local family planning clinic. Given these clinics' reliance on federal and state funding, decreased public support might seriously impair family planning provision in rural areas.

Adult↗
PubMed1976

Neoplasms of the central nervous system. incidence and population selectivity in the Washington DC, metropolitan area.

During the period 1960 through 1969, 990 primary neoplasms of the central nervous system were diagnosed in hospitals in the Washington, DC, Standard Metropolitan Statistical Area (SMSA). All cases were identified according to age, race, sex, histologic type, and date of diagnosis. A West African composite of 253 cases was used for comparison. In the Washington SMSA, the age-adjusted incidence rates were: for Caucasians 5.5 in males and 3.6 in females and for Negroes 4.8 in males and 3.4 in females per 100,000 annual population. Caucasians in the Washington SMSA had a higher relative proportion of gliomas than Negroes in the same area and in Africa (p less than 0.005). The relative proportion of pituitary adenomas was higher in American Negroes (p less than 0.005) and in Africans than in Caucasians. The comparable pattern of CNS tumors in American and African Negroes, relative to Caucasians, suggests that in the development of neoplasms of the central nervous system racial factors may be of importance.

Africa, Western↗
PubMed1987

Characterization of chromosomes with hybrid genes for Hb Lepore-Washington, Hb Lepore-Baltimore, Hb P-Nilotic, and Hb Kenya.

This study concerns the characterization of chromosomes with hybrid genes for Hb Lepore-Washington (44 chromosomes), for Hb Lepore-Baltimore (5 chromosomes), for Hb P-Nilotic (8 chromosomes), and for Hb Kenya (7 chromosomes) by determining a relatively large number of restriction enzyme polymorphism. Two, and possibly three, different Hb Lepore-Washington chromosomes were identified by specific haplotypes, while the haplotype of the Hb Lepore-Baltimore chromosome had its own characteristic pattern. A likely conclusion is that the crossovers leading to the formation of these chromosomes have occurred as independent events within the populations. Chromosomes with the delta beta-Lepore-Washington hybrid gene maintained specific characteristics (such as increased Hb F levels in heterozygotes, and high or low G gamma values in this Hb F) which have been observed in normal individuals with chromosomes having comparable haplotypes. Only one haplotype was observed for each of the chromosomes carrying either the beta delta-P-Nilotic hybrid gene or the A gamma beta hybrid gene of Hb Kenya.

Chromosome Mapping↗
PubMed2004

The sudden death of Patsy Custis, or George Washington on sudden unexplained death in epilepsy.

Patsy Custis, George Washington's stepdaughter, died suddenly during a brief seizure in 1773. Accounts of Patsy's illness and unexpected death were abstracted from George Washington's papers available via the Library of Congress. Patsy's epilepsy, the treatments she received, and his descriptions of her death were studied. Sudden unexplained death in epilepsy (SUDEP) criteria are applied and discussed. George Washington's description of Patsy's epilepsy and subsequent death meet criteria for SUDEP.

Cause of Death↗
PubMed2002

Pedestrian crashes in Washington, DC and Baltimore.

Police crash reports were obtained for pedestrian-motor vehicle crashes in Washington, DC (N = 852) and Baltimore (N = 1234) for the year 1998. Reports were coded using procedures developed and applied in these two cities during the 1970s, including the determination of pedestrian crash type, primary precipitating factor, and culpability. Results indicated substantial differences between crash patterns observed during the 1970s and those observed during 1998. Midblock dart-dash crashes, which typically involve a precipitating factor or critical error by a child pedestrian, decreased (from 37% to 15% in Washington). Across all crashes in both cities, the number of drivers who made a critical error leading to the crash was nearly equivalent to the number of pedestrians who made a critical error. Overall, pedestrians were slightly more likely to be judged culpable (50% vs. 39%). Turning vehicle crashes, which typically involve a driver's failure to grant a pedestrian the right of way at a signalized intersection, increased (from 9% to 25% in Washington). Countermeasures to reduce the number of pedestrians hit by turning vehicles are discussed.

Accidents, Traffic↗
PubMed1997

Predominant tree aeroallergens of the Washington, DC area: a six year survey (1989-1994).

OBJECTIVE: A 6-year (1989 to 1994) aerobiologic survey of the Washington DC area was performed to identify predominant area tree pollens, atmospheric concentrations, and peak flowering periods. METHODS: Aeroallergen sampling was conducted using a volumetric rotating-arm impaction Rotorod sampler (Sampling Technologies, Inc, Los Altos Hills, California). RESULTS: The Washington DC pollen calendar may begin as early as January when pollen of the Cupresseacea, Aceracea, Pinaceae, and Betulaceae are observed in small amounts. February through June encompasses the major part of our tree season with considerable overlapping of pollination periods for various trees. The Ulmaceae have two distinct pollinating times with later flowering species of elm pollinating August through October coinciding with ragweed season. April is usually the month with the highest weekly average concentrations. Each year oaks contribute more than 50% of the total tree pollen count followed by pollen of the Pinacea, Cupresseacea, Moracea, and Betuleacea. Times for onset of pollination as well as peak atmospheric concentrations varied from year to year. High production years for some tree aeroallergens are low years for others. CONCLUSION: The Washington DC area is exposed to significant atmospheric concentrations of tree pollen from February through June. Establishing what area tree aeroallergens predominate with respect to their atmospheric concentrations and peak pollinating times is essential for the effective diagnosis and treatment of the tree-allergic patient.

Air Pollutants↗
PubMed2000

108th Convention of the American Psychological Association. Washington, DC, August 4-8, 2000

Washington, DC--the nation's capital--celebrates a history rich in diversity and character. One of the most popular cities for sightseeing, Washington contains countless points of interest for its visitors. The world's largest museum complex, the Smithsonian Institution, invites you to explore exhibits that highlight the scientific, cultural, political, and technological developments of the United States and its people. Visit the home to original pieces of the American heritage, such as the Declaration of Independence, the Constitution, and the Bill of Rights, that have helped to shape the way we live today. The art lovers among you will delight in the seven major art galleries. See the modern art and sculpture of the Hirshhorn Museum and the newly opened Sculpture Garden; the Sackler Gallery's collection of Asian art; and the only museum devoted to the art and culture of Africa, the National Museum of African Art. In Washington, there is music in the air, from the Kennedy Center's many stages and the clubs of Georgetown and Adams Morgan to the military bands that give concerts on the Mall. Whatever your culinary desire, be it authentic Texas chili or the finest Asian cuisine, you'll find it at one of the city's internationally famous eateries. What a perfect place for APA to convene its first annual convention of the new millennium!

Journal Article↗
PubMed2002

Analysis of sMMO-containing type I methanotrophs in Lake Washington sediment.

Methane-oxidizing bacteria (methanotrophs) containing soluble methane monooxygenase (sMMO) are of interest in natural environments due to the high co-metabolic activity of this enzyme with contaminants such as trichloroethylene. We have analysed sMMO-containing methanotrophs in sediment from a freshwater lake. Environmental clone banks for a gene encoding a diagnostic sMMO subunit (mmoX) were generated using DNA extracted from Lake Washington sediment and subjected to RFLP analysis. Representatives from the six RFLP groups were cloned and sequenced, and all were found to group with Type I Methylomonas mmoX, although a majority were divergent from known Methylomonas mmoX sequences. Direct hybridization of Lake Washington sediment DNA was carried out using a series of sMMO- and Methylomonas-specific probes to assess the significance of these sMMO-containing Methylomonas-like strains in the sediment. The total sMMO-containing population and the sMMO-containing Methylomonas-like population were estimated to be similar to previous estimates for total methanotrophs and Type I methanotrophs. These results suggest that the major methanotrophic population in Lake Washington sediment consists of sMMO-containing Methylomonas-like (Type I) methanotrophs. The whole-cell TCE degradation kinetics of such a strain, LW15, isolated from this environment, were determined and found to be similar to values reported for other sMMO-containing methanotrophs. The numerical significance of sMMO-containing Methylomonas-like methanotrophs in a mesotrophic lake environment suggests that these methanotrophs may play an important role in methanotroph-mediated transformations, including co-metabolism of halogenated solvents, in natural environments.

Methylomonas↗