A Disaster in the Making: Addressing the Vulnerability of Low-Income Communities to Extreme Weather

A Disaster in the Making: Addressing the Vulnerability of Low-Income Communities to Extreme Weather
Source: Center for American Progress

On October 29, 2012, Superstorm Sandy hit the northeastern United States and became the deadliest and largest Atlantic hurricane of the year and the second costliest in U.S. history after Hurricane Katrina. Heeding the lessons that emerged from the blundered response to Katrina in New Orleans in 2005, the federal government was quick to react to Sandy with Federal Emergency Management Agency, or FEMA, officials arriving throughout the region and President Barack Obama surveying the damage from the ground.

Despite the quick response, however, many low-income residents of the region continued to face dire circumstances. Many low-income elderly and disabled residents of New York City’s public housing complexes were stranded in their apartments for weeks after the storm due to elevator outages. Other residents remained in the high rises, despite having no heat or power, because they had nowhere else to go or no means of getting out of their neighborhood. In other parts of the region, low-income people were unable to make it to food stamp centers for assistance. The estimated cost of the destruction wrought by Sandy was $65 billion, with low-income households greatly impacted.

National Congress of American Indians: Tribal Directory

Tribal Directory
Source: National Congress of American Indians
List by area, list by tribe name, search by keyword, or browse alphabetically. Also includes listings for tribal organizations and Alaskan Native corporations.

Root Causes, Clinical Effects, and Outcomes of Unintentional Exposures to Buprenorphine by Young Children

Root Causes, Clinical Effects, and Outcomes of Unintentional Exposures to Buprenorphine by Young Children
Source: Journal of Pediatrics

Objective
To characterize the rates, root causes, and clinical effects of unintentional exposures to buprenorphine sublingual formulations among young children and to determine whether exposure characteristics differ between formulations.

Study design
Unintentional exposures to buprenorphine-containing products among children 28 days to less than 6 years old were collected from the Researched Abuse, Diversion, and Addiction-Related Surveillance System Poison Center Program and Reckitt Benckiser Pharmaceuticals’ pharmacovigilance system from October 2009-March 2012. After adjustment for drug availability, negative binomial regression was used to estimate average exposure rates. Root cause assessment was conducted, and an expert clinician panel adjudicated causality and severity of moderate to severe adverse events (AEs).

Results
A total of 2380 cases were reviewed, including 4 deaths. Exposures to buprenorphine-naloxone combination film were significantly less frequent than exposures to buprenorphine tablets (rate ratio 3.5 [95% CI, 2.7-4.5]) and buprenorphine-naloxone combination tablets (rate ratio 8.8 [7.2-10.6]). The most commonly identified root causes were medication stored in sight, accessed from a bag or purse, and not stored in the original packaging. Among 536 panel review cases, the most common AEs reported for all formulations were lethargy, respiratory depression, miosis, and vomiting. The highest level AE severity did not differ significantly by formulation.

Conclusions
Unintentional exposure to buprenorphine can cause central nervous system depression, respiratory depression, and death in young children. Exposure rates to film formulations are significantly less than to tablet formulations. Package and storage deficiencies contribute to unintentional exposures in young children.

See: ‘One Pill Can Kill’: Effects of Unintentional Opioid Exposure in Young Children (Science Daily)

CDC Releases 2014 Edition of “Yellow Book”

CDC Releases 2014 Edition of “Yellow Book”
Source: Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention today released the online version of the 2014 edition of CDC Health Information for International Travel, commonly known as the “Yellow Book.” Nicknamed for its yellow cover, this is the ultimate guide for healthy international travel. The most recent version includes special guidance for people who will be living long-term in areas with malaria. The 2014 edition also expanded its chapter on select destinations, providing insiders’ knowledge and specific health risks about popular tourist destinations.

A team of almost 200 experts update this health guide every two years. The Yellow Book provides the latest official CDC recommendations to keep international travelers safe and healthy. It includes a complete catalog of travel-related diseases and up-to-date vaccine and booster recommendations. The information in the book does not just stop with infectious diseases; it also includes advice about preventing and treating common travel-related ailments such as altitude illness, motion sickness, and jet lag. The book offers useful tips on topics such as traveling with pets, packing a travel health kit, avoiding counterfeit medications in foreign countries, and getting travel health and evacuation insurance for emergencies. In addition, the Yellow Book provides advice for people traveling with young children, individuals with disabilities or chronic illnesses, and those traveling for humanitarian aid work or study abroad.

CDC releases 2012 School Health Policies and Practices Study results

CDC releases 2012 School Health Policies and Practices Study results
Source: Centers for Disease Control and Prevention

School districts nationwide are showing improvements in measures related to nutritional policies, physical education and tobacco policies, according to the 2012 School Health Policies and Practices Study (SHPPS). SHPPS is the largest and most comprehensive survey to assess school health policies.
…
Key findings include:
Nutrition:

• The percentage of school districts that allowed soft drink companies to advertise soft drinks on school grounds decreased from 46.6 percent in 2006 to 33.5 percent in 2012.
• Between 2006 and 2012, the percentage of districts that required schools to prohibit offering junk food in vending machines increased from 29.8 percent to 43.4 percent.
• Between 2006 and 2012, the percentage of districts with food procurement contracts that addressed nutritional standards for foods that can be purchased separately from the school breakfast or lunch increased from 55.1 percent to 73.5 percent.
• Between 2000 and 2012, the percentage of districts that made information available to families on the nutrition and caloric content of foods available to students increased from 35.3 percent to 52.7 percent.

Physical education/physical activity:

• The percentage of school districts that required elementary schools to teach physical education increased from 82.6 percent in 2000 to 93.6 percent in 2012.
• More than half of school districts (61.6 percent) had a formal agreement, such as a memorandum of agreement or understanding, between the school district and another public or private entity for shared use of school or community property. Among those districts, more than half had agreements with a local youth organization (e.g., the YMCA, Boys or Girls Clubs, or the Boy Scouts or Girl Scouts) or a local parks or recreation department.

Tobacco:

• The percentage of districts with policies that prohibited all tobacco use during any school-related activity increased from 46.7 percent in 2000 to 67.5 percent in 2012.

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New From the GAO

New GAO Reports
Source: Government Accountability Office

1. VA Benefits: Improvements Needed to Ensure Claimants Receive Appropriate Representation. GAO-13-643, August 1.
http://www.gao.gov/products/GAO-13-643
Highlights – http://www.gao.gov/assets/660/656501.pdf

2. Agricultural Trade: USDA Is Monitoring Market Development Programs as Required but Could Improve Analysis of Impact. GAO-13-740, July 31.
http://www.gao.gov/products/GAO-13-740
Highlights – http://www.gao.gov/assets/660/656441.pdf

Waste Not, Want Not: The Efficiency of Health Expenditure in Emerging and Developing Economies

Waste Not, Want Not: The Efficiency of Health Expenditure in Emerging and Developing Economies
Source: International Monetary Fund

Public health spending is low in emerging and developing economies relative to advanced economies and health outputs and outcomes need to be substantially improved. Simply increasing public expenditure in the health sector, however, may not significantly affect health outcomes if the efficiency of this spending is low. This paper quantifies the inefficiency of public health expenditure and the associated potential gains for emerging and developing economies using a stochastic frontier model that controls for the socioeconomic determinants of health, and provides country-specific estimates. The results suggest that African economies have the lowest efficiency. At current spending levels, they could boost life expectancy up to about five years if they followed best practices.

Early Childhood Program Participation, From the National Household Education Surveys Program of 2012

Early Childhood Program Participation, From the National Household Education Surveys Program of 2012
Source: National Center for Education Statistics

This report presents findings from the Early Childhood Program Participation Survey of the National Household Education Surveys Program of 2012 (NHES:2012). The Early Childhood Program Participation Survey collected data on children’s participation in relative care, nonrelative care, and center-based care arrangements. It also collected information from parents about the main reason for choosing care, what factors were important to parents when choosing a care arrangement, and parents’ participation in various learning activities with their children.

Parent and Family Involvement in Education, From the National Household Education Surveys Program of 2012

Parent and Family Involvement in Education, From the National Household Education Surveys Program of 2012
Source: National Center for Education Statistics

This report presents findings from the Parent and Family Involvement in Education Survey of the National Household Education Surveys Program of 2012 (NHES:2012). The Parent and Family Involvement in Education Survey collected data on children enrolled in public or private school for kindergarten through 12th grade or homeschooled for these grades. The survey collected information about various aspects of parent involvement in education, such as help with homework, family activities, and parent involvement at school. For homeschooled students, the survey asks questions related to the student’s homeschooling experiences, the sources of the curriculum, and the reasons for homeschooling.

Three Reports — HHS OIG

Three Reports — HHS OIG
Source: U.S. Department of Health and Human Services, Office of Inspector General

+ Frequency of Medicare Recertification Surveys for Hospices Is Unimproved

WHY WE DID THIS STUDY
This memorandum report follows up on the 2007 OIG report Medicare Hospices: Certification and Centers for Medicare & Medicaid Services Oversight (OEI-06-05-00260), which found that the most recent recertification survey for 14 percent of State-surveyed hospices had occurred more than 6 years previously, with an average of 9 years. Further, when surveys did occur, 46 percent of the surveyed hospices received citations for health deficiencies, with the most frequently cited deficiencies related to care planning and quality issues. We recommended that CMS seek statutory or regulatory timeframes for the frequency of hospice recertification surveys by State survey agencies, and suggested a timeframe of 3 years. CMS did not concur with the recommendation, indicating that conducting more frequent surveys would require congressional action to allocate additional resources. CMS policy sets targets for the frequency of hospice recertification surveys by State survey agencies. These targets vary over time based on available resources and priorities.
HOW WE DID THIS STUDY
We analyzed national survey data for all hospices that had Medicare payments in 2011 and that were subject to surveys by State survey agencies on behalf of CMS, a total of 2,483 hospices. We determined the certification survey frequency for each State-surveyed hospice by calculating the time between the date of the most recent certification survey (either initial certification or recertification) and the index date, February 28, 2013. We determined the proportion of hospices that had not been surveyed within the 6 years preceding the index date, both nationally and by State, and compared those results to our prior findings.
WHAT WE FOUND
We found that the frequency of recertification surveys has not improved since 2005. Seventeen percent of State-surveyed hospices had not been recertified within the 6 years prior to the index date of February 28, 2013, with some hospices experiencing longer intervals since their last survey. We also found that in 12 States, more than 25 percent of hospices had not been recertified within the previous 6 years. These findings illustrate that CMS’s use of fluctuating annual targets does not ensure timely recertification surveys of all hospices and raises concerns about whether CMS and contracted State survey agencies can ensure hospice compliance with Medicare CoPs and quality-of-care requirements for hospices.

Therefore, we reiterate the recommendation that CMS seek statutory or regulatory timeframes for the frequency of hospice recertification surveys. CMS could consider setting this survey frequency standard at 3 years, to match the 3-year interval used by accrediting organizations (as approved by CMS); however, given resource limitations, setting a mandatory frequency-even for an interval of more than 3 years-could help to ensure improvement in survey frequency and avoid lengthy intervals between surveys for individual hospices.

+ Medicaid Drug Pricing in State Maximum Allowable Cost Programs

WHY WE DID THIS STUDY
To take advantage of lower market prices for certain multiple-source drugs, States may use the Federal upper limit (FUL) and/or State Maximum Allowable Cost (MAC) programs. However, FUL amounts have often exceeded market prices, and the Affordable Care Act (ACA), P.L. 111 148, required CMS to change the method it uses to calculate these amounts. Unlike the FUL program, State MAC programs give States flexibility in determining which drugs to include and in setting reimbursement rates. Because drug use is expected to increase under the ACA provisions that expand Medicaid, an aggressive MAC program may help States contain Medicaid drug costs.
HOW WE DID THIS STUDY
In January 2012, we surveyed the 45 States (including the District of Columbia) with MAC programs to identify the methods used to set MAC prices and criteria used to select covered MAC drugs. We also obtained the MAC prices and drugs covered at that time. We compared States’ criteria for selecting drugs and setting prices in their MAC programs. We also calculated the aggregate percentage difference between each State’s MAC prices and the FUL amounts in effect for the first quarter of 2012 (based on published prices), as well as the draft FUL amounts set by the ACA (based on average manufacturer price). Finally, we identified the State with the most aggressive MAC program and calculated the potential national savings had all States used this program.
WHAT WE FOUND
Most of the 45 States with MAC programs used acquisition cost to set MAC prices. In comparison, the pre-ACA FUL amounts were, on average, nearly double State MAC prices in January 2012, in the aggregate. However, the post-ACA FUL amounts were lower, on average, than MAC prices, in the aggregate. Although these amounts were required to take effect in October 2010, as of May 2013 CMS had not implemented them. Unlike the FUL program, State MAC programs give States flexibility in setting their coverage requirements. As a result, State MAC programs covered a wide range of drugs-significantly more than are covered under the FUL program. Lastly, we found that States could achieve additional cost savings by using more aggressive MAC pricing formulas and inclusion criteria. We identified Wyoming’s MAC program as the one that could produce the greatest savings.
WHAT WE RECOMMEND
We recommend that CMS complete the implementation of the post-ACA FUL amounts. We also recommend that CMS encourage States to reevaluate their MAC programs for additional cost saving opportunities. CMS concurred with our recommendations.

+ GAO Forum Highlights Report: Data Analytics For Oversight and Law Enforcement

Oversight and law enforcement agencies play an important role in eliminating fraud, waste, and abuse. Sharing data, knowledge, and analytic tools can assist government agencies in this effort. However, while there is a tremendous amount of information the government can use in preventing and detecting fraud, waste, and abuse, using and leveraging these data can be challenging.

In January 2013, GAO, the Council of the Inspectors General on Integrity and Efficiency, and the Recovery Accountability and Transparency Board convened a forum with the purpose of exploring ways in which oversight and law enforcement agencies use data analytics to assist in the prevention and detection of fraud, waste, and abuse, as well as identifying the most-significant challenges to realizing the potential of data analytics and actions that the government can take to address these challenges. HHS OIG played a significant role in helping plan and conduct this forum.

This report summarizes the key themes that emerged from the discussion in the forum. Specifically, the report discusses the challenges and opportunities in (1) accessing and using data and (2) sharing data. In addition, participants identified next steps to address these challenges and capitalize on opportunities.

Reducing Overclassification of DHS’ National Security Information

Reducing Overclassification of DHS’ National Security Information (PDF)
Source: U.S. Department of Homeland Security, Office of Inspector General

The Department of Homeland Security (DHS) creates, receives, handles, and stores classified information as part of its homeland security, emergency response, and continuity missions. As creators and users of classified information, DHS is responsible for both implementing national policies and establishing departmental policies, to ensure that such information is adequately safeguarded when necessary and appropriately shared whenever possible. With proper classification of intelligence products, DHS can share more information with State, local, and tribal entities, as well as the private sector.

The Reducing Over-Classification Act of October 2010 (Public Law 111-258) requires the DHS Secretary to develop a strategy to prevent the over-classification and promote the sharing of homeland security and other information. This is the first of two reviews we are mandated to conduct under this act.

Specifically, we assessed the overall state of the DHS national security information program and reviewed 13 DHS components to determine whether applicable classification policies, procedures, rules, and regulations have been adopted, followed, and effectively administered. We also identified policies, procedures, rules, regulations, and management practices that may be contributing to persistent misclassification. We coordinated with other Offices of Inspector General and the Information Security Oversight Office of the National Archives and Records Administration to ensure that our review’s evaluations followed a consistent methodology that allowed for cross-agency comparisons.

As a result of our review, we determined that DHS has adopted and successfully implemented all policies and procedures required by applicable Federal regulations and intelligence community directives. Through implementing Office of the Chief Security Officer’s policies and procedures, DHS has a strong program that should lead to better communication and sharing of intelligence throughout the Federal Government and with State, local, and tribal entities, as well as private sector partners. However, the Department’s program can be strengthened by deploying a new classification management tool after testing, and by capturing all classified holdings better. We are making two recommendations that when implemented will improve the Department’s overall management of its classification processes. The Department concurred with both recommendations.

CRS — Bee Health: Background and Issues for Congress

Bee Health: Background and Issues for Congress (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

Bees, both commercially managed honey bees and wild bees, play an important role in global food production. In the United States alone, the value of insect pollination to U.S. agricultural production is estimated at $16 billion annually, of which about three-fourths is attributable to honey bees. Worldwide, the contribution of bees and other insects to global crop production for human food is valued at about $190 billion. Given the importance of honey bees and other bee species to food production, many have expressed concern about whether a “pollinator crisis” has been occurring in recent decades.

Over the past few decades there has been heightened concern about the plight of honey bees as well as other bee and pollinator species. Although honey bee colony losses due to bee pests, parasites, and disease are not uncommon, there is the perception that bee health has been declining at a faster rate both in the United States and globally in recent years. This situation gained increased attention in late 2006 as some commercial beekeepers began reporting sharp declines in their honey bee colonies. Because of the severity and unusual circumstances of these colony declines, scientists named this phenomenon colony collapse disorder (CCD). Since then, honey bee colonies have continued to dwindle each year, for reasons not solely attributable to CCD. In fact, the U.S. Department of Agriculture (USDA) reports that CCD may not be the only or even the major cause of bee colony losses in recent years. In the United States, USDA estimates of overwinter colony losses from all causes have averaged more than 30% annually since 2006.

To date, the precise reasons for bee colony losses are not yet known. Reasons cited for bee declines include a wide range of possible factors thought to be affecting pollinator species. These include bee pests and disease, diet and nutrition, genetics, habitat loss and other environmental stressors, agricultural pesticides, and beekeeping management issues, as well as the possibility that bees are being affected by cumulative, multiple exposures and/or the interactive effects of several of these factors.

USDA continues to research possible causes of bee colony losses, and has published a series of reports detailing the agency’s progress in this area. In 2013, USDA and the U.S. Environmental Protection Agency (EPA) published a joint report, National Stakeholders Conference on Honey Bee Health. A 2007 report by the National Research Council of the National Academy of Sciences (NAS), Status of Pollinators in North America, also provides a detailed scientific context concerning bee health. Both USDA and the NAS report conclude that many factors contribute to pollinator declines in North America.

Following heightened concern over honey bee colony losses in 2006-2007, Congress provided for increased funding for bee research, among other types of farm program support to protect pollinators, as part of the 2008 farm bill (P.L. 110-246). In the 113th Congress, both the House- and Senate-passed versions of the 2013 farm bill (H.R. 2642 and S. 954) include provisions addressing honey bees and other pollinators. In addition, outside the farm bill debate, H.R. 2692 would suspend registrations of neonicotinoids and ban new registrations of any pesticide for use unless EPA determines the insecticide would not cause unreasonable adverse effects on pollinators, including honey bees and native bees, as well as other pollinators.

The state of amphibians in the United States

The state of amphibians in the United States
Source: U.S. Forest Service

More than 25 years ago, scientists began to identify unexplained declines in amphibian populations around the world. Much has been learned since then, but amphibian declines have not abated and the interactions among the various threats to amphibians are not clear. Amphibian decline is a problem of local, national, and international scope that can affect ecosystem function, biodiversity, and commerce. This fact sheet provides a snapshot of the state of the amphibians and introduces examples to illustrate the range of issues in the United States.

NFL Stadium Guides: Here’s your game-day tour guide for every venue in the NFL

NFL Stadium Guides: Here’s your game-day tour guide for every venue in the NFL
Source: ESPN

Have you tailgated with the hardy souls in freezing temperatures at Lambeau Field in Green Bay, Wis.? Or Arrowhead Stadium in Kansas City, Mo.? Or at new Soldier Field in Chicago?

Maybe you prefer your football indoors at Ford Field in Detroit or the Superdome in New Orleans?

Or maybe you can’t decide, so you want both. Reliant Stadium in Houston, Lucas Oil Stadium in Indianapolis and University of Phoenix Stadium in Glendale, Ariz., may be your destinations of choice as they have retractable roofs.

Regardless of where you want to put yourself — in the Black Hole in Oakland, Calif., or a mile high in Denver — for an NFL game, this should be your starting point. Our NFL Stadium Guides are designed to enhance your game-day experience.

Do you need to see from where you’ll be watching the action? See the seating chart.

You don’t have tickets? For goodness’ sake, buy them now.

From the weather forecast to seating capacity, from directions to parking, from venue history to best options for public transportation, consider the NFL Stadium Guides your game-day tour guide.

And may the best team — and best-prepared fans — win.

All Legal Same-Sex Marriages Will Be Recognized for Federal Tax Purposes

All Legal Same-Sex Marriages Will Be Recognized for Federal Tax Purposes
Source: U.S. Department of the Treasury

The U.S. Department of the Treasury and the Internal Revenue Service (IRS) today ruled that same-sex couples, legally married in jurisdictions that recognize their marriages, will be treated as married for federal tax purposes. The ruling applies regardless of whether the couple lives in a jurisdiction that recognizes same-sex marriage or a jurisdiction that does not recognize same-sex marriage.

The ruling implements federal tax aspects of the June 26th Supreme Court decision invalidating a key provision of the 1996 Defense of Marriage Act.

“Today’s ruling provides certainty and clear, coherent tax filing guidance for all legally married same-sex couples nationwide. It provides access to benefits, responsibilities and protections under federal tax law that all Americans deserve,” said Secretary Jacob J. Lew. “This ruling also assures legally married same-sex couples that they can move freely throughout the country knowing that their federal filing status will not change.”

Under the ruling, same sex couples will be treated as married for all federal tax purposes, including income and gift and estate taxes. The ruling applies to all federal tax provisions where marriage is a factor, including filing status, claiming personal and dependency exemptions, taking the standard deduction, employee benefits, contributing to an IRA, and claiming the earned income tax credit or child tax credit.

Any same-sex marriage legally entered into in one of the 50 states, the District of Columbia, a U.S. territory, or a foreign country will be covered by the ruling. However, the ruling does not apply to registered domestic partnerships, civil unions, or similar formal relationships recognized under state law.

Legally-married same-sex couples generally must file their 2013 federal income tax return using either the “married filing jointly” or “married filing separately” filing status.

Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010

Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010
Source: The Lancet

Background
No systematic attempts have been made to estimate the global and regional prevalence of amphetamine, cannabis, cocaine, and opioid dependence, and quantify their burden. We aimed to assess the prevalence and burden of drug dependence, as measured in years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs).

Methods
We conducted systematic reviews of the epidemiology of drug dependence, and analysed results with Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) Bayesian meta-regression technique (DisMod-MR) to estimate population-level prevalence of dependence and use. GBD 2010 calculated new disability weights by use of representative community surveys and an internet-based survey. We combined estimates of dependence with disability weights to calculate prevalent YLDs, YLLs, and DALYs, and estimated YLDs, YLLs, and DALYs attributable to drug use as a risk factor for other health outcomes.

Findings
Illicit drug dependence directly accounted for 20·0 million DALYs (95% UI 15·3—25·4 million) in 2010, accounting for 0·8% (0·6—1·0) of global all-cause DALYs. Worldwide, more people were dependent on opioids and amphetamines than other drugs. Opioid dependence was the largest contributor to the direct burden of DALYs (9·2 million, 95% UI 7·1—11·4). The proportion of all-cause DALYs attributed to drug dependence was 20 times higher in some regions than others, with an increased proportion of burden in countries with the highest incomes. Injecting drug use as a risk factor for HIV accounted for 2·1 million DALYs (95% UI 1·1—3·6 million) and as a risk factor for hepatitis C accounted for 502 000 DALYs (286 000—891 000). Suicide as a risk of amphetamine dependence accounted for 854 000 DALYs (291 000—1 791 000), as a risk of opioid dependence for 671 000 DALYs (329 000—1 730 000), and as a risk of cocaine dependence for 324 000 DALYs (109 000—682 000). Countries with the highest rate of burden (>650 DALYs per 100 000 population) included the USA, UK, Russia, and Australia.

Interpretation
Illicit drug use is an important contributor to the global burden of disease. Efficient strategies to reduce disease burden of opioid dependence and injecting drug use, such as delivery of opioid substitution treatment and needle and syringe programmes, are needed to reduce this burden at a population scale.

Funding
Australian National Health and Medical Research Council, Australian Government Department of Health and Ageing, Bill & Melinda Gates Foundation.

Free registration required.

Mapping the Latino Population, By State, County and City

Mapping the Latino Population, By State, County and City
Source: Pew Hispanic Center

The nation’s Hispanic population, while still anchored in its traditional settlement areas, continues to disperse across the U.S., according to a Pew Research Center analysis of U.S. Census Bureau data.

Today, the 100 largest counties by Hispanic population contain 71% of all Hispanics. Los Angeles County, CA alone contains 4.9 million Hispanics, or 9% of the nation’s Hispanic population. But the share of all Hispanics who live in these same counties has fallen from 75% in 2000 and 78% in 1990 (Fry, 2008), reflecting Hispanic population growth outside of these 100 counties.

Half (52%) of those counties are in three states—California, Texas and Florida. Along with Arizona, New Mexico, New York, New Jersey and Illinois, these eight states contain three-quarters (74%) of the nation’s Latino population. But with the dispersal of the U.S. Latino population across the country, this share too is down from 79% in 2000 and 84% in 1990.

The geographic settlement patterns are to some degree aligned with the diverse countries of origin of the Hispanic population. For example, Mexican origin Hispanics are the dominant group in the Los Angeles-Long Beach metropolitan area, making up 78% of the area’s Hispanics. They are also the dominant group in many metropolitan areas in the border states of Arizona, California, New Mexico and Texas. But along the East Coast the composition of Hispanic origin groups differs. In the New York-New Jersey metropolitan area, Puerto Ricans and Dominicans are the dominant Hispanic origin groups. In Miami-Hialeah, FL, Cubans are the dominant Hispanic group and in the Washington, D.C. metropolitan areas, Salvadorans are the largest Hispanic origin group among that area’s Hispanics. Nationally, Mexicans are the largest Hispanic origin group, making up 64.6% of all Hispanics.

Alcohol Intake Between Menarche and First Pregnancy: A Prospective Study of Breast Cancer Risk

Alcohol Intake Between Menarche and First Pregnancy: A Prospective Study of Breast Cancer Risk
Source: Journal of the National Cancer Institute

Background
Adult alcohol consumption during the previous year is related to breast cancer risk. Breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. No study has characterized the contribution of alcohol consumption during this interval to risks of proliferative benign breast disease (BBD) and breast cancer.

Methods
We used data from 91005 parous women in the Nurses’ Health Study II who had no cancer history, completed questions on early alcohol consumption in 1989, and were followed through June 30, 2009, to analyze breast cancer risk. A subset of 60093 women who had no history of BBD or cancer in 1991 and were followed through June 30, 2001, were included in the analysis of proliferative BBD. Relative risks (RRs) were estimated using Cox proportional hazard regression.

Results
We identified 1609 breast cancer cases and 970 proliferative BBD cases confirmed by central histology review. Alcohol consumption between menarche and first pregnancy, adjusted for drinking after first pregnancy, was associated with risks of breast cancer (RR = 1.11 per 10g/day intake; 95% confidence interval [CI] = 1.00 to 1.23) and proliferative BBD (RR = 1.16 per 10g/day intake; 95% CI = 1.02 to 1.32). Drinking after first pregnancy had a similar risk for breast cancer (RR = 1.09 per 10g/day intake; 95% CI = 0.96 to 1.23) but not for BBD. The association between drinking before first pregnancy and breast neoplasia appeared to be stronger with longer menarche to first pregnancy intervals.

Conclusions
Alcohol consumption before first pregnancy was consistently associated with increased risks of proliferative BBD and breast cancer.

Alcohol is considered by the International Agency for Research on Cancer to be causally related to invasive breast cancer (hereafter called “breast cancer”) (1), with a 7% to 10% increase in risk for each 10g alcohol consumed daily by adult women (2–4). One mechanism may be alcohol-induced increases in circulating estrogens and subsequently epithelial cell proliferation (3). However, the risk attributable to alcohol intake during adolescence and early adulthood remains inconclusive (2,5–12).

Younger age at menarche and older age at first full-term pregnancy (hereafter called “pregnancy”) are associated with increased risk for breast cancer (13–15). Breast tissue undergoes rapid cellular proliferation between these reproductive events, and risk accumulates most rapidly until the terminal differentiation that accompanies first pregnancy. First pregnancy has both a short-term adverse effect on risk and a long-term reduction in subsequent risk accumulation (16). The longer the interval between menarche and first pregnancy the greater is a woman’s breast cancer risk (14,15,17). Therefore, menarche to first pregnancy represents a window of time when breast tissue is particularly vulnerable to carcinogenic stimuli (18). Alcohol consumption in late adolescence and early adulthood is associated with increased risk of proliferative benign breast disease (BBD), a known risk marker for breast cancer (19,20).

We therefore hypothesized that alcohol consumed before first pregnancy is associated with risks of both proliferative BBD and breast cancer, independent of drinking after first pregnancy. Such an association may be stronger when the menarche to first pregnancy interval is longer.

State of the Climate 2012

State of the Climate 2012 (PDF)
Source: Bulletin of the American Meteorological Society (via NOAA)

For the first time in several years, the El Niño-Southern Oscillation did not dominate regional climate conditions around the globe. A weak La Niña dissipated to ENSOneutral conditions by spring, and while El Niño appeared to be emerging during summer, this phase never fully developed as sea surface temperatures in the eastern equatorial Pacific uncharacteristically returned to neutral conditions. Nevertheless, other large-scale climate patterns and extreme weather events impacted various regions during the year. A negative phase of the Arctic Oscillation from mid-January to early February contributed to frigid conditions in parts of northern Africa, eastern Europe, and western Asia. A lack of rain during the 2012 wet season led to the worst drought in at least the past three decades for northeastern Brazil. Central North America also experienced one of its most severe droughts on record. The Caribbean observed a very wet dry season and it was the Sahel’s wettest rainy season in 50 years.

Overall, the 2012 average temperature across global land and ocean surfaces ranked among the 10 warmest years on record. The global land surface temperature alone was also among the 10 warmest on record. In the upper atmosphere, the average stratospheric temperature was record or near-record cold, depending on the dataset. After a 30-year warming trend from 1970 to 1999 for global sea surface temperatures, the period 2000–12 had little further trend. This may be linked to the prevalence of La Niña-like conditions during the 21st century. Heat content in the upper 700 m of the ocean remained near record high levels in 2012. Net increases from 2011 to 2012 were observed at 700-m to 2000-m depth and even in the abyssal ocean below. Following sharp decreases in global sea level in the first half of 2011 that were linked to the effects of La Niña, sea levels rebounded to reach records highs in 2012. The increased hydrological cycle seen in recent years continued, with more evaporation in drier locations and more precipitation in rainy areas. In a pattern that has held since 2004, salty areas of the ocean surfaces and subsurfaces were anomalously salty on average, while fresher areas were anomalously fresh.

Global tropical cyclone activity during 2012 was near average, with a total of 84 storms compared with the 1981–2010 average of 89. Similar to 2010 and 2011, the North Atlantic was the only hurricane basin that experienced above-normal activity. In this basin, Sandy brought devastation to Cuba and parts of the eastern North American seaboard. All other basins experienced either near- or below-normal tropical cyclone activity. Only three tropical cyclones reached Category 5 intensity–all in the Western North Pacific basin. Of these, Super Typhoon Bopha became the only storm in the historical record to produce winds greater than 130 kt south of 7°N. It was also the costliest storm to affect the Philippines and killed more than 1000 residents.

Minimum Arctic sea ice extent in September and Northern Hemisphere snow cover extent in June both reached new record lows.

Climatic change and assisted migration: Strategic options for forest and conservation nurseries

Climatic change and assisted migration: Strategic options for forest and conservation nurseries
Source: U.S. Forest Service

In light of current studies (for example, Gray and Hamann 2012; Zhu and others 2012) that show climate will change faster than plants can adapt or migrate naturally, it begs the question, “What does this mean for forestry, specifically forest and conservation nurseries?” Growing trees that just survive may become more important than promoting fast growth rates for superior genetics (Hebda 2008). In a recent survey of state and commercial nurseries in the US, most state nurseries have not explored how changes in climate will impact their abilities to select, produce, and provide trees that are suitable to projected climatic conditions (Tepe and Meretsky 2011).