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Sample records for massachusetts health study

  1. Changes in mortality after Massachusetts health care reform: a quasi-experimental study.

    PubMed

    Sommers, Benjamin D; Long, Sharon K; Baicker, Katherine

    2014-05-06

    The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear. To determine whether the Massachusetts reform was associated with changes in all-cause mortality and mortality from causes amenable to health care. Comparison of mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions. Changes in mortality rates for adults in Massachusetts counties from 2001 to 2005 (prereform) and 2007 to 2010 (postreform) were compared with changes in a propensity score-defined control group of counties in other states. Adults aged 20 to 64 years in Massachusetts and control group counties. Annual county-level all-cause mortality in age-, sex-, and race-specific cells (n = 146,825) from the Centers for Disease Control and Prevention's Compressed Mortality File. Secondary outcomes were deaths from causes amenable to health care, insurance coverage, access to care, and self-reported health. Reform in Massachusetts was associated with a significant decrease in all-cause mortality compared with the control group (-2.9%; P = 0.003, or an absolute decrease of 8.2 deaths per 100,000 adults). Deaths from causes amenable to health care also significantly decreased (-4.5%; P < 0.001). Changes were larger in counties with lower household incomes and higher prereform uninsured rates. Secondary analyses showed significant gains in coverage, access to care, and self-reported health. The number needed to treat was approximately 830 adults gaining health insurance to prevent 1 death per year. Nonrandomized design subject to unmeasured confounders. Massachusetts results may not generalize to other states. Health reform in Massachusetts was associated with significant reductions in all-cause mortality and deaths from causes amenable to health care. None.

  2. Massachusetts health reform and disparities in joint replacement use: difference in differences study

    PubMed Central

    Kapoor, Alok; Katz, Jeffrey N; McCormick, Danny; Lasser, Karen E; Feng, Chen; Manze, Meredith G; Kressin, Nancy R

    2015-01-01

    Objective To estimate the impact of the insurance expansion in 2006 on use of knee and hip replacement procedures by race/ethnicity, area income, and the use of hospitals that predominantly serve poor people (“safety net hospitals”). Design Quasi-experimental difference in differences study examining change after reform in the share of procedures performed in safety net hospitals by race/ethnicity and area income, with adjustment for patients’ residence, demographics, and comorbidity. Setting State of Massachusetts, United States. Participants Massachusetts residents aged 40-64 as the target beneficiaries of reform and similarly aged residents of New Jersey, New York, and Pennsylvania as the comparison (control) population. Main outcomes measures Number of knee and hip replacement procedures per 10 000 population and use of safety net hospitals. Procedure counts from state discharge data for 2.5 years before and after reform, and multivariate difference in differences. Poisson regression was used to adjust for demographics, economic conditions, secular time, and geographic factors to estimate the change in procedure rate associated with health reform by race/ethnicity and area income. Results Before reform, the number of procedures (/10 000) in Massachusetts was lower among Hispanic people (12.9, P<0.001) than black people (28.1) and white people (30.1). Overall, procedure use increased 22.4% during the 2.5 years after insurance expansion; reform in Massachusetts was associated with a 4.7% increase. The increase associated with reform was significantly higher among Hispanic people (37.9%, P<0.001) and black people (11.4%, P<0.05) than among white people (2.8%). Lower income was not associated with larger increases in procedure use. The share of knee and hip replacement procedures performed in safety net hospitals in Massachusetts decreased by 1.0% from a level of 12.7% before reform. The reduction was larger among Hispanic people (−6.4%, P<0.001) than white

  3. Massachusetts health reform and disparities in joint replacement use: difference in differences study.

    PubMed

    Hanchate, Amresh D; Kapoor, Alok; Katz, Jeffrey N; McCormick, Danny; Lasser, Karen E; Feng, Chen; Manze, Meredith G; Kressin, Nancy R

    2015-02-20

    To estimate the impact of the insurance expansion in 2006 on use of knee and hip replacement procedures by race/ethnicity, area income, and the use of hospitals that predominantly serve poor people ("safety net hospitals"). Quasi-experimental difference in differences study examining change after reform in the share of procedures performed in safety net hospitals by race/ethnicity and area income, with adjustment for patients' residence, demographics, and comorbidity. State of Massachusetts, United States. Massachusetts residents aged 40-64 as the target beneficiaries of reform and similarly aged residents of New Jersey, New York, and Pennsylvania as the comparison (control) population. Number of knee and hip replacement procedures per 10 000 population and use of safety net hospitals. Procedure counts from state discharge data for 2.5 years before and after reform, and multivariate difference in differences. Poisson regression was used to adjust for demographics, economic conditions, secular time, and geographic factors to estimate the change in procedure rate associated with health reform by race/ethnicity and area income. Before reform, the number of procedures (/10 000) in Massachusetts was lower among Hispanic people (12.9, P<0.001) than black people (28.1) and white people (30.1). Overall, procedure use increased 22.4% during the 2.5 years after insurance expansion; reform in Massachusetts was associated with a 4.7% increase. The increase associated with reform was significantly higher among Hispanic people (37.9%, P<0.001) and black people (11.4%, P<0.05) than among white people (2.8%). Lower income was not associated with larger increases in procedure use. The share of knee and hip replacement procedures performed in safety net hospitals in Massachusetts decreased by 1.0% from a level of 12.7% before reform. The reduction was larger among Hispanic people (-6.4%, P<0.001) than white people (-1.0%), and among low income residents (-3.9%, p<0.001) than high

  4. Cancer increase study methodology: A review and discussion of the ``Southeastern Massachusetts Health Study 1978--1986``

    SciTech Connect

    Sever, L.E.; Baker, D.A.; Gilbert, E.S.; Mahaffey, J.A.

    1993-09-01

    In October 1990 the Massachusetts Department of Public Health released a report of an epidemiologic study of adult leukemia occurring in the vicinity of the Pilgrim 1 Nuclear Power Plant near Plymouth, Massachusetts. The study used a case-control design in which adult leukemia cases occurring between 1978 and 1986 in 22 towns were compared with persons without leukemia (controls) selected from the same study population. Exposure scores, used to estimate potential for exposure to radioactive emissions from Pilgrim, were calculated for all cases and controls. When the exposure scores of cases were compared with those of controls, the analyses showed the scores to be higher for the leukemia cases, suggesting that individuals with the highest potential for exposure to Pilgrim emissions had a significantly increased risk of leukemia. This association was found only for cases diagnosed before 1984; for cases diagnosed during 1984, 1985, or 1986, no association was observed between leukemia case status and potential for exposure to emissions from the plant. Our review of the report and supporting documents shows no major methodologic problems that would account for the finding of an association between leukemia risk and the Pilgrim plant. Examination of the study findings in relation to what is known about leukemia risks associated with radiation exposure, however, indicates that the results of the Southeastern Massachusetts Health Study are inconsistent with a large body of evidence from a number of other studies.

  5. Improvements in health status after Massachusetts health care reform.

    PubMed

    Van Der Wees, Philip J; Zaslavsky, Alan M; Ayanian, John Z

    2013-12-01

    Massachusetts enacted health care reform in 2006 to expand insurance coverage and improve access to health care. The objective of our study was to compare trends in health status and the use of ambulatory health services before and after the implementation of health reform in Massachusetts relative to that in other New England states. We used a quasi-experimental design with data from the Behavioral Risk Factor Surveillance System from 2001 to 2011 to compare trends associated with health reform in Massachusetts relative to that in other New England states. We compared self-reported health and the use of preventive services using multivariate logistic regression with difference-in-differences analysis to account for temporal trends. We estimated predicted probabilities and changes in these probabilities to gauge the differential effects between Massachusetts and other New England states. Finally, we conducted subgroup analysis to assess the differential changes by income and race/ethnicity. The sample included 345,211 adults aged eighteen to sixty-four. In comparing the periods before and after health care reform relative to those in other New England states, we found that Massachusetts residents reported greater improvements in general health (1.7%), physical health (1.3%), and mental health (1.5%). Massachusetts residents also reported significant relative increases in rates of Pap screening (2.3%), colonoscopy (5.5%), and cholesterol testing (1.4%). Adults in Massachusetts households that earned up to 300% of the federal poverty level gained more in health status than did those above that level, with differential changes ranging from 0.2% to 1.3%. Relative gains in health status were comparable among white, black, and Hispanic residents in Massachusetts. Health care reform in Massachusetts was associated with improved health status and the greater use of some preventive services relative to those in other New England states, particularly among low

  6. Improvements in Health Status after Massachusetts Health Care Reform

    PubMed Central

    van der Wees, Philip J; Zaslavsky, Alan M; Ayanian, John Z

    2013-01-01

    Context Massachusetts enacted health care reform in 2006 to expand insurance coverage and improve access to health care. The objective of our study was to compare trends in health status and the use of ambulatory health services before and after the implementation of health reform in Massachusetts relative to that in other New England states. Methods We used a quasi-experimental design with data from the Behavioral Risk Factor Surveillance System from 2001 to 2011 to compare trends associated with health reform in Massachusetts relative to that in other New England states. We compared self-reported health and the use of preventive services using multivariate logistic regression with difference-in-differences analysis to account for temporal trends. We estimated predicted probabilities and changes in these probabilities to gauge the differential effects between Massachusetts and other New England states. Finally, we conducted subgroup analysis to assess the differential changes by income and race/ethnicity. Findings The sample included 345,211 adults aged eighteen to sixty-four. In comparing the periods before and after health care reform relative to those in other New England states, we found that Massachusetts residents reported greater improvements in general health (1.7%), physical health (1.3%), and mental health (1.5%). Massachusetts residents also reported significant relative increases in rates of Pap screening (2.3%), colonoscopy (5.5%), and cholesterol testing (1.4%). Adults in Massachusetts households that earned up to 300% of the federal poverty level gained more in health status than did those above that level, with differential changes ranging from 0.2% to 1.3%. Relative gains in health status were comparable among white, black, and Hispanic residents in Massachusetts. Conclusions Health care reform in Massachusetts was associated with improved health status and the greater use of some preventive services relative to those in other New England states

  7. Medical bankruptcy in Massachusetts: has health reform made a difference?

    PubMed

    Himmelstein, David U; Thorne, Deborah; Woolhandler, Steffie

    2011-03-01

    Massachusetts' recent health reform has decreased the number of uninsured, but no study has examined medical bankruptcy rates before and after the reform was implemented. In 2009, we surveyed 199 Massachusetts bankruptcy filers regarding medical antecedents of their financial collapse using the same questions as in a 2007 survey of 2314 debtors nationwide, including 44 in Massachusetts. We designated bankruptcies as "medical" based on debtors' stated reasons for filing, income loss due to illness, and the magnitude of their medical debts. In 2009, illness and medical bills contributed to 52.9% of Massachusetts bankruptcies, versus 59.3% of the bankruptcies in the state in 2007 (P=.44) and 62.1% nationally in 2007 (P<.02). Between 2007 and 2009, total bankruptcy filings in Massachusetts increased 51%, an increase that was somewhat less than the national norm. (The Massachusetts increase was lower than in 54 of the 93 other bankruptcy districts.) Overall, the total number of medical bankruptcies in Massachusetts increased by more than one third during that period. In 2009, 89% of debtors and all their dependents had health insurance at the time of filing, whereas one quarter of bankrupt families had experienced a recent lapse in coverage. Massachusetts' health reform has not decreased the number of medical bankruptcies, although the medical bankruptcy rate in the state was lower than the national rate both before and after the reform. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Massachusetts health care reform: is it working?

    PubMed

    McAdoo, Joshua; Irving, Julian; Deslich, Stacie; Coustasse, Alberto

    2013-01-01

    Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion on Medicaid for Massachusetts. Since the 2006 reform, 401 000 additional residents have obtained insurance. The number of Massachusetts residents who had access to health care increased substantially after the health care reform was enacted, to 98.1% of residents. The Massachusetts health care reform has not saved money for the state; its funding has been covered by Federal spending. However, reform has been sustained over time because of the high percentage of state residents who have supported the state mandate to obtain health care coverage.

  9. A Case Study of Environmental, Health and Safety Issues Involving the Burlington, Massachusetts Public School System. "Tips, Suggestions, and Resources for Investigating and Resolving EHS Issues in Schools."

    ERIC Educational Resources Information Center

    Dresser, Todd H.

    An investigation was initiated concerning the environmental health within the Burlington, Massachusetts public school system to determine what specific environmental hazards were present and determine ways of eliminating them. This report presents 20 case studies that detail the environmental health issues involved, the approaches taken in…

  10. Affordability of health care under publicly subsidized insurance after Massachusetts health care reform: a qualitative study of safety net patients.

    PubMed

    Zallman, Leah; Nardin, Rachel; Malowney, Monica; Sayah, Assaad; McCormick, Danny

    2015-10-29

    The Affordable Care Act (ACA) and the 2006 Massachusetts (MA) health reform law, on which the ACA was based, aimed to improve the affordability of care largely by expanding publicly sponsored insurances. Both laws also aimed to promote consumer understanding of how to acquire, maintain and use these public plans. A prior study found an association between the level of cost-sharing required in these plans and the affordability of care. Preparatory to a quantitative study we conducted this qualitative study that aimed to examine (1) whether cost sharing levels built into the public insurance types that formed the backbone of the MA health reform led to unaffordability of care and if so, (2) how insurances with higher cost sharing levels led to unaffordability of care in this context. We interviewed 12 consumers obtaining the most commonly obtained insurances under MA health reform (Medicaid and Commonwealth Care) at a safety net hospital emergency department. We purposefully interviewed a stratified sample of higher and low cost sharing recipients. We used a combination of inductive and deductive codes to analyze the data according to degree of cost-sharing required by different insurance types. We found that higher cost sharing plans led to unaffordability of care, as evidenced by unmet medical needs, difficulty affording basic non-medical needs due to expenditures on medical care, and reliance on non-insurance resources to pay for care. Participants described two principal mechanisms by which higher cost sharing led to unaffordability of care: (1) cost sharing above what their incomes allowed and (2) poor understanding of how to effectively acquire, maintain and utilize insurance new public plans. Further efforts to investigate the relationship between perceived affordability of care and understanding of insurance for the insurance types obtained under MA health reform may be warranted. A potential focus for further work may be quantitative investigation of how the

  11. Community health educators band together in Massachusetts.

    PubMed

    Sheffield, R

    1979-01-01

    Begun last year with only six participants, the Massachusetts Consumer Health Educators Association, now 100 members strong, is in the business of sharing experiences to help alleviate its members' feelings of being alone. Meetings are held once a month, and authorities in the health education field are invited to speak. The Consumer Health Educators' first major project is the compilation of an index of hospital-based health education programs in the state.

  12. Massachusetts health reform and Veterans Affairs health system enrollment.

    PubMed

    Wong, Edwin S; Maciejewski, Matthew L; Herbert, Paul L; Bryson, Christopher L; Liu, Chuan-Fen

    2014-08-01

    Veterans Health Administration (VA) operates the largest integrated health system in the nation. The Affordable Care Act (ACA) does not require any changes to VA, but the individual mandate and expanded health insurance options may change veterans' preferences for coverage. We examined the impact of healthcare reform in Massachusetts, which also included these policy changes, on veterans' enrollment in VA, private insurance, and Medicaid. Massachusetts' healthcare reform in June 2006 served as a natural experiment. Using data from the 2004-2013 Current Population Surveys, we examined enrollment in VA, private insurance, and Medicaid, comparing veterans residing in Massachusetts with veterans residing in neighboring New England states that did not undergo health reform. We estimated the probability of being enrolled in VA, private insurance, and Medicaid before and after healthcare reform, using multivariate probit models while adjusting for individual characteristics. Using a difference-in-difference approach, we compared pre-post changes in enrollment probability among Massachusetts and non-Massachusetts veterans, respectively. Compared with other New England veterans, Massachusetts veterans decreased their enrollment in VA and private insurance by 0.2 (P = .857) and 0.9 (P = .666) percentage points, respectively, following health reform. In contrast, Medicaid enrollment increased by 2.5 percentage points (P = .038). Healthcare reform in Massachusetts was associated with greater Medicaid enrollment, but was not significantly associated with VA and private insurance enrollment. Our results are significant for informing VA fiscal planning in the post ACA era.

  13. Health and Risk Behaviors of Massachusetts Youth, 2007: The Report

    ERIC Educational Resources Information Center

    Massachusetts Department of Elementary and Secondary Education, 2008

    2008-01-01

    This paper presents the results of two coordinated surveys of Massachusetts adolescents, the 2007 Massachusetts Youth Risk Behavior Survey (ESE) and the Massachusetts Youth Health Survey (DPH). These two surveys were supported by funding from the Centers for Disease Control and Prevention (CDC) and administered in a random selection of 124 public…

  14. Did Massachusetts Health Reform Affect Veterans Affairs Primary Care Use?

    PubMed

    Wong, Edwin S; Maciejewski, Matthew L; Hebert, Paul L; Batten, Adam; Nelson, Karin M; Fihn, Stephan D; Liu, Chuan-Fen

    2016-09-20

    Massachusetts Health Reform (MHR), implemented in 2006, introduced new health insurance options that may have prompted some veterans already enrolled in the Veterans Affairs Healthcare System (VA) to reduce their reliance on VA health services. This study examined whether MHR was associated with changes in VA primary care (PC) use. Using VA administrative data, we identified 147,836 veterans residing in Massachusetts and neighboring New England (NE) states from October 2004 to September 2008. We applied difference-in-difference methods to compare pre-post changes in PC use among Massachusetts and other NE veterans. Among veterans not enrolled in Medicare, VA PC use was not significantly different following MHR for Massachusetts veterans relative to other NE veterans. Among VA-Medicare dual enrollees, MHR was associated with an increase of 24.5 PC visits per 1,000 veterans per quarter (p = .048). Despite new non-VA health options through MHR, VA enrollees continued to rely on VA PC. © The Author(s) 2016.

  15. Structural and organizational characteristics associated with performance of essential public health services in small jurisdictions: findings from a statewide study in Massachusetts.

    PubMed

    Hyde, Justeen; Arsenault, Lisa; Waggett, Jessica; Mills, Brianna; Cox, Harold; MacVarish, Kathleen; Fried, Lise

    2012-11-01

    This study examined jurisdictional, organizational, and structural characteristics associated with capacity to deliver 10 essential public health services (EPHS) in Massachusetts, a state where a majority of local public health departments serve small municipalities. A survey was administered to local health directors or board of health chairs. The main outcome of the study was capacity to perform EPHS, measured by a 25-item screening tool. Seventy percent of the 351 boards of health in Massachusetts participated in the study. Greatest capacity was demonstrated in EPHS 2 (Diagnose and Investigate Health Problems) and EPHS 6 (Enforce Laws and Regulations). The capacity to perform the 8 other essential services was limited. Bivariate analysis indicates that overall capacity to perform EPHS is significantly associated with population size, poverty rate, annual municipal budget, and perceived understanding of the roles and responsibilities of local boards of health among elected municipal officials. The latter was the strongest predictor of overall capacity in multivariate analysis. Findings are aligned with studies examining factors associated with capacity to perform EPHS in large public health jurisdictions. The results suggest that one strategy for improving capacity to perform EPHS in smaller jurisdictions is to educate elected municipal leaders about the responsibilities of local health officials. Clarification regarding the role small jurisdictions with limited resources can play to ensure the equitable delivery of essential public health services and a strategy for measuring their contributions is important, especially as the national public health accreditation program gains momentum in the United States.

  16. Effect of Massachusetts health reform on chronic disease outcomes.

    PubMed

    Stryjewski, Tomasz P; Zhang, Fang; Eliott, Dean; Wharam, J Frank

    2014-12-01

    To determine whether Massachusetts Health Reform improved health outcomes in uninsured patients with hyperlipidemia, diabetes, or hypertension. Partners HealthCare Research Patient Data Registry (RPDR). We examined 1,463 patients with hyperlipidemia, diabetes, or hypertension who were uninsured in the 3 years before the 2006 Massachusetts Health Reform implementation. We assessed mean quarterly total cholesterol, glycosylated hemoglobin, and systolic blood pressure in the respective cohorts for five follow-up years compared with 3,448 propensity score-matched controls who remained insured for the full 8-year study period. We used person-level interrupted time series analysis to estimate changes in outcomes adjusting for sex, age, race, estimated household income, and comorbidity. We also analyzed the subgroups of uninsured patients with poorly controlled disease at baseline, no evidence of established primary care in the baseline period, and those who received insurance in the first follow-up year. In 5 years after Massachusetts Health Reform, patients who were uninsured at baseline did not experience detectable trend changes in total cholesterol (-0.39 mg/dl per quarter, 95 percent confidence interval [-1.11 to 0.33]), glycosylated hemoglobin (-0.02 percent per quarter [-0.06 to 0.03]), or systolic blood pressure (-0.06 mmHg per quarter [-0.29 to 0.18]). Analyses of uninsured patients with poorly controlled disease, no evidence of established primary care in the baseline period, and those who received insurance in the first follow-up year yielded similar findings. Massachusetts Health Reform was not associated with improvements in hyperlipidemia, diabetes, or hypertension control after 5 years. Interventions beyond insurance coverage might be needed to improve the health of chronically ill uninsured persons. © Health Research and Educational Trust.

  17. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    PubMed

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide. Copyright © 2016 by Duke University Press.

  18. Universal Health Insurance Coverage in Massachusetts Did Not Change the Trajectory of Arthroplasty Use or Costs.

    PubMed

    Kurtz, Steven M; Lau, Edmund; Ong, Kevin L; Katz, Jeffrey N; Bozic, Kevin J

    2016-05-01

    The state of Massachusetts enacted universal health insurance in 2006. However it is unknown whether the increased access to care resulted in changes to surgical use or costs. We asked the following related research questions: compared with the United States as a whole, how did the (1) number of cases (as a percentage of the overall population, to account for changes in the overall population during the time surveyed), (2) payer mix, and (3) inpatient costs for arthroplasty change in Massachusetts after introduction of health insurance reform? We analyzed the use and cost of primary THAs and TKAs in Massachusetts using the State Inpatient Database (SID) between 2002 and 2011 compared with the Nationwide Inpatient Sample (NIS) during the same years. The SID captures 100% of inpatient procedures in Massachusetts, while the NIS is a nationally representative database of inpatient procedures for the United States. The SID and NIS are publicly available data sources from the Agency for Healthcare Research and Quality, and include information regarding procedure volumes, payer mixes, and costs. Inpatient costs were defined similarly in both databases by using hospital charges and an average cost-to-charge ratio that is unique for each hospital. The incidence of arthroplasties was calculated by dividing the procedure volume by the relevant population (either for Massachusetts or the entire country) based on public data from the United States Census bureau. The incidence of THAs and TKAs performed in Massachusetts increased steadily throughout the study period, and paralleled a similar increase in the United States as a whole. In Massachusetts, the incidence of THAs increased by 59% between 2002 and 2011, and the incidence of TKAs likewise increased by 80%. The trends for the incidence in total joint arthroplasties were similar to those for Massachusetts for the United States as a whole. The period of health insurance reform in Massachusetts was associated with a greater

  19. Massachusetts health care reform and orthopaedic trauma: lessons learned.

    PubMed

    Harris, Mitchel B

    2014-10-01

    Massachusetts was the first state to implement its own version of the Affordable Care Act (ACA), when it passed the Massachusetts Health Care Reform (MHR) in 2006. Similar to the ACA, its explicit purpose was universal access to health care to all residents of Massachusetts. We believe that the influence of MHR on orthopaedic trauma in Massachusetts will have implications on trauma systems across the country, given the similarities between ACA and MHR. Therefore, in this article, we discuss our experiences as Orthopaedic trauma surgeons with regard to MHR. In this regard, we reviewed the effects of the implementation of MHR on the orthopaedic trauma services at 3 of the 4 level one trauma centers in Boston, MA. Our results demonstrate a dramatic reduction in the proportion of uncompensated care at these centers in addition to the number of uninsured patients with orthopaedic trauma injuries.

  20. Behavioral Health Screening among Massachusetts Children Receiving Medicaid.

    PubMed

    Savageau, Judith A; Keller, David; Willis, Georgianna; Muhr, Kathleen; Aweh, Gideon; Simons, Jack; Sherwood, Emily

    2016-11-01

    To assess the impact of a Massachusetts Medicaid policy change (the Children's Behavioral Health Initiative; CBHI, which required and reimbursed behavioral health [BH] screening with standardized tools at well child visits and developed intensive home- and community-based BH services) on primary care practice examining the relationship of BH screening to subsequent BH service utilization. Using a repeated cross-sectional design, our 2010 and 2012 Medicaid study populations each included 2000 children/adolescents under the age of 21 years. For each year, the population was randomly selected and stratified into 4 age groups, with 500 members selected per group. Two data sources were used: medical records and Medicaid claims. The CBHI had a large impact on formal BH screening and treatment utilization among children/adolescents enrolled in Medicaid. Screening increased substantially (73%: 2010; 74%: 2012) since the baseline/premandate period (2007) when only 4% of well child visits included a formal screen. BH utilization increased among those formally screened but decreased among those with informal assessments. CBHI implementation transformed the relationship between primary care and BH services. Changes in regulation and payment resulted in widespread BH screening in Massachusetts primary care practices caring for children/adolescents on Medicaid. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Readmission penalties and health insurance expansions: a dispatch from Massachusetts.

    PubMed

    Chen, Christopher; Scheffler, Gabriel; Chandra, Amitabh

    2014-11-01

    Payers are penalizing hospitals for high readmission rates. It is unknown whether major changes in population insurance coverage can affect readmission rates, despite the Affordable Care Act's coverage expansions coming into effect this year. To evaluate the impact of a large-scale insurance expansion on hospital readmissions, using Massachusetts' 2006 health reform as a natural experiment. Difference-in-difference time-series design. All Massachusetts acute-care hospitals. Inpatient visits from 2004 to 2010. Primary outcome was the hospital 30-day readmission rate. Readmissions to any Massachusetts hospital were tracked. Decreases in uninsurance rates during and after reform were largely limited to the hospital quartile with the highest prereform uninsurance rates (from 14% uninsured at the start of the reform to 2.9% by the end of the study period). The other hospitals collectively experienced a smaller decline in their uninsured admissions (5.9% at the start of reform to 2.5% by the end of the study period). According to difference-in-difference regression analysis, the highest uninsured hospital quartile experienced a modest increase in their unadjusted readmission rate of 0.6 percentage points (95% confidence interval: 0.1%-1.1%) during the reform period as compared to the other hospital quartiles (P = 0.01). This represents a relative increase of 4.5% in the readmission rate. Risk-adjusted readmission rates showed no corresponding change. The Affordable Care Act's insurance expansion may be associated with an increase in unadjusted readmission rates among hospitals that cared for disproportionate numbers of uninsured patients. Risk-adjustment appears to take this effect into account. © 2014 Society of Hospital Medicine.

  2. Survival Rates in Trauma Patients Following Health Care Reform in Massachusetts.

    PubMed

    Osler, Turner; Glance, Laurent G; Li, Wenjun; Buzas, Jeffery S; Hosmer, David W

    2015-07-01

    Massachusetts introduced health care reform (HCR) in 2006, expecting to expand health insurance coverage and improve outcomes. Because traumatic injury is a common acute condition with important health, disability, and economic consequences, examination of the effect of HCR on patients hospitalized following injury may help inform the national HCR debate. To examine the effect of Massachusetts HCR on survival rates of injured patients. Retrospective cohort study of 1,520,599 patients hospitalized following traumatic injury in Massachusetts or New York during the 10 years (2002-2011) surrounding Massachusetts HCR using data from the State Inpatient Databases. We assessed the effect of HCR on mortality rates using a difference-in-differences approach to control for temporal trends in mortality. Health care reform in Massachusetts in 2006. Survival until hospital discharge. During the 10-year study period, the rates of uninsured trauma patients in Massachusetts decreased steadily from 14.9% in 2002 to 5.0.% in 2011. In New York, the rates of uninsured trauma patients fell from 14.9% in 2002 to 10.5% in 2011. The risk-adjusted difference-in-difference assessment revealed a transient increase of 604 excess deaths (95% CI, 419-790) in Massachusetts in the 3 years following implementation of HCR. Health care reform did not affect health insurance coverage for patients hospitalized following injury but was associated with a transient increase in adjusted mortality rates. Reducing mortality rates for acutely injured patients may require more comprehensive interventions than simply promoting health insurance coverage through legislation.

  3. Massachusetts health reform implementation: major progress and future challenges.

    PubMed

    McDonough, John E; Rosman, Brian; Butt, Mehreen; Tucker, Lindsey; Howe, Lisa Kaplan

    2008-01-01

    Since its passage in April 2006, the Massachusetts health reform law (Chapter 58) has expanded affordable insurance coverage to 355,000 people. Major milestones have been achieved, including establishment of new coverage programs, merger of small-group and nongroup insurance markets, creation of an insurance "Connector," determination of affordability and penalty standards for an individual mandate, and launch of employer responsibility requirements. Key challenges remain, including full implementation of the individual mandate, cost control, and securing of long-term financing. Massachusetts health reform is offering valuable and important lessons for the nation.

  4. Experience of the Veterans Health Administration in Massachusetts after state health care reform.

    PubMed

    Chan, Stephanie H; Burgess, James F; Clark, Jack A; Mayo-Smith, Michael F

    2014-11-01

    Starting in 2006, Massachusetts enacted a series of health insurance reforms that successfully led to 96.6% of its population being covered by 2011. As the rest of the nation undertakes similar reforms, it is unknown how the Veterans Health Administration (VHA), one of many important Federal health care programs, will be affected. Our state-level study approach assessed the effects of health reform on utilization of VHA services in Massachusetts from 2005 to 2011. Models were adjusted for state-level demographic and economic characteristics, including health insurance rates, unemployment rates, median household income, poverty rates, and percent of population 65 years and older. No statistically significant associative change was observed in Massachusetts relative to other states over this time period. The findings raise important questions about the continuing role of VHA in American health care as health insurance coverage is one of many factors that influence decisions on where to seek health care. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  5. The Massachusetts health insurance law: providing health insurance to all.

    PubMed

    Kleinpeter, Myra A

    2006-11-01

    There have been increasing rates of uninsured patients in the United States over the past few decades. Despite this growing problem, little progress has been made to decrease the rate of growth of uninsured patients or to provide affordable insurance coverage to those who are unable to maintain insurance coverage throughout the year. The legislature in the Commonwealth of Massachusetts has enacted legislation that requires health insurance for all in the same manner that automobile insurance is required in many states. This bold comprehensive legislation augments current Medicaid and state child health insurance program coverage and expands coverage options for part-time workers, those employed by small companies or those employed at lower-income jobs.

  6. Implementation of Competitive Food and Beverage Standards in a Sample of Massachusetts Schools: The NOURISH Study (Nutrition Opportunities to Understand Reforms Involving Student Health)

    PubMed Central

    Hoffman, Jessica A.; Rosenfeld, Lindsay; Schmidt, Nicole; Cohen, Juliana F. W.; Gorski, Mary; Chaffee, Ruth; Smith, Lauren; Rimm, Eric B.

    2015-01-01

    Background During 2012, Massachusetts adopted comprehensive school competitive food and beverage standards that closely align with Institute of Medicine recommendations and Smart Snacks in School national standards. Objective We examined the extent to which a sample of Massachusetts middle schools and high schools sold foods and beverages that were compliant with the state competitive food and beverage standards after the first year of implementation, and complied with four additional aspects of the regulations. Design Observational cohort study with data collected before implementation (Spring 2012) and 1 year after implementation (Spring 2013). Participants/setting School districts (N=37) with at least one middle school and one high school participated. Main outcome measures Percent of competitive foods and beverages that were compliant with Massachusetts standards and compliance with four additional aspects of the regulations. Data were collected via school site visits and a foodservice director questionnaire. Statistical analyses performed Multilevel models were used to examine change in food and beverage compliance over time. Results More products were available in high schools than middle schools at both time points. The number of competitive beverages and several categories of competitive food products sold in the sample of Massachusetts schools decreased following the implementation of the standards. Multilevel models demonstrated a 47-percentage-point increase in food and 46-percentage-point increase in beverage compliance in Massachusetts schools from 2012 to 2013. Overall, total compliance was higher for beverages than foods. Conclusions This study of a group of Massachusetts schools demonstrated the feasibility of schools making substantial changes in response to requirements for healthier competitive foods, even in the first year of implementation. PMID:26210085

  7. Implementation of Competitive Food and Beverage Standards in a Sample of Massachusetts Schools: The NOURISH Study (Nutrition Opportunities to Understand Reforms Involving Student Health).

    PubMed

    Hoffman, Jessica A; Rosenfeld, Lindsay; Schmidt, Nicole; Cohen, Juliana F W; Gorski, Mary; Chaffee, Ruth; Smith, Lauren; Rimm, Eric B

    2015-08-01

    During 2012, Massachusetts adopted comprehensive school competitive food and beverage standards that closely align with Institute of Medicine recommendations and Smart Snacks in School national standards. We examined the extent to which a sample of Massachusetts middle schools and high schools sold foods and beverages that were compliant with the state competitive food and beverage standards after the first year of implementation, and complied with four additional aspects of the regulations. Observational cohort study with data collected before implementation (Spring 2012) and 1 year after implementation (Spring 2013). School districts (N=37) with at least one middle school and one high school participated. Percent of competitive foods and beverages that were compliant with Massachusetts standards and compliance with four additional aspects of the regulations. Data were collected via school site visits and a foodservice director questionnaire. Multilevel models were used to examine change in food and beverage compliance over time. More products were available in high schools than middle schools at both time points. The number of competitive beverages and several categories of competitive food products sold in the sample of Massachusetts schools decreased following the implementation of the standards. Multilevel models demonstrated a 47-percentage-point increase in food and 46-percentage-point increase in beverage compliance in Massachusetts schools from 2012 to 2013. Overall, total compliance was higher for beverages than foods. This study of a group of Massachusetts schools demonstrated the feasibility of schools making substantial changes in response to requirements for healthier competitive foods, even in the first year of implementation. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  8. Expanding Coverage to Low-Income Childless Adults in Massachusetts: Implications for National Health Reform

    PubMed Central

    Long, Sharon K; Dahlen, Heather

    2014-01-01

    Objective To draw on the experiences under Massachusetts's 2006 reform, the template for the Affordable Care Act (ACA), to provide insights into the potential impacts of the ACA Medicaid expansion for low-income childless adults in other states. Data Sources/Study Setting The study takes advantage of the natural experiment in Massachusetts and combined data from two surveys—the Massachusetts Health Reform Survey (MHRS) and the National Health Interview Survey (NHIS)—to estimate the impacts of reform on low-income adults. Study Design Difference-in-differences models of the impacts of health reform, using propensity-score reweighting to improve the match between Massachusetts and the comparison states. Data Collection/Extraction Methods Data for low-income adults are obtained by combining data from the MHRS and the NHIS, where the MHRS provides a relatively large Massachusetts sample and the NHIS provides data for samples in other states to support the difference-in-differences model. Supplemental data on county economic and health care market characteristics are obtained from the Area Health Resource File. Principal Findings There are strong increases in coverage and access to health care for low-income adults under health reform in Massachusetts, with the greatest gains observed for childless adults, who were not eligible for public coverage prior to reform. Conclusions In the states that implement the Medicaid provisions of the ACA, we would expect to see large increases in coverage rates and commensurate gains in access to care for low-income childless adults. Linking state and federal surveys offers a strategy for leveraging the value of state-specific survey data for stronger policy evaluations. PMID:24834813

  9. Expanding coverage to low-income childless adults in Massachusetts: implications for national health reform.

    PubMed

    Long, Sharon K; Dahlen, Heather

    2014-12-01

    To draw on the experiences under Massachusetts's 2006 reform, the template for the Affordable Care Act (ACA), to provide insights into the potential impacts of the ACA Medicaid expansion for low-income childless adults in other states. The study takes advantage of the natural experiment in Massachusetts and combined data from two surveys-the Massachusetts Health Reform Survey (MHRS) and the National Health Interview Survey (NHIS)-to estimate the impacts of reform on low-income adults. Difference-in-differences models of the impacts of health reform, using propensity-score reweighting to improve the match between Massachusetts and the comparison states. Data for low-income adults are obtained by combining data from the MHRS and the NHIS, where the MHRS provides a relatively large Massachusetts sample and the NHIS provides data for samples in other states to support the difference-in-differences model. Supplemental data on county economic and health care market characteristics are obtained from the Area Health Resource File. There are strong increases in coverage and access to health care for low-income adults under health reform in Massachusetts, with the greatest gains observed for childless adults, who were not eligible for public coverage prior to reform. In the states that implement the Medicaid provisions of the ACA, we would expect to see large increases in coverage rates and commensurate gains in access to care for low-income childless adults. Linking state and federal surveys offers a strategy for leveraging the value of state-specific survey data for stronger policy evaluations. © Health Research and Educational Trust.

  10. The Massachusetts Commonwealth Health Insurance Connector: structure and functions.

    PubMed

    Lischko, Amy M; Bachman, Sara S; Vangeli, Alyssa

    2009-05-01

    The Commonwealth Health Insurance Connector Authority is the centerpiece of Massachusetts' ambitious health care reforms, which were implemented beginning in 2006. The Connector is an independent quasi-governmental agency created by the Massachusetts legislature to facilitate the purchase of affordable, high-quality health insurance by small businesses and individuals without access to employer-sponsored coverage. This issue brief describes the structure and functions of the Connector, providing a primer to policymakers interested in exploring similar reforms at the state and national level. The authors describe how the Connector works to promote administrative ease, eliminate paperwork, offer portability of coverage, and provide some standardization and choice of plans. National policymakers looking to achieve similar policy goals may find some of the structural components and functions of the Connector to be transferable to a national health reform model, say the authors.

  11. The impact of the Massachusetts health care reform on unpaid medical bills.

    PubMed

    Arrieta, Alejandro

    2013-08-01

    The Massachusetts health care reform was expected to reduce the financial burden of medical care, but literature exploring this effect is limited. In this study, we use hospital financial information and a panel data difference-in-difference model to assess the impact of the Massachusetts health care reform on unpaid medical bills. We find that the reform reduced the financial burden for patients, reflected by a 26percent decrease in hospital bad debt. The effect was more pronounced among safety-net hospitals, indicating a larger benefit for the most vulnerable population.

  12. Vulnerability-Based Spatial Sampling Stratification for the National Children’s Study, Worcester County, Massachusetts: Capturing Health-Relevant Environmental and Sociodemographic Variability

    PubMed Central

    Downs, Timothy J.; Ogneva-Himmelberger, Yelena; Aupont, Onesky; Wang, Yangyang; Raj, Ann; Zimmerman, Paula; Goble, Robert; Taylor, Octavia; Churchill, Linda; Lemay, Celeste; McLaughlin, Thomas; Felice, Marianne

    2010-01-01

    Background The National Children’s Study is the most ambitious study ever attempted in the United States to assess how environmental factors impact child health and development. It aims to follow 100,000 children from gestation until 21 years of age. Success requires breaking new interdisciplinary ground, starting with how to select the sample of > 1,000 children in each of 105 study sites; no standardized protocol exists for stratification of the target population by factoring in the diverse environments it inhabits. Worcester County, Massachusetts, like other sites, stratifies according to local conditions and local knowledge, subject to probability sampling rules. Objectives We answer the following questions: How do we divide Worcester County into viable strata that represent its health-relevant environmental and sociodemographic heterogeneity, subject to sampling rules? What potential does our approach have to inform stratification at other sites? Results We developed a multivariable, vulnerability-based method for spatial sampling consisting of two descriptive indices: a hazards/stressors exposure index (comprising three proxy variables), and an adaptive capacity/sociodemographic character index (five variables). Multivariable, health-relevant stratification at the start of the study may improve detection power for environment–child health associations down the line. Eighteen strata capture countywide heterogeneity in the indices and have optimal relative homogeneity within each. They achieve comparable expected birth counts and conform to local concepts of space. Conclusion The approach offers moderate to high potential to inform other sites, limited by intersite differences in data availability, geodemographics, and technical capacity. Energetic community engagement from the start promotes local stratification coherence, plus vital researcher–community trust and co-ownership for sustainability. PMID:20211802

  13. Designing and regulating health insurance exchanges: lessons from Massachusetts.

    PubMed

    Ericson, Keith M Marzilli; Starc, Amanda

    The Massachusetts health care reform provides preliminary evidence on the function of health insurance exchanges and individual insurance markets. This paper describes the type of products consumers choose and the dynamics of consumer choice. Evidence shows that choice architecture, including product standardization and the use of heuristics (rules of thumb), affects choice. In addition, while consumers often choose less generous plans in the exchange than in traditional employer-sponsored insurance, there is considerable heterogeneity in consumer demand, as well as some evidence of adverse selection. We examine the role of imperfect competition between insurers, and document the impact of pricing and product regulation on the level and distribution of premiums. Given our extensive choice data, we synthesize the evidence of the Massachusetts exchange to inform the design and regulation on other exchanges.

  14. Weight and mental health status in Massachusetts, National Survey of Children's Health, 2007.

    PubMed

    Lu, Emily; Dayalu, Rashmi; Diop, Hafsatou; Harvey, Elizabeth M; Manning, Susan E; Uzogara, Stella G

    2012-12-01

    This study explores how weight status is related to mental health status among Massachusetts children, aged 10-17 years. We used data from the 2007 National Survey of Children's Health to examine the association between weight status (body mass index-for-age) and parent-reported mental health status among Massachusetts children (N = 827). Multivariable log binomial regression was performed to calculate the adjusted prevalence ratios (aPR) of three mental health outcomes (behavioral, emotional, and social) as related to weight status, after controlling for covariates including physical activity, sex, race/ethnicity, maternal education, poverty status, special health needs, and neighborhood safety. Almost one-third (32.5 %) of Massachusetts children were either overweight or obese. Sex was a significant effect modifier of the association between weight status and negative emotions. After stratifying by sex and controlling for covariates, the relationship between weight status and negative emotions remained significant among girls (aPR = 1.8, 95 % CI 1.3-2.6). Children who did not exercise at all were significantly more likely to exhibit negative behaviors (aPR = 1.3, 95 % CI 1.0-1.6), negative emotions (boys' aPR = 3.3, 95 % CI 1.6-6.9; girls' aPR = 2.6, 95 % CI 1.5-4.5), and fewer social skills (aPR = 1.9, 95 % CI 1.3-2.9) than those who exercised at least 20 min every day of the week. Overweight/obese children, especially girls, were more likely than children of normal weight to have parent-reported negative emotions, suggesting an association between weight status and mental health. Lower levels of physical activity were associated with negative mental health outcomes, supporting the benefits of physical activity for all children.

  15. The experiences of Massachusetts hospitals as statewide health insurance reform was implemented.

    PubMed

    Bazzoli, Gloria J; Clement, Jan P

    2014-02-01

    Hospitals treat many uninsured patients and shoulder substantial amounts of uncompensated care. Health reform as implemented in Massachusetts, then, would be expected to bode well for hospitals as many people obtain coverage from private and public programs. We examined changes in Massachusetts hospital payer mix, unreimbursed costs of care for the uninsured and those in means-tested public programs, and overall financial condition for the period 2004 to 2010. Despite increases in coverage, unreimbursed costs for the uninsured and those in means-tested government programs did not decrease appreciably for Massachusetts hospitals over the study period. Major safety-net hospitals, which play a substantial role in serving the uninsured and Medicaid, had some initial easing of this burden but their financial situation weakened through 2010. The U.S. economic recession and Massachusetts budget pressures, which in part resulted from reform implementation, likely offset advantages hospitals experienced from reductions in the uninsured. Our analysis suggests that state actions in Massachusetts to change payment programs that the two major safety net hospitals relied on to support indigent care contributed to their financial difficulties.

  16. The eastern Massachusetts sea breeze study

    NASA Astrophysics Data System (ADS)

    Thorp, Jennifer E.

    This study investigates many different aspects of the sea breeze at Logan Airport in Boston, Massachusetts (KBOS) and along the Massachusetts coastline. Part of the study adapts the method of predicting sea breeze events developed by Miller and Keim (2003) for Portsmouth, New Hampshire (KPSM) to KBOS. A nearly ten-year dataset of hourly KBOS surface observations (1998-2007) was used to identify 879 days when the sea breeze occurred or was likely to occur at the airport. These days were classified as sea breeze, marginal, or non-sea breeze events. Sea breeze events were further classified into fast and slow transitions, with a fast transition identified by a wind shift taking one hour or less to develop, and a slow transition identified by a wind shift taking two hours or more to develop. Marginal events were events that had a duration of 1 hour or less, no clear start or finish, or were interrupted by periods of "calm" or "light and variable" winds. Non-events were events in which the background conditions for a sea breeze to occur existed, but a sea breeze did not develop. Times of onset and event durations for the sea breeze events (fast, slow, and marginal) were calculated and used to create seasonal statistics by event type. It was found that seasonal variation did occur with both characteristics, but was more evident in the time of onset. Slow events occurred earliest in the day overall, while marginal events occurred a bit later, and fast events occurred the latest. Slow events had the longest duration overall, while marginal events, by definition, had the shortest duration. Seasonally, similar results were found for both characteristics with a few variations. United States surface analyses for each event at the time of onset (or average time of onset, 1500 UTC, for non-events) were classified using the seven synoptic classes developed by Miller and Keim (2003), and statistics were developed to evaluate the distribution of synoptic classes amongst the

  17. Massachusetts health care reform and reduced racial disparities in minimally invasive surgery.

    PubMed

    Loehrer, Andrew P; Song, Zirui; Auchincloss, Hugh G; Hutter, Matthew M

    2013-12-01

    Racial disparities in receipt of minimally invasive surgery (MIS) persist in the United States and have been shown to also be associated with a number of driving factors, including insurance status. However, little is known as to how expanding insurance coverage across a population influences disparities in surgical care. To evaluate the impact of Massachusetts health care reform on racial disparities in MIS. A retrospective cohort study assessed the probability of undergoing MIS vs an open operation for nonwhite patients in Massachusetts compared with 6 control states. All discharges (n = 167,560) of nonelderly white, black, or Latino patients with government insurance (Medicaid or Commonwealth Care insurance) or no insurance who underwent a procedure for acute appendicitis or acute cholecystitis at inpatient hospitals between January 1, 2001, and December 31, 2009, were assessed. Data are from the Hospital Cost and Utilization Project State Inpatient Databases. The 2006 Massachusetts health care reform, which expanded insurance coverage for government-subsidized, self-pay, and uninsured individuals in Massachusetts. Adjusted probability of undergoing MIS and difference-in-difference estimates. Prior to the 2006 reform, Massachusetts nonwhite patients had a 5.21-percentage point lower probability of MIS relative to white patients (P < .001). Nonwhite patients in control states had a 1.39-percentage point lower probability of MIS (P = .007). After reform, nonwhite patients in Massachusetts had a 3.71-percentage point increase in the probability of MIS relative to concurrent trends in control states (P = .01). After 2006, measured racial disparities in MIS resolved in Massachusetts, with nonwhite patients having equal probability of MIS relative to white patients (0.06 percentage point greater; P = .96). However, nonwhite patients in control states without health care reform have a persistently lower probability of MIS relative to white patients

  18. Massachusetts Health Care Reform and Reduced Racial Disparities in Minimally Invasive Surgery

    PubMed Central

    Loehrer, Andrew P.; Song, Zirui; Auchincloss, Hugh G.; Hutter, Matthew M.

    2014-01-01

    Importance Racial disparities in receipt of minimally invasive surgery (MIS) persist in the United States and have been shown to also be associated with a number of driving factors, including insurance status. However, little is known as to how expanding insurance coverage across a population influences disparities in surgical care. Objective To evaluate the impact of Massachusetts health care reform on racial disparities in MIS. Design, Setting, and Participants A retrospective cohort study assessed the probability of undergoing MIS vs an open operation for nonwhite patients in Massachusetts compared with 6 control states. All discharges (n = 167 560) of nonelderly white, black, or Latino patients with government insurance (Medicaid or Commonwealth Care insurance) or no insurance who underwent a procedure for acute appendicitis or acute cholecystitis at inpatient hospitals between January 1, 2001, and December 31, 2009, were assessed. Data are from the Hospital Cost and Utilization Project State Inpatient Databases. Intervention The 2006 Massachusetts health care reform, which expanded insurance coverage for government-subsidized, self-pay, and uninsured individuals in Massachusetts. Main Outcomes and Measures Adjusted probability of undergoing MIS and difference-in-difference estimates. Results Prior to the 2006 reform, Massachusetts nonwhite patients had a 5.21–percentage point lower probability of MIS relative to white patients (P < .001). Nonwhite patients in control states had a 1.39–percentage point lower probability of MIS (P = .007). After reform, nonwhite patients in Massachusetts had a 3.71–percentage point increase in the probability of MIS relative to concurrent trends in control states (P = .01). After 2006, measured racial disparities in MIS resolved in Massachusetts, with nonwhite patients having equal probability of MIS relative to white patients (0.06 percentage point greater; P = .96). However, nonwhite patients in control states without

  19. Risk selection in the Massachusetts State employee health insurance program.

    PubMed

    Yu, W; Ellis, R P; Ash, A

    2001-12-01

    Using the Diagnostic Cost Group (DCG) model developed from a national sample, we examine biased selection among one fee-for-service (FFS) plan, one preferred provider organization, and several health maintenance organizations (HMOs) in Massachusetts. The proportions of enrollees in low-risk groups are higher in the HMO plans and lower in the FFS plan. The average age in the FFS plan is 9 years greater than that in the HMO plans. Actual premiums are not consistent with risk levels among HMO plans, resulting in gains in some HMO plans and losses in others as high as 20% compared to expected expenses as computed by the DCG model.

  20. Massachusetts health reform and access for children with special health care needs.

    PubMed

    Smith, Anna Jo; Chien, Alyna T

    2014-08-01

    Children with special health care needs (CSHCN) face unique challenges in accessing affordable health care. Massachusetts implemented major health reform in 2006; little is known about the impact of this state's health reform on uninsurance, access to care, and financial protection for privately and publicly insured CSHCN. We used a difference-in-differences (DD) approach to compare uninsurance, access to primary and specialty care, and financial protection in Massachusetts versus other states and Washington, DC before and after Massachusetts health reform. Parent-reported data were used from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs and adjusted for age, gender, race/ethnicity, non-English language at home, and functional difficulties. Postreform, living in Massachusetts was not associated with significant decreases in uninsurance or increases in access to primary care for CSHCN. For privately insured CSHCN, Massachusetts was associated with increased access to specialists (DD = 6.0%; P ≤ .001) postreform. For publicly insured CSHCN, however, there was a significant decrease in access to prescription medications (DD = -7.2%; P = .003) postreform. Living in Massachusetts postreform was not associated with significant changes in financial protection compared with privately or publicly insured CSHCN in other states. Massachusetts health reform likely improved access to specialists for privately insured CSHCN but did not decrease instances of uninsurance, increase access to primary care, or improve financial protection for CSHCN in general. Comparable provisions within the Affordable Care Act may produce similarly modest outcomes for CSHCN. Copyright © 2014 by the American Academy of Pediatrics.

  1. What will become of the medical mecca? Health care spending in Massachusetts.

    PubMed

    Mechanic, Robert E

    2003-01-01

    Massachusetts has been called a "medical mecca." It has also been called the world's most expensive health care market. This paper concludes that claims of excess costs in Massachusetts are overstated. Massachusetts hospitals have lower inpatient costs than peer institutions in other states, yet the state's concentration of academic hospitals tilts the system toward higher spending. In markets like Massachusetts, there is growing pressure to demonstrate tangible benefits to justify the additional costs of academic health centers (AHCs). Applying new information technologies to proactively manage patients with expensive chronic illnesses is a critical area for future collaboration between payers and AHCs.

  2. Industry-Education Partnerships: Massachusetts Case Studies.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Education, Quincy. Office of Community Education.

    This document consists largely of descriptions of 15 industry-education partnerships in Massachusetts, selected on the basis of their creativity; the range of partnership organizations and activity they represent; the diversity of students, teachers, businesses, and communities they affect; and their innovative and efficient coordination and…

  3. Industry-Education Partnerships: Massachusetts Case Studies.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Education, Quincy. Office of Community Education.

    This document consists largely of descriptions of 15 industry-education partnerships in Massachusetts, selected on the basis of their creativity; the range of partnership organizations and activity they represent; the diversity of students, teachers, businesses, and communities they affect; and their innovative and efficient coordination and…

  4. Exploring Massachusetts Health Care Reform Impact on Fee-for-Service Funded Substance Use Disorder Treatment Providers

    PubMed Central

    Fields, Dail; Pruett, Jana; Roman, Paul M.

    2016-01-01

    The Affordable Care Act (ACA) is forecast to increase the demand for and utilization of substance use disorder (SUD) treatment. Massachusetts implemented health reforms similar to the ACA in 2006 -2007 that included expanding coverage for SUD treatment. This study explored the impact of Massachusetts health reforms from 2007 to 2010 on SUD treatment providers in Massachusetts, who relied on fee-for-service billings for more than 50% of their revenue. The changes across treatment facilities located in Massachusetts were compared to changes in other similar fee-for-service funded SUD treatment providers in Northeast states bordering Massachusetts and in all other states across the US. From 2007-2010, the percentage changes for Massachusetts based providers were significantly different from the changes among providers located in the rest of the US for admissions, outpatient census, average weeks of outpatient treatment, residential/in-patient census, detoxification census, length of average inpatient and outpatient stays, and provision of medication assisted treatment. Contrary to previous studies of publicly funded treatment providers, the results of this exploratory study of providers dependent on fee-for-service revenues were consistent with some predictions for the overall effects of the ACA PMID:26514378

  5. Exploring Massachusetts Health Care Reform Impact on Fee-for-Service-Funded Substance Use Disorder Treatment Providers.

    PubMed

    Fields, Dail; Pruett, Jana; Roman, Paul M

    2015-01-01

    The Affordable Care Act (ACA) is forecast to increase the demand for and utilization of substance use disorder (SUD) treatment. Massachusetts implemented health reforms similar to the ACA in 2006-2007 that included expanding coverage for SUD treatment. This study explored the impact of Massachusetts health reforms from 2007 to 2010 on SUD treatment providers in Massachusetts, who relied on fee-for-service billings for more than 50% of their revenue. The changes across treatment facilities located in Massachusetts were compared to changes in other similar fee-for-service-funded SUD treatment providers in Northeast states bordering Massachusetts and in all other states across the US. From 2007-2010, the percentage changes for Massachusetts based providers were significantly different from the changes among providers located in the rest of the US for admissions, outpatient census, average weeks of outpatient treatment, residential/in-patient census, detoxification census, length of average inpatient and outpatient stays, and provision of medication-assisted treatment. Contrary to previous studies of publicly funded treatment providers, the results of this exploratory study of providers dependent on fee-for-service revenues were consistent with some predictions for the overall effects of the ACA.

  6. The Impact of the Massachusetts Behavioral Health Child Screening Policy on Service Utilization.

    PubMed

    Hacker, Karen; Penfold, Robert; Arsenault, Lisa N; Zhang, Fang; Soumerai, Stephen B; Wissow, Lawrence S

    2017-01-01

    In 2008, Massachusetts Medicaid implemented a pediatric behavioral health (BH) screening mandate. This study conducted a population-level, longitudinal policy analysis to determine the impact of the policy on ambulatory, emergency, and inpatient BH care in comparison with use of these services in California, where no similar policy exists. With Medicaid Analytic Extract (MAX) data, an interrupted time-series analysis with control series design was performed to assess changes in service utilization in the 18 months (January 2008-June 2009) after a BH screening policy was implemented in Massachusetts and to compare service utilization with California's. Outcomes included population rates of BH screening, BH-related outpatient visits, BH-related emergency department visits, BH-related hospitalizations, and psychotropic drug use. Medicaid-eligible children from January 1, 2006, to December 31, 2009, with at least ten months of Medicaid eligibility who were older than 4.5 years and younger than 18 years were included. Compared with rates in California, Massachusetts rates of BH screening and BH-related outpatient visits rose significantly after Massachusetts implemented its screening policy. BH screening rose about 13 per 1,000 youths per month during the first nine months, and BH-related outpatient visits rose to about 4.5 per 1,000 youths per month (p<.001). Although BH-related emergency department visits, hospitalization and psychotropic drug use increased, there was no difference between the states in rate of increase. The goal of BH screening is to identify previously unidentified children with BH issues and provide earlier treatment options. The short-term outcomes of the Massachusetts policy suggest that screening at preventive care visits led to more BH-related outpatient visits among vulnerable children.

  7. "Operation Helping Hands": Massachusetts health and medical response to Hurricane Katrina.

    PubMed

    Condon, Suzanne; Savoia, Elena; Cadigan, Rebecca Orfaly; Getchell, Marya; Burstein, Jonathan L; Auerbach, Bruce; Koh, Howard K

    2010-01-01

    As Hurricane Katrina bore down on New Orleans in August 2005, the city's mandatory evacuation prompted the exodus of an estimated 80% of its 485,000 residents. According to estimates from the US Centers for Disease Control and Prevention (CDC), at least 18 states subsequently hosted more than 200,000 evacuees. In this case study, "Operation Helping Hands" (OHH), the Massachusetts health and medical response in assisting Hurricane Katrina evacuees is described. Operation Helping Hands represents the largest medical response to evacuees in recent Massachusetts history. The data describing OHH were derived from a series of structured interviews conducted with two leading public health officials directing planning efforts, and a sample of first responders with oversight of operations at the evacuation site. Also, a literature review was conducted to identify similar experiences, common challenges, and lessons learned. Activities and services were provided in the following areas: (1) administration and management; (2) medical and mental health; (3) public health; and (4) social support. This study adds to the knowledge base for future evacuation and shelter planning, and presents a conceptual framework that could be used by other researchers and practitioners to describe the process and outcomes of similar operations. This study provides a description of the planning and implementation efforts of the largest medical evacuee experience in recent Massachusetts history, an effort that involved multiple agencies and partners. The conceptual framework can inform future evacuation and shelter initiatives at the state and national levels, and promotes the overarching public health goal of the highest attainable standard of health for all.

  8. Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland

    PubMed Central

    Bernstein, Judith; Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul; Tinanoff, Norman

    2017-01-01

    Objectives To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. Sample Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format. Design Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care. Measurements Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively. Results Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records. Conclusions NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children. PMID:28360245

  9. Massachusetts health reform: employers, lower-wage workers and universal coverage.

    PubMed

    Felland, Laurie; Draper, Debra; Liebhaber, Allison

    2007-07-01

    As Massachusetts' landmark effort to reach nearly universal health coverage unfolds, the state is now focusing on employers to take steps to increase coverage. All employers--except firms with fewer than 11 workers--face new requirements under the 2006 law, including establishing Section 125, or cafeteria, plans to allow workers to purchase insurance with pre-tax dollars and paying a $295 annual fee if they do not make a "fair and reasonable" contribution to the cost of workers' coverage. Through interviews with Massachusetts health care leaders (see Data Source), the Center for Studying Health System Change (HSC) examined how the law is likely to affect employer decisions to offer health insurance to workers and employee decisions to purchase coverage. Market observers believe many small firms may be unaware of specific requirements and that some could prove onerous. Moreover, the largest impact on small employers may come from the individual mandate for all residents to have a minimum level of health insurance. This mandate may add costs for firms if more workers take up coverage offers, seek more generous coverage or pressure employers to offer coverage. Despite reform of the individual and small group markets, including development of new insurance products, concerns remain about the affordability of coverage and the ability to stem rising health care costs.

  10. A Model of Objectives for a Program of Continuing Education for Psychiatric Nurses in Community Mental Health Work in Massachusetts.

    ERIC Educational Resources Information Center

    Goodman, Lillian Rachel

    The purpose of this study was (1) to develop a model of required functions and effective behaviors of psychiatric nurses in mental health programs in Massachusetts and (2) to construct a model of objectives of a continuing education program for them. Perceptual data concerning functions of nurses were gathered by interviews with authorities,…

  11. Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

    PubMed

    Korenman, Sanders D; Remler, Dahlia K

    2016-12-01

    We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the health inclusive poverty rate.

  12. Does Health Reform Change Femoral Neck Fracture Care? A Natural Experiment in the State of Massachusetts.

    PubMed

    Schoenfeld, Andrew J; Weaver, Michael J; Power, Robyn K; Harris, Mitchel B

    2015-11-01

    To determine whether hospital processes and hospital quality associated with the care of femoral neck fractures were significantly altered by the implementation of healthcare reform in Massachusetts. Pre-post retrospective study. Massachusetts Statewide Inpatient Dataset (SID). Patients treated for femoral neck fracture (n = 23,485) in the periods prehealth (2003-06) and posthealth reform (2008-10). Differences in hospital processes for fracture care and quality measures were assessed for the periods before and after health reform. Differences in hospital processes for fracture care (type of surgical intervention, length of stay, and discharge disposition) and quality metrics [mortality, complications, re-operation, and failure to rescue (FTR)] in the periods before and after health reform were assessed using regression techniques to adjust for differences in case mix and the type of surgical intervention. There were no significant differences in the type of surgical intervention performed prereform and postreform (P = 0.27). After adjustment for case mix and surgical intervention, length of stay was significantly reduced {regression coefficient -0.07 [95% confidence interval (CI), -0.09 to -0.06]} as were the odds of FTR [odds ratio 0.73 (95% CI, 0.59-0.92)]. Discharges to skilled nursing facilities significantly increased in the postreform period [relative risk ratio 1.15 (95% CI, 1.03-1.30)]. Findings associated with FTR were driven by changes in the detection of surveillance sensitive complications. Health reform in Massachusetts led to no clinically meaningful differences in hospital processes for femoral neck fracture care. Although some differences in quality measures were noted, these cannot necessarily be attributed to health care reform.

  13. Increased use of the emergency department after health care reform in Massachusetts.

    PubMed

    Smulowitz, Peter B; O'Malley, James; Yang, Xiaowen; Landon, Bruce E

    2014-08-01

    With implementation of the Patient Protection and Affordable Care Act, 30 million individuals are predicted to gain access to health insurance. The experience in Massachusetts, which implemented a similar reform beginning in 2006, should provide important lessons about the effect of health care reform on emergency department (ED) utilization. Our objective is to understand the extent to which Massachusetts health care reform was associated with changes in ED utilization. We compared changes in ED utilization at the population level for individuals from areas of the state that were affected minimally by health care reform with those from areas that were affected the most, as well as for those younger than 65 years and aged 65 years or older. We used a difference-in-differences identification strategy to compare rates of ED visits in the prereform period, during the reform, and in the postreform period. Because we did not have population-level data on insurance status, we estimated area-level insurance rates by using the percentage of actual visits made during each period by individuals with insurance. We studied 13.3 million ED visits during 2004 to 2009. Increasing insurance coverage in Massachusetts was associated with increasing use of the ED; these results were consistent across all specifications, including the younger than 65 years versus aged 65 years or older comparison. Depending on the model used, the implementation of health care reform was estimated to result in an increase in ED visits per year of between 0.2% and 1.2% within reform and 0.2% and 2.2% postreform compared with the prereform period. The implementation of health care reform in Massachusetts was associated with a small but consistent increase in the use of the ED across the state. Whether this was due to the elimination of financial barriers to seeking care in the ED, a persistent shortage in access to primary care for those with insurance, or some other cause is not entirely clear and will

  14. Acculturation and a Potential Relationship with Oral Health Outcomes Among Somali Refugees in Massachusetts.

    PubMed

    Hunter-Adams, Jo; Cochran, Jennifer; Laird, Lance D; Paasche-Orlow, Michael K; Geltman, Paul L

    2017-08-31

    This paper explores the relationship between acculturation and oral health in a study of Somali refugees. This cross-sectional survey included structured surveys and dental examinations of a convenience sample of 439 Somali adults living in Massachusetts. Associations between an acculturation scale and: (1) lifetime history of caries and (2) access to oral health services were calculated. In bivariate analyses, many individual questions in the scale were associated with outcomes. In multivariate analysis, speaking English (OR 0.5, CI 0.28-0.84) was associated with better access to, and utilization of, dental health services while reading American books and newspapers in English was associated with increased lifetime history of dental disease (OR 2.6, CI 1.1-6.0). As specific elements of acculturation have different relationships with oral health among Somali refugees, a summary acculturation scale may have limited utility. Ongoing efforts to remove language barriers may improve oral health.

  15. Effects of Massachusetts health reform on the use of clinical preventive services.

    PubMed

    Okoro, Catherine A; Dhingra, Satvinder S; Coates, Ralph J; Zack, Matthew; Simoes, Eduardo J

    2014-09-01

    Expansion of health insurance coverage, and hence clinical preventive services (CPS), provides an opportunity for improvements in the health of adults. The degree to which expansion of health insurance coverage affects the use of CPS is unknown. To assess whether Massachusetts health reform was associated with changes in healthcare access and use of CPS. We used a difference-in-differences framework to examine change in healthcare access and use of CPS among working-aged adults pre-reform (2002-2005) and post-reform (2007-2010) in Massachusetts compared with change in other New England states (ONES). Population-based, cross-sectional Behavioral Risk Factor Surveillance System surveys. A total of 208,831 survey participants aged 18 to 64 years. Massachusetts health reform enacted in 2006. Four healthcare access measures outcomes and five CPS. The proportions of adults who had health insurance coverage, a healthcare provider, no cost barrier to healthcare, an annual routine checkup, and a colorectal cancer screening increased significantly more in Massachusetts than those in the ONES. In Massachusetts, the prevalence of cervical cancer screening in pre-reform and post-reform periods was about the same; however, the ONES had a decrease of -1.6 percentage points (95 % confidence interval [CI] -2.5, -0.7; p <0.001). As a result, the prevalence of cervical cancer screening in Massachusetts was increased relative to the ONES (1.7, 95 % CI 0.2, 3.2; p = 0.02). Cholesterol screening, influenza immunization, and breast cancer screening did not improve more in Massachusetts than in the ONES. Data are self-reported. Health reform may increase healthcare access and improve use of CPS. However, the effects of health reform on CPS use may vary by type of service and by state.

  16. Winning Policy Change to Promote Community Health Workers: Lessons From Massachusetts in The Health Reform Era

    PubMed Central

    Mason, Terry; Wilkinson, Geoffrey W.; Nannini, Angela; Martin, Cindy Marti; Fox, Durrell J.

    2011-01-01

    There is a national movement among community health workers (CHWs) to improve compensation, working conditions, and recognition for the workforce through organizing for policy change. As some of the key advocates involved, we describe the development in Massachusetts of an authentic collaboration between strong CHW leaders of a growing statewide CHW association and their public health allies. Collaborators worked toward CHW workforce and public health objectives through alliance building and organizing, legislative advocacy, and education in the context of opportunities afforded by health care reform. This narrative of the path to policy achievements can inform other collaborative efforts attempting to promote a policy agenda for the CHW workforce across the nation. PMID:22021281

  17. Winning policy change to promote community health workers: lessons from massachusetts in the health reform era.

    PubMed

    Mason, Terry; Wilkinson, Geoffrey W; Nannini, Angela; Martin, Cindy Marti; Fox, Durrell J; Hirsch, Gail

    2011-12-01

    There is a national movement among community health workers (CHWs) to improve compensation, working conditions, and recognition for the workforce through organizing for policy change. As some of the key advocates involved, we describe the development in Massachusetts of an authentic collaboration between strong CHW leaders of a growing statewide CHW association and their public health allies. Collaborators worked toward CHW workforce and public health objectives through alliance building and organizing, legislative advocacy, and education in the context of opportunities afforded by health care reform. This narrative of the path to policy achievements can inform other collaborative efforts attempting to promote a policy agenda for the CHW workforce across the nation.

  18. Forest Health Monitoring in Massachusetts, 1996-1999

    Treesearch

    Northeastern Research Station

    2002-01-01

    Massachusetts has mature forests dominated by hardwood species. Most of the trees are healthy, with full crowns (low transparency, high density), little dieback and little damage. Red maple trees made up almost one quarter of the trees and had slightly higher amounts of dieback, thinner crowns, and more damage than other common tree species.

  19. Women and health reform: how national health care can enhance coverage, affordability, and access for women (examples from massachusetts).

    PubMed

    Fitzgerald, Therese; Cohen, Laura; Hyams, Tracey; Sullivan, Katherine M; Johnson, Paula A

    2014-01-01

    Massachusetts women have the highest rates of health insurance coverage in the nation and women's access to care has improved across all demographic groups. However, important challenges persist. As national health reform implementation moves forward under the Affordable Care Act (ACA), states will likely encounter many of the same women's health challenges experienced in Massachusetts over the past 7 years. A review of the literature and data analyses comparing health care services access, utilization, and cost, and health outcomes from Massachusetts pre- and post-2006 health care reform identified two key challenges in women's continuity of coverage and affordability. These areas are crucial for state and national policymakers to consider in improving women's health as they work to implement health care reform at the state and federal levels. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  20. Behavioral health care for children: the massachusetts child psychiatry access project.

    PubMed

    Straus, John H; Sarvet, Barry

    2014-12-01

    Access to behavioral health care for children is essential to achieving good health care outcomes. Pediatric primary care providers have an essential role to play in identifying and treating behavioral health problems in children. However, they lack adequate training and resources and thus have generally been unable to meet children's need for behavioral health care. The Massachusetts Child Psychiatry Access Project has addressed this problem by delivering telephone child psychiatry consultations and specialized care coordination support to over 95 percent of the pediatric primary care providers in Massachusetts. Established in 2004, the project consists of six regional hubs, each of which has one full-time-equivalent child psychiatrist, licensed therapist, and care coordinator. Collectively, the hubs are available to over 95 percent of the 1.5 million children in Massachusetts. In fiscal year 2013 the Massachusetts Child Psychiatry Access Project served 10,553 children. Pediatric primary care providers enrolled in the project reported a dramatic improvement in their ability to meet the psychiatric needs of their patients. Telephone child psychiatry consultation programs for pediatric primary care providers, many modeled after the Massachusetts project, have spread across the United States.

  1. The Association of Health Reform and Infant Health: Evidence from Massachusetts.

    PubMed

    Boudreaux, Michel H; Dagher, Rada K; Lorch, Scott A

    2017-10-02

    To estimate whether the incidence of low birthweight and rates of infant mortality were associated with Massachusetts health reform in the overall population and for subgroups that are at higher risk for poor health outcomes. Individual-level data on birthweight were obtained from the National Center for Health Statistics detailed natality files, and aggregated county-level mortality rates were generated from linked birth-death files. We used restricted versions of each file that had intact state and substate geographic identifiers. We employed a quasi-experimental difference-in-differences design. We found small and statistically nonsignificant associations between the reform and the incidence of low birthweight and infant mortality rates. Results were consistent across a number of subgroups and were robust to alternative comparison groups and alternative modeling assumptions. We found no evidence that the Massachusetts reform was associated with improvements in individual low birthweights or county-level infant mortality rates, despite increasing health insurance coverage rates for adult women of child-bearing age. Because our mortality analysis was ecological, we are not able to draw conclusions about how an individual-level health insurance intervention for uninsured pregnant women would affect the mortality outcomes of their infants. © Health Research and Educational Trust.

  2. The Preventive Health and Health Services Block Grant: the Massachusetts experience.

    PubMed Central

    Havas, S; Blik, C

    1987-01-01

    The Preventive Health and Health Services Block Grant funds a variety of disparate programs in health promotion and disease prevention. Many of these programs were funded by categorical grants to the States prior to the creation of this block grant in 1981. This block grant allows States to set priorities among the different programs by shifting their funding allocations. In addition, there is considerable opportunity to use these funds creatively in shaping the content of their programs. The Massachusetts Department of Public Health's experience with this block grant is reviewed, showing the grant's critical importance in the department's statewide disease prevention efforts. In order to maximize public health impact, the department has shifted its funding allocations based on explicit criteria. These criteria represent a model that may have widespread applicability for other State health departments. PMID:3108944

  3. Disparities in access to healthy and unhealthy foods in central Massachusetts: implications for public health policy.

    PubMed

    Olendzki, Barbara C; Procter-Gray, Elizabeth; Wedick, Nicole M; Patil, Vijayalakshmi; Zheng, Hua; Kane, Kevin; Land, Thomas; Li, Wenjun

    2015-01-01

    To analyze geographic and income disparities in access to healthy foods in central Massachusetts. We surveyed 106 (92% of all) food stores longitudinally in the study area between 2007 and 2010. We analyzed the geographic and temporal variations in community- and store-level healthy food availability indices (HFAI) and unhealthy food availability indices (UFAI) overall and by select store and community characteristics. Twenty-seven of 68 communities in the study area (39.7%) had no food store and 5 (8.3%) had one or few stores with very limited availability of healthy foods, affecting 23.7% of the county population. Lack of food stores was associated strongly with lower housing density and upper tertile of median household income. About 45% of the surveyed stores had inadequate availabilities of healthy food. Store-level HFAI and UFAI scores were highly correlated, and higher among larger stores affiliated with a chain (vs independent). Though healthy foods were usually most available in larger stores, unhealthy foods were widely available in all stores. Over half of central Massachusetts communities, mostly rural and small, had either no food store or few stores with limited availabilities of healthy foods. Immediate policy interventions on the food environment are necessary in these communities. Further, without examining what is actually sold in stores, analysis of disparities in access to healthy food relies on the number of food stores, which can lead to a distorted picture of accessibility and mislead community health policies.

  4. Understanding the Decisions and Values of Stakeholders in Health Information Exchanges: Experiences From Massachusetts

    PubMed Central

    Simon, Steven R.; Volk, Lynn A.; Tripathi, Micky; Bates, David

    2009-01-01

    Objectives. We studied how health information exchange systems are established by examining the decisions (and thus, indirectly, the values) of key stakeholders (health care providers) participating in a health information exchange pilot project in 3 Massachusetts communities. Our aim was to understand how these kinds of information exchanges can be made viable. Methods. We used semistructured interviews to assess health care providers' decision-making processes in selecting technical architectures and vendors for the pilot projects to uncover their needs, expectations, and motivations. Results. Our interviews indicated that, after extensive evaluations, health care providers in all 3 communities eventually selected a hybrid architecture that included a central data repository. However, the reasons for selecting this architecture varied considerably among the 3 communities, reflecting their particular values. Plans to create a community patient portal also differed across communities. Conclusions. Our findings suggest that, to become established, health information exchange efforts must foster trust, appeal to strategic interests of the medical community as a whole, and meet stakeholder expectations of benefits from quality measurements and population health interventions. If health information exchange organizations cannot address these factors, sustainability will remain precarious. PMID:19299671

  5. Cape queer? A case study of Provincetown, Massachusetts.

    PubMed

    Krahulik, Karen Christel

    2006-01-01

    Cape Queer is a case study that details how sexuality intersects with race, gender, and class in the development of the gay and lesbian resort community, Provincetown, Massachusetts. It asks scholars to pay closer attention to the ways in which methodologies and practices utilizing LGBT studies and queer theory can combine rather than separate to interrogate LGBT and queer histories, politics and communities. In the process, it assesses how the global mechanics of capitalism led to the local queering and eventually un-queering of a gentrified, white, gay and lesbian enclave.

  6. Impact of Subsidized Health Insurance Coverage on Emergency Department Utilization by Low-income Adults in Massachusetts.

    PubMed

    Lee, Jennifer; Ding, Ru; Zeger, Scott L; McDermott, Aidan; Habteh-Yimer, Getachew; Chin, Michael; Balder, Rebecca S; McCarthy, Melissa L

    2015-01-01

    In 2006, Massachusetts expanded insurance coverage to many low-income individuals. This study aimed to estimate the change in emergency department (ED) utilization per individual among a cohort who qualified for subsidized health insurance following the Massachusetts health care reform. We obtained Massachusetts public health insurance enrollment data for the fiscal years 2004-2008 and identified 353,515 adults who enrolled in Commonwealth Care, a program that subsidizes insurance for low-income adults. We merged the enrollment data with statewide ED visit claims and created a longitudinal file that indicated each enrollee's ED visits and insurance status each month during the preenrollment and postenrollment periods. We estimated the ratio in an individual's odds of an ED visit during the postperiod versus preperiod by conditional logistic regression. Among the 112,146 CommCare enrollees who made at least 1 ED visit during the study period, an individual's odds of an ED visit decreased 4% [odds ratio (OR)=0.96; 95% confidence interval (CI), 0.94, 0.98] postenrollment. However, it varied significantly depending on preenrollment insurance status. A person's odds of an ED visit was 12% higher in the postperiod among enrollees not publicly insured prior (OR=1.12; 95% CI, 1.10, 1.25), but was 18% lower among enrollees who transitioned from the Health Safety Net, a program that pays for limited services for low-income individuals (OR=0.82; 95% CI, 0.78, 0.85). Expanding subsidized health insurance did not uniformly change ED utilization for all newly insured low-income adults in Massachusetts.

  7. Massachusetts Institute of Technology Security Studies Program

    DTIC Science & Technology

    2006-01-01

    CNBC’s “Strategy Session” and “The Wall Street Journal Report.” His most recent book, co-authored with Gregory T. Huang, Guanxi (The Art of...World War II: Was Spykman Right?” Security Studies, December 2005. Robert Buderi/Gregory T. Huang, Guanxi (The Art of Relationships): Microsoft, China

  8. Effect of Massachusetts health insurance reform on mammography use and breast cancer stage at diagnosis.

    PubMed

    Keating, Nancy L; Kouri, Elena M; He, Yulei; West, Dee W; Winer, Eric P

    2013-01-15

    Massachusetts law requires all residents to maintain a minimum level of health insurance, and rates of uninsurance in that state decreased from 6.4% in 2006 to 1.9% in 2010. The authors of this report assessed whether health insurance expansion was associated with use of mammography and earlier stage at breast cancer diagnosis. By using a prereform/postreform design with a concurrent control (California), mammography rates in the last year were assessed using the Behavioral Risk Factor Surveillance System survey and the diagnosis of stage I (vs II/III/IV) breast cancers based on cancer registry data among women ages 41 to 64. Propensity score analyses were used to compare California women who were most similar to women in Massachusetts with Massachusetts women. Among propensity-weighted cohorts, adjusted mammography rates in Massachusetts were 69.2% in 2006, 69.5% in 2008, and 69.0% in 2010. In California, the rates were 59% in 2006, 60.3% in 2008, and 56.2% in 2010 (P = .89 for interaction by state for 2010 vs 2006). Among propensity-weighted cohorts, adjusted rates of diagnosis with stage I cancers were 52.2% in 2006, 53.5% in 2007, and 52.4% in 2008 in Massachusetts versus 46.4% in 2006, 46.3% in 2007, and 45.7% in 2008 in California (P = .58 for interaction by state for 2010 vs 2006). Health insurance reform in Massachusetts was not associated with increased rates of mammography or earlier stage at diagnosis compared with California, possibly because of insurance and mammography rates that already were high. Additional research is needed to assess the impact of insurance expansions in other populations, especially those with higher uninsurance rates. Copyright © 2012 American Cancer Society.

  9. The accountable health care act of Massachusetts: mixed results for an experiment in universal health care coverage.

    PubMed

    Norbash, Alexander; Hindson, David; Heineke, Janelle

    2012-10-01

    The affordable health care act of Massachusetts, signed into law in 2006, resulted in 98% of Massachusetts residents' having some form of insurance coverage by 2011, the highest coverage rate for residents of any state in the nation. With a strong economy, a low unemployment rate, a robust health care delivery system, an extremely low number of undocumented immigrants, and a low baseline uninsured rate, Massachusetts was well positioned for such an effort. Ingredients included mandates, the creation of separate insurance vehicles directed to both poverty-level and non-poverty-level residents, and the reallocation of the former free care pool. The mandates included consumer mandates and employer mandates; the consumer mandate applies to all Massachusetts residents at the risk of losing personal state tax exemptions, and the employer mandate applies to all Massachusetts businesses with 10 or more employees at the risk of per employee financial penalties. The insurance vehicles were created with premiums allocated on the basis of ability to pay by income classes. Unexpected effects included escalating taxpayer health care costs, with taxpayers shouldering the burden for the newly insured, continuing escalating health care costs at a rate greater than the national average, overburdening primary caregivers as newly insured sought new primary care gatekeepers in a system with primary caregiver shortages, and deprivation of support to the safety-net hospitals as a result of siphoned commonwealth free care pool funds. This exercise demonstrates specific benefits and shortfalls of the Massachusetts health care reform experiment, given the conditions and circumstances found in Massachusetts at the time of implementation.

  10. Health reform in Massachusetts increased adult dental care use, particularly among the poor.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko

    2013-09-01

    States frequently expand or limit dental benefits for adults covered by Medicaid. As part of statewide health reform in 2006, Massachusetts expanded dental benefits to all adults ages 19-64 whose annual income was at or below 100 percent of the federal poverty level. We examined the impact of this reform and found that it led to an increase in dental care use among the Massachusetts adult population, driven by gains among poor adults. Compared to the prereform period, dental care use increased by 2.9 percentage points among all nonelderly adults in Massachusetts, relative to all nonelderly adults in eight control states. For poor Massachusetts adults, the effect was larger-an eleven-percentage-point increase in dental care use above the increase among the state's nonpoor residents. The Massachusetts experience provides evidence that providing dental benefits to poor adults through Medicaid can improve dental care access and use. Our results imply that the lack of expanded dental coverage for low-income adults under the Affordable Care Act is a missed opportunity to improve access to oral care.

  11. Hospital Utilization and Universal Health Insurance Coverage: Evidence from the Massachusetts Health Care Reform Act.

    PubMed

    Cseh, Attila; Koford, Brandon C; Phelps, Ryan T

    2015-12-01

    The Affordable Care Act is currently in the roll-out phase. To gauge the likely implications of the national policy we analyze how the Massachusetts Health Care Reform Act impacted various hospitalization outcomes in each of the 25 major diagnostic categories (MDC). We utilize a difference-in-difference approach to identify the impact of the Massachusetts reform on insurance coverage and patient outcomes. This identification is achieved using six years of data from the Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project. We report MDC-specific estimates of the impact of the reform on insurance coverage and type as well as length of stay, number of diagnoses, and number of procedures. The requirement of universal insurance coverage increased the probability of being covered by insurance. This increase was in part a result of an increase in the probability of being covered by Medicaid. The percentage of admissions covered by private insurance fell. The number of diagnoses rose as a result of the law in the vast majority of diagnostic categories. Our results related to length of stay suggest that looking at aggregate results hides a wealth of information. The most disparate outcomes were pregnancy related. The length of stay for new-born babies and neonates rose dramatically. In aggregate, this increase serves to mute decreases across other diagnoses. Also, the number of procedures fell within the MDCs for pregnancy and child birth and that for new-born babies and neonates. The Massachusetts Health Care Reform appears to have been effective at increasing insurance take-up rates. These increases may have come at the cost of lower private insurance coverage. The number of diagnoses per admission was increased by the policy across nearly all MDCs. Understanding the changes in length of stay as a result of the Massachusetts reform, and perhaps the Affordable Care Act, requires MDC-specific analysis. It appears that the most important distinction

  12. Barriers to contraceptive access after health care reform: experiences of young adults in Massachusetts.

    PubMed

    Bessett, Danielle; Prager, Joanna; Havard, Julia; Murphy, Danielle J; Agénor, Madina; Foster, Angel M

    2015-01-01

    To explore how Massachusetts' 2006 health insurance reforms affected access to sexual and reproductive health (SRH) services for young adults. We conducted 11 focus group discussions across Massachusetts with 89 women and men aged 18 to 26 in 2009. Most young adults' primary interaction with the health system was for contraceptive and other SRH services, although they knew little about these services. Overall, health insurance literacy was low. Parents were primary decision makers in health insurance choices or assisted their adult children in choosing a plan. Ten percent of our sample was uninsured at the time of the discussion; a lack of knowledge about provisions in Chapter 58 rather than calculated risk analysis characterized periods of uninsurance. The dynamics of being transitionally uninsured, moving between health plans, and moving from a location defined by insurance companies as the coverage area limited consistent access to contraception. Notably, staying on parents' insurance through extended dependency, a provision unique to the post-reform context, had implications for confidentiality and access. Young adults' access to and utilization of contraceptive services in the post-reform period were challenged by unanticipated barriers related to information and privacy. The experience in Massachusetts offers instructive lessons for the implementation of national health care reform. Young adult-targeted efforts should address the challenges of health service utilization unique to this population. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  13. The time is now: tackling racial and ethnic disparities in mental and behavioral health services in Massachusetts.

    PubMed

    Alegría, Margarita; Cook, Benjamin; Loder, Stephen; Doonan, Michael

    2014-12-11

    Massachusetts is in the midst of a demographic shift that will leave the state with unprecedented ethnic, racial and cultural diversity. In light of this change, health care services in the Commonwealth need to respond to and serve an increasingly multicultural population. The time is now for bold initiatives to reduce behavioral health and health service disparities by building collaborations between policymakers, insurers/payers, provider organizations, training institutions, and community groups. In the same way collaboration among diverse stakeholders enabled the Commonwealth to lead the nation in achieving near universal access to health insurance, a new collaboration can pave the way for the elimination of behavioral health and health care disparities. This brief compiles current information on racial and ethnic disparities in mental health and substance use disorders and treatment disparities in Massachusetts. It concludes with state level policy recommendations. The Brief does not recommend policies already in motion, such as moving to universal insurance coverage, enforcement of parity laws, policies to expand coverage of drug treatment services or greater inclusion of consumers in the development and configuration of behavioral health services. Recommendations offered are based on best practices and evidence-based research. Most research, however, studies incremental changes. To transform rather than reform the system, we integrate consideration of experience and research from other policy areas. The ultimate goal is to generate an action plan that motivates policymakers to address persistent racial and ethnic disparities in the availability and quality of behavioral health services in the Commonwealth.

  14. Impact of the 2006 Massachusetts health care insurance reform on neurosurgical procedures and patient insurance status.

    PubMed

    Villelli, Nicolas W; Das, Rohit; Yan, Hong; Huff, Wei; Zou, Jian; Barbaro, Nicholas M

    2017-01-01

    OBJECTIVE The Massachusetts health care insurance reform law passed in 2006 has many similarities to the federal Affordable Care Act (ACA). To address concerns that the ACA might negatively impact case volume and reimbursement for physicians, the authors analyzed trends in the number of neurosurgical procedures by type and patient insurance status in Massachusetts before and after the implementation of the state's health care insurance reform. The results can provide insight into the future of neurosurgery in the American health care system. METHODS The authors analyzed data from the Massachusetts State Inpatient Database on patients who underwent neurosurgical procedures in Massachusetts from 2001 through 2012. These data included patients' insurance status (insured or uninsured) and the numbers of procedures performed classified by neurosurgical procedural codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Each neurosurgical procedure was grouped into 1 of 4 categories based on ICD-9-CM codes: 1) tumor, 2) other cranial/vascular, 3) shunts, and 4) spine. Comparisons were performed of the numbers of procedures performed and uninsured patients, before and after the implementation of the reform law. Data from the state of New York were used as a control. All data were controlled for population differences. RESULTS After 2008, there were declines in the numbers of uninsured patients who underwent neurosurgical procedures in Massachusetts in all 4 categories. The number of procedures performed for tumor and spine were unchanged, whereas other cranial/vascular procedures increased. Shunt procedures decreased after implementation of the reform law but exhibited a similar trend to the control group. In New York, the number of spine surgeries increased, as did the percentage of procedures performed on uninsured patients. Other cranial/vascular procedures decreased. CONCLUSIONS After the Massachusetts health care

  15. Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

    PubMed

    Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

    2015-10-29

    Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

  16. Mandate-based health reform and the labor market: Evidence from the Massachusetts reform.

    PubMed

    Kolstad, Jonathan T; Kowalski, Amanda E

    2016-05-01

    We model the labor market impact of the key provisions of the national and Massachusetts "mandate-based" health reforms: individual mandates, employer mandates, and subsidies. We characterize the compensating differential for employer-sponsored health insurance (ESHI) and the welfare impact of reform in terms of "sufficient statistics." We compare welfare under mandate-based reform to welfare in a counterfactual world where individuals do not value ESHI. Relying on the Massachusetts reform, we find that jobs with ESHI pay $2812 less annually, somewhat less than the cost of ESHI to employers. Accordingly, the deadweight loss of mandate-based health reform was approximately 8 percent of its potential size. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Mandate-Based Health Reform and the Labor Market: Evidence from the Massachusetts Reform*

    PubMed Central

    Kolstad, Jonathan T.; Kowalski, Amanda E.

    2016-01-01

    We model the labor market impact of the key provisions of the national and Massachusetts “mandate-based” health reforms: individual mandates, employer mandates, and subsidies. We characterize the compensating differential for employer-sponsored health insurance (ESHI) and the welfare impact of reform in terms of “sufficient statistics.” We compare welfare under mandate-based reform to welfare in a counterfactual world where individuals do not value ESHI. Relying on the Massachusetts reform, we find that jobs with ESHI pay $2,812 less annually, somewhat less than the cost of ESHI to employers. Accordingly, the deadweight loss of mandate-based health reform was approximately 8 percent of its potential size. PMID:27037897

  18. Barriers to Routine HIV Testing Among Massachusetts Community Health Center Personnel

    PubMed Central

    Mimiaga, Matthew J.; Johnson, Carey V.; Reisner, Sari L.; VanDerwarker, Rodney; Mayer, Kenneth H.

    2011-01-01

    Objectives We assessed the extent to which Centers for Disease Control and Prevention (CDC) recommendations have influenced routine HIV testing among Massachusetts community health center (CHC) personnel, and identified specific barriers and facilitators to routine testing. Methods Thirty-one CHCs were enrolled in the study. We compared those that did and did not receive funding support from the federal Ryan White HIV/AIDS Program. An anonymous survey was administered to a maximum five personnel from each CHC, including a senior administrator, the medical director, and three medical providers. Overall, 137 participants completed the survey. Results Among all CHCs, 53% of administrators reported having implemented routine HIV testing at their CHCs; however, only 33% of medical directors/providers reported having implemented routine HIV testing in their practices (p<0.05). Among administrators, 60% of those from Ryan White-supported CHCs indicated that both they and their CHCs were aware of CDC's recommendations, compared with 27% of administrators from non-Ryan White-supported CHCs. The five most frequently reported barriers to the implementation of routine HIV testing were (1) constraints on providers' time (68%), (2) time required to administer counseling (65%), (3) time required to administer informed consent (52%), (4) lack of funding (35%), and (5) need for additional training (34%). In a multivariable logistic regression model, the provision of on-site HIV testing by nonmedical staff resulted in increased odds of conducting routine HIV testing (odds ratio [OR] = 9.84, 95% confidence interval [CI] 1.77, 54.70). However, the amount of time needed to administer informed consent was associated with decreased odds of providing routine testing (OR=0.21, 95% CI 0.05, 0.92). Conclusions Routine HIV testing is not currently being implemented uniformly among Massachusetts CHCs. Future efforts to increase implementation should address personnel concerns regarding time

  19. Data from studies of previous radioactive waste disposal in Massachusetts Bay

    SciTech Connect

    Curtis, W.R.; Mardis, H.M.

    1984-12-01

    This report presents the results of studies conducted in Massachusetts Bay during 1981 and 1982. Included are data from: (1) a side scan sonar survey of disposal areas in the Bay that was carried out by the National Oceanic and Atmospheric Administration (NOAA) for EPA; (2) Collections of sediment and biota by NOAA for radiochemical analysis by EPA; (3) collections of marketplace seafood samples by the Food and Drug Administration (FDA) for radioanalysis by both FDA and EPA; and (4) a radiological monitoring survey of LLW disposal areas by EPA to determine whether there should be any concern for public health resulting from previous LLW disposals in the Bay.

  20. Sediment studies in the Assabet River, central Massachusetts, 2003

    USGS Publications Warehouse

    Zimmerman, Marc J.; Sorenson, Jason R.

    2005-01-01

    From its headwaters in Westborough, Massachusetts, to its confluence with the Sudbury River, the 53-kilometer-long Assabet River passes through a series of small towns and mixed land-use areas. Along the way, wastewater-treatment plants release nutrient-rich effluents that contribute to the eutrophic state of this waterway. This condition is most obvious where the river is impounded by a series of dams that have sequestered large amounts of sediment and support rooted and floating macrophytes and epiphytic algae. The water in parts of these impoundments may also have low concentrations of dissolved oxygen, another symptom of eutrophication. All of the impoundments had relatively shallow maximum water depths, which ranged from approximately 2.4 to 3.4 meters, and all had extensive shallow areas. Sediment volumes estimated for the six impoundments ranged from approximately 380 cubic meters in the Aluminum City impoundment to 580,000 cubic meters in the Ben Smith impoundment. The other impoundments had sediment volumes of 120,000 cubic meters (Powdermill), 67,000 cubic meters (Gleasondale), 55,000 cubic meters (Hudson), and 42,000 cubic meters (Allen Street). The principal objective of this study was the determination of sediment volume, extent, and chemistry, in particular, the characterization of toxic inorganic and organic chemicals in the sediments. To determine the bulk-sediment chemical-constituent concentrations, more than one hundred sediment cores were collected in pairs from the six impoundments. One core from each pair was sampled for inorganic constituents and the other for organic constituents. Most of the cores analyzed for inorganics were sectioned to provide information on the vertical distribution of analytes; a subset of the cores analyzed for organics was also sectioned. Approximately 200 samples were analyzed for inorganic constituents and 100 for organics; more than 10 percent were quality-control replicate or blank samples. Maximum bulk

  1. What Can Massachusetts Teach Us about National Health Insurance Reform?

    ERIC Educational Resources Information Center

    Couch, Kenneth A., Ed.; Joyce, Theodore J., Ed.

    2011-01-01

    The Patient Protection and Affordable Care Act (PPACA) is the most significant health policy legislation since Medicare in 1965. The need to address rising health care costs and the lack of health insurance coverage is widely accepted. Health care spending is approaching 17 percent of gross domestic product and yet 45 million Americans remain…

  2. What Can Massachusetts Teach Us about National Health Insurance Reform?

    ERIC Educational Resources Information Center

    Couch, Kenneth A., Ed.; Joyce, Theodore J., Ed.

    2011-01-01

    The Patient Protection and Affordable Care Act (PPACA) is the most significant health policy legislation since Medicare in 1965. The need to address rising health care costs and the lack of health insurance coverage is widely accepted. Health care spending is approaching 17 percent of gross domestic product and yet 45 million Americans remain…

  3. Health care IT collaboration in Massachusetts: the experience of creating regional connectivity.

    PubMed

    Halamka, John; Aranow, Meg; Ascenzo, Carl; Bates, David; Debor, Greg; Glaser, John; Goroll, Allan; Stowe, Jim; Tripathi, Micky; Vineyard, Gordon

    2005-01-01

    The state of Massachusetts has significant early experience in planning for and implementing interoperability networks for exchange of clinical and financial data. Members of our evolving data-sharing organizations gained valuable experience that is of potential benefit to others regarding the governance, policies, and technologies underpinning regional health information organizations. We describe the history, roles, and evolution of organizations and their plans for and success with pilot projects.

  4. Change in Health Insurance Coverage in Massachusetts and Other New England States by Perceived Health Status: Potential Impact of Health Reform

    PubMed Central

    Zack, Matthew M.; Strine, Tara W.; Druss, Benjamin G.; Simoes, Eduardo

    2013-01-01

    Objectives. We examined the impact of Massachusetts health reform and its public health component (enacted in 2006) on change in health insurance coverage by perceived health. Methods. We used 2003–2009 Behavioral Risk Factor Surveillance System data. We used a difference-in-differences framework to examine the experience in Massachusetts to predict the outcomes of national health care reform. Results. The proportion of adults aged 18 to 64 years with health insurance coverage increased more in Massachusetts than in other New England states (4.5%; 95% confidence interval [CI] = 3.5%, 5.6%). For those with higher perceived health care need (more recent mentally and physically unhealthy days and activity limitation days [ALDs]), the postreform proportion significantly exceeded prereform (P < .001). Groups with higher perceived health care need represented a disproportionate increase in health insurance coverage in Massachusetts compared with other New England states—from 4.3% (95% CI = 3.3%, 5.4%) for fewer than 14 ALDs to 9.0% (95% CI = 4.5%, 13.5%) for 14 or more ALDs. Conclusions. On the basis of the Massachusetts experience, full implementation of the Affordable Care Act may increase health insurance coverage especially among populations with higher perceived health care need. PMID:23597359

  5. Change in health insurance coverage in Massachusetts and other New England States by perceived health status: potential impact of health reform.

    PubMed

    Dhingra, Satvinder S; Zack, Matthew M; Strine, Tara W; Druss, Benjamin G; Simoes, Eduardo

    2013-06-01

    We examined the impact of Massachusetts health reform and its public health component (enacted in 2006) on change in health insurance coverage by perceived health. We used 2003-2009 Behavioral Risk Factor Surveillance System data. We used a difference-in-differences framework to examine the experience in Massachusetts to predict the outcomes of national health care reform. The proportion of adults aged 18 to 64 years with health insurance coverage increased more in Massachusetts than in other New England states (4.5%; 95% confidence interval [CI] = 3.5%, 5.6%). For those with higher perceived health care need (more recent mentally and physically unhealthy days and activity limitation days [ALDs]), the postreform proportion significantly exceeded prereform (P < .001). Groups with higher perceived health care need represented a disproportionate increase in health insurance coverage in Massachusetts compared with other New England states--from 4.3% (95% CI = 3.3%, 5.4%) for fewer than 14 ALDs to 9.0% (95% CI = 4.5%, 13.5%) for 14 or more ALDs. On the basis of the Massachusetts experience, full implementation of the Affordable Care Act may increase health insurance coverage especially among populations with higher perceived health care need.

  6. Transgender Health in Massachusetts: Results From a Household Probability Sample of Adults

    PubMed Central

    Scott, Gunner; Stowell, Grace Sterling; Landers, Stewart J.

    2012-01-01

    Despite higher rates of unemployment and poverty among transgender adults (n = 131; 0.5% weighted) than among nontransgender adults (n = 28 045) in our population-based Massachusetts household sample, few health differences were observed between transgender and nontransgender adults. Transgender adults who are stably housed and participated in a telephone health survey may represent the healthiest segment of the transgender population. Our findings demonstrate a need for diverse sampling approaches to monitor transgender health, including adding transgender measures to population-based surveys, and further highlight economic inequities that warrant intervention. PMID:22095354

  7. Report from Massachusetts: employers largely support health care reform, and few signs of crowd-out appear.

    PubMed

    Gabel, Jon R; Whitmore, Heidi; Pickreign, Jeremy

    2008-01-01

    Based on a 2007 survey of 1,056 randomly selected Massachusetts firms, this paper presents findings about employers' attitudes about, knowledge of, and responses to recently enacted reform legislation. A majority of Massachusetts employers agree that all employers bear some responsibility for providing health benefits, firms not offering benefits should be required to pay a "fair share" contribution up to $295 annually per employee, and employers with ten or fewer employees should not be exempt from this requirement. Only 24 percent of employers with 3-50 workers are familiar with the Connector purchasing pool. About 3 percent of Massachusetts small employers intend to drop coverage, similar to national figures.

  8. Tobacco companies’ efforts to undermine ingredient disclosure: the Massachusetts benchmark study

    PubMed Central

    Velicer, Clayton; Aguinaga-Bialous, Stella; Glantz, Stanton

    2015-01-01

    Objectives To assess the Massachusetts Benchmark ‘Study’ (MBS) that the tobacco companies presented to the Massachusetts Department of Public Health (MDPH) in 1999 in response to ingredient disclosure regulations in the state. This case study can inform future ingredient disclosure regulations, including implementation of Articles 9 and 10 of the WHO Framework Convention on Tobacco Control (FCTC). Methods We analysed documents available at http://legacy.library.ucsf.edu to identify internal communications regarding the design and execution of the MBS and internal studies on the relationship between tar, nicotine and carbon monoxide and smoke constituents and reviewed publications that further evaluated data published as part of the MBS. Results The companies conducted extensive studies of cigarette design factors and ingredients that significantly impacted the levels of constituents. While this study asserted that by-brand emissions could be estimated reliably from published tar, nicotine, and carbon monoxide levels, the tobacco companies were well aware that factors beyond tar, nicotine and carbon monoxide influenced levels of constituents included in the study. This severely limited the potential usefulness of the MBS predictor equations. Conclusions Despite promises to provide data that would allow regulators to predict constituent data for all brands on the market, the final MBS results offered no useful predictive information to inform regulators, the scientific community or consumers. When implementing FCTC Articles 9 and 10, regulatory agencies should demand detailed by-brand information on tobacco product constituents and toxin deliveries to users. PMID:26292701

  9. Health Literacy, Acculturation, and the Use of Preventive Oral Health Care by Somali Refugees Living in Massachusetts

    PubMed Central

    Hunter Adams, Jo; Penrose, Katherine L.; Cochran, Jennifer; Rybin, Denis; Doros, Gheorghe; Henshaw, Michelle; Paasche-Orlow, Michael

    2013-01-01

    Background This study investigated the impact of English health literacy and spoken proficiency and acculturation on preventive dental care use among Somali refugees in Massachusetts. Methods 439 adult Somalis in the U.S. ≤ 10 years ago were interviewed. English functional health literacy, dental word recognition, and spoken proficiency were measured using STOFHLA, REALD, and BEST Plus. Logistic regression tested associations of language measures with preventive dental care use. Results Without controlling for acculturation, participants with higher health literacy were 2.0 times more likely to have had preventive care (p=0.02). Subjects with higher word recognition were 1.8 times as likely to have had preventive care (p=0.04). Controlling for acculturation, these were no longer significant, and spoken proficiency was not associated with increased preventive care use. Discussion English health literacy and spoken proficiency were not associated with preventive dental care. Other factors, like acculturation, were more predictive of care use than language skills. PMID:23748902

  10. No Further Action Decision Under CERCLA Study 43R Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    List under the Comprehensive Environmental Response, Compensation and Liability Act ( CERCLA ) as amended by the Superfund Amendments and Reauthorization... CERCLA STUDY AREA 43R HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS CONTRACT DAAA15-91-D-0008 U.S. ARMY ENVIRONMENTAL CENTER ABERDEEN PROVING...ACTION DECISION UNDER CERCLA STUDY AREA 43R HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS I * Prepared for: U.S. Army Environmental Center

  11. Sediment quality assessment studies in Boston Harbor, Massachusetts

    SciTech Connect

    Carr, R.S.; Chapman, D.C.; Biedenbach, J.M.; Long, E.R.; Thursby, G.; MacDonald, D.D.

    1995-12-31

    As part of NOAA`s National Status and Trends program, a bioeffects assessment study was conducted in the vicinity of Boston Harbor, Massachusetts. Surficial sediment samples were collected at 55 sites and subsamples were tested for toxicity using (1) the 10-day whole sediment test with Ampelisca abdita, (2) the sea urchin (Arbacia punctulata) fertilization and embryological development assays with sediment pore water, and (3) Microtox{trademark} assay with organic sediment extracts. Eleven percent of the samples were significantly toxic in the amphipod test, only 4% were toxic in the sea urchin fertilization test whereas all of the samples were highly toxic in the sea urchin embryological development assay; the Microtox assay determined 56% of the organic sediment extracts to be significantly toxic. Sediment chemical analyses for metals, AVS/SEM, PAHs, PCBs, and pesticides were performed on 30 of the 55 samples. Twenty-seven of the 30 samples exceeded at least one probable effects level (PEL) value. For the 20 samples that exceeded 5 or more PELS, the concordance between the predicted and observed toxicity was 20% for the amphipod test, 60% for the Microtox test, and 100% for the sea urchin embryological development assay. There were no significant correlations among the different toxicity tests or between the tests and the contaminant concentrations in the bulk sediment. Possible explanations for the apparent lack of correlation between the sediment chemistry and the toxicity tests will be discussed.

  12. Health care utilization and charges following the enactment of the 2007 Graduated Drivers Licensing Law in Massachusetts.

    PubMed

    Sangji, Naveen F; Ramly, Elie P; Kaafarani, Haytham M A; Seethala, Raghu; Raybould, Toby; Camargo, Carlos A; Velmahos, George; Masiakos, Peter T; Lee, Jarone

    2015-10-01

    Graduated Drivers Licensing (GDL) programs phase in driving privileges for teenagers. In 2007, Massachusetts implemented a stricter version of the 1998 GDL law, with increased fines and education. This study evaluated the impact of the law on motor vehicle crash (MVC)-related health care utilization and charges. Massachusetts government and US Census Bureau data were analyzed to compare the rates of MVC-related emergency department (ED) visits and hospital charges before (2002-2006) and after (2007-2011) the 2007 GDL law. Three driver age groups were studied: 16-17 (evaluating the law effect), 18-20 (evaluating the sustainability of the effect), and 25-29 years old (control group). MVC-related ED visits per population decreased after the law for all three age groups (16-17: 2326 to 713; 18-20: 2110 to 1304; 25-29: 1694 to 1228; per 100,000, p<0.001), but the decrease was greater amongst teenagers (16-17: -69%; 18-20: -38%) compared to the control group (-27%); p<0.001. MVC-related hospital charges per population also decreased for teenagers but increased for the control group (16-17: $2.70 m to $1.45 m; 18-20: $3.52 m to $2.26 m; 25-29: $1.86 m to $1.92 m; per 100,000, p<0.001). The 2007 GDL law in Massachusetts was associated with significant decreases in MVC-related health care utilization and hospital charges among teenage drivers. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Massachusetts Study of Teacher Supply and Demand: Trends and Projections

    ERIC Educational Resources Information Center

    Levin, Jesse; Berg-Jacobson, Alex; Atchison, Drew; Lee, Katelyn; Vontsolos, Emily

    2015-01-01

    In April 2015, the Massachusetts Department of Elementary and Secondary Education (ESE) commissioned American Institutes for Research (AIR) to develop a comprehensive set of 10-year projections of teacher supply and demand in order to inform planning for future workforce needs. This included state-level projections both in the aggregate, as well…

  14. Design of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study.

    PubMed

    Taveras, Elsie M; Blaine, Rachel E; Davison, Kirsten K; Gortmaker, Steven; Anand, Shikha; Falbe, Jennifer; Kwass, Jo-Ann; Perkins, Meghan; Giles, Catherine; Criss, Shaniece; Colchamiro, Rachel; Baidal, Jennifer Woo; Land, Thomas; Smith, Lauren

    2015-02-01

    Childhood obesity is highly prevalent, is associated with both short- and long-term adverse outcomes, disproportionately affects racial/ethnic minority and economically deprived children, and represents a major threat to public health. Among the most promising approaches for its prevention and management are multilevel, multisector strategies. The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study was a comprehensive, systematic intervention to prevent and reduce childhood obesity among low-income children ages 2-12 years in two selected cities in Massachusetts. Building on the Obesity Chronic Care Model, MA-CORD expanded a state public health department community-level obesity prevention initiative that incorporated evidence-based interventions in primary healthcare, the Women, Infants, and Children program, early care and education, schools/afterschool programs, as well as community-wide programs to improve food, beverage, physical activity (PA), and messaging environments. The study used a combination of pre- and post-time series and quasi-experimental designs to examine the extent to which the intervention resulted in changes in BMI, individual-level lifestyle behaviors, satisfaction with healthcare services, and quality of life among children, as well as changes in health policies, programs, and environments in the two intervention cities, compared to a comparison city. The intervention period was 2 years. MA-CORD will determine the extent to which a multisetting, multilevel intervention that integrates activities in primary care with broader public health interventions in schools, early care and education, and the community at large can improve children's dietary and PA behaviors and ultimately reduce obesity in low-income children.

  15. Design of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study

    PubMed Central

    Blaine, Rachel E.; Davison, Kirsten K.; Gortmaker, Steven; Anand, Shikha; Falbe, Jennifer; Kwass, Jo-Ann; Perkins, Meghan; Giles, Catherine; Criss, Shaniece; Colchamiro, Rachel; Woo Baidal, Jennifer; Land, Thomas; Smith, Lauren

    2015-01-01

    Abstract Background: Childhood obesity is highly prevalent, is associated with both short- and long-term adverse outcomes, disproportionately affects racial/ethnic minority and economically deprived children, and represents a major threat to public health. Among the most promising approaches for its prevention and management are multilevel, multisector strategies. Methods/Design: The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study was a comprehensive, systematic intervention to prevent and reduce childhood obesity among low-income children ages 2–12 years in two selected cities in Massachusetts. Building on the Obesity Chronic Care Model, MA-CORD expanded a state public health department community-level obesity prevention initiative that incorporated evidence-based interventions in primary healthcare, the Women, Infants, and Children program, early care and education, schools/afterschool programs, as well as community-wide programs to improve food, beverage, physical activity (PA), and messaging environments. The study used a combination of pre– and post–time series and quasi-experimental designs to examine the extent to which the intervention resulted in changes in BMI, individual-level lifestyle behaviors, satisfaction with healthcare services, and quality of life among children, as well as changes in health policies, programs, and environments in the two intervention cities, compared to a comparison city. The intervention period was 2 years. Conclusions: MA-CORD will determine the extent to which a multisetting, multilevel intervention that integrates activities in primary care with broader public health interventions in schools, early care and education, and the community at large can improve children's dietary and PA behaviors and ultimately reduce obesity in low-income children. PMID:25469676

  16. The Early Impact Of The 'Alternative Quality Contract' On Mental Health Service Use And Spending In Massachusetts.

    PubMed

    Barry, Colleen L; Stuart, Elizabeth A; Donohue, Julie M; Greenfield, Shelly F; Kouri, Elena; Duckworth, Kenneth; Song, Zirui; Mechanic, Robert E; Chernew, Michael E; Huskamp, Haiden A

    2015-12-01

    Accountable care using global payment with performance bonuses has shown promise in controlling spending growth and improving care. This study examined how an early model, the Alternative Quality Contract (AQC) established in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA), has affected care for mental illness. We compared spending and use for enrollees in AQC organizations that did and did not accept financial risk for mental health with enrollees not participating in the contract. Compared with BCBSMA enrollees in organizations not participating in the AQC, we found that enrollees in participating organizations were slightly less likely to use mental health services and, among mental health services users, small declines were detected in total health care spending, but no change was found in mental health spending. The declines in probability of use of mental health services and in total health spending among mental health service users attributable to the AQC were concentrated among enrollees in organizations that accepted financial risk for behavioral health. Interviews with AQC organization leaders suggested that the contractual arrangements did not meaningfully affect mental health care delivery in the program's initial years, but organizations are now at varying stages of efforts to improve mental health integration. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Assessment of fish health in Ashumet and Johns Ponds adjacent to the Massachusetts Military Reservation

    SciTech Connect

    Greeley, M.S. Jr.; Adams, S.M.; Hinton, D.E.

    1995-12-31

    Ashumet and Johns Ponds are located adjacent to the Massachusetts Military Reservation (MMR) on Cape Cod, and lie in or near the paths of several plumes of groundwater contamination flowing from the MMR. This study had the objective of documenting the present status of fish in both ponds in efforts to establish base-line conditions for any future biological monitoring activities and to determine whether evidence exists for current contaminant impacts. This objective was addressed through three complimentary approaches, including the determination of Health Assessment Index (HAI) scores for fish sampled from Ashumet and Johns Ponds and several reference ponds in the area, measurement of various biochemical and physiological indicators in fish tissues and fluids and histopathological examinations of fish organs. For each of the three primary fish species examined in this study, largemouth bass, brown bullhead catfish, and yellow perch, many similarities were noted in the physiological, biochemical and histopathological condition of fish in all the study ponds. However, mean HAIs tended to be slightly higher (indicative of poorer health) in Ashumet and Johns Ponds, due in part to pathologies related to a higher incidence of parasitic infection at these sites. The most striking differences between the ponds were very high prevalences of oral and body surface papillomas in brown bullhead catfish from Johns Pond (59%) and Ashumet Pond (34%). Although pesticides, PCBs, and other chemical contaminants were present in fish from all of ponds, there was no obvious relationship between chemical body burdens and the responses of any of the measured indicator parameters, nor was there any conclusive evidence of current impacts on fish from the contaminant plumes.

  18. The politics of universal access: the Massachusetts Health Security Act of 1988.

    PubMed

    Goldberger, S A

    1990-01-01

    This article analyzes the passage of an unprecedented state law, promising every resident access to affordable health insurance. The Massachusetts Health Security Act of 1988 was the product of a set of political and financial pressures that had been developing for nearly a decade. Hospital, insurance, and business interests were unable to reach a new accommodation on hospital payment. This logjam created the opportunity for a policy breakthrough, but did not inherently lend itself to progressive reform. It was consumer activism that forced the traditional powers in health policy to address the interests of the uninsured. By imposing a more public-interest agenda on the process, consumers were able to change the configuration of the stalemate, but could not resolve it. The particular terms of the stalemate, however, made possible a new, more aggressive role for state government in health policy. Unable to satisfy their competing interests within a policy framework that had universal access as a goal, traditionally powerful interest groups found themselves increasingly dependent on the state to broker a new agreement. While the many concessions made to these groups are likely to prove to be the bill's undoing, the unraveling of the agreement will not end the story. The same pressures which led to passage of the Massachusetts law and which are now causing other states to act will continue to exert their effect until a more durable solution is found.

  19. Use of fees to fund local public health services in Western Massachusetts.

    PubMed

    Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E

    2015-01-01

    Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.

  20. Health consequences of the snow disaster in Massachusetts, February 6, 1978.

    PubMed Central

    Glass, R I; O'Hare, P; Conrad, J L

    1979-01-01

    On February 6, 1978, the largest New England blizzard of the century struck eastern Massachusetts. On request, four days later, the Center for Disease Control provided epidemiologic assistance. On-site disaster assistance provided decision-makers with immediate health surveillance information useful in helping the area return to normal. No outbreaks of infectious diseases and no significant increase in the number of deaths were observed in the week following the blizzard. Some of the deaths which occurred immediately after the blizzard might have been prevented if traffic had been banned earlier. PMID:225958

  1. Managed care, networks and trends in hospital care for mental health and substance abuse treatment in Massachusetts: 1994-1999.

    PubMed

    Fleming, Elaine; Lien, Hsienming; Ma, Ching-To Albert; McGuire, Thomas G

    2003-03-01

    Rates of inpatient care for mental health and substance abuse treatment have been reported to fall after the introduction of managed care, but the actual decline may be overstated. Almost all managed care impact studies are based on pre-post comparisons, which have two drawbacks: secular downward trends may be attributed to a managed care effect and self-selection may exaggerate the impact of managed care. Therefore it is useful to examine long-term population-based trends in use associated with the growth of managed care. This paper examines trends in inpatient care for mental health and substance abuse treatment in Massachusetts between 1994 and 1999 by service provider and payer. We analyze how managed care impacts the trends in mental health and substance abuse care. We provide an overview of the health market in Massachusetts and compare trends in mental health and substance abuse services with all inpatient services. To analyze the impact of managed care, we compare the per discharge cost of managed care and fee for service plans in Medicare and Medicaid. Finally, we examine the role played by hospital networks in managed care. The reduction in service costs for mental health and substance abuse, about 25% in six years, is mostly due to the decline in the average cost per inpatient episode. This is only slightly greater than the decline in costs for all inpatient care. Managed care has reduced both the quantity (average length of stay) and intensity of health care (expenditure per day). Simulations suggest that the creation of hospital networks by managed care accounts for around 50% of the differential between the average costs of the HMO and FFS sectors. We find that the cost reductions in mental health and substance abuse services are larger than for physical health, but not by much. The average length of stay and average day cost is lower for managed care plans than for FFS plans, and much of this difference is attributable to the hospitals managed care

  2. Massachusetts Health Reform Cost Less and Was More Effective for Uninsured Individuals With Venous Thromboembolism: A Cost-Effectiveness Analysis.

    PubMed

    Kapoor, Alok; Shaffer, Nicholas; Hanchate, Amresh; Roberts, Mark; Smith, Kenneth

    2016-05-01

    Patients with venous thromboembolism (VTE) require access to comprehensive physician and pharmacy benefits to prevent recurrence and hemorrhage. Before 2006, Massachusetts provided these benefits through a program restricted to safety net hospitals called Free Care. Providing portable health insurance through Massachusetts health reform could improve outcomes for uninsured with VTE but its cost-effectiveness is unknown. We constructed a Markov decision analysis model comparing our conceptualization of the Massachusetts health reform (health reform strategy) to no health reform strategy for a patient beginning warfarin for new episode of VTE. In the model, a patient may develop recurrent VTE or develop hemorrhage or stop warfarin after 6 months if no event occurs. To measure effectiveness, we analyzed laboratory data from Boston Medical Center, the largest safety net hospital in Massachusetts. Specifically, we measured the probability of having a subtherapeutic warfarin level for patients newly insured compared with those on Free Care prereform adjusting for secular trends. To calculate inpatient costs, we used the Health Care Utilization Project. We then calculated the incremental cost-effectiveness ratio for the health reform strategy adjusted to 2014 USD per quality-adjusted life-year (QALY) and performed sensitivity analyses. The health reform strategy cost less and gained more QALYs than the no health reform strategy. Our result was most sensitive to the odds that Health Reform protected against a subtherapeutic warfarin level, the cost of Health Reform, and the percentage of total health care costs attributable to VTE in Massachusetts. The health reform strategy cost less and was more effective than the no health reform strategy for patients with VTE.

  3. Jacobson v Massachusetts: It’s Not Your Great-Great-Grandfather’s Public Health Law

    PubMed Central

    Mariner, Wendy K.; Annas, George J.; Glantz, Leonard H.

    2005-01-01

    Jacobson v Massachusetts, a 1905 US Supreme Court decision, raised questions about the power of state government to protect the public’s health and the Constitution’s protection of personal liberty. We examined conceptions about state power and personal liberty in Jacobson and later cases that expanded, superseded, or even ignored those ideas. Public health and constitutional law have evolved to better protect both health and human rights. States’ sovereign power to make laws of all kinds has not changed in the past century. What has changed is the Court’s recognition of the importance of individual liberty and how it limits that power. Preserving the public’s health in the 21st century requires preserving respect for personal liberty. PMID:15798113

  4. Home health and home care in Massachusetts after the Balanced Budget Act of 1997: implications of cost containment pressures for service authorizations.

    PubMed

    Caro, Francis G; Porell, Frank W; Sullivan, Donna M; Safran-Norton, Clare E; Miltiades, Helen

    2002-01-01

    This paper explores the response of the Massachusetts state-funded home care program for the elderly when its clients encountered barriers to the receipt of home health services because of HMO enrollment and the implementation of the Balanced Budget Act of 1997. Clients of three regional case management agencies serving the Massachusetts state home care program whose home care services were interrupted because of hospitalization between January 1 and April 30, 1999 and whose services were resumed after they returned home were studied. Detailed data are reported that show how the long-term personal assistance services provided through the state program were often complemented by temporary home health services after elders returned home. The multivariate analysis revealed that the authorization of state-funded personal care services was keyed to the status of home health aide services. After hospitalization, the presence of a home health aide reduced the likelihood of authorization of personal care. At final assessment, the situation was reversed, that is, the withdrawal of a home health aide increased the likelihood of authorization of personal care. The findings suggest that more restrictive Medicare reimbursement policies for home health services led to greater state expenditures for personal care services. In other words, less generous Medicare financing shifted a greater portion of the burden of financing home care to the state of Massachusetts. These findings raise important policy questions about the balance of responsibility between the federal government and states to provide financing of home care services for the elderly.

  5. Support for National Health Insurance Seven Years Into Massachusetts Healthcare Reform: Views of Populations Targeted by the Reform.

    PubMed

    Saluja, Sonali; Zallman, Leah; Nardin, Rachel; Bor, David; Woolhandler, Steffie; Himmelstein, David U; McCormick, Danny

    2016-01-01

    Before the Affordable Care Act (ACA), many surveys showed majority support for national health insurance (NHI), also known as single payer; however, little is currently known about views of the ACA's targeted population. Massachusetts residents have had seven years of experience with state health care reform that became the model for the ACA. We surveyed 1,151 adults visiting safety-net emergency departments in Massachusetts in late 2013 on their preference for NHI or the Massachusetts reform and on their experiences with insurance. Most of the patients surveyed were low-income and non-white. The majority of patients (72.0%) preferred NHI to the Massachusetts reform. Support for NHI among those with public insurance, commercial insurance, and no insurance was 68.9%, 70.3%, and 86.3%, respectively (p < .001). Support for NHI was higher among patients dissatisfied with their insurance plan (83.3% vs. 68.9%, p = .014), who delayed medical care (81.2% vs. 69.6%, p < .001) or avoided purchasing medications due to cost (87.3% vs. 71.4%; p = .01). Majority support for NHI was observed in every demographic subgroup. Given the strong support for NHI among disadvantaged Massachusetts patients seven years after state health reform, a reappraisal of the ACA's ability to meet the needs of underserved patients is warranted.

  6. Cigarette smoke chemistry market maps under Massachusetts Department of Public Health smoking conditions.

    PubMed

    Morton, Michael J; Laffoon, Susan W

    2008-06-01

    This study extends the market mapping concept introduced by Counts et al. (Counts, M.E., Hsu, F.S., Tewes, F.J., 2006. Development of a commercial cigarette "market map" comparison methodology for evaluating new or non-conventional cigarettes. Regul. Toxicol. Pharmacol. 46, 225-242) to include both temporal cigarette and testing variation and also machine smoking with more intense puffing parameters, as defined by the Massachusetts Department of Public Health (MDPH). The study was conducted over a two year period and involved a total of 23 different commercial cigarette brands from the U.S. marketplace. Market mapping prediction intervals were developed for 40 mainstream cigarette smoke constituents and the potential utility of the market map as a comparison tool for new brands was demonstrated. The over-time character of the data allowed for the variance structure of the smoke constituents to be more completely characterized than is possible with one-time sample data. The variance was partitioned among brand-to-brand differences, temporal differences, and the remaining residual variation using a mixed random and fixed effects model. It was shown that a conventional weighted least squares model typically gave similar prediction intervals to those of the more complicated mixed model. For most constituents there was less difference in the prediction intervals calculated from over-time samples and those calculated from one-time samples than had been anticipated. One-time sample maps may be adequate for many purposes if the user is aware of their limitations. Cigarette tobacco fillers were analyzed for nitrate, nicotine, tobacco-specific nitrosamines, ammonia, chlorogenic acid, and reducing sugars. The filler information was used to improve predicting relationships for several of the smoke constituents, and it was concluded that the effects of filler chemistry on smoke chemistry were partial explanations of the observed brand-to-brand variation.

  7. Massachusetts Et Al. v Environmental Protection Agency: Implications For Public Health Policy And Practice

    PubMed Central

    Payne, Perry W.; Rosenbaum, Sara

    2007-01-01

    This installment of Law and the Public's Health reviews the U.S. Supreme Court's April 2, 2007, decision in Massachusetts et al. v Environmental Protection Agency1 and considers its implications for public health policy and practice. This landmark decision focused on a central concern in administrative law; namely, when an agency vested with the authority to regulate in the public's health has the power to refuse to carry out a legislative directive. The subject of the case was regulation of greenhouse gas emissions by new motor vehicles under the section 202(a)(1) of the Clean Air Act, but the central question was allocation of powers between a legislative branch that desires action and an executive branch agency that for policy reasons refuses to act. PMID:18051675

  8. The Impact of Massachusetts Health Care Reform on Access, Quality, and Costs of Care for the Already-Insured

    PubMed Central

    Joynt, Karen E; Chan, David C; Zheng, Jie; Orav, E John; Jha, Ashish K

    2015-01-01

    Objective To assess the impact of Massachusetts Health Reform (MHR) on access, quality, and costs of outpatient care for the already-insured. Data Sources/Study Setting Medicare data from before (2006) and after (2009) MHR implementation. Study Design We performed a retrospective difference-in-differences analysis of quantity of outpatient visits, proportion of outpatient quality metrics met, and costs of care for Medicare patients with ≥1 chronic disease in 2006 versus 2009. We used the remaining states in New England as controls. Data Collection/Extraction Methods We used existing Medicare claims data provided by the Centers for Medicare and Medicaid Services. Principal Findings MHR was not associated with a decrease in outpatient visits per year compared to controls (9.4 prereform to 9.6 postreform in MA vs. 9.4–9.5 in controls, p = .32). Quality of care in MA improved more than controls for hemoglobin A1c monitoring, mammography, and influenza vaccination, and similarly to controls for diabetic eye examination, colon cancer screening, and pneumococcal vaccination. Average costs for patients in Massachusetts increased from $9,389 to $10,668, versus $8,375 to $9,114 in control states (p < .001). Conclusions MHR was not associated with worsening in access or quality of outpatient care for the already-insured, and it had modest effects on costs. This has implications for other states expanding insurance coverage under the Affordable Care Act. PMID:25219772

  9. Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study.

    PubMed

    Little, Mark P; Zablotska, Lydia B; Brenner, Alina V; Lipshultz, Steven E

    2016-03-01

    High-dose ionizing radiation is associated with circulatory disease. Risks from lower-dose fractionated exposures, such as from diagnostic radiation procedures, remain unclear. In this study we aimed to ascertain the relationship between fractionated low-to-medium dose radiation exposure and circulatory disease mortality in a cohort of 13,568 tuberculosis patients in Massachusetts, some with fluoroscopy screenings, between 1916 and 1961 and follow-up until the end of 2002. Analysis of mortality was in relation to cumulative thyroid (cerebrovascular) or lung (all other circulatory disease) radiation dose via Poisson regression. Over the full dose range, there was no overall radiation-related excess risk of death from circulatory disease (n = 3221; excess relative risk/Gy -0.023; 95% CI -0.067, 0.028; p = 0.3574). Risk was somewhat elevated in hypertensive heart disease (n = 89; excess relative risk/Gy 0.357; 95% CI -0.043, 1.030, p = 0.0907) and slightly decreased in ischemic heart disease (n = 1950; excess relative risk/Gy -0.077; 95% CI -0.130, -0.012; p = 0.0211). However, under 0.5 Gy, there was a borderline significant increasing trend for all circulatory disease (excess relative risk/Gy 0.345; 95% CI -0.032, 0.764; p = 0.0743) and for ischemic heart disease (excess relative risk/Gy 0.465; 95% CI, -0.032, 1.034, p = 0.0682). Pneumolobectomy increased radiation-associated risk (excess relative risk/Gy 0.252; 95% CI 0.024, 0.579). Fractionation of dose did not modify excess risk. In summary, we found no evidence of radiation-associated excess circulatory death risk overall, but there are indications of excess circulatory death risk at lower doses (<0.5 Gy). Although consistent with other radiation-exposed groups, the indications of higher risk at lower doses are unusual and should be confirmed against other data.

  10. Preventive Care for Low-Income Women in Massachusetts Post–Health Reform

    PubMed Central

    Soukup, Jane; Riden, Heather; Tovar, Dora; Orton, Piper; Burdick, Elisabeth; Capistran, Mary Ellen; Morisset, Jennifer; Browne, Elizabeth E.; Fitzmaurice, Garrett; Johnson, Paula A.

    2014-01-01

    Abstract Background: Before enacting health insurance reform in 2006, Massachusetts provided free breast, cervical cancer, and cardiovascular risk screening for low-income uninsured women through a federally subsidized program called the Women's Health Network (WHN). This article examines whether, as women transitioned to insurance to pay for screening tests after health reform legislation was passed, cancer and cardiovascular disease screening changed among WHN participants between 2004 and 2010. Methods: We examined claims data from the Massachusetts health insurance exchange and chart review data to measure utilization of mammography, Pap smear, and blood pressure screening among WHN participants in five community health centers in greater Boston. We conducted a longitudinal analysis, by insurance type, using generalized estimating equations to examine the likelihood of screening at recommended intervals in the postreform period compared to the prereform period. Results: Pre- and postreform, we found a high prevalence of recommended mammography (86% vs. 88%), Pap smear (88% vs. 89%), and blood pressure screening (87% vs. 91%) that was similar or improved for most women postreform. Screening use differed by insurance type. Recommended mammography screening was statistically significantly increased among women with state-subsidized private insurance (odds ratio [OR] 1.58, p<0.05). Women with unsubsidized private insurance or Medicare had decreased Pap smear use postreform. Although screening prevalence was high, 31% of women required state safety-net funds to pay for screening tests. Conclusion: Our results suggest a continued need for safety-net programs to support preventive screening among low-income women after implementation of healthcare reform. PMID:24798240

  11. The Early Impact Of The ‘Alternative Quality Contract’ On Mental Health Service Use And Spending In Massachusetts

    PubMed Central

    Barry, Colleen L.; Stuart, Elizabeth A.; Donohue, Julie M.; Greenfield, Shelly F.; Kouri, Elena; Duckworth, Kenneth; Song, Zirui; Mechanic, Robert E.; Chernew, Michael E.; Huskamp, Haiden A.

    2016-01-01

    Accountable care using global payment with performance bonuses has shown promise in controlling spending growth and improving care. This study examined how an early model, the Alternative Quality Contract (AQC) established in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA), has affected care for mental illness. We compared spending and use for enrollees in AQC organizations that did and did not accept financial risk for mental health with enrollees not participating in the contract. Compared with BCBSMA enrollees in organizations not participating in the AQC, we found that enrollees in organizations participating in the AQC were slightly less likely to use mental health services and had small declines in total health care spending, but no change was found in mental health spending among all users. The declines in probability of use of mental health services and in total health spending attributable to the AQC were concentrated among enrollees in AQC organizations that accepted financial risk for behavioral health. Interviews with AQC organization leaders suggested that the contractual arrangements did not meaningfully affect mental health care delivery in the program’s initial years, but organizations are now at varying stages of efforts to improve integration. PMID:26643628

  12. Changes in the care of patients with cervical spine fractures following health reform in Massachusetts.

    PubMed

    Schoenfeld, Andrew J; Wahlquist, Trevor C; Bono, Christopher M; Lehrich, Jessica L; Power, Robyn K; Harris, Mitchel B

    2015-08-01

    There is a substantial concern among spine surgeons that healthcare reform efforts will alter the processes through which spinal care is delivered and decrease overall quality. We used the Statewide Inpatient Dataset for Massachusetts to evaluate changes in hospital processes and quality of care for patients with cervical fractures following the implementation of health reform. This was a pre-post retrospective analysis of patients (n=9,387) treated for cervical fractures in Massachusetts between 2003-2006 and 2008-2010. Changes in hospital processes (surgical intervention, length of stay (LOS) and environment of care) and quality of care (mortality, complications, reoperation and failure to rescue (FTR)) were the outcomes of interest. FTR is a quality measure that evaluates a hospital's capacity to avoid mortality following the occurrence of a sentinel complication. Patients treated between 2003 and 2006 were considered the pre-reform group. The post-reform cohort consisted of those treated from 2008 to 2010. Baseline differences between cohorts were evaluated using chi-square or Mann-Whitney U tests. Unadjusted comparisons between the dependent variables and the onset of healthcare reform were performed, followed by regression techniques that adjusted for differences in case-mix and whether a surgical intervention was performed. Multivariable logistic regression was used for categorical variables and negative binomial regression was employed for continuous variables. The rates of surgical intervention remained unchanged pre- and post-reform (p=0.25). Hospital length of stay (RC: -0.18, 95% CI: -0.22, -0.14) and the FTR rate following surveillance insensitive complications (OR: 0.49, 95% CI: 0.25, 0.94) were significantly reduced following health reform. Post-reform, academic centers experienced a 22% reduction in mortality (95% CI: 0.61, 0.99) a 40% decrease in FTR (95% CI: 0.40, 0.89), a 30% decrease in surveillance insensitive complications (95% CI: 0.51, 0

  13. Behavioral Health Services Following Implementation of Screening in Massachusetts Medicaid Children

    PubMed Central

    Penfold, Robert B.; Arsenault, Lisa N.; Zhang, Fang; Murphy, Michael; Wissow, Lawrence S.

    2014-01-01

    OBJECTIVES: To determine the relationship of child behavioral health (BH) screening results to receipt of BH services in Massachusetts Medicaid (MassHealth) children. METHODS: After a court decision, Massachusetts primary care providers were mandated to conduct BH screening at well-child visits and use a Current Procedural Terminology code along with a modifier indicating whether a BH need was identified. Using MassHealth claims data, a cohort of continuously enrolled (July 2007–June 2010) children was constructed. The salient visit (first use of the modifier, screening code, or claim in fiscal year 2009) was considered a reference point to examine BH history and postscreening BH services. Bivariate and multivariate logistic regression analyses were performed to determine predictors of postscreening BH services. RESULTS: Of 261 160 children in the cohort, 45% (118 464) were screened and 37% had modifiers. Fifty-seven percent of children screening positive received postscreening BH services compared with 22% of children screening negative. However, only 30% of newly identified children received BH services. The strongest predictors of postscreening BH services for children without a BH history were being in foster care (odds ratio, 10.38; 95% confidence interval, 9.22–11.68) and having a positive modifier (odds ratio, 3.79; 95% confidence interval, 3.53–4.06). CONCLUSIONS: Previous BH history, a positive modifier, and foster care predicted postscreening BH services. Only one-third of newly identified children received services. Thus although screening is associated with an increase in BH recognition, it may be insufficient to improve care. Additional strategies may be needed to enhance engagement in BH services. PMID:25225135

  14. Screening for Behavioral Health Issues in Children Enrolled in Massachusetts Medicaid

    PubMed Central

    Penfold, Robert; Arsenault, Lisa; Zhang, Fang; Murphy, Michael; Wissow, Larry

    2014-01-01

    OBJECTIVES: To understand mandated behavioral health (BH) screening in Massachusetts Medicaid including characteristics of screened children, predictors of positive screens, and whether screening identifies children without a previous BH history. METHODS: Massachusetts mandated BH screening in particularly among underidentified groups. 2008. Providers used a billing code and modifier to indicate a completed screen and whether a BH need was identified. Using MassHealth claims data, children with ≥300 days of eligibility in fiscal year (FY) 2009 were identified and categorized into groups based on first use of the modifier, screening code, or claim. Bivariate analyses were conducted to determine differences among groups. BH history was examined by limiting the sample to those continuously enrolled in FY 2008 and 2009. Multivariate logistic regression was used to determine predictors of positive screens. RESULTS: Of 355 490 eligible children, 46% had evidence of screening. Of those with modifiers, 12% were positive. Among continuously enrolled children (FY 2008 and FY 2009) with evidence of screening, 43% with positive modifiers had no BH history. This “newly identified” group were more likely to be female, younger, minority, and from rural residences (P < .0001). Among children with modifiers; gender (male), age (5–7), being in foster care, recent BH history, and Hispanic ethnicity predicted having a positive modifier. CONCLUSIONS: The high rate of newly identified Medicaid children with a BH need suggests that screening is performing well, particularly among underidentified groups. To better assess screening value, future work on cost-effectiveness and the impact on subsequent mental health treatment is needed. PMID:24298005

  15. Health Risk Behaviors in a Representative Sample of Bisexual and Heterosexual Female High School Students in Massachusetts

    ERIC Educational Resources Information Center

    White Hughto, Jaclyn M.; Biello, Katie B.; Reisner, Sari L.; Perez-Brumer, Amaya; Heflin, Katherine J.; Mimiaga, Matthew J.

    2016-01-01

    Background: Differences in sexual health-related outcomes by sexual behavior and identity remain underinvestigated among bisexual female adolescents. Methods: Data from girls (N?=?875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and…

  16. Health Risk Behaviors in a Representative Sample of Bisexual and Heterosexual Female High School Students in Massachusetts

    ERIC Educational Resources Information Center

    White Hughto, Jaclyn M.; Biello, Katie B.; Reisner, Sari L.; Perez-Brumer, Amaya; Heflin, Katherine J.; Mimiaga, Matthew J.

    2016-01-01

    Background: Differences in sexual health-related outcomes by sexual behavior and identity remain underinvestigated among bisexual female adolescents. Methods: Data from girls (N?=?875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and…

  17. The effect of Massachusetts health reform on 30 day hospital readmissions: retrospective analysis of hospital episode statistics.

    PubMed

    Lasser, Karen E; Hanchate, Amresh D; McCormick, Danny; Manze, Meredith G; Chu, Chieh; Kressin, Nancy R

    2014-03-31

    To analyse changes in overall readmission rates and disparities in such rates, among patients aged 18-64 (those most likely to have been affected by reform), using all payer inpatient discharge databases (hospital episode statistics) from Massachusetts and two control states (New York and New Jersey). Difference in differences analysis to identify the post-reform change, adjusted for secular changes unrelated to reform. US hospitals in Massachusetts, New York, and New Jersey. Adults aged 18-64 admitted for any cause, excluding obstetrical. Readmissions at 30 days after an index admission. After adjustment for known confounders, including age, sex, comorbidity, hospital ownership, teaching hospital status, and nurse to census ratio, the odds of all cause readmission in Massachusetts was slightly increased compared with control states post-reform (odds ratio 1.02, 95% confidence interval 1.01 to 1.04, P<0.05). Racial and ethnic disparities in all cause readmission rates did not change in Massachusetts compared with control states. In analyses limited to Massachusetts only, there were minimal overall differences in changes in readmission rates between counties with differing baseline uninsurance rates, but black people in counties with the highest uninsurance rates had decreased odds of readmission (0.91, 0.84 to 1.00) compared with black people in counties with lower uninsurance rates. Similarly, white people in counties with the highest uninsurance rates had decreased odds of readmission (0.96, 0.94 to 0.99) compared with white people in counties with lower uninsurance rates. In the United States, and in Massachusetts in particular, extending health insurance coverage alone seems insufficient to improve readmission rates. Additional efforts are needed to reduce hospital readmissions and disparities in this outcome.

  18. Study of Massachusetts Two-Year College Students: Implications for Massachusetts Four-Year Colleges and Universities.

    ERIC Educational Resources Information Center

    Beals, Ernest W.; And Others

    The increased mobility of undergraduate students moving from one campus to another in Massachusetts has presented problems for admissions and transfer officers of 2- and 4-year institutions. At a meeting of these officers it was decided to establish a committee to collect transfer student data on a state-wide basis and to conduct state-wide…

  19. Studying the Past through a Different Lens: Sports and Leisure History in Needham, Massachusetts.

    ERIC Educational Resources Information Center

    Banit, Thomas F.

    1994-01-01

    Contends that, although the topic of sports and leisure seems suited for study primarily at the national level, local communities can be rich sources of information. Describes the role of sports history within the overall work of the Needham (Massachusetts) Historical Society. (CFR)

  20. Evaluation of Child Care Subsidy Strategies: Massachusetts Family Child Care Study. Executive Summary

    ERIC Educational Resources Information Center

    Collins, Ann; Goodson, Barbara

    2010-01-01

    This report presents findings from the Massachusetts Family Child Care study, a two-year evaluation designed to examine the impacts on providers and children of an early childhood education program aimed at improving the development and learning opportunities in the care settings and, as a consequence, the outcomes for children in care. The early…

  1. Evaluation of Child Care Subsidy Strategies: Massachusetts Family Child Care Study

    ERIC Educational Resources Information Center

    Collins, Ann; Goodson, Barbara; Luallen, Jeremy; Fountain, Alyssa Rulf; Checkoway, Amy

    2010-01-01

    This report presents findings from the Massachusetts Family Child Care study, a two-year evaluation of the impacts of an early childhood education program on providers and children in family child care. The program--"LearningGames"--is designed to train caregivers to stimulate children's cognitive, language, and social-emotional…

  2. Occupational Life in Massachusetts: A System Dynamics Study of Poverty and Underemployment.

    ERIC Educational Resources Information Center

    Garet, Michael S.

    A study of underemployment, written as part of the development of a management information project (MISOE) for the Division of Occupational Education of the Department of Education in Massachusetts, the work represents the beginning of an effort to bring systematic, empirically based policy analysis to bear on problems of occupational education.…

  3. Parks and the urban heat island: A longitudinal study in Westfield, Massachusetts

    Treesearch

    Robert S. Bristow; Robert Blackie; Nicole. Brown

    2012-01-01

    Urban landscapes often have warmer temperatures than the surrounding countryside, a phenomenon known as the urban heat island (UHI) effect. This study compares and contrasts temperatures across Westfield, Massachusetts, a moderate size New England city, and considers the influence that the city’s parks and protected areas have on the local microclimate. The data show a...

  4. Trends in uninsured clients visiting health centers funded by the Title X family planning program - Massachusetts, 2005-2012.

    PubMed

    Carter, Marion; Desilets, Kathleen; Gavin, Lorrie; Moskosky, Sue; Clark, Jill

    2014-01-24

    In 2006, Massachusetts passed legislation that broadened access to health insurance for its residents. The percentage of the state population that had health insurance (obtained through either private insurance or publicly funded programs) subsequently increased, reaching 97% in 2011, leaving only 3% uninsured, compared with approximately 9%-20% uninsured among nonelderly residents in 2006. Given such high rates of insurance coverage, questions arise about the need for categorical public health programs designed to serve clients without health insurance. This report describes trends in the percentage of uninsured clients seen at community-based organizations in Massachusetts that received federal funding for one such program, the Title X family planning program. Title X program data from 2005-2012 indicate that client volume remained high throughout the period, and that the percentage of clients who were uninsured declined, from 59% in 2005 to 36% in 2012. Across years, young adults aged 20-29 years and persons whose incomes were 101%-250% of the federal poverty level were more likely to be uninsured than were persons in other age and income groups. After health-care reform, publicly funded family planning services in Massachusetts saw continued demand from uninsured and insured clients. Family planning services in other states implementing health-care reform might have a similar experience, and public health agencies are encouraged to track such trends to monitor the demand for such services and inform budget planning and resource allocation.

  5. The impact of the 2006 Massachusetts health care reform law on spine surgery patient payer-mix status and age.

    PubMed

    Villelli, Nicolas W; Yan, Hong; Zou, Jian; Barbaro, Nicholas M

    2017-09-15

    OBJECTIVE Several similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors' prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US. METHODS Using the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012. Payer-mix status was assigned as Medicare, Medicaid, private insurance, uninsured, or other, which included government-funded programs and workers' compensation. A comparison of the payer-mix status and patient age, both before and after the policy, was performed. The New York State data were used as a control. RESULTS The authors analyzed 81,821 spine surgeries performed in Massachusetts and 248,757 in New York. After 2008, there was a decrease in uninsured and private insurance spine surgeries, with a subsequent increase in the Medicare and "other" categories for Massachusetts. Medicaid case numbers did not change. This correlated to an increase in surgeries performed in the age group of patients 65-84 years old, with a decrease in surgeries for those 18-44 years old. New York showed an increase in all insurance categories and all adult age groups. CONCLUSIONS After the Massachusetts reform, spine surgery decreased in private insurance and uninsured categories, with the majority of these surgeries transitioning to Medicare. Moreover, individuals who were younger than 65 years did not show an increase in spine surgeries, despite having greater access to health insurance. In a health care system that requires insurance, the decrease in private insurance is primarily due to an increasing elderly

  6. Characterizing the low wage immigrant workforce: a comparative analysis of the health disparities among selected occupations in Somerville, Massachusetts.

    PubMed

    Panikkar, Bindu; Woodin, Mark A; Brugge, Doug; Hyatt, Raymond; Gute, David M

    2014-05-01

    This study estimates job-related risks among common low wage occupations (cleaning, construction, food service, cashier/baggers, and factory workers) held by predominantly Haitian, El Salvadorian, and Brazilian immigrants living or working in Somerville, Massachusetts. A community-based cross-sectional survey on immigrant occupational health was conducted between 2006 and 2009 and logistic regression was used to assess the job-related risks among the most common low wage occupations. Construction workers reported significantly higher health risks, and lower access to occupational health services than the other occupations. Compared to cashier/baggers, the reference population in this study, cleaners reported significantly lower access to health and safety and work training and no knowledge of workers' compensation. Factory workers reported significantly lower work training compared to cashier/baggers. Food service workers reported the least access to doctors compared to the other occupations. We found significant variability in risks among different low wage immigrant occupations. The type of occupation independently contributed to varying levels of risks among these jobs. We believe our findings to be conservative and recommend additional inquiry aimed at assuring the representativeness of our findings. © 2013 Wiley Periodicals, Inc.

  7. Unmet need for disability-related health care services and employment status among adults with disabilities in the Massachusetts Medicaid program.

    PubMed

    Henry, Alexis D; Long-Bellil, Linda; Zhang, Jianying; Himmelstein, Jay

    2011-10-01

    The employment rate among adults with disabilities is significantly lower than that among adults without disabilities. Ensuring access to rehabilitative and other health care services may help to address health-related barriers to employment for working-age people with disabilities. This study examined the relationship of unmet need for 6 disability-related health care services to current employment status among working-age adults with disabilities enrolled in the Massachusetts Medicaid (MassHealth Standard) program. Study participants included 436 MassHealth Standard members aged 19 to 64 who responded to the 2005/2006 MassHealth Employment and Disability Survey. Variables included members' demographic characteristics; Medicaid health plan and Medicare enrollment; members' self-report of potentially disabling conditions and current health status; access to health care as well as need and unmet need for 6 specific disability-related health care services (medications, mental health services, substance abuse services, medical supplies, durable medical equipment, personal assistance services); and current employment status. Fifteen percent of members reported currently working. Logistic regression analysis showed that (controlling for demographics, disability, health status, and other factors) members with greater unmet need were significantly less likely to be working (odds ratio = 0.58; 95% confidence interval = 0.33 to 0.99). Members' experience of unmet need was significantly greater for physical health services (supplies, durable medical equipment, personal assistance services) than for behavioral health services (mental health and substance abuse services) or medications. Working members generally rated services as important to work. Approximately 10% to 22% of nonworking members thought they would be able to work if needs were met. Meeting unmet needs for disability-related health care services may result in modest increases in employment among certain working

  8. Town-Level Characteristics and Smoking Policy Adoption in Massachusetts: Are Local Restaurant Smoking Regulations Fostering Disparities in Health Protection?

    PubMed Central

    Skeer, Margie; George, Sarah; Hamilton, William L.; Cheng, Debbie M.; Siegel, Michael

    2004-01-01

    Objectives. We identified and quantified differences in sociodemographic characteristics of communities relative to the strength of local restaurant smoking regulations in Massachusetts. Methods. We examined the relationship between the strength of the 351 local restaurant smoking regulations in Massachusetts and a number of town-level characteristics, using a multinomial logistic regression model. Results. Characteristics important to the adoption of stronger restaurant smoking regulations included higher education and per capita income, geographic region, voter support for a state cigarette tax initiative, board of health funding to promote clean indoor air policymaking, and the presence of a bordering town with a strong regulation. Conclusions. The current pattern of smoke-free restaurant policy enactment fosters socioeconomic and geographic disparities in health protection, undermining an important national health goal. PMID:14759944

  9. Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients.

    PubMed

    Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith

    2014-01-01

    Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated

  10. Health hazard evaluation report HETA 96-0137-2607, Yankee Atomic Electric Company, Rowe, Massachusetts

    SciTech Connect

    Sylvain, D.C.

    1996-10-01

    In response to a request from the Health and Safety Supervisor at the Yankee Nuclear Power Station (SIC-4911), Rowe, Massachusetts, an investigation was begun into ozone (10028156) exposure during plasma arc cutting and welding. Welders had reported chest tightness, dry cough, and throat and bronchial irritation. The nuclear power station was in the process of being decommissioned, and workers were dismantling components using welding and cutting methods. Of the operations observed during the site visit, the highest ozone concentrations were generated during plasma arc cutting, followed by metal inert gas (MIG) welding and arc welding. During plasma arc cutting the average and peak concentrations exceeded the NIOSH ceiling recommended exposure limit of 0.1 part per million. The author concludes that ozone exposure during plasma arc cutting and MIG welding presented a health hazard to welders. The author recommends that improvements be made in the local exhaust ventilation, that nitrogen-dioxide levels be monitored during hot work, and that many exposed workers wear protective clothing, use ultraviolet blocking lotion, and continue the use appropriate shade of eye protection.

  11. Health risk behaviors in a representative sample of bisexual and heterosexual female high school students in Massachusetts

    PubMed Central

    Biello, Katie B.; Reisner, Sari L.; Perez-Brumer, Amaya; Heflin, Katherine J.; Mimiaga, Matthew J.

    2015-01-01

    BACKGROUND Differences in sexual health-related outcomes by sexual behavior and identity remain under-investigated among bisexual female adolescents. METHODS Data from girls (N = 875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and psychosocial health by lifetime sexual behavior (behaviorally bisexual vs. behaviorally heterosexual) and sexual identity (bisexual vs. heterosexual) adjusting for grade and race/ethnicity. RESULTS Overall, 10.5% of girls reported lifetime bisexual behavior and 8.1% reported a bisexual identity. Behavior and identity were discordant for bisexual young women as 53.2% of behaviorally bisexual students had a bisexual identity and 46.8% had a heterosexual identity. Bisexual identity and behavior were associated with unprotected intercourse at last sexual encounter, early sexual debut, 4 or more lifetime partners, history of forced/unwanted sex, STI testing history, past-year depression, and past-month drug use (all ps < .05). CONCLUSION Bisexuality, whether defined by identity or behavior, is associated with adverse sexual and psychosocial health outcomes in adolescent girls. Studies that explore wellness across the lifespan, and are designed to recognize developmental differences burgeoning in adolescence, may provide insights into the differential sexual risk outcomes observed among bisexual girls. PMID:26645422

  12. The Massachusetts BMI letter: A qualitative study of responses from parents of obese children

    PubMed Central

    Moyer, Lindsay J.; Carbone, Elena T.; Anliker, Jean A.; Goff, Sarah L.

    2015-01-01

    Objectives Massachusetts (MA) public schools conduct mandated body-mass index (BMI) screening and until recently, communicated results in a letter to parents/caregivers, to encourage primary care visits and provide aggregate data to the state Department of Public Health. This study assessed the letter's readability and qualitatively explored parents’ responses to it. Methods Readability of the BMI letter was calculated. Audio-taped 1-h focus groups were conducted with parents/caregivers of 8- to 14-year-old obese (≥95th BMI-for-age percentile) children. A semistructured interview guide was used to elicit responses. Qualitative content analysis was conducted on transcripts to identify emergent themes. Results Readability analysis showed higher grade levels than recommended. Eight focus groups consisting of two to six parents each were conducted (n = 29); 83% were female, mean age 41 ± 9 years, and 65% self-identified as Hispanic/Latino. Key themes identified included usefulness of the BMI letter, concerns about utility of BMI for screening, concerns about impacting self-esteem, and failure to understand the letter. Conclusions The MA BMI letter may not have been achieving its desired goal with some parents. Practice implications: Emergent themes from this study could be used to test effectiveness of similar BMI letters nationwide and develop strategies to improve communication to parents. PMID:24290240

  13. What happens to the women who fall through the cracks of health care reform? Lessons from Massachusetts.

    PubMed

    Dennis, Amanda; Blanchard, Kelly; Córdova, Denisse; Wahlin, Britt; Clark, Jill; Edlund, Karen; McIntosh, Jennifer; Tsikitas, Lenore

    2013-04-01

    We investigated the impact of Massachusetts health care reform on low-income women's experiences accessing insurance and health services, specifically reproductive health services such as contraception. Our findings suggest that concentrated efforts are needed to make sure that health services are available and accessible to populations who fall through the cracks of health care reform, including immigrants, minors and young adults, and women living outside urban areas. In addition, systems changes are needed to ensure that women going through common life transitions, such as pregnancy, marriage, moving, or graduating from school, have continuous access to insurance, and therefore health services, as their lives change. These groups face barriers enrolling in and maintaining their insurance coverage as well as obtaining timely health care benefits they are eligible for through their insurance benefits or public health programs. Without intervention, many in these groups may delay or avoid seeking health care altogether, which may increase health care disparities in the long term. Family planning providers in Massachusetts have played a critical role in mitigating barriers to insurance and health care. However, recent threats to defund family planning providers call into question the ability of these providers to continue providing much-needed services.

  14. Health-hazard evaluation report HETA 88-236-2090, Boston Globe, Boston, Massachusetts

    SciTech Connect

    Seitz, T.A.

    1990-12-01

    In response to a request from a joint management/union committee at the Boston Globe (SIC-2711), a health hazard evaluation was conducted at both printing facilities of the company located in Dorchester and Billerica, Massachusetts concerning exposures to solvents and inks, and the occurrence of hematuria, bladder cancer, and respiratory, skin and neuropsychological complaints. Worker exposures to particulate material were quite low for pressmen and other press room employees working on the first deck. The areas by the folder where paper was cut had the highest particulate concentrations. Particulate samples appeared to consist primarily of paper dust, rather than ink mist. Concentrations of total naphthas were higher in air samples obtained during the make ready shift. The lack of glove use by some workers as well as the use of improper glove materials were deemed important factors in dermal exposures. The author concludes that there was a potential for significant dermal exposure to organic solvents, particularly glycol ethers. The author recommends the use of proper gloves, better techniques for cleaning equipment, institution of a formal respiratory protection program, better attention to personal hygiene and eating habits at the work site, vacuuming to remove dust from the cutters, improvements in the ceiling mounted exhaust system, repairing of some of the available safety equipment, and installation of local exhaust ventilation.

  15. A Longitudinal Study of Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Hospitalizations for Cardiovascular Disease

    PubMed Central

    Land, Thomas; Rigotti, Nancy A.; Levy, Douglas E.; Paskowsky, Mark; Warner, Donna; Kwass, Jo-Ann; Wetherell, LeAnn; Keithly, Lois

    2010-01-01

    Background Insurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage on health care utilization and costs is a barrier to the broader adoption of this policy, especially by publicly funded state Medicaid insurance programs. Whether a publicly funded tobacco cessation benefit leads to decreased medical claims for tobacco-related diseases has not been studied. We examined the experience of Massachusetts, whose Medicaid program adopted comprehensive coverage of tobacco cessation medications in July 2006. Over 75,000 Medicaid subscribers used the benefit in the first 2.5 years. On the basis of earlier secondary survey work, it was estimated that smoking prevalence declined among subscribers by 10% during this period. Methods and Findings Using claims data, we compared the probability of hospitalization prior to use of the tobacco cessation pharmacotherapy benefit with the probability of hospitalization after benefit use among Massachusetts Medicaid beneficiaries, adjusting for demographics, comorbidities, seasonality, influenza cases, and the implementation of the statewide smoke-free air law using generalized estimating equations. Statistically significant annualized declines of 46% (95% confidence interval 2%–70%) and 49% (95% confidence interval 6%–72%) were observed in hospital admissions for acute myocardial infarction and other acute coronary heart disease diagnoses, respectively. There were no significant decreases in hospitalizations rates for respiratory diagnoses or seven other diagnostic groups evaluated. Conclusions Among Massachusetts Medicaid subscribers, use of a comprehensive tobacco cessation pharmacotherapy benefit was associated with a significant decrease in claims for hospitalizations for acute myocardial infarction and acute coronary heart disease, but no significant change in hospital claims for other diagnoses. For low

  16. The Impact of Immigration and Customs Enforcement on Immigrant Health: Perceptions of Immigrants in Everett, Massachusetts, USA

    PubMed Central

    Hacker, Karen; Chu, Jocelyn; Leung, Carolyn; Marra, Robert; Pirie, Alex; Brahimi, Mohamed; English, Margaret; Beckmann, Joshua; Acevedo-Garcia, Dolores; Marlin, Robert P.

    2011-01-01

    U.S. immigrants have faced a changing landscape with regard to immigration enforcement over the last two decades. Following the passage of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, and the creation of the Immigration and Customs Enforcement (ICE) agency after the attacks of September 11, 2001, detention and deportation activity increased substantially. As a result, immigrants today are experiencing heightened fear of profiling and deportation. Little research exists on how these activities affect the health and well-being of U.S. immigrant communities. This study sought to address this gap by using community-based participatory research to investigate the impact of enhanced immigration enforcement on immigrant health in Everett, Massachusetts, USA, a city with a large and diverse immigrant population. Community partners and researchers conducted 6 focus groups with 52 immigrant participants (documented and undocumented) in five languages in May 2009. The major themes across the groups included: 1) Fear of deportation, 2) Fear of collaboration between local law enforcement and ICE and perception of arbitrariness on the part of the former and 3) Concerns about not being able to furnish documentation required to apply for insurance and for health care. Documented and undocumented immigrants reported high levels of stress due to deportation fear, which affected their emotional well-being and their access to health services. Recommendations from the focus groups included improving relationships between immigrants and local police, educating immigrants on their rights and responsibilities as residents, and holding sessions to improve civic engagement. Immigration enforcement activities and the resulting deportation fear are contextual factors that undermine trust in community institutions and social capital, with implications for health and effective integration processes. These factors should be considered by any community seeking to

  17. The impact of Immigration and Customs Enforcement on immigrant health: perceptions of immigrants in Everett, Massachusetts, USA.

    PubMed

    Hacker, Karen; Chu, Jocelyn; Leung, Carolyn; Marra, Robert; Pirie, Alex; Brahimi, Mohamed; English, Margaret; Beckmann, Joshua; Acevedo-Garcia, Dolores; Marlin, Robert P

    2011-08-01

    U.S. immigrants have faced a changing landscape with regard to immigration enforcement over the last two decades. Following the passage of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, and the creation of the Immigration and Customs Enforcement (ICE) agency after the attacks of September 11, 2001, detention and deportation activity increased substantially. As a result, immigrants today are experiencing heightened fear of profiling and deportation. Little research exists on how these activities affect the health and well-being of U.S. immigrant communities. This study sought to address this gap by using community-based participatory research to investigate the impact of enhanced immigration enforcement on immigrant health in Everett, Massachusetts, USA, a city with a large and diverse immigrant population. Community partners and researchers conducted 6 focus groups with 52 immigrant participants (documented and undocumented) in five languages in May 2009. The major themes across the groups included: 1) Fear of deportation, 2) Fear of collaboration between local law enforcement and ICE and perception of arbitrariness on the part of the former and 3) Concerns about not being able to furnish documentation required to apply for insurance and for health care. Documented and undocumented immigrants reported high levels of stress due to deportation fear, which affected their emotional well-being and their access to health services. Recommendations from the focus groups included improving relationships between immigrants and local police, educating immigrants on their rights and responsibilities as residents, and holding sessions to improve civic engagement. Immigration enforcement activities and the resulting deportation fear are contextual factors that undermine trust in community institutions and social capital, with implications for health and effective integration processes. These factors should be considered by any community seeking to

  18. No Further Action Decision Under CERCLA Study Area 43L Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Comprehensive Environmental Response, Compensation and Liability Act ( CERCLA ) asg amended by the Superfund Amendments and Reauthorization Act. An... CERCLA STUDY AREA 43L HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS CONTRACT DAAA15-91-D-0008 U.S. ARMY ENVIRONMENTAL CENTER ABERDEEN PROVING...DECISION UNDER CERCLA STUDY AREA 43L HISTORIC GAS STATION SITES ! FORT DEVENS, MASSACHUSETTS I I I 5 Prepared for: U.S. Army Environmental Center I

  19. No Further Action Decision Under CERCLA Study Area 43Q Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Liability Act ( CERCLA ) as amended by the Superfund Amendments and Reauthorization Act. An Enhanced Preliminary Assessment (PA) was also performed at... CERCLA STUDY AREA 43Q HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS , CONTRACT DAAA15-91-D-0008 U.S. ARMY ENVIRONMENTAL CENTER ABERDEEN PROVING...ACTION DECISION UNDER CERCLA STUDY AREA 43Q HISTORIC GAS STATION SITES 5 FORT DEVENS, MASSACHUSETTS V a I i Prepared for: U.S. Army Environmental Center

  20. Public health assessment for New Bedford Site, New Bedford, Bristol County, Massachusetts, Region 1. Cerclis No. MAD980731335. Final report

    SciTech Connect

    1995-04-21

    New Bedford Harbor drains the Acushnet River into Buzzards Bay in southeastern Massachusetts. Extensive polychlorinated biphenyl (PCB) and heavy metal contamination have been detected in the estuary that drains the river, a portion of which is exposed as a mudflat at low tide. This contamination has also been detected in sediment sampled from the remainder of the harbor. Based on the information reviewed, ATSDR has concluded that this site is of public health hazard because of the risk to human health resulting from ongoing exposure to PCBs via ingestion of contaminated fish within harbor waters and dermal contact with PCB-contaminated sediments.

  1. Healthy workplaces? A survey of Massachusetts employers.

    PubMed

    Tremblay, Patricia A; Nobrega, Suzanne; Davis, Letitia; Erck, Elizabeth; Punnett, Laura

    2013-01-01

    This study examines worksite health promotion (WHP) and occupational health and safety (OHS) activities by Massachusetts employers, and the extent to which workplaces with programming in one domain were more likely to have the other as well. In 2008, the Massachusetts Department of Public Health surveyed a stratified sample of Massachusetts worksites. A mailed questionnaire to be completed by workplace representatives. Massachusetts worksites returning the questionnaire. Questionnaire items about worksite characteristics, WHP, and some OHS practices. We scored levels of WHP and OHS activity; examined the relationship between activities in the two domains by employer characteristics; and assessed self-reported coordination between them. The 890 responding worksites had higher scores for OHS (mean = 48% of practices, SD = 24%) than WHP (mean = 20%, SD = 12%). The difference between these scores varied by a factor of two across industry sectors and was smallest for workforces of 100+ employees (p = .001). Employers with no unionized workers reported fewer activities in both domains (p < .0001). Only 28% of respondents reported always/often coordinating OHS and WHP efforts; these organizations had more activities overall in both domains. Larger and unionized workplaces in Massachusetts were more likely to offer both WHP and OHS programming. Self-reported coordination was somewhat associated with more activity in both domains, although levels of WHP activity varied widely.

  2. Rates of Insurance for Injured Patients Before and After Health Care Reform in Massachusetts: A Possible Case of Double Jeopardy

    PubMed Central

    Collins, Courtney E.; Wiseman, Jason T.; Psoinos, Charles M.; Flahive, Julie M.; Kiefe, Catarina I.

    2014-01-01

    Objectives. We determined how preinjury insurance status and injury-related outcomes among able-bodied, community-dwelling adults treated at a Level I Trauma Center in central Massachusetts changed after health care reform. Methods. We compared insurance status at time of injury among non-Medicare-eligible adult Massachusetts residents before (2004–2005) and after (2009–2010) health care reform, adjusted for demographic and injury covariates, and modeled associations between insurance status and trauma outcomes. Results. Among 2148 patients before health care reform and 2477 patients after health care reform, insurance rates increased from 77% to 84% (P < .001). Younger patients, men, minorities, and penetrating trauma victims were less likely to be insured irrespective of time period. Uninsured patients were more likely to be discharged home without services (adjusted odds ratio = 3.46; 95% confidence interval = 2.65, 4.52) compared with insured patients. Conclusions. Preinjury insurance rates increased for trauma patients after health care reform but remained lower than in the general population. Certain Americans may be in “double jeopardy” of both higher injury incidence and worse outcomes because socioeconomic factors placing them at risk for injury also present barriers to compliance with an individual insurance mandate. PMID:24825208

  3. The Visiting Specialist Model of Rural Health Care Delivery: A Survey in Massachusetts

    ERIC Educational Resources Information Center

    Drew, Jacob; Cashman, Suzanne B.; Savageau, Judith A.; Stenger, Joseph

    2006-01-01

    Context: Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. Purpose: To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of…

  4. The Visiting Specialist Model of Rural Health Care Delivery: A Survey in Massachusetts

    ERIC Educational Resources Information Center

    Drew, Jacob; Cashman, Suzanne B.; Savageau, Judith A.; Stenger, Joseph

    2006-01-01

    Context: Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. Purpose: To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of…

  5. No Further Action Decision Under CERCLA, Study Area 14, Landfill No. 10, Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    I I I U.S. ArmyEnvironmentalCenter NO FURTHER ACTION DECISION UNDER 5 CERCLA * STUDY AREA 14 LANDFILL NO. 10 U FORT DEVENS, MASSACHUSETTS CONTRACT...45, 1 Feb 93 replaces THAMA Form 45 which is obsolete. U 1I NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 14 LANDFILL NO. 10 3 FORT DEVENS...Environmental Services, Inc. Portland, Maine Project No. 7053-12 JANUARY 1995 ! I I I U NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 14 LANDFILL NO. 10

  6. Massachusetts Institute of Technology Defense and Arms Control Studies Program

    DTIC Science & Technology

    1995-01-01

    the 1995 General James H. Doolittle dinner and workshop, an event DACS cosponsored with the Olin Institute of Strategic Studies at Harvard and the...several prominent analysts of the war participated in the all day event which was held on April 19, 1995. Our keynote speakers were Lieutenant General...Calvin Waller, who was General Schwartzkoff’s deputy, and Lieutenant General Thomas Kelly, who was head of operations on the Joint Staff during the war

  7. Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.

    PubMed

    Shindul-Rothschild, Judith; Gregas, Matt

    2013-01-01

    The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.

  8. Public health assessment for Re-Solve, Incorporated, Dartmouth, Bristol County, Massachusetts, Region 1: CERCLIS number MAD980520621. Final report

    SciTech Connect

    Not Available

    1999-05-25

    The Re-Solve National Priorities List (NPL) site is a 6-acre area situated in the town of Dartmouth, Massachusetts. During the years 1956-1980 the Re-Solve Company distilled industrial solvents on-site. Waste materials from this process were disposed of by burning solvents in four on-site lagoons and spreading waste oils in various portions of the site. Elevated levels of polychlorinated biphenyls (PCBs) and volatile organic compounds (VOCs) were measured in soils throughout the site in 1981, and it was added to the NPL in December 1982. This site is characterized as a past and present public health hazard primarily due to the likely past and present exposure to PCBs through the consumption of PCB contaminated fish and eels from area water bodies. Based upon results of fish sampling that detected PCBs in area eel, the Massachusetts Department of Public Health issued and updated an advisory in 1986 and 1994 recommending that people not eat the fish and eel caught in these affected waters. The potentially exposed population; therefore, include area fishers who may be consuming contaminated fish or eel.

  9. Low-income Renewable Energy Programs: Case Studies of State Policy in California and Massachusetts

    NASA Astrophysics Data System (ADS)

    Kelly, Kaitlin

    Energy policies aimed at reducing the burden of monthly utility costs on low-income families have been established since the 1970s. Energy use impacts low-income families and organizations through housing specific costs, health and wellness, and opportunity costs. States have begun to run renewable energy installation programs aimed at reducing costs for low-income communities. This thesis examines two of these programs, the solar photovoltaic policies in California as part of the Single Family Affordable Solar Housing and Multi-family Affordable Solar Housing programs, and the Low-income Solar Housing program in Massachusetts. Lessons learned from reviewing these programs are that renewable energy programs are an effective strategy for reducing utility costs for low-income communities, but that the total effectiveness of the program is dependent on removing cost barriers, implementing energy efficiency improvements, and increasing consumer education through established community networks and relationships.

  10. Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers.

    PubMed

    LaBelle, Colleen T; Han, Steve Choongheon; Bergeron, Alexis; Samet, Jeffrey H

    2016-01-01

    We describe a Massachusetts Bureau of Substance Abuse Services' (BSAS) initiative to disseminate the office-based opioid treatment with buprenorphine (OBOT-B) Massachusetts Model from its development at Boston Medical Center (BMC) to its implementation at fourteen community health centers (CHCs) beginning in 2007. The Massachusetts Collaborative Care Model for the delivery of opioid agonist therapy with buprenorphine, in which nurses working with physicians play a central role in the evaluation and monitoring of patients, holds promise for the effective expansion of treatment for opioid use disorders. The training of and technical assistance for the OBOT nurses as well as a limited program assessment are described. Data spanning 6years (2007-2013) report patient demographics, prior treatment for opioid use disorders, history of overdose, housing, and employment. The expansion of OBOT to the fourteen CHCs increased the number of physicians who were "waivered" (i.e., enabling their prescribing of buprenorphine) by 375%, from 24 to 114, within 3years. During this period the annual admissions of OBOT patients to CHCs markedly increased. Dissemination of the Massachusetts Model of the Office-Based Opioid Treatment with Buprenorphine employing a collaborative care model with a central role for nursing enabled implementation of effective treatment for patients with an opioid use disorder at community health centers throughout Massachusetts while effectively engaging primary care physicians in this endeavor. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Effect of the planet health intervention on eating disorder symptoms in Massachusetts middle schools, 2005-2008.

    PubMed

    Austin, S Bryn; Spadano-Gasbarro, Jennifer L; Greaney, Mary L; Blood, Emily A; Hunt, Anne T; Richmond, Tracy K; Wang, Monica L; Mezgebu, Solomon; Osganian, Stavroula K; Peterson, Karen E

    2012-01-01

    The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous cross-sectional survey data from students on DWCB at baseline and Year 3 follow-up (n = 16,369). Multivariate logistic analyses with generalized estimating equations examined the effect of intervention activities on odds of students reporting DWCB at follow-up. Students in schools reaching a high number of youth with Planet Health lessons on reducing television viewing had lower odds of DWCB at follow-up (odds ratio [OR], 0.80 per 100 lesson-exposures; 95% confidence interval [CI], 0.74-0.85). In addition, reduced odds of DWCB at follow-up were found in schools with active staff teamwork (OR, 0.76; 95% CI, 0.66-0.86) and the presence of programs addressing television viewing goals with staff (OR, 0.38; 95% CI, 0.28-0.53). Combined evidence from efficacy and effectiveness trials and now from dissemination research indicates that appropriately designed obesity prevention programs can achieve DWCB prevention on a large scale.

  12. Effect of the Planet Health Intervention on Eating Disorder Symptoms in Massachusetts Middle Schools, 2005–2008

    PubMed Central

    Spadano-Gasbarro, Jennifer L.; Greaney, Mary L.; Blood, Emily A.; Hunt, Anne T.; Richmond, Tracy K.; Wang, Monica L.; Mezgebu, Solomon; Osganian, Stavroula K.; Peterson, Karen E.

    2012-01-01

    Introduction The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. Methods Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous cross-sectional survey data from students on DWCB at baseline and Year 3 follow-up (n = 16,369). Multivariate logistic analyses with generalized estimating equations examined the effect of intervention activities on odds of students reporting DWCB at follow-up. Results Students in schools reaching a high number of youth with Planet Health lessons on reducing television viewing had lower odds of DWCB at follow-up (odds ratio [OR], 0.80 per 100 lesson-exposures; 95% confidence interval [CI], 0.74–0.85). In addition, reduced odds of DWCB at follow-up were found in schools with active staff teamwork (OR, 0.76; 95% CI, 0.66–0.86) and the presence of programs addressing television viewing goals with staff (OR, 0.38; 95% CI, 0.28–0.53). Conclusion Combined evidence from efficacy and effectiveness trials and now from dissemination research indicates that appropriately designed obesity prevention programs can achieve DWCB prevention on a large scale. PMID:23194779

  13. A health impact assessment of proposed public transportation service cuts and fare increases in Boston, Massachusetts (U.S.A.).

    PubMed

    James, Peter; Ito, Kate; Buonocore, Jonathan J; Levy, Jonathan I; Arcaya, Mariana C

    2014-08-07

    Transportation decisions have health consequences that are often not incorporated into policy-making processes. Health Impact Assessment (HIA) is a process that can be used to evaluate health effects of transportation policy. We present a rapid HIA, conducted over eight weeks, evaluating health and economic effects of proposed fare increases and service cuts to Boston, Massachusetts' public transportation system. We used transportation modeling in concert with tools allowing for quantification and monetization of multiple pathways. We estimated health and economic costs of proposed public transportation system changes to be hundreds of millions of dollars per year, exceeding the budget gap the public transportation authority was required to close. Significant health pathways included crashes, air pollution, and physical activity. The HIA enabled stakeholders to advocate for more modest fare increases and service cuts, which were eventually adopted by decision makers. This HIA was among the first to quantify and monetize multiple pathways linking transportation decisions with health and economic outcomes, using approaches that could be applied in different settings. Including health costs in transportation decisions can lead to policy choices with both economic and public health benefits.

  14. Impact of School Staff Health on Work Productivity in Secondary Schools in Massachusetts

    ERIC Educational Resources Information Center

    Alker, Heather J.; Wang, Monica L.; Pbert, Lori; Thorsen, Nancy; Lemon, Stephenie C.

    2015-01-01

    Background: Healthy, productive employees are an integral part of school health programs. There have been few assessments of work productivity among secondary school staff. This study describes the frequency of 3 common health risk factors--obesity, depressive symptoms, and smoking--and their impact on work productivity in secondary school…

  15. Impact of School Staff Health on Work Productivity in Secondary Schools in Massachusetts

    ERIC Educational Resources Information Center

    Alker, Heather J.; Wang, Monica L.; Pbert, Lori; Thorsen, Nancy; Lemon, Stephenie C.

    2015-01-01

    Background: Healthy, productive employees are an integral part of school health programs. There have been few assessments of work productivity among secondary school staff. This study describes the frequency of 3 common health risk factors--obesity, depressive symptoms, and smoking--and their impact on work productivity in secondary school…

  16. DSM-III and the College Mental Health Setting: The University of Massachusetts Experience.

    ERIC Educational Resources Information Center

    Hersch, Jeffrey B.; And Others

    1983-01-01

    A quality-assessment study was conducted at a university mental health service to review diagnostic practices, using the third edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Health Disorders." Diagnostic practices of the staff and problems with student record keeping are discussed.…

  17. Evaluation of the Massachusetts Expanded Learning Time (ELT) Initiative: Final Study Findings

    ERIC Educational Resources Information Center

    Checkoway, Amy; Gamse, Beth; Velez, Melissa; Linkow, Tamara

    2013-01-01

    The Massachusetts Expanded Learning Time (ELT) initiative provides grants to selected schools to redesign their schedules by adding 300-plus instructional hours to the school year to improve outcomes, broaden enrichment opportunities, and provide teachers with more planning and professional development time. The Massachusetts Department of…

  18. Homemaker Reaction to EFNEP/Food Stamp Pilot Nutrition Education Project. A 1983 Pennsylvania and Massachusetts Survey. Extension Studies 92.

    ERIC Educational Resources Information Center

    Dunn, Polly P.; And Others

    Between 1982 and 1983, more than 750 homemakers from Pennsylvania and Massachusetts participated in a national study to test selected methods of delivering nutrition education to low-income families. The study, the Expanded Food and Nutrition Education Program (EFNEP)/Food Stamp Pilot Project, was conducted through the EFNEP in 10 states. At the…

  19. Flooding and emergency room visits for gastrointestinal illness in Massachusetts: a case-crossover study.

    PubMed

    Wade, Timothy J; Lin, Cynthia J; Jagai, Jyotsna S; Hilborn, Elizabeth D

    2014-01-01

    Floods and other severe weather events are anticipated to increase as a result of global climate change. Floods can lead to outbreaks of gastroenteritis and other infectious diseases due to disruption of sewage and water infrastructure and impacts on sanitation and hygiene. Floods have also been indirectly associated with outbreaks through population displacement and crowding. We conducted a case-crossover study to investigate the association between flooding and emergency room visits for gastrointestinal illness (ER-GI) in Massachusetts for the years 2003 through 2007. We obtained ER-GI visits from the State of Massachusetts and records of floods from the National Oceanic and Atmospheric Association's Storm Events Database. ER-GI visits were considered exposed if a flood occurred in the town of residence within three hazard periods of the visit: 0-4 days; 5-9 days; and 10-14 days. A time-stratified bi-directional design was used for control selection, matching on day of the week with two weeks lead or lag time from the ER-GI visit. Fixed effect logistic regression models were used to estimate the risk of ER-GI visits following the flood. A total of 270,457 ER-GI visits and 129 floods occurred in Massachusetts over the study period. Across all counties, flooding was associated with an increased risk for ER-GI in the 0-4 day period after flooding (Odds Ratio: 1.08; 95% Confidence Interval: 1.03-1.12); but not the 5-9 days (Odds Ratio: 0.995; 95% Confidence Interval: 0.955-1.04) or the 10-14 days after (Odds Ratio: 0.966, 95% Confidence Interval: 0.927-1.01). Similar results were observed for different definitions of ER-GI. The effect differed across counties, suggesting local differences in the risk and impact of flooding. Statewide, across the study period, an estimated 7% of ER-GI visits in the 0-4 days after a flood event were attributable to flooding.

  20. Flooding and Emergency Room Visits for Gastrointestinal Illness in Massachusetts: A Case-Crossover Study

    PubMed Central

    Wade, Timothy J.; Lin, Cynthia J.; Jagai, Jyotsna S.; Hilborn, Elizabeth D.

    2014-01-01

    Introduction Floods and other severe weather events are anticipated to increase as a result of global climate change. Floods can lead to outbreaks of gastroenteritis and other infectious diseases due to disruption of sewage and water infrastructure and impacts on sanitation and hygiene. Floods have also been indirectly associated with outbreaks through population displacement and crowding. Methods We conducted a case-crossover study to investigate the association between flooding and emergency room visits for gastrointestinal illness (ER-GI) in Massachusetts for the years 2003 through 2007. We obtained ER-GI visits from the State of Massachusetts and records of floods from the National Oceanic and Atmospheric Association’s Storm Events Database. ER-GI visits were considered exposed if a flood occurred in the town of residence within three hazard periods of the visit: 0–4 days; 5–9 days; and 10–14 days. A time-stratified bi-directional design was used for control selection, matching on day of the week with two weeks lead or lag time from the ER-GI visit. Fixed effect logistic regression models were used to estimate the risk of ER-GI visits following the flood. Results and Conclusions A total of 270,457 ER-GI visits and 129 floods occurred in Massachusetts over the study period. Across all counties, flooding was associated with an increased risk for ER-GI in the 0–4 day period after flooding (Odds Ratio: 1.08; 95% Confidence Interval: 1.03–1.12); but not the 5–9 days (Odds Ratio: 0.995; 95% Confidence Interval: 0.955–1.04) or the 10–14 days after (Odds Ratio: 0.966, 95% Confidence Interval: 0.927–1.01). Similar results were observed for different definitions of ER-GI. The effect differed across counties, suggesting local differences in the risk and impact of flooding. Statewide, across the study period, an estimated 7% of ER-GI visits in the 0–4 days after a flood event were attributable to flooding. PMID:25329916

  1. Brave new world: mental health experiences of Puerto Ricans, immigrant Latinos, and Brazilians in Massachusetts.

    PubMed

    Sánchez, Mónica; Cardemil, Esteban; Adams, Sara Trillo; Calista, Joanne L; Connell, Joy; Depalo, Alexandra; Ferreira, Juliana; Gould, Diane; Handler, Jeffrey S; Kaminow, Paula; Melo, Tatiana; Parks, Allison; Rice, Eric; Rivera, Ismael

    2014-01-01

    Depression and anxiety are of the most commonly occurring mental health disorders in the United States. Despite a variety of efficacious interventions for depression and anxiety, it is clear that ethnic minorities experience mental health care disparities in their access to mental health services and the quality of treatment they receive. Research indicates that Latino heterogeneity impacts access to depression and anxiety treatment. In addition, Brazilians are becoming an increasingly visible minority within the United States and are often depicted as Latinos. The current study sought to understand the role of acculturation and stigma in mental health symptom endorsement and treatment seeking among Puerto Ricans, immigrant Latinos, and Brazilians. A total of 250 self-identified Latinos and Brazilians were interviewed about their mental health symptom and treatment experience, acculturation, and stigma toward mental illness. Results indicated considerable variability across the three groups, with Puerto Ricans endorsing higher rates of depression and anxiety, as well as higher rates of treatment seeking, than either the immigrant Latinos or the Brazilians. Acculturation played a differential role in the endorsement of anxiety treatment seeking for Brazilians. Finally, although the three groups differed in the extent to which they experienced stigma about mental health issues, stigma did not predict symptom endorsement or treatment-seeking behavior for any of the three groups. These findings underscore the importance of attending to both between-groups and within-group differences in the mental health and mental health treatment experiences of different ethnic groups.

  2. The Cultural Basis for Oral Health Practices among Somali Refugees Pre- and Post-Resettlement in Massachusetts

    PubMed Central

    Adams, Jo Hunter; Young, Samorga; Laird, Lance D.; Geltman, Paul L.; Cochran, Jennifer J.; Hassan, Ahmed; Egal, Fadumo; Paasche-Orlow, Michael K.; Barnes, Linda L.

    2014-01-01

    Background Oral health disparities related to socioeconomic status have been well described in the U.S., but oral health among refugee groups has not been well characterized. This article examines oral health among Somali refugees in Massachusetts. Methods Eighty-three (83) participants were purposively selected for an in-depth, open-ended interview related to oral health. Results Older individuals associated use of the stick brush with the Islamic practice of cleansing before prayer. When unable to find stick brushes in the U.S., many adopted the Western toothbrush. Parents expressed concern that their children had adopted U.S. practices of brushing with a toothbrush only once or twice a day. Conclusions/implications Somali oral health practices have changed following arrival to the U.S., but the underlying model for oral health care remains rooted in Islam. By acknowledging the value of traditional practices, dentists may communicate the value of Western preventive and restorative dentistry, and recommend approaches to integrating the two. PMID:24185145

  3. Neo-Democracy in Educational Policy-Making: A Critical Case Study of Neoliberal Reform in Massachusetts

    ERIC Educational Resources Information Center

    Piazza, Peter

    2017-01-01

    This paper explores changes to the educational policy-making arena through case study analysis of a Massachusetts law passed in 2012 that limits seniority-based job protections for public K-12 teachers. I use data from interviews with policy stakeholders, observations of public meetings, and policy artifacts to explore struggles over democratic…

  4. Neo-Democracy in Educational Policy-Making: A Critical Case Study of Neoliberal Reform in Massachusetts

    ERIC Educational Resources Information Center

    Piazza, Peter

    2017-01-01

    This paper explores changes to the educational policy-making arena through case study analysis of a Massachusetts law passed in 2012 that limits seniority-based job protections for public K-12 teachers. I use data from interviews with policy stakeholders, observations of public meetings, and policy artifacts to explore struggles over democratic…

  5. Franchising Public Education: A Study of the Linkage of Charter Schools and Private Education Management Companies in Massachusetts.

    ERIC Educational Resources Information Center

    Rhim, Lauren Morando

    School franchising (defined as the replication of a particular product or service across a wide geographic region) marks a radical departure from the traditional view of the community-based neighborhood school. This paper reports on a study of a growing niche of charter school private management contracts in Massachusetts. The focus is on the…

  6. Massachusetts Healthcare Reform and Trends in Emergent Colon Resection.

    PubMed

    Eskander, Mariam F; Bliss, Lindsay A; McCarthy, Ellen P; de Geus, Susanna W L; Chau Ng, Sing; Nagle, Deborah; Rodrigue, James R; Tseng, Jennifer F

    2016-11-01

    Insurance impacts access to therapeutic options, yet little is known about how healthcare reform might change the pattern of surgical admissions. We compared rates of emergent admissions and outcomes after colectomy before and after reform in Massachusetts with a nationwide control group. This study is a retrospective cohort analysis in a natural experiment. Prereform was defined as hospital discharge from 2002 through the second quarter of 2006 and postreform from the third quarter of 2006 through 2012. Categorical variables were compared by χ. Piecewise functions were used to test the effect of healthcare reform on the rate of emergent surgeries. The study included acute care hospitals in the Massachusetts Healthcare Cost and Utilization Project State Inpatient Database (2002-2012) and the Nationwide Inpatient Sample (2002-2011). Patients aged 18 to 64 years with public or no insurance who underwent inpatient colectomy (via International Classification of Diseases, Ninth Revision, Clinical Modification procedural code) were included and patients with Medicare were excluded. Massachusetts health care reform was the study intervention. We measured the rate of emergent colectomy, complications, and mortality. The unadjusted rate of emergent colectomies was lower in Massachusetts after reform but did not change nationally over the same time period. For emergent surgeries in Massachusetts, a piecewise model with an inflection point (peak) in the third quarter of 2006, coinciding with implementation of healthcare reform in Massachusetts, had a lower mean squared error than a linear model. In comparison, the national rate of emergent surgeries demonstrated no change in pattern. Postreform, length of stay decreased by 1 day in Massachusetts; however, there were no significant improvements in other outcomes. The study was limited by its retrospective design and unadjusted analysis. There was a unique and sustained decline in the rate of emergent colon resection among

  7. Health hazard evaluation report HETA 82-212-1553, Screen Printing Shops, Boston, Massachusetts and Denton, Maryland areas

    SciTech Connect

    Baker, E.; Smith, T.; Quinn, M.

    1985-01-01

    Environmental and breathing zone samples were analyzed for organic solvents at five small printing shops (SIC-2751) in the Boston, Massachusetts and Denton, Maryland areas. The evaluation was requested by the union because of complaints of headache, nausea, dizziness, and other symptoms among silk screen printing workers. Nineteen exposed and four unexposed workers were interviewed. Urine samples were obtained and analyzed for methyl-hippuric-acid (2198643) and hippuric-acid (495692), metabolites of xylene (1330207) and toluene (108883). Exposed workers reported a prevalence of symptoms such as headache, trouble remembering, and disorientation. These did not differ significantly, however, from the prevalence of such symptoms among the unexposed workers. The authors conclude that a potential health hazard due to solvent exposures at the facilities exists. Recommendations include using gloves to reduce skin exposure and performing environmental and medical monitoring.

  8. Characterizing submarine groundwater discharge: A seepage meter study in Waquoit Bay, Massachusetts

    NASA Astrophysics Data System (ADS)

    Michael, Holly A.; Lubetsky, Jonathan S.; Harvey, Charles F.

    2003-03-01

    A seepage meter study was performed in Waquoit Bay on Cape Cod, Massachusetts to characterize the amount, pattern, and origin of submarine groundwater discharge. Measurements from grids of 40 seepage meters provide a detailed representation of groundwater flux in both space and time. At the head of the bay, a distinct band of high, saline discharge was observed between 25 and 45 m from the shoreline. Slug tests indicated no pattern of permeability to explain the band of discharge, and the band was not observed offshore of an island where freshwater discharge is negligible. Experiments using clusters of seepage meters showed large variability in discharge at the meter scale and similar temporal variation throughout the domain, reflecting tidal influence primarily near shore. The small-scale variability challenges the assumption of locally homogeneous flow used in many models, and the band of discharge contradicts predictions that total outflow is largely fresh and decreases monotonically from shore.

  9. Working conditions of Brazilian immigrants in Massachusetts.

    PubMed

    Eduardo Siqueira, C; Jansen, Tiago

    2012-06-01

    Brazilian immigration to Massachusetts and other states in the US grew significantly in the last two decades. There is a lack of data about the working conditions and health and safety hazards faced by Brazilian immigrant workers. We surveyed over 500 workers in Eastern Massachusetts through a community-based participatory research project to explore occupational and immigration factors that may represent a risk to the health of Brazilian immigrant workers, who mostly work in the construction, housecleaning, and food services segments of the state labor force. Our pilot study suggests that Brazilian immigrant workers are exposed to chemical, ergonomic, physical, and psychosocial job hazards and have experienced a variety of health symptoms that may be associated with these work environment exposures. Since most Brazilian workers have not received proper training to recognize the hazards, there is an urgent need for the implementation of culturally adequate training programs and enforcement of safety and health regulations to prevent occupational injuries and fatalities.

  10. Perinatal outcomes associated with assisted reproductive technology: the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART).

    PubMed

    Declercq, Eugene; Luke, Barbara; Belanoff, Candice; Cabral, Howard; Diop, Hafsatou; Gopal, Daksha; Hoang, Lan; Kotelchuck, Milton; Stern, Judy E; Hornstein, Mark D

    2015-04-01

    To compare on a population basis the birth outcomes of women treated with assisted reproductive technologies (ART), women with indicators of subfertility but without ART, and fertile women. Longitudinal cohort study. Not applicable. A total of 334,628 births and fetal deaths to Massachusetts mothers giving birth in a Massachusetts hospital from July 1, 2004, to December 31, 2008, subdivided into three subgroups for comparison: ART 11,271, subfertile 6,609, and fertile 316,748. None. Four outcomes-preterm birth, low birth weight, small for gestational age, and perinatal death-were modeled separately for singletons and twins with the use of logistic regression for the primary comparison between ART births and those to the newly created population-based subgroup of births to women with indicators of subfertility but no ART. For singletons, the risks for both preterm birth and low birth weight were higher for the ART group (adjusted odds ratios [AORs] 1.23 and 1.26, respectively) compared with the subfertile group, and risks in both the ART and the subfertile groups were higher than those among the fertile births group. For twins, the risk of perinatal death was significantly lower among ART births than fertile (AOR 0.55) or subfertile (AOR 0.15) births. The use of a population-based comparison group of subfertile births without ART demonstrated significantly higher rates of preterm birth and low birth weight in ART singleton births, but these differences are smaller than differences between ART and fertile births. Further refinement of the measurement of subfertile births and examination of the independent risks of subfertile births is warranted. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Using Satellite-Based Spatiotemporal Resolved Air Temperature Exposure to Study the Association between Ambient Air Temperature and Birth Outcomes in Massachusetts

    PubMed Central

    Melly, Steven J.; Coull, Brent A.; Nordio, Francesco; Schwartz, Joel D.

    2015-01-01

    Background Studies looking at air temperature (Ta) and birth outcomes are rare. Objectives We investigated the association between birth outcomes and daily Ta during various prenatal exposure periods in Massachusetts (USA) using both traditional Ta stations and modeled addresses. Methods We evaluated birth outcomes and average daily Ta during various prenatal exposure periods in Massachusetts (USA) using both traditional Ta stations and modeled address Ta. We used linear and logistic mixed models and accelerated failure time models to estimate associations between Ta and the following outcomes among live births > 22 weeks: term birth weight (≥ 37 weeks), low birth weight (LBW; < 2,500 g at term), gestational age, and preterm delivery (PT; < 37 weeks). Models were adjusted for individual-level socioeconomic status, traffic density, particulate matter ≤ 2.5 μm (PM2.5), random intercept for census tract, and mother’s health. Results Predicted Ta during multiple time windows before birth was negatively associated with birth weight: Average birth weight was 16.7 g lower (95% CI: –29.7, –3.7) in association with an interquartile range increase (8.4°C) in Ta during the last trimester. Ta over the entire pregnancy was positively associated with PT [odds ratio (OR) = 1.02; 95% CI: 1.00, 1.05] and LBW (OR = 1.04; 95% CI: 0.96, 1.13). Conclusions Ta during pregnancy was associated with lower birth weight and shorter gestational age in our study population. Citation Kloog I, Melly SJ, Coull BA, Nordio F, Schwartz JD. 2015. Using satellite-based spatiotemporal resolved air temperature exposure to study the association between ambient air temperature and birth outcomes in Massachusetts. Environ Health Perspect 123:1053–1058; http://dx.doi.org/10.1289/ehp.1308075 PMID:25850104

  12. National Forest Health Monitoring Program Maryland and Massachusetts Street Tree Monitoring Pilot Projects

    Treesearch

    Buckelew Cumming Anne; Daniel Twardus; William Smith

    2006-01-01

    Urban forests have many components: park trees, small woodlands, riparian buffers, street trees, and others. While some communities conduct city-wide inventories of street tree populations, there has been no comprehensive, statewide sampling to characterize the structure, health, and function of street tree populations. A statewide Street Tree Monitoring pilot study...

  13. Acculturation and sociocultural influences on dietary intake and health status among Puerto Rican adults in Massachusetts

    USDA-ARS?s Scientific Manuscript database

    Previous studies have shown negative consequences of acculturation on lifestyle factors, health status, and dietary intake of Hispanic immigrants in the US. Despite prevalent type 2 diabetes and low socioeconomic status (SES) among Puerto Rican adults living on the US mainland, little is known about...

  14. Translating access into utilization: lessons from the design and evaluation of a health insurance Web site to promote reproductive health care for young women in Massachusetts.

    PubMed

    Janiak, Elizabeth; Rhodes, Elizabeth; Foster, Angel M

    2013-12-01

    Following state-level health care reform in Massachusetts, young women reported confusion over coverage of contraception and other sexual and reproductive health services under newly available health insurance products. To address this gap, a plain-language Web site titled "My Little Black Book for Sexual Health" was developed by a statewide network of reproductive health stakeholders. The purpose of this evaluation was to assess the health literacy demands and usability of the site among its target audience, women ages 18-26 years. We performed an evaluation of the literacy demands of the Web site's written content and tested the Web site's usability in a health communications laboratory. Participants found the Web site visually appealing and its overall design concept accessible. However, the Web site's literacy demands were high, and all participants encountered problems navigating through the Web site. Following this evaluation, the Web site was modified to be more usable and more comprehensible to women of all health literacy levels. To avail themselves of sexual and reproductive health services newly available under expanded health insurance coverage, young women require customized educational resources that are rigorously evaluated to ensure accessibility. To maximize utilization of reproductive health services under expanded health insurance coverage, US women require customized educational resources commensurate with their literacy skills. The application of established research methods from the field of health communications will enable advocates to evaluate and adapt these resources to best serve their targeted audiences. © 2013.

  15. Standardized Screening for Mental Health Needs of Detained Youths from Various Ethnic Origins: The Dutch Massachusetts Youth Screening Instrument-Second Version (MAYSI-2).

    PubMed

    Colins, Olivier F; Grisso, Thomas; Vahl, Pauline; Guy, Laura; Mulder, Eva; Hornby, Natasja; Pronk, Christine; Markus, Monica; Doreleijers, Theo; Vermeiren, Robert

    In the U.S., the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) has been shown to be a reliable and valid tool to identify youth with mental health needs upon entry in detention facilities. The present study examined the factor structure, internal consistency, and convergent validity of the Dutch MAYSI-2 administered as part of routine clinical assessments in up to 955 detained male adolescents. Standardized mental health screening questionnaires (Youth Self-Report and Strengths and Difficulties Questionnaire) were used to test the convergent validity of the Dutch MAYSI-2. Confirmatory factor analyses showed that the factor structure of the original MAYSI-2 could be replicated with the Dutch MAYSI-2. Internal consistency indices showed that the Dutch MAYSI-2 provides a reliable screening of mental health needs. In addition, the Dutch MAYSI-2 scales were related with conceptually parallel measures of the same targeted mental health needs in the total group. With a few exceptions, the internal consistency and convergent validity was supported across ethnic groups as well. Overall, these results suggest the psychometric properties of the Dutch MAYSI-2 to be promising. Implications and limitations of the current study's findings and directions for future research are discussed.

  16. Acculturation and Sociocultural Influences on Dietary Intake and Health Status among Puerto Rican Adults in Massachusetts

    PubMed Central

    Van Rompay, Maria I.; McKeown, Nicola M.; Castaneda-Sceppa, Carmen; Falcon, Luis M.; Ordovas, José M.; Tucker, Katherine L.

    2011-01-01

    Background Previous studies have shown negative consequences of acculturation on lifestyle factors, health status, and dietary intake of Hispanic immigrants in the US. Despite prevalent type 2 diabetes and low socioeconomic status (SES) among Puerto Rican adults living on the US mainland, little is known about acculturation in this group. Objective We investigated associations among acculturation, lifestyle characteristics, health status, and carbohydrate nutrition in Puerto Rican adults. A secondary objective was to investigate possible confounding and/or effect modification on these associations by SES. Design Cross-sectional data from the Boston Puerto Rican Health Study, which included 1219 Puerto Ricans in the Boston area, aged 45–75 years. Statistical analyses Characteristics were compared using ANCOVA, linear trend and Pearson’s chi-square tests across quartiles of acculturation. Tests for interaction by poverty status were conducted. Proportional contributions of foods to intake of total carbohydrate and fiber were assessed using SAS RANK. Results Levels of acculturation were low, despite young age at first arrival to the US mainland (25.4 ± 12.3 y) and long length of stay (34.2 ± 12.2 y). Greater English language use was associated with higher SES, alcohol consumption, physical activity, better perceived health, and less central obesity. Acculturation was associated with lower legume fiber and greater cereal fiber intake. Among those above the poverty threshold, acculturation was associated with lower dietary glycemic index and starch intake, and greater fruit and non-starchy vegetable intake. Conclusions In contrast to studies with Mexican Americans, the association of acculturation with dietary quality in these Puerto Rican adults was mixed, but tended toward better carbohydrate quality. Dietary recommendations should include maintenance of traditional, healthful dietary practices including consumption of legumes, but also reduction in refined

  17. The health of safety net hospitals following Massachusetts health care reform: changes in volume, revenue, costs, and operating margins from 2006 to 2009.

    PubMed

    Mohan, Arun; Grant, Jennifer; Batalden, Maren; McCormick, Danny

    2013-01-01

    Massachusetts health care reform, designed to expand coverage and access to care for vulnerable populations, serves as the model for national health reform in the United States that will be implemented in 2014. Yet, little is known about how the reform may have affected the demand for and the financial performance of safety net hospitals (SNH), the primary source of care for such populations before the reform. Using a quasi-experimental design that included all acute care hospitals in the state, we calculated changes in mean inpatient and outpatient volumes, revenue, and operating margins at SNH from the pre-reform (Fiscal Year 2006) to the post-reform (Fiscal Year 2009) period. We contrasted these changes with contemporaneous changes occurring among non-safety net hospitals (NSNH) using a difference-in-differences approach. We found that SNH in Massachusetts continue to play a disproportionately large role in caring for disadvantaged patients after reform, but that their financial performance has declined considerably compared with NSNH. Ongoing reform efforts in the United States should account for continued SNH demand among the most vulnerable patients and should be designed so as not to undermine the financial stability of SNH that meet this demand.

  18. Ecosystem-based management and refining governance of wind energy in the Massachusetts coastal zone: A case study approach

    NASA Astrophysics Data System (ADS)

    Kumin, Enid C.

    While there are as yet no wind energy facilities in New England coastal waters, a number of wind turbine projects are now operating on land adjacent to the coast. In the Gulf of Maine region (from Maine to Massachusetts), at least two such projects, one in Falmouth, Massachusetts, and another on the island of Vinalhaven, Maine, began operation with public backing only to face subsequent opposition from some who were initially project supporters. I investigate the reasons for this dynamic using content analysis of documents related to wind energy facility development in three case study communities. For comparison and contrast with the Vinalhaven and Falmouth case studies, I examine materials from Hull, Massachusetts, where wind turbine construction and operation has received steady public support and acceptance. My research addresses the central question: What does case study analysis of the siting and initial operation of three wind energy projects in the Gulf of Maine region reveal that can inform future governance of wind energy in Massachusetts state coastal waters? I consider the question with specific attention to governance of wind energy in Massachusetts, then explore ways in which the research results may be broadly transferable in the U.S. coastal context. I determine that the change in local response noted in Vinalhaven and Falmouth may have arisen from a failure of consistent inclusion of stakeholders throughout the entire scoping-to-siting process, especially around the reporting of environmental impact studies. I find that, consistent with the principles of ecosystem-based and adaptive management, design of governance systems may require on-going cycles of review and adjustment before the implementation of such systems as intended is achieved in practice. I conclude that evolving collaborative processes must underlie science and policy in our approach to complex environmental and wind energy projects; indeed, collaborative process is fundamental to

  19. No Further Action Decision Under CERCLA Study Area 43N Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    National Priorities List under the Comprehensive Environmental Response, Compensation and Liability Act ( CERCLA ), as amended by the Superfund ...T UT1ON STATEM4NT A Approved for Public Release Distribution Unlimited NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43N HISTORIC GAS STATION...DECISION UNDER CERCLA STUDY AREA 43N HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS 3 TABLE OF CONTENTS U Section Title Page No. EXECUTIVE SUMMARY

  20. No Further Action Decision Under CERCLA Study Area 43E Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    National Priorities List under the Comprehensive Environmental Response, Compensation and Liability Act ( CERCLA ) asg amended by the Superfund ...U T7,UTION1 STA 7 TAApproved for Public Release Distribution Unlimited I U.S. Army NO FURTHER ACTION DECISION UNDER Environmental Center CERCLA STUDY...FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43E HISTORIC GAS STATION SITES I FORT DEVENS, MASSACHUSETTS i I 1 Prepared for: U.S. Army

  1. No Further Action Decision Under CERCLA, Study Area 43B, Historic Gas Station Sites, Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    8217on the National Priorities List under the Comprehensive Environmental Response, Compensation and Liability Act ( CERCLA ), as amended by the Superfund ...I U.S. Army EnvironmentalCenter NO FURTHER ACTION DECISION UNDER CERCLA * STUDY AREA 43B HISTORIC GAS STATION SITES U FORT DEVENS, MASSACHUSETTS I I...AEC Form 45, 1 Feb 93 replaces THAMA Form 45 which is obsolete. I NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43B HISTORIC GAS STATION SITES I

  2. No Further Action Decision Under CERCLA, Study Area 43P Historic Gas Station Sites, Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Compensation and Liability Act ( CERCLA ) as amended by the Superfund Amendments and Reauthorization Act. An Enhanced Preliminary Assessment (PA) was also...I Approved for Public ’,eas e, Distribution Unlimited E U.S. Army IEnvironmentalCenter NO FURTHER ACTION DECISION UNDER CERCLA i STUDY AREA 43P... CERCLA STUDY AREA 43P HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS a I I Prepared for: U.S. Army Environmental Center Aberdeen Proving Ground

  3. Regional Charging Infrastructure for Plug-In Electric Vehicles: A Case Study of Massachusetts

    SciTech Connect

    Wood, Eric; Raghavan, Sesha; Rames, Clement; Eichman, Joshua; Melaina, Marc

    2017-01-01

    Given the complex issues associated with plug-in electric vehicle (PEV) charging and options in deploying charging infrastructure, there is interest in exploring scenarios of future charging infrastructure deployment to provide insight and guidance to national and regional stakeholders. The complexity and cost of PEV charging infrastructure pose challenges to decision makers, including individuals, communities, and companies considering infrastructure installations. The value of PEVs to consumers and fleet operators can be increased with well-planned and cost-effective deployment of charging infrastructure. This will increase the number of miles driven electrically and accelerate PEV market penetration, increasing the shared value of charging networks to an expanding consumer base. Given these complexities and challenges, the objective of the present study is to provide additional insight into the role of charging infrastructure in accelerating PEV market growth. To that end, existing studies on PEV infrastructure are summarized in a literature review. Next, an analysis of current markets is conducted with a focus on correlations between PEV adoption and public charging availability. A forward-looking case study is then conducted focused on supporting 300,000 PEVs by 2025 in Massachusetts. The report concludes with a discussion of potential methodology for estimating economic impacts of PEV infrastructure growth.

  4. No Further Action Decision Under CERCLA Study Area 43C Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Environmental Response, Compensation and Liability Act ( CERCLA ) as amended by the Superfund Amendments and Reauthorization Act. An Enhanced Preliminary...DISTRIBUTION STATEMENT A Approved for Public Release Distribution Unlimited U.S. Army Environmental NO FURTHER ACTION DECISION UNDER Center CERCLA ...NO FURTHER ACTION UNDER CERCLA STUDY AREA 43C HISTORIC GAS STATION SITES FORT DEVENS, MASSACHUSETTS 3 TABLE OF CONTENTS Section Title Page No. U

  5. Groundwater flow delineation study at the Massachusetts Military Reservation using the colloidal borescope

    SciTech Connect

    Kearl, P.M.; Gardner, F.G.; Gunderson, M.J.

    1993-02-01

    Observations of colloidal movement under natural conditions using the colloidal borescope were conducted at several sites in the vicinity of the Massachusetts Military Reservation (MM) located on Cape Cod. The purpose of the study was to assess the reliability of the colloidal borescope and provide additional hydrogeologic data for site-characterization work. Because of the variability observed in groundwater flow at other sites, a well-characterized site was needed to test the borescope. Results of this work indicate that existing hydrologic information specific to the various sites tested at the MM compares favorably with the borehole velocity data collected with the colloidal borescope. Direction measurements at the MM, however, appear to be less reliable than at other sites tested. Most significant among factors potentially affecting direction measurements is the relatively flat hydraulic gradient at the MM, which is an order of magnitude less than at other sites. This is due to the gentle topography and the relatively high permeability of the aquifer. Under these conditions, the geometric alignment of preferential flow paths could dominate flow direction. If the gradient is increased, flow will tend to parallel the hydraulic gradient. This report describes the field site and the colloidal borescope and discusses the results and conclusions of the field investigations.

  6. Building America Case Study: Boiler Control Replacement for Hydronically Heated Multifamily Buildings, Cambridge, Massachusetts (Fact Sheet)

    SciTech Connect

    Not Available

    2014-11-01

    The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency. Efficient operation of the heating system faced several obstacles, including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68 degrees F) than day (73 degrees F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.

  7. Technology Solutions Case Study: Boiler Control Replacement for Hydronically Heated Multifamily Buildings, Cambridge, Massachusetts

    SciTech Connect

    2014-11-01

    The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency, which faced several obstacles, including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68°F) than day (73° F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.

  8. New Whole-House Case Study: Transformations, Inc. Net Zero Energy Communities, Devens, Easthampton, Townsend, Massachusetts

    SciTech Connect

    2013-11-01

    In 2009, Transformations, Inc. partnered with Building America team Building Science Corporation (BSC) to build new net zero energy houses in three developments in Massachusetts. The company has been developing strategies for cost-effective super-insulated homes in the New England market since 2006. After years of using various construction techniques, it has developed a specific set of assemblies and specifications that achieve a 44.9% reduction in energy use compared with a home built to the 2009 International Residential Code, qualifying the houses for the DOE’s Challenge Home. The super-insulated houses provide data for several research topics in a cold climate. BSC studied the moisture risks in double stud walls insulated with open cell spray foam and cellulose. The mini-split air source heat pump (ASHP) research focused on the range of temperatures experienced in bedrooms as well as the homeowners’ perceptions of equipment performance. BSC also examined the developer’s financing options for the photovoltaic (PV) systems, which take advantage of Solar Renewable Energy Certificates, local incentives, and state and federal tax credits.

  9. Health in Day Care: A Guide for Day Care Providers in Massachusetts.

    ERIC Educational Resources Information Center

    Kendrick, Abby Shapiro, Ed.; Messenger, Katherine P., Ed.

    This reference manual and resource guide describes high standards for health policies and day care procedures that reflect current research and recommendations of experts. Chapters 1 and 2, which concern day care's role in health, cover health education in day care and the basics relating to policies, providers, and records. Chapters 3-5 concern…

  10. Landfill Remediation Feasibility Study, Devens, Massachusetts. Volume 2. Appendices A Through F

    DTIC Science & Technology

    1997-01-01

    Shepley’s Hill Landfill. The RI/FS work effort is complete and the Army has prepared a Proposed Plan for comment . The plan calls for some important...WETLAND DEPRESSION TYPE III 24-HOUR .39 55 WOODS (FAIR - HSG A/B) RAINFALL= 2.6 IN .43 59 SPAN= 5-20 HRS, dt=.l HRS Method Comment Tc (ma) TR-55 SHEET FLOW...34Stratigraphy of the Merrimack Belt, Central Massachusetts." In The Bedrock Geology of Massachusetts. U.S. Geological Survey Professional Paper 1366-G. pp. 61

  11. A case-control study of childhood leukemia in Woburn, Massachusetts: the relationship between leukemia incidence and exposure to public drinking water.

    PubMed

    Costas, Kevin; Knorr, Robert S; Condon, Suzanne K

    2002-12-02

    A 1981 Massachusetts Department of Public Health study confirmed a childhood leukemia cluster in Woburn, Massachusetts. Our follow-up investigation attempts to identify factors potentially responsible for the cluster. Woburn has a 130-year industrial history that resulted in significant local deposition of tannery and chemical manufacturing waste. In 1979, two of the city's eight municipal drinking water wells were closed when tests identified contamination with solvents including trichloroethylene. By 1986, 21 childhood leukemia cases had been observed (5.52 expected during the seventeen year period) and the case-control investigation discussed herein was begun. Nineteen cases and 37 matched controls comprised the study population. A water distribution model provided contaminated public water exposure estimates for subject residences. Results identified a non-significant association between potential for exposure to contaminated water during maternal pregnancy and leukemia diagnosis, (odds ratio = 8.33, 95% CI 0.73-94.67). However, a significant dose-response relationship (P < 0.05) was identified for this exposure period. In contrast, the child's potential for exposure from birth to diagnosis showed no association with leukemia risk. Wide confidence intervals suggest cautious interpretation of association magnitudes. Since 1986, expected incidence has been observed in Woburn including 8 consecutive years with no new childhood leukemia diagnoses.

  12. Long-Term Development of a “Whole Community” Best Practice Model to Address Health Disparities in the Cambodian Refugee and Immigrant Community of Lowell, Massachusetts

    PubMed Central

    Toof, Robin; Silka, Linda; Liang, Sidney; Sou, Linda; Najarian, Lisa; Peou, Sonith; Och, Sheila

    2010-01-01

    Cambodians in Lowell, Massachusetts, experience significant health disparities. Understanding the trauma they have experienced in Cambodia and as refugees has been the starting point for Lowell Community Health Center's whole community approach to developing community-based interventions. This approach places physical-psychosocial-spiritual needs at the center of focus and is attentive to individual and institutional barriers to care. Interventions are multilevel. The effect of the overall program comes from the results of each smaller program, the collaborations and coordination with the Cambodian community and community-based organizations, and the range and levels of services available through the health center. PMID:20864723

  13. Massachusetts Expanded Learning Time (ELT) Initiative. Case Studies 2010-2011

    ERIC Educational Resources Information Center

    Caven, Meghan; Checkoway, Amy; Fisman, Lianne; Gamse, Beth; Fountain, Alyssa Rulf

    2012-01-01

    The Massachusetts Expanded Learning Time (ELT) initiative was launched in 2005, and it provides grants to selected schools across multiple districts to increase instructional time by at least 300 hours per academic year. Participating schools receive an additional $1,300 per student to lengthen the day and/or year. Schools are expected to use the…

  14. Impact of Massachusetts Health Reform on Inpatient Care Use: Was the Safety-Net Experience Different Than in the Non-Safety-Net?

    PubMed

    Hanchate, Amresh D; McCormick, Danny; Lasser, Karen E; Feng, Chen; Manze, Meredith G; Kressin, Nancy R

    2017-10-01

    Most inpatient care for the uninsured and other vulnerable subpopulations occurs in safety-net hospitals. As insurance expansion increases the choice of hospitals for the previously uninsured, we examined if Massachusetts health reform was associated with shifts in the volume of inpatient care from safety-net to non-safety-net hospitals overall, or among other vulnerable sociodemographic (racial/ethnic minority, low socioeconomic status, high uninsured rate area) and clinical subpopulations (emergent status, diagnosis). Discharge records for adults discharged from all nonfederal acute care hospitals in Massachusetts, New Jersey, New York, and Pennsylvania 2004-2010. Using a difference-in-differences design, we compared pre-/post-reform changes in safety-net and non-safety-net hospital discharge outcomes in Massachusetts among adults 18-64 with corresponding changes in comparisons states with no reform, overall, and by subpopulations. Reform was not associated with changes in inpatient care use at safety-net and non-safety-net hospitals across all discharges or in most subpopulations examined. Demand for inpatient care at safety-net hospitals may not decrease following insurance expansion. Whether this is due to other access barriers or patient preference needs to be explored. © Health Research and Educational Trust.

  15. 21 CFR 808.71 - Massachusetts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EXEMPTIONS FROM FEDERAL PREEMPTION OF STATE AND LOCAL MEDICAL DEVICE REQUIREMENTS Listing of Specific State and Local Exemptions § 808.71 Massachusetts. (a) The following Massachusetts medical...

  16. Health assessment for Atlas Tack Corporation, Fairhaven, Massachusetts, Region 1. CERCLIS No. MAD001026319. Preliminary report

    SciTech Connect

    Not Available

    1990-06-04

    The Atlas Tack Site was listed by the U.S. Environmental Protection Agency (EPA) on the National Priorities List (NPL) in 1990. From the mid 1940s to 1978, the Atlas Tack Company discharged industrial wastes in the form of organic solvents and metal filings to an unlined lagoon, which was adjacent to a saltwater tidal marsh. The lagoon contents were removed in 1985, transported to RCRA approved landfills and the lagoon was then backfilled. Factory operations ceased in 1985 and currently only a welding company operates on the site. Ground water monitoring, conducted in 1987, detected elevated levels of benzene, toluene, arsenic, cadmium, lead, chromium, and cyanide in monitoring wells drilled in various areas of the site. Subsequent to sludge removal, extraction procedure (EP) toxicity analyses were done on various soil samples recovered from the site. Based on the available information, this site is considered to be of potential public health concern caused by the possibility of exposure to hazardous substances. In accordance with CERCLA as amended, the Atlas Tack Co. site has been evaluated for appropriate follow-up studies. If data becomes available suggesting that human exposure to significant levels of hazardous substances is currently occurring, or has occurred in the past, ATSDR will reevaluate this site for any indicated follow-up.

  17. Inventory 1967: Massachusetts Health Manpower Training at Less than a Baccalaureate Level. Part I.

    ERIC Educational Resources Information Center

    Training Center for Comprehensive Care, Jamaica Plain, MA.

    Of 379 institutions receiving a questionnaire on their paramedical training programs, 369 replied. They supplied data on 465 courses in 56 job categories. Those conducting the courses include hospitals, nursing homes, high schools, colleges, universities, technical schools, community service agencies, the State Department of Public Health, and an…

  18. Health Impact Assessment(HIA)of Building Renovations at Gerena Community School, Springfield, Massachusetts

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) has conducted an HIA at the German Gerena Community School in Springfield, MA. HIA is a six-step systematic process that uses an array of data sources, analytic methods and stakeholder input to determine the potential health effects of...

  19. Health Impact Assessment(HIA)of Building Renovations at Gerena Community School, Springfield, Massachusetts

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) has conducted an HIA at the German Gerena Community School in Springfield, MA. HIA is a six-step systematic process that uses an array of data sources, analytic methods and stakeholder input to determine the potential health effects of...

  20. No Further Action Decision Under CERCLA Study Area 43S Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    I SApr( eid for Public 𔃽ase i i D stribution Unhirnited I U.S. Army Environmental , Center NO FURTHER ACTION DECISION UNDER I : CERCLA STUDY AREA 43S...ACTION DECISION UNDER CERCLA STUDY AREA 43S HISTORIC GAS STATION SITES 3 FORT DEVENS, MASSACHUSET’TS I I, £ Prepared for: U.S. Army Environmental...JANUARY 1995 I 3 I I I I NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43S HISTORIC GAS STATION SITESU FORT DEVENS, MASSACHUSETTS 5- TABLE OF

  1. Aggregating QECB Allocations & Using QECBs to Support the Private Sector. A Case Study on Massachusetts

    SciTech Connect

    Zimring, Mark; Borgeson, Merrian

    2012-08-01

    Qualified Energy Conservation Bonds (QECBs) are federally-subsidized bonds that enable state, tribal, and local government issuers to borrow money to fund a range of energy conservation projects at very attractive interest rates and long terms. While small allocation sizes have deterred some local governments from pursuing issuances, state agencies in Massachusetts have partnered with local governments to aggregate QECBs to support a range of public and private projects. In most states, QECBs have been utilized primarily to fund energy conservation projects for public entities, but Massachusetts has facilitated over $10 million of private activity QECB issuances to support three privately-owned renewable energy projects—with more projects in the pipeline.

  2. Graduate medical education funding: a Massachusetts General Hospital case study and review.

    PubMed

    Guss, Daniel; Prestipino, Ann L; Rubash, Harry E

    2012-02-15

    During the past century, graduate medical education funding has evolved in response to the increasing specialization of modern medicine as well as the need for federal funding to effectively sustain specialty training. This article reviews historical and current funding methods for graduate medical education and examines current funding using Massachusetts General Hospital (MGH) as a case example. Notably, it also explores whether graduate medical education funding at a large academic center such as MGH is commensurate with expenditures.

  3. Existing Whole-House Solutions Case Study: Multifamily Individual Heating and Ventilation Systems, Lawrence, Massachusetts

    SciTech Connect

    2013-11-01

    The conversion of an older Massachusetts building into condominiums illustrates a safe, durable, and cost-effective solution for heating and ventilation systems that can potentially benefit millions of multifamily buildings. In this project, Merrimack Valley Habitat for Humanity (MVHfH) partnered with U.S. Department of Energy Building America team Building Science Corporation (BSC) to provide high performance affordable housing for 10 families in the retrofit of an existing mass masonry building (a former convent).

  4. Perspectives on the Massachusetts Community Health Information Profile (MassCHIP): developing an online data query system to target a variety of user needs and capabilities.

    PubMed

    Cohen, Bruce B; Franklin, Saul; West, James K

    2006-01-01

    The Massachusetts Community Health Information Profile (MassCHIP) has many distinctive features. These features evolved to maximize the usefulness of this query system for a broad group of users with varied needs, differing levels of knowledge about public health, and diverse experience using public health data. Three major features of MassCHIP help target our large user population. These features are as follows: (1) multiple avenues of entry to initiate queries ranging from an alphabetical list of simple topics to detailed International Classification of Disease codes; (2) the inclusion of data sets from other state agencies in addition to those of the Massachusetts Department of Public Health to reflect a broad view of public health; and (3) the capacity to retrieve data for multiple levels of geography, from the neighborhood through the state, including planning districts and hospitals. In this article, we discuss the history and design of MassCHIP, and focus on the features of MassCHIP that target a great variety of user needs and capabilities, and which are distinctive among Web-based data query systems.

  5. Federal and state public health authority and mandatory vaccination: is Jacobson v Massachusetts still valid?

    PubMed

    Marshall, Lewis W; Marshall, Brenda L; Valladares, Glenn

    2010-01-01

    Novel H1N1 influenza virus infected more than 43,000 people, killed 353 and spread to more than 122 countries within a few months. The World Health Organization declared a stage 6 worldwide pandemic. Healthcare workers and hospitals prepared for the worst. Federal and State regulations provided the legal framework to allow for the preparation and planning for a pandemic. One State had mandated both seasonal and Novel H1N1 vaccination of all healthcare workers in an effort to reduce transmission of influenza in healthcare facilities. The US Supreme Court decided in 1905 that the police power of the State permitted a State Department of Health the leeway to mandate vaccination in the face of a contagious disease. Law suits were filed, and a temporary injunction barring mandatory vaccination was entered by the court. While awaiting a court hearing, the mandatory vaccination regulation was rescinded because of the shortage of both seasonal and H1N1 vaccine. Based on the current state of the pandemic and the shortage of vaccination, it is possible that the US Supreme Court would uphold mandatory vaccination in a pandemic.

  6. Touching Hearts, Touching Minds: Using Emotion-Based Messaging to Promote Healthful Behavior in the Massachusetts WIC Program

    ERIC Educational Resources Information Center

    Colchamiro, Rachel; Ghiringhelli, Kara; Hause, Judith

    2010-01-01

    The "Touching Hearts, Touching Minds" initiative was funded through a 2003 United States Department of Agriculture Special Projects grant to revitalize nutrition education and services in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program. The 30 nutrition education materials and…

  7. Touching Hearts, Touching Minds: Using Emotion-Based Messaging to Promote Healthful Behavior in the Massachusetts WIC Program

    ERIC Educational Resources Information Center

    Colchamiro, Rachel; Ghiringhelli, Kara; Hause, Judith

    2010-01-01

    The "Touching Hearts, Touching Minds" initiative was funded through a 2003 United States Department of Agriculture Special Projects grant to revitalize nutrition education and services in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program. The 30 nutrition education materials and…

  8. Forest statistics for Massachusetts

    Treesearch

    John R. Peters; Teresa M. Bowers

    1977-01-01

    This report contains data from the second inventory of the forest resources of Massachusetts. The inventory was completed in 1971 by the Northeastern Forest Experiment Station in cooperation with the Massachusetts Department of Natural Resources.

  9. Parents' supportive reactions to sexual orientation disclosure associated with better health: results from a population-based survey of LGB adults in Massachusetts.

    PubMed

    Rothman, Emily F; Sullivan, Mairead; Keyes, Susan; Boehmer, Ulrike

    2012-01-01

    This study investigated associations between coming out to parents, experiences of parental support, and self-reported health behaviors and conditions among a population-based sample of LGB individuals using data collected via the 2002 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS; N = 177). We explored the following two hypotheses: 1) Lesbian, gay, and bisexual (LGB) individuals who had never disclosed their sexual orientation to a parent would report higher levels of risk behaviors and poorer health conditions than those who had come out; and 2) among LGB respondents who had come out to their parents, the individuals whose parents had reacted unsupportively would report higher levels of risk behaviors and poorer health conditions than those who had come out to parents who were supportive. Approximately two thirds of gay and bisexual (GB) males and lesbian and bisexual (LB) females reported receiving adequate social and emotional support from the parent to whom they first disclosed their sexual orientation. Among LB females, no disclosure of sexual orientation to a parent was associated with significantly elevated levels of past-month illicit drug use (AOR 12.16, 95% CI 2.87-51.54), fair or poor self-reported health status (AOR 5.71, 95% CI 1.45-22.51), and >15 days of depression in the past month (AOR 5.95, 95% CI 1.78-19.90), controlling for potential confounders. However, nondisclosure to a parent by GB males was not associated with greater odds of any of the health indicators assessed. Among GB males, those with unsupportive parents were significantly more likely to report current binge drinking (AOR 6.94, 95% CI 1.70-28.35) and >15 days depression in the past month (AOR 6.08, 95% CI 1.15-32.15), and among LB females, those with unsupportive parents were significantly more likely to report lifetime illicit drug use (AOR 11.43, 95% CI 2.50-52.30), and >15 days depression in the past month (AOR 5.51, 95% CI 1.36-22.36). We conclude that coming

  10. Intelligent transportation systems case study: central artery (I-93)/tunnel (I-90) project, Boston, Massachusetts, USA

    NASA Astrophysics Data System (ADS)

    Luchian, Sergiu F.; Krechmer, Daniel

    1995-01-01

    The Central Artery/Tunnel (CA/T) project provides an excellent opportunity to implement and test the application of Intelligent Transportation Systems (ITS) technology to improve traffic safety in a congested urban corridor. As currently designed, the CA/T project will have the most extensive ITS capabilities of any highway in the U.S.A., and numerous opportunities exist to build upon these capabilities. Advances in the state-of-the-art of both ITS technology and applications can improve the safety and convenience of the travelling public in Eastern Massachusetts and provide significant regional economic benefits as well.

  11. Pathways of Thriving and Resilience: Growth Responses to Adversity and Trauma in Two Cambodian Communities: A Comparative Study between Lowell, Massachusetts and Phnom Penh, Cambodia.

    ERIC Educational Resources Information Center

    West, Cheryl D.

    This qualitative study investigated individual, contextual, and cultural factors that promote trauma-related resilience and positive growth among Cambodian survivors of the Pol Pot regime who reside in Phnom Penh, Cambodia and Lowell, Massachusetts. A thriving paradigm framed semi-structured interviews that were conducted with 21 Cambodians in…

  12. Building America Case Study: Solar Water Heating in Multifamily Buildings, Greenfield, Massachusetts

    SciTech Connect

    2016-05-01

    Solar domestic hot water (SDHW) systems have been installed on buildings for decades, but because of relatively high costs they have not achieved significant market penetration in most of the country. As more buildings move towards zero net energy consumption, however, many designers and developers are looking more closely at SDHW. In multifamily buildings especially, SDHW may be more practical for several reasons: (1) When designing for zero net energy consumption, solar water heating may be part of the lowest cost approach to meet water heating loads. (2) Because of better scale, SDHW systems in multifamily buildings cost significantly less per dwelling than in single-family homes. (3) Many low-load buildings are moving away from fossil fuels entirely. SDHW savings are substantially greater when displacing electric resistance water heating. (4) In addition to federal tax incentives, some states have substantial financial incentives that dramatically reduce the costs (or increase the benefits) of SDHW systems in multifamily buildings. With support from the U.S. DOE Building America program, the Consortium for Advanced Residential Buildings (CARB) worked with a developer in western Massachusetts to evaluate a SDHW system on a 12-unit apartment building. Olive Street Development completed construction in spring of 2014, and CARB has been monitoring performance of the water heating systems since May 2014.

  13. Building America Case Study: Indirect Solar Water Heating Systems in Single-Family Homes, Greenfield, Massachusetts

    SciTech Connect

    2016-04-01

    Solar water heating systems are not new, but they have not become prevalent in most of the U.S. Most of the country is cold enough that indirect solar thermal systems are required for freeze protection, and average installed cost of these systems is $9,000 to $10,000 for typical systems on single-family homes. These costs can vary significantly in different markets and with different contractors, and federal and regional incentives can reduce these up-front costs by 50% or more. In western Massachusetts, an affordable housing developer built a community of 20 homes with a goal of approaching zero net energy consumption. In addition to excellent thermal envelopes and PV systems, the developer installed a solar domestic water heating system (SDHW) on each home. The Consortium for Advanced Residential Buildings (CARB), a research consortium funded by the U.S. Department of Energy Building America program, commissioned some of the systems, and CARB was able to monitor detailed performance of one system for 28 months.

  14. Technology Solutions Case Study: Monitoring of Double Stud Wall Moisture Conditions in the Northeast, Devens, Massachusetts

    SciTech Connect

    2015-03-01

    Double stud walls have a higher risk of interior-sourced condensation moisture damage when compared with high-R approaches using exterior insulating sheathing. In this project, Building Science Corporation monitored moisture conditions in double-stud walls from 2011 through 2014 at a new production house located in Devens, Massachusetts. The builder, Transformations, Inc., has been using double-stud walls insulated with 12 in. of open cell polyurethane spray foam (ocSPF); however, the company has been considering a change to netted and blown cellulose insulation for cost reasons. Cellulose is a common choice for double-stud walls because of its lower cost (in most markets). However, cellulose is an air-permeable insulation, unlike spray foams, which increases interior moisture risks. The team compared three double-stud assemblies: 12 in. of ocSPF, 12 in. of cellulose, and 5-½ in. of ocSPF at the exterior of a double-stud wall (to approximate conventional 2 × 6 wall construction and insulation levels, acting as a control wall). These assemblies were repeated on the north and south orientations, for a total of six assemblies.

  15. Conservation Commissions in Massachusetts.

    ERIC Educational Resources Information Center

    Scheffey, Andrew J. W.

    The Conservation Foundation reported on the experience of a resource development specialist in the state of Massachusetts on the public's growing concern for environmental quality. After tracing the origins of the Massachusetts movement, the report draws upon a variety of specific state experiences to illustrate the commission's growing pains and…

  16. Massachusetts: more mirage than miracle.

    PubMed

    Miller, Tom

    2006-01-01

    Enactment of the Massachusetts health reform plan stemmed primarily from several factors unique to the state. They were augmented by a questionable rationale that this latest version of health reform would forestall even greater threats ahead to the interests of the state's business community, private insurance policyholders, and taxpayers. The plan's foremost achievement involves development of a "Connector" mechanism to facilitate pooling and purchasing beyond the workplace. However, its successful implementation will be challenged by the complexities of enforcing an individual mandate and changing the long-standing course of an overregulated and high-cost health market.

  17. Access and utilization of healthcare services in Massachusetts, United States: a qualitative study of the perspectives and experiences of Brazilian-born immigrant women.

    PubMed

    Lindsay, Ana C; de Oliveira, Mariana Gonçalves; Wallington, Sherrie F; Greaney, Mary L; Machado, Marcia Maria Tavares; Freitag Pagliuca, Lorita M; Arruda, Carlos Andre Moura

    2016-09-02

    Understanding immigrants' interactions with the United States (US) healthcare system will likely make it possible to meet their healthcare needs and improve their quality of life in the US. Although challenges to accessing and utilizing healthcare in the US have been identified, there is little information specific to Brazilian-born immigrants' experiences. Brazilians comprise a fast-growing immigrant population group in the US. The purpose of this study was to explore Brazilian immigrant women's perspectives and experiences with healthcare services in the US to gain insights into factors amenable to interventions that may contribute to disparities in access to and utilization of services. Five focus groups were conducted from April to May in 2015 using a purposeful sampling of Brazilian-born immigrant women living in Massachusetts, US. Thirty-five women participated in this study. Although participants expressed their overall satisfaction with the US healthcare system, they noted several barriers to care, including sociocultural differences in delivery of care and communication barriers, including inconsistent quality of interpreting services. This study provides new information on the experiences and challenges faced by Brazilian immigrant women in accessing and utilizing healthcare services in the US and points out opportunities for improving services and the overall health of this immigrant population. Addressing noted sociocultural differences and communication barriers including inconsistent quality of hospital's interpreting services might enhance Brazilian-born immigrants' experiences with the healthcare system.

  18. Public health assessment for Nyanza Chemical Waste Dump, Ashland, Middlesex County, Massachusetts, Region 1. Cerclis No. MAD990685422. Final report

    SciTech Connect

    Not Available

    1994-06-29

    The Nyanza site is located in Ashland, Massachusetts, approximately 22 miles west of Boston. More than 100 different chemicals (mainly dyes, but additionally a number of semi-volatiles including benzidine, dianisidine, o-tolidine, and 2-napthylamine) have been detected at the site, which encompasses a 35-acre area. Liquid wastes from Nyanza have been discharged into the environment in several different ways including into the underground vault, unlined lagoons, and nearby brooks and wetlands. Surface water and soil on-site are known to have been contaminated. Groundwater beneath and downgradient of the site is known to be contaminated. Releases into the ambient air are known to have occurred historically. These releases have included oleum, bromine, and nitric acid. Opportunity for human exposure in the past was high and included exposures to children playing in the soils and lagoons on-site as well as in the Chemical Brook.

  19. A Health Impact Assessment of a Proposed Bill to Decrease Speed Limits on Local Roads in Massachusetts (U.S.A.)

    PubMed Central

    James, Peter; Ito, Kate; Banay, Rachel F.; Buonocore, Jonathan J.; Wood, Benjamin; Arcaya, Mariana C.

    2014-01-01

    Decreasing traffic speeds increases the amount of time drivers have to react to road hazards, potentially averting collisions, and makes crashes that do happen less severe. Boston’s regional planning agency, the Metropolitan Area Planning Council (MAPC), in partnership with the Massachusetts Department of Public Health (MDPH), conducted a Health Impact Assessment (HIA) that examined the potential health impacts of a proposed bill in the state legislature to lower the default speed limits on local roads from 30 miles per hour (mph) to 25 mph. The aim was to reduce vehicle speeds on local roads to a limit that is safer for pedestrians, cyclists, and children. The passage of this proposed legislation could have had far-reaching and potentially important public health impacts. Lower default speed limits may prevent around 18 fatalities and 1200 serious injuries to motorists, cyclists and pedestrians each year, as well as promote active transportation by making local roads feel more hospitable to cyclists and pedestrians. While a lower speed limit would increase congestion and slightly worsen air quality, the benefits outweigh the costs from both a health and economic perspective and would save the state approximately $62 million annually from prevented fatalities and injuries. PMID:25279544

  20. A health impact assessment of a proposed bill to decrease speed limits on local roads in Massachusetts (U.S.A.).

    PubMed

    James, Peter; Ito, Kate; Banay, Rachel F; Buonocore, Jonathan J; Wood, Benjamin; Arcaya, Mariana C

    2014-10-02

    Decreasing traffic speeds increases the amount of time drivers have to react to road hazards, potentially averting collisions, and makes crashes that do happen less severe. Boston's regional planning agency, the Metropolitan Area Planning Council (MAPC), in partnership with the Massachusetts Department of Public Health (MDPH), conducted a Health Impact Assessment (HIA) that examined the potential health impacts of a proposed bill in the state legislature to lower the default speed limits on local roads from 30 miles per hour (mph) to 25 mph. The aim was to reduce vehicle speeds on local roads to a limit that is safer for pedestrians, cyclists, and children. The passage of this proposed legislation could have had far-reaching and potentially important public health impacts. Lower default speed limits may prevent around 18 fatalities and 1200 serious injuries to motorists, cyclists and pedestrians each year, as well as promote active transportation by making local roads feel more hospitable to cyclists and pedestrians. While a lower speed limit would increase congestion and slightly worsen air quality, the benefits outweigh the costs from both a health and economic perspective and would save the state approximately $62 million annually from prevented fatalities and injuries.

  1. Massachusetts General Hospital starts own degree programs.

    PubMed

    1979-01-01

    Massachusetts General Hospital has established a new Education Division that administers various degree programs in seven professional fields. Major emphasis is on interdisciplinary study and integration of the academic and the clinical components of training.

  2. The Enough Abuse Campaign: Building the Movement to Prevent Child Sexual Abuse in Massachusetts

    ERIC Educational Resources Information Center

    Schober, Daniel J.; Fawcett, Stephen B.; Bernier, Jetta

    2012-01-01

    This case study describes the Enough Abuse Campaign, a multidisciplinary, statewide effort to prevent child sexual abuse in Massachusetts. The study uses the Institute of Medicine's Framework for Collaborative Community Action on Health to provide a systematic description of the campaign's process of implementation, which includes: (a) developing…

  3. The Enough Abuse Campaign: Building the Movement to Prevent Child Sexual Abuse in Massachusetts

    ERIC Educational Resources Information Center

    Schober, Daniel J.; Fawcett, Stephen B.; Bernier, Jetta

    2012-01-01

    This case study describes the Enough Abuse Campaign, a multidisciplinary, statewide effort to prevent child sexual abuse in Massachusetts. The study uses the Institute of Medicine's Framework for Collaborative Community Action on Health to provide a systematic description of the campaign's process of implementation, which includes: (a) developing…

  4. Nutrition Counts. Massachusetts Nutrition Surveillance System. FY90 Annual Report.

    ERIC Educational Resources Information Center

    Wiecha, Jean L.; And Others

    "Nutrition Counts," the pediatric portion of the Massachusetts Department of Public Health's (MDPH) Nutrition Surveillance System, monitors and describes aspects of nutritional status among groups of young children in the state. This report presents cross-sectional data describing 5,176 infants and young children in Massachusetts. Of…

  5. Nutrition Counts. Massachusetts Nutrition Surveillance System. FY90 Annual Report.

    ERIC Educational Resources Information Center

    Wiecha, Jean L.; And Others

    "Nutrition Counts," the pediatric portion of the Massachusetts Department of Public Health's (MDPH) Nutrition Surveillance System, monitors and describes aspects of nutritional status among groups of young children in the state. This report presents cross-sectional data describing 5,176 infants and young children in Massachusetts. Of…

  6. Health-hazard evaluation report HETA 91-254-2186, Ropes and Gray Photocopy Center, Boston, Massachusetts

    SciTech Connect

    Cook, C.K.; Crandall, M.S.

    1992-03-01

    In response to a request from a group of employees at the Pitney Bowes Management Services, Ropes and Gray Photocopy Center (SIC-7334), Boston, Massachusetts, an evaluation was undertaken of worker exposures to photocopy emissions. The photocopy center has been in operation for 2 years. Six full time employees worked the day shift operating six photocopiers of various models. Approximately 1 million copies were generated monthly at the site. Qualitative and quantitative analyses of air samples taken for volatile organic carbons revealed trace amounts of 1,1,1-trichloroethane (71556), isooctane (540841), toluene (108883), xylene (1330207), and benzene (71432). Ozone (10028156) concentrations as high as 0.41 parts per million (ppm) were detected at approximately 3 feet from the exhaust of each photocopier. Carbon-dioxide (124389) concentrations ranged from 300 to 825ppm. Respirable dust concentrations ranged from less than 10 to 50 micrograms per cubic meter. Carbon-monoxide (630080) was not detected. The authors conclude that the evaluation did not reveal a hazard to explain the respiratory symptoms experienced by the workers. The finding that the ventilation system moved too small an amount of air in a measured period of time may account for the accumulation of airborne contaminants within the building. Recommendations were made to improve the ventilation.

  7. Media Competition Implementation for the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD): Adoption and Reach

    PubMed Central

    Criss, Shaniece; Cheung, Lilian; Giles, Catherine; Gortmaker, Steven; Viswanath, Kasisomayajula; Kwass, Jo-Ann; Davison, Kirsten

    2016-01-01

    The Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD) was a multi-level, multi-sector community intervention with a media competition component to provide an overarching synergy and promote awareness of target behaviors to reduce childhood obesity. Students participating in the media competition were tasked with developing videos, song/rap lyrics, and artwork that reflected the goals. The aim of this study is to document the process used to develop and implement the media competition along with its reach and adoption. An adapted version of Neta and colleagues’ 2015 framework on dissemination and implementation was used to summarize the process by which the media competition was developed and implemented. Adoption was defined by whether eligible schools or afterschool programs decided to implement the media competition. Reach was defined by student participation rates within schools/programs and the number of votes cast for the finalists on the coalition website and students’ paper ballots. A total of 595 students participated in the media competition from 18 school and afterschool programs in two communities. Adoption of the media competitions ranged from 22% to 100% in programs and reach ranged from 3% to 33% of the student population. The documentation of the implementation should contribute to the replication of the media competition. PMID:27058549

  8. Media Competition Implementation for the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD): Adoption and Reach.

    PubMed

    Criss, Shaniece; Cheung, Lilian; Giles, Catherine; Gortmaker, Steven; Viswanath, Kasisomayajula; Kwass, Jo-Ann; Davison, Kirsten

    2016-04-05

    The Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD) was a multi-level, multi-sector community intervention with a media competition component to provide an overarching synergy and promote awareness of target behaviors to reduce childhood obesity. Students participating in the media competition were tasked with developing videos, song/rap lyrics, and artwork that reflected the goals. The aim of this study is to document the process used to develop and implement the media competition along with its reach and adoption. An adapted version of Neta and colleagues' 2015 framework on dissemination and implementation was used to summarize the process by which the media competition was developed and implemented. Adoption was defined by whether eligible schools or afterschool programs decided to implement the media competition. Reach was defined by student participation rates within schools/programs and the number of votes cast for the finalists on the coalition website and students' paper ballots. A total of 595 students participated in the media competition from 18 school and afterschool programs in two communities. Adoption of the media competitions ranged from 22% to 100% in programs and reach ranged from 3% to 33% of the student population. The documentation of the implementation should contribute to the replication of the media competition.

  9. Mandatory insurance coverage and hospital productivity in Massachusetts: bending the curve?

    PubMed

    Thompson, Mark A; Huerta, Timothy R; Ford, Eric W

    2012-01-01

    The aim of this study was to examine whether universal insurance coverage mandates lead to a more productive use of hospital resources. The American Hospital Association's Annual Survey and the Centers for Medicare and Medicaid Services' case mix index for fiscal years 2005 through 2008 were used. A Malmquist approach was used to assess hospitals' productivity in the United States and Massachusetts over the sample period. Propensity score matching is used to "simulate" a randomized control group of hospitals from other markets to compare with Massachusetts. Comparisons are then made to examine if productivity differences are due to universal health insurance coverage mandate. In the early stages, Massachusetts' coverage mandates lead to a significant drop in hospitals' productivity relative to comparable facilities in other states. In 2008, Massachusetts functioned 3.53% below its 2005 level, whereas facilities across the United States have seen a 4.06% increase over the same period. If the individual mandate is implemented nationwide, the Massachusetts' experience indicates that a near-term decrease in overall hospital productivity will occur. As such, current cost estimates of the Patient Protection and Affordable Care Act's impact on overall health spending are potentially understated.

  10. The Volunteer Health Advisor Program of Cambridge Health Alliance: "A Bridge Between the Community and the Health Care System" Cambridge, Massachusetts

    ERIC Educational Resources Information Center

    Perspectives in Peer Programs, 2005

    2005-01-01

    Cambridge Health Alliance's Volunteer Health Advisor (VHA) Program was developed to create an effective and cost efficient outreach network to improve community health status. The program's mission is to improve community health by working collaboratively with faith-based and community-based organizations to recruit, train, and support a…

  11. Simmons Hall, Massachusetts.

    ERIC Educational Resources Information Center

    Amelar, Sarah

    2003-01-01

    Describes the design of Simmons Hall, an undergraduate dormitory at the Massachusetts Institute of Technology, including the educational context and design goals. Includes information on the architects, as well as floor plans and photographs. (EV)

  12. Health Care Reform: America's Dilemma. Report on the National Meeting (Boston, Massachusetts, November 28-29, 1990).

    ERIC Educational Resources Information Center

    Labor/Higher Education Council, Washington, DC.

    Health care reform's direct effect on higher education and labor is the subject of this conference report. Individual, panel, and interactive work group presentations addressing the values and options on health care issues are included. Following an introduction, three papers discuss the U.S. health care system: (1) "National Health Care…

  13. Health Care Reform: America's Dilemma. Report on the National Meeting (Boston, Massachusetts, November 28-29, 1990).

    ERIC Educational Resources Information Center

    Labor/Higher Education Council, Washington, DC.

    Health care reform's direct effect on higher education and labor is the subject of this conference report. Individual, panel, and interactive work group presentations addressing the values and options on health care issues are included. Following an introduction, three papers discuss the U.S. health care system: (1) "National Health Care…

  14. Case-control study of lung cancer risk from residential radon exposure in Worcester county, Massachusetts.

    PubMed

    Thompson, Richard E; Nelson, Donald F; Popkin, Joel H; Popkin, Zenaida

    2008-03-01

    A study of lung cancer risk from residential radon exposure and its radioactive progeny was performed with 200 cases (58% male, 42% female) and 397 controls matched on age and sex, all from the same health maintenance organization. Emphasis was placed on accurate and extensive year-long dosimetry with etch-track detectors in conjunction with careful questioning about historic patterns of in-home mobility. Conditional logistic regression was used to model the outcome of cancer on radon exposure, while controlling for years of residency, smoking, education, income, and years of job exposure to known or potential carcinogens. Smoking was accounted for by nine categories: never smokers, four categories of current smokers, and four categories of former smokers. Radon exposure was divided into six categories (model 1) with break points at 25, 50, 75, 150, and 250 Bq m, the lowest being the reference. Surprisingly, the adjusted odds ratios (AORs) were, in order, 1.00, 0.53, 0.31, 0.47, 0.22, and 2.50 with the third category significantly below 1.0 (p < 0.05), and the second, fourth, and fifth categories approaching statistical significance (p < 0.1). An alternate analysis (model 2) using natural cubic splines allowed calculating AORs as a continuous function of radon exposure. That analysis produces AORs that are substantially less than 1.0 with borderline statistical significance (0.048 < or = p < or = 0.05) between approximately 85 and 123 Bq m. College-educated subjects in comparison to high-school dropouts have a significant reduction in cancer risk after controlling for smoking, years of residency, and job exposures with AOR = 0.30 (95% CI: 0.13, 0.69), p = 0.005 (model 1).

  15. Provider characteristics associated with guideline-nonadherent gonorrhea treatment, Massachusetts, 2010.

    PubMed

    Swails, Jennifer; Smock, Laura; Hsu, Katherine

    2014-02-01

    Emerging antibiotic resistance may be slowed through effective implementation of treatment guidelines. Our case-control study showed that providers who treated gonorrhea differently from guidelines in Massachusetts accounted for approximately 4% of cases and were associated with private practice/health maintenance organization settings and lower-incidence locations. Patient β-lactam allergy was also significantly associated with guideline nonadherence.

  16. Great Teachers Are Not Born, They Are Made: Case Study Evidence from Massachusetts Charters. White Paper No. 130

    ERIC Educational Resources Information Center

    Candal, Cara Stillings

    2015-01-01

    In recent decades, the Commonwealth of Massachusetts has implemented reforms aimed at improving and controlling the quality of the teaching workforce in public schools. Among those reforms are tests for licensure that assess both general and content-area specific knowledge, requirements for ongoing teacher professional development, and procedures…

  17. Food Insecurity and Cardiovascular Health in Pregnant Women: Results From the Food for Families Program, Chelsea, Massachusetts, 2013–2015

    PubMed Central

    Morales, Mary E.; Epstein, Michael H.; Marable, Danelle E.; Oo, Sarah A.

    2016-01-01

    Background Food insecurity, uncertainty about the ability to acquire adequate food, is associated with cardiometabolic disease in pregnant women. Whether food insecurity interventions improve cardiometabolic health is unknown. Methods We conducted a retrospective analysis of women who visited the obstetrics clinic in a community health center from 2013 through 2015. Patients could be referred to the Food for Families (Food for Families) program, which connects food insecure women to food resources. We hypothesized that participation in Food for Families would be associated with better blood pressure and blood glucose trends during pregnancy. We used a propensity score–matched design to reduce bias from differential entry into Food for Families. Results Eleven percent of women who visited the obstetrics clinic were referred to Food for Families. In propensity score–matched analyses, we found no difference in baseline systolic blood pressure (SBP) between those who were referred and enrolled in Food for Families (113.5 mm Hg), those who were referred and did not enroll in Food for Families (113.9 mm Hg), and those who were not referred to Food for Families (114 mm Hg) (P = .79). However, during pregnancy, women who were referred to and enrolled in Food for Families had a better SBP trend (0.2015 mm Hg/wk lower, P = .006). SBP trends did not differ between women who were referred and did not enroll in Food for Families and those who were not referred. We observed no differences in blood glucose trends between groups (P = .40). Conclusions Food for Families participation was associated with better blood pressure trends in pregnant women but no differences in blood glucose trends. Food insecurity reduction programs may improve cardiovascular health for vulnerable pregnant women, and this topic deserves further study incorporating randomized program entry. PMID:27809418

  18. Massachusetts health reform’s effect on hospitals’ racial mix of patients and on patients’ use of safety-net hospitals

    PubMed Central

    Lasser, Karen E.; Hanchate, Amresh D.; McCormick, Danny; Chu, Chieh; Xuan, Ziming; Kressin, Nancy R.

    2016-01-01

    Background Due to residential segregation and a lack of health insurance, minorities often receive care in different facilities than whites. Massachusetts (MA) health reform provided insurance to previously uninsured patients, which enabled them to potentially shift inpatient care to non-minority-serving or non-safety-net hospitals. Objectives Examine whether MA health reform affected hospitals’ racial mix of patients, and individual patients’ use of safety-net hospitals. Research design Difference-in-differences analysis of 2004–2009 inpatient discharge data from MA, compared to New York (NY), and New Jersey (NJ), to identify post-reform changes, adjusting for secular changes. Subjects (1) Hospital-level analysis (discharges): 345 MA, NY, and NJ hospitals; (2) patient-level analysis (patients): 39,921 patients with ≥ 2 hospitalizations at a safety-net hospital in the pre-reform period Measures Pre- to post-reform changes in percentage of discharges that are minority (black and Hispanic) at minority-serving hospitals; adjusted odds of patient movement from safety-net hospitals (pre-reform) to non-safety-net hospitals (post-reform) by age group and state. Results Treating NJ as the comparison state, MA reform was associated with an increase of 5.8% (95% CI 1.4% to 10.3%) in the percentage of minority discharges at MA minority-serving hospitals; with NY as the comparison state, the change was 2.1% (95% CI −0.04% to 4.3%). Patient movement from safety-net to non-safety-net hospitals was slightly greater in MA than comparison states (difference-in-differences adjusted OR 1.1, 95% CI, 1.0–1.2, p=0.04). Conclusions Following MA health reform, the safety-net remains an important component of the healthcare system. PMID:27261638

  19. Vulnerability, risk perception, and health profile of marginalized people exposed to multiple built-environment stressors in Worcester, Massachusetts: a pilot project.

    PubMed

    Downs, Timothy J; Ross, Laurie; Goble, Robert; Subedi, Rajendra; Greenberg, Sara; Taylor, Octavia

    2011-04-01

    Millions of low-income people of diverse ethnicities inhabit stressful old urban industrial neighborhoods. Yet we know little about the health impacts of built-environment stressors and risk perceptions in such settings; we lack even basic health profiles. Difficult access is one reason (it took us 30 months to survey 80 households); the lack of multifaceted survey tools is another. We designed and implemented a pilot vulnerability assessment tool in Worcester, Massachusetts. We answer: (1) How can we assess vulnerability to multiple stressors? (2) What is the nature of complex vulnerability-including risk perceptions and health profiles? (3) How can findings be used by our wider community, and what lessons did we learn? (4) What implications arise for science and policy? We sought a holistic picture of neighborhood life. A reasonably representative sample of 80 respondents captured data for 254 people about: demographics, community concerns and resources, time-activity patterns, health information, risk/stress perceptions, and resources/capacities for coping. Our key findings derive partly from the survey data and partly from our experience in obtaining those data. Data strongly suggest complex vulnerability dominated by psychosocial stress. Unexpected significant gender and ethnic disease disparities emerged: notably, females have twice the disease burden of males, and white females twice the burden of females of color (p < 0.01). Self-reported depression differentiated by gender and age is illustrative. Community based participatory research (CBPR) approaches require active engagement with marginalized populations, including representatives as funded partners. Complex vulnerability necessitates holistic, participatory approaches to improve scientific understanding and societal responses.

  20. Vulnerability, Risk Perception, and Health Profile of Marginalized People Exposed to Multiple Built-Environment Stressors in Worcester, Massachusetts: A Pilot Project

    PubMed Central

    Downs, Timothy J.; Ross, Laurie; Goble, Robert; Subedi, Rajendra; Greenberg, Sara; Taylor, Octavia

    2011-01-01

    Millions of low-income people of diverse ethnicities inhabit stressful old urban industrial neighborhoods. Yet we know little about the health impacts of built-environment stressors and risk perceptions in such settings; we lack even basic health profiles. Difficult access is one reason (it took us 30 months to survey 80 households); the lack of multifaceted survey tools is another. We designed and implemented a pilot vulnerability assessment tool in Worcester, Massachusetts. We answer: (1) How can we assess vulnerability to multiple stressors? (2) What is the nature of complex vulnerability—including risk perceptions and health profiles? (3) How can findings be used by our wider community, and what lessons did we learn? (4) What implications arise for science and policy? We sought a holistic picture of neighborhood life. A reasonably representative sample of 80 respondents captured data for 254 people about: demographics, community concerns and resources, time-activity patterns, health information, risk/stress perceptions, and resources/capacities for coping. Our key findings derive partly from the survey data and partly from our experience in obtaining those data. Data strongly suggest complex vulnerability dominated by psychosocial stress. Unexpected significant gender and ethnic disease disparities emerged: notably, females have twice the disease burden of males, and white females twice the burden of females of color (p < 0.01). Self-reported depression differentiated by gender and age is illustrative. Community based participatory research (CBPR) approaches require active engagement with marginalized populations, including representatives as funded partners. Complex vulnerability necessitates holistic, participatory approaches to improve scientific understanding and societal responses. PMID:21175719

  1. Development and validation of the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale: an exploratory and methodological study.

    PubMed

    Yu, David Tai Wai; Jones, Alice Yee Man; Pang, Marco Yiu Chung

    2012-09-01

    The Massachusetts General Hospital Acupuncture Sensation Scale (MASS) is a tool to measure needle sensations. The aims of the present study were to develop a Chinese version and to assess its psychometric properties. This study was a methodological and exploratory study. The English version of the MASS was translated into Chinese using standardised translation procedures. Content validity was conducted by nine acupuncture experts. The prefinal Chinese version (C-MASS) was then administered to 30 acupuncture-naïve, healthy subjects. Electroacupuncture was performed on the right LI4 and LI11 acupoints for 30 min. A test-retest reliability measurement was administered 1-2 weeks later. Construct validity was examined by comparing results from C-MASS and the Short-Form McGill Pain Questionnaire (SF-MPQ). The construct validity was further assessed by the principle component analysis. C-MASS demonstrated a content validity ratio on relevance and importance from -0.04 to 1.00. Convergent validity was demonstrated by its significant association with the sensory dimension of SF-MPQ (γ=0.63, p<0.05). Discriminant validity was demonstrated by its low association with the affective dimension of SF-MPQ (γ=-0.3, p=0.111). A five-factor structure of C-MASS was established by factor analysis. C-MASS demonstrated good internal consistency (Cronbach's α=0.71) and test-retest reliability (intraclass correlation coefficient=0.92). Since the descriptor 'sharp pain' was not a valid needle sensation related to deqi, this was removed from C-MASS. We renamed the scale as the Modified MASS-Chinese version (C-MMASS). A 12-descriptor C-MMASS was established and shown to be a reliable and valid tool in reporting needle sensations associated with deqi among healthy young Chinese people.

  2. Preliminary design study of a central solar heating plant with seasonal storage at the University of Massachusetts, Amherst

    NASA Astrophysics Data System (ADS)

    Breger, D. S.; Sunderland, J. E.

    1991-04-01

    This report documents the design development and selection of the final preliminary design of a Central Solar Heating Plant with Seasonal Storage (CSHPSS) for the University of Massachusetts in Amherst (UMass). The effort has been performed by the Department of Mechanical Engineering at UMass under contract with the U.S. Department of Energy. Phase 1 of this project was directed at site selection for the CSHPSS project and was reported earlier. This report focuses on the Phase 2 development of the site conditions and analytical study of project design, performance, and cost. The UMass site presents an excellent opportunity of a CSHPSS project in terms of land availability for a large collector array, a 100 foot deep deposit of soft, saturated clay for seasonal thermal energy storage, and appropriate low temperature heating loads. The project under study represents the first implementation of this solar technology in the United States and results from the International Energy Agency collaboration on CSHPSS since 1979. The preliminary design calls for a large 10,000 m(exp 2) parabolic trough collector array, 70,000 m(exp 3) storage volume in clay with heat transfer through 900 boreholes. Design optimization is based on computer simulations using MINSUN and TRNSYS. The design is expected to provide 95 percent of the 3500 MWh heating and hot water load. A project cost of $3.12 million (plus $240,000 for HVAC load retrofit) is estimated, which provides an annualized cost of $66.2/MWh per unit solar energy delivered. The project will proceed into an engineering phase in Spring 1991.

  3. Massachusetts Coverage Expansion Associated with Reduction in Primary Care Utilization among Medicare Beneficiaries

    PubMed Central

    Bond, Amelia M; White, Chapin

    2013-01-01

    Objective. To examine whether expanding coverage for the nonelderly affects primary care utilization among Medicare beneficiaries. Data Source. Zip code–level files from Dartmouth Atlas for Massachusetts and surrounding states, including Medicare utilization for 2005 (pre expansion) and 2007 (post expansion), and health insurance coverage for 2005. Study Design. We use two zip code–level outcomes: arc percent change in primary care visits per Medicare beneficiary per year, and percentage point change in the share of beneficiaries with one or more primary care visits. We use a regression-based difference-in-difference analysis that compares Massachusetts with surrounding states, and zip codes with high, medium, and low uninsurance rates in 2005. The 2005 uninsurance rates correspond to the size of Massachusetts' coverage expansion. We use propensity scores for identification of comparable zip codes and for weighting. Principal Findings. In areas of Massachusetts with the highest uninsurance rates—where insurance expansion had the largest impact—visits per beneficiary fell 6.9 percent (p < .001) relative to areas of Massachusetts with the smallest uninsurance rates. Conclusions. The expansion of coverage for the nonelderly reduced primary care visits, but it did not reduce the percent of beneficiaries with at least one visit. These results could imply restricted access, increased efficiency, or some blend. PMID:24117239

  4. Environmental and economic evaluation of the Massachusetts Smoke-Free Workplace Law.

    PubMed

    Alpert, Hillel R; Carpenter, Carrie M; Travers, Mark J; Connolly, Gregory N

    2007-08-01

    An environmental and economic evaluation of the smoke-free law in Massachusetts provides a broad appreciation of how a state-wide smoking ban affects the health of patrons and workers as well as the industries that are commonly concerned about the effects of smoking bans on business. The aim of this study is to evaluate environmental and economic effects of the statewide Massachusetts statewide Smoke-Free Workplace Law. Before and after the smoking ban, air quality testing was conducted in a sample (n = 27) of hospitality venues and state-wide economic changes were assessed. Compliance, in terms of patronage was measured by person-counts. Environmental outcomes were respirable suspended particles (RSP) less than 2.5 microns in diameter (PM2.5). Economic outcomes were meals tax collections, employment in the food services and drinking places and accommodations industries. On average, levels of respirable suspended particles (RSPs) less than 2.5 microns in diameter (PM2.5) decreased 93% in these venues after the Massachusetts Smoke-free Workplace Law went into effect. No statistically significant changes were observed among the economic indicators. This evaluation demonstrates that the state-wide Massachusetts law has effectively improved indoor air quality in a sample of Massachusetts venues and has not negatively affected several economic indicators.

  5. Birth Outcomes by Infertility Treatment: Analyses of the Population-Based Cohort Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART)

    PubMed Central

    Luke, Barbara; Stern, Judy E.; Kotelchuck, Milton; Declercq, Eugene R.; Anderka, Marlene; Diop, Hafsatou

    2016-01-01

    Objective To evaluate pregnancy and birth outcomes by infertility treatment. Study Design ART data on women who were both treated and gave birth in Massachusetts were linked to vital records and hospital data. Singleton and twin live births were categorized by ART treatment parameters; risks for adverse outcomes (pregnancy hypertension, PIH; gestational diabetes, GDM; primary cesarean, CS; prematurity, PTB; low birthweight, LBW; small-for-gestation, SGA; large-for-gestation, LGA; and birth defects, BD) were modeled using logistic regression (adjusted odds ratios, AORs, and 95% confidence intervals), adjusted for parental and treatment factors. GDM and PIH were additionally modeled as adverse outcomes. Results Among the 8,948 pregnancies, risks were significantly higher among twins (PIH-2.58, GDM-1.30, CS-5.83, PTB-11.84, LBW-10.68, SGA-2.17; BD-2.54); donor oocytes (PIH-1.87, CS-1.43, PTB-1.43); ICSI (SGA-1.20); and the presence of >one fetal heartbeat at six-weeks gestation (two fetal heartbeats: PTB-1.49, LBW-1.57; three fetal heartbeats: PTB-2.07, LBW-2.30, SGA-2.04). Thawed embryos were associated with a higher risk for PIH (1.30), but lower risks for LBW (0.79) and SGA (0.38). GDM was associated with increased risks for CS (1.22), LGA (1.40), and BD (1.50); PIH was associated with risks for CS (1.86), PTB (2.70), and LBW (1.83). Conclusions Plurality is the predominant ART treatment risk factor associated with substantial excess morbidity for both mother and infants. PMID:27172633

  6. 21 CFR 808.71 - Massachusetts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Massachusetts. 808.71 Section 808.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... requirements are enforceable notwithstanding section 521 of the act because the Food and Drug Administration...

  7. 21 CFR 808.71 - Massachusetts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Massachusetts. 808.71 Section 808.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... requirements are enforceable notwithstanding section 521 of the act because the Food and Drug Administration...

  8. Public health assessment for Iron Horse Park, Billerica, Middlesex County, Massachusetts, Region 1. Cerclis No. MAD051787323. Addendum

    SciTech Connect

    1995-01-11

    The initial health assessment and related amendment for Iron Horse Park were completed in December of 1988 and amended in April of 1990 (PB90-136128 and PB92-963707), respectively. These health assessments identified numerous data gaps which were addressed in subsequent investigations released by the United States Environmental Protection Agency (USEPA). Health concerns detailed in this addendum are based on findings of these monitoring activities conducted on or near the Shaffer Landfill at Iron Horse Park.

  9. A Health Impact Assessment of Proposed Public Transportation Service Cuts and Fare Increases in Boston, Massachusetts (U.S.A.)

    PubMed Central

    James, Peter; Ito, Kate; Buonocore, Jonathan J.; Levy, Jonathan I.; Arcaya, Mariana C.

    2014-01-01

    Transportation decisions have health consequences that are often not incorporated into policy-making processes. Health Impact Assessment (HIA) is a process that can be used to evaluate health effects of transportation policy. We present a rapid HIA, conducted over eight weeks, evaluating health and economic effects of proposed fare increases and service cuts to Boston, Massachusetts’ public transportation system. We used transportation modeling in concert with tools allowing for quantification and monetization of multiple pathways. We estimated health and economic costs of proposed public transportation system changes to be hundreds of millions of dollars per year, exceeding the budget gap the public transportation authority was required to close. Significant health pathways included crashes, air pollution, and physical activity. The HIA enabled stakeholders to advocate for more modest fare increases and service cuts, which were eventually adopted by decision makers. This HIA was among the first to quantify and monetize multiple pathways linking transportation decisions with health and economic outcomes, using approaches that could be applied in different settings. Including health costs in transportation decisions can lead to policy choices with both economic and public health benefits. PMID:25105550

  10. [Documents make a difference: the case of Brazilian domestic workers in Massachusetts, USA].

    PubMed

    Siqueira, C Eduardo; Soares, Gabriella Barreto; Araújo, Pedro Luiz de; Tracy, Maria Natalicia

    2016-07-21

    Brazilian immigrants in the United States experience various social, labor, and health challenges. This study aimed to analyze the profile of female Brazilian domestic workers in Massachusetts, USA, through a description of their working conditions and self-rated health. This was a cross-sectional study of 198 domestic workers in Massachusetts, recruited with "snowball" sampling. The instrument addressed participants' demographic characteristics, work conditions, and self-rated health. Data were analyzed with SPSS 21.0. Among the interviewees, 95.5% were women, 62.1% were 30 to 49 years of age, and 55.6% were undocumented. Documented and undocumented participants showed statistically significant differences in demographics, work conditions, and health. Irregular immigrant status appears to have a negative impact on domestic workers' living and health conditions.

  11. Active Bodies, Active Minds: A Case Study on Physical Activity and Academic Success in Lawrence, Massachusetts. Understanding Boston

    ERIC Educational Resources Information Center

    Sacheck, Jennifer; Wright, Catherine; Chomitz, Virginia; Chui, Kenneth; Economos, Christina; Schultz, Nicole

    2015-01-01

    This case study addresses two major priorities of the Boston Foundation--health and education. Since the 2007 publication of the "Understanding Boston" report "The Boston Paradox: Lots of Health Care, Not Enough Health," the Boston Foundation has worked to draw attention to the epidemic of preventable chronic disease that not…

  12. Building America Case Study: Monitoring of Double Stud Wall Moisture Conditions in the Northeast, Devens, Massachusetts (Fact Sheet)

    SciTech Connect

    Not Available

    2015-03-01

    Double-stud walls insulated with cellulose or low-density spray foam can have R-values of 40 or higher. However, double stud walls have a higher risk of interior-sourced condensation moisture damage, when compared with high-R approaches using exterior insulating sheathing. Moisture conditions in double stud walls were monitored in Zone 5A (Massachusetts); three double stud assemblies were compared.

  13. A Methology for Assessing the Regional Transportation Energy Demands of Different Spatial Residential Development Scenarios: a Case Study for the Upper Housatonic River Basin, Massachusetts

    NASA Technical Reports Server (NTRS)

    Oski, J. A.; Fabos, J. G.; Gross, M.

    1982-01-01

    A method is suggested whereby regional landscape planning efforts can be aided by the use of a geographic information system to determine sites for more energy efficient residential and mixed use developments within a study area. The location of land parcels suited for residential and mixed land use developments in the Upper Housatonic River Basin Study Area in Berkshire County, Massachusetts is described as well as the three development options. Significant steps in the procedure are discussed and the computation of the transportation energy requirement is elaborated.

  14. A Methology for Assessing the Regional Transportation Energy Demands of Different Spatial Residential Development Scenarios: a Case Study for the Upper Housatonic River Basin, Massachusetts

    NASA Technical Reports Server (NTRS)

    Oski, J. A.; Fabos, J. G.; Gross, M.

    1982-01-01

    A method is suggested whereby regional landscape planning efforts can be aided by the use of a geographic information system to determine sites for more energy efficient residential and mixed use developments within a study area. The location of land parcels suited for residential and mixed land use developments in the Upper Housatonic River Basin Study Area in Berkshire County, Massachusetts is described as well as the three development options. Significant steps in the procedure are discussed and the computation of the transportation energy requirement is elaborated.

  15. Biomanufacturing in Massachusetts: An Assessment and Educational Analysis.

    ERIC Educational Resources Information Center

    Minuteman Regional Vocational Technical School, Lexington, MA.

    A study examined the nature and requirements of biomanufacturing work force development in Massachusetts. The jobs created by biotechnology and skill requirements for the different levels of biotechnology jobs were analyzed. Next, study task force members visited 23 companies throughout Massachusetts and interviewed a wide selection of personnel,…

  16. Bladder cancer in Massachusetts related to chlorinated and chloraminated drinking water: a case-control study

    SciTech Connect

    Zierler, S.; Feingold, L.; Danley, R.A.; Craun, G.

    1988-03-01

    Consumers of chlorinated drinking water have a small excess of bladder cancer. Risk may have been underestimated because of confounding and misclassification of exposure status. To address these problems, we undertook a case-control study. Detailed residential histories were obtained by telephone interviews with informants of 614 individuals who died of primarily bladder cancer and 1,074 individuals who died of other causes. Their surface water has been disinfected with chlorine or a combination of chlorine and ammonia (cloramine) since 1938. The mortality ratio for bladder cancer among individuals who resided only in communities supplied with drinking water disinfected with chlorine, relative to individuals who resided only in communities supplied with drinking water disinfected with chloramine, was 1.6 (95% confidence interval = 1.2-2.1), using all controls; when the comparison group was restricted to individuals who died of lymphoma, the mortality odds ratio was 2.7 (95% confidence interval = 1.7-4.3).

  17. Bladder cancer in Massachusetts related to chlorinated and chloraminated drinking water: a case-control study.

    PubMed

    Zierler, S; Feingold, L; Danley, R A; Craun, G

    1988-01-01

    Consumers of chlorinated drinking water have a small excess of bladder cancer. Risk may have been underestimated because of confounding and misclassification of exposure status. To address these problems, we undertook a case-control study. Detailed residential histories were obtained by telephone interviews with informants of 614 individuals who died of primarily bladder cancer and 1,074 individuals who died of other causes. Their surface water has been disinfected with chlorine or a combination of chlorine and ammonia (cloramine) since 1938. The mortality ratio for bladder cancer among individuals who resided only in communities supplied with drinking water disinfected with chlorine, relative to individuals who resided only in communities supplied with drinking water disinfected with chloramine, was 1.6 (95% confidence interval = 1.2-2.1), using all controls; when the comparison group was restricted to individuals who died of lymphoma, the mortality odds ratio was 2.7 (95% confidence interval = 1.7-4.3).

  18. Use of intensive care services and associated hospital mortality after Massachusetts healthcare reform*.

    PubMed

    Lyon, Sarah M; Wunsch, Hannah; Asch, David A; Carr, Brendan G; Kahn, Jeremy M; Cooke, Colin R

    2014-04-01

    To use the natural experiment of health insurance reform in Massachusetts to study the impact of increased insurance coverage on ICU utilization and mortality. Population-based cohort study. Massachusetts and four states (New York, Washington, Nebraska, and North Carolina) that did not enact reform. All nonpregnant nonelderly adults (age 18-64 yr) admitted to nonfederal acute care hospitals in one of the five states of interest were eligible, excluding patients who were not residents of a respective state at the time of admission. We used a difference-in-differences approach to compare trends in ICU admissions and outcomes of in-hospital mortality and discharge destination for ICU patients. Healthcare reform in Massachusetts was associated with a decrease in ICU patients without insurance from 9.3% to 5.1%. There were no significant changes in adjusted ICU admission rates, mortality, or discharge destination. In a sensitivity analysis excluding a state that enacted Medicaid reform prior to the study period, our difference-in-differences analysis demonstrated a significant increase in mortality of 0.38% per year (95% CI, 0.12-0.64%) in Massachusetts, attributable to a greater per-year decrease in mortality postreform in comparison states (-0.37%; 95% CI, -0.52% to -0.21%) compared with Massachusetts (0.01%; 95% CI, -0.20% to 0.11%). Massachusetts healthcare reform increased the number of ICU patients with insurance but was not associated with significant changes in ICU use or discharge destination among ICU patients. Reform was also not associated with changed in-hospital mortality for ICU patients; however, this association was dependent on the comparison states chosen in the analysis.

  19. Use of intensive care services and associated hospital mortality after Massachusetts healthcare reform

    PubMed Central

    Lyon, Sarah M.; Wunsch, Hannah; Asch, David A.; Carr, Brendan G.; Kahn, Jeremy M.; Cooke, Colin R.

    2016-01-01

    Objective To use the natural experiment of health insurance reform in Massachusetts to study the impact of increased insurance coverage on ICU utilization and mortality Design Population based cohort study Setting Massachusetts and 4 states (New York, Washington, Nebraska, and North Carolina) that did not enact reform Participants All non-pregnant, non-elderly adults (age 18–64), admitted to non-federal, acute-care hospitals in one of the five states of interest were eligible, excluding patients who were not residents of a respective state at the time of admission. Measurements We used a difference-in-differences approach to compare trends in ICU admissions and outcomes of in-hospital mortality and discharge destination for ICU patients. Main Result Healthcare reform in Massachusetts was associated with a decrease in ICU patients without insurance from 9.3% to 5.1%. There were no significant changes in adjusted ICU admission rates, mortality, or discharge destination. In a sensitivity analysis excluding a state that enacted Medicaid reform prior to the study period, our difference-in differences analysis demonstrated a significant increase in mortality of 0.38% per year (95% CI 0.12 – 0.64%) in Massachusetts, attributable to a greater per-year decrease in mortality post-reform in comparison states (−0.37%, 95% CI −0.52 – −0.21%) compared to Massachusetts (0.01%, 95% CI −0.20% – 0.11%). Conclusion Massachusetts healthcare reform increased the number of ICU patients with insurance but was not associated with significant changes in ICU use or discharge destination among ICU patients. Reform was also not associated with changed in-hospital mortality for ICU patients; however, this association was dependent upon the comparison states chosen in the analysis. PMID:24275512

  20. Massachusetts' forest resources, 2011

    Treesearch

    Brett J. Butler; Randall S. Morin; Mark D. Nelson

    2012-01-01

    This publication provides an overview of forest resource attributes for Massachusetts based on an annual inventory conducted by the Forest Inventory and Analysis (FIA) program at the Northern Research Station of the U.S. Forest Service. These estimates, along with web-posted core tables, will be updated annually. For more information please refer to page 4 of this...

  1. Forests of Massachusetts, 2016

    Treesearch

    Brett J. Butler

    2017-01-01

    This report provides an overview of forest resources in Massachusetts based on an inventory conducted by the U.S. Forest Service, Forest Inventory and Analysis (FIA) program of the Northern Research Station.Estimates are based on field data collected using the FIA annualized sample design. Results are for the measurement years 2011-2016 with comparisons made to 2007-...

  2. Massachusetts' Forest Resources, 2006

    Treesearch

    Brett J. Butler; Charles Burnham; I. Ted Goodnight; Barbara O' Connell; Bryan Tirrell

    2008-01-01

    Table 1 and Figures 2 and 3 have been revised by the authors and these revisions were incorporated into the publication on May 27, 2008. This publication provides an overview of forest resource attributes for Massachusetts based on an annual inventory conducted by the Forest Inventory and Analysis program at the Northern Research Station of the U.S. Forest Service....

  3. Massachusetts' forest resources, 2010

    Treesearch

    Brett J. Butler; William N. Hill; Cassandra Kurtz; W. Keith. Moser

    2011-01-01

    This publication provides an overview of forest resource attributes for Massachusetts based on an annual inventory conducted by the Forest Inventory and Analysis (FIA) program at the Northern Research Station of the U.S. Forest Service. These estimates, along with web-posted core tables, will be updated annually. For more information please refer to page 4 of this...

  4. Carbon burial in salt marshes following tidal restriction: A case study from Cape Cod, Massachusetts

    NASA Astrophysics Data System (ADS)

    Sanks, K. M.; Gonneea, M. E.; Kroeger, K. D.; Spivak, A. C.; Roberts, D.

    2016-12-01

    Current and future sea-level rise poses an imminent threat to coastal ecosystems, in part due to accelerating global warming resulting from increasing greenhouse gasses, mainly CO2 and CH4, in the atmosphere. Coastal ecosystems, such as salt marshes, sequester CO2 at greater rates than terrestrial ecosystems and store carbon for millennia, potentially playing an important role in the climate system due to their influence on atmospheric greenhouse gas concentrations. However, these ecosystems have lost significant area globally and continue to be threatened by coastal development, rising sea level, and climate change. Restoration of coastal wetlands has been undertaken to preserve ecosystem services, such as bird and wild life habitat, storm protection, and recreation. The potential impact of wetland restoration on carbon burial is also an important ecosystem service. Indeed, it is now possible to receive carbon credits on voluntary carbon markets for coastal wetland restoration that demonstrate net carbon removal. However, science lags policy, as little is known about carbon burial post restoration. Nine marshes in Cape Cod, MA were studied to compare the natural marsh to restored areas where a tidal restriction previously impeded the supply of salt water, causing the loss of salt marsh vegetation. Over the past 5 to 20 years, these restrictions were widened to allow for increased tidal flow, which has allowed salt marsh vegetation to prosper again. Sediment cores were taken from both restored and natural areas in the marsh and age dated using the 210Pb continuous rate of supply model. Carbon density was evaluated in the top 80 cm of all cores. In the region of the cores representing post restoration conditions, the mean carbon densities of the natural sites are similar when compared to restored sites, thus showing that through restoration of salt marsh vegetation, carbon sequestration rates are similar to undisturbed salt marshes. Regions of the sediment cores

  5. An Analysis of the Massachusetts Healthcare Law.

    PubMed

    Stephens, James H; Ledlow, Gerald R; Sach, Michael V; Reagan, Julie K

    2017-01-01

    Healthcare in the United States has been one topic of the debates and discussion in the country for many years. The challenge for affordable, accessible, and quality healthcare for most Americans has been on the agenda of federal and state legislatures. There is probably no other state that has drawn as much individual attention regarding this challenge as the state of Massachusetts. While researching the topic for this article, it was discovered that financial and political perspectives on the success or failure of the healthcare model in Massachusetts vary depending on the aspect of the system being discussed. In this article the authors give a brief history and description of the Massachusetts Healthcare Law, explanation of how the law is financed, identification of the targeted populations in Massachusetts for which the law provides coverage, demonstration of the actual benefit coverage provided by the law, and review of the impact of the law on healthcare providers such as physicians and hospitals. In addition, there are explanations about the impact of the law on health insurance companies, discussion of changes in healthcare premiums, explanation of costs to the state for the new program, reviews of the impact on the health of the insured, and finally, projections on the changes that healthcare facilities will need to make to maintain fiscal viability as a result of this program.

  6. A Qualitative Exploration of Low-Income Women's Experiences Accessing Abortion in Massachusetts.

    PubMed

    Dennis, Amanda; Manski, Ruth; Blanchard, Kelly

    2015-01-01

    At a time when most states are working to restrict abortion, Massachusetts stands out as one of the few states with multiple state-level policies in place that support abortion access for low-income women. In 2006, Massachusetts passed health care reform, which resulted in almost all residents having insurance. Also, almost all state-level public and subsidized insurance programs cover abortion and there are fewer restrictions on abortion in Massachusetts compared with other states. We explored low-income women's experiences accessing abortion in Massachusetts through 27 in-depth telephone interviews with a racially diverse sample of low-income women who obtained abortions. Interviews were digitally recorded, transcribed, coded, and analyzed thematically. Most women described having access to timely, conveniently located, affordable, and highly acceptable abortion care. However, a sizable minority of women had difficulty enrolling in or staying on insurance, making abortion expensive. A small minority of women said their abortion care could be improved by increasing emotional support and privacy, and decreasing appointment times. Some limited data also suggest that young women and immigrant women face specific barriers to care. This study provides important, novel information about the need for state-level policies that support access to health insurance and comprehensive abortion coverage. Such policies, along with a well-functioning health care environment, help to ensure that low-income women have access to abortion. However, not all abortion access challenges have been resolved in Massachusetts. More work is needed to ensure that all women can access affordable, confidential care that is responsive to their specific needs and preferences. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. Geology of Massachusetts and Rhode Island

    USGS Publications Warehouse

    Emerson, Benjamin Kendall

    1917-01-01

    In preparing the present treatise and the accompanying geologic map of Massachusetts and Rhode Island (PI. X, in pocket) I have endeavored to use all the material available. The matter has been greatly condensed, for the detailed geology of a considerable part of the area will be described in a number of forthcoming folios of the Geologic Atlas of the United States. The Holyoke folio, published in 1898, covered the major part of the Triassic rocks in Massachusetts, but as those rocks have since been more thoroughly studied they are here treated in greater detail to bring their discussion up to date.

  8. Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts Outcomes Study of Assisted Reproductive Technology.

    PubMed

    Luke, Barbara; Gopal, Daksha; Cabral, Howard; Stern, Judy E; Diop, Hafsatou

    2017-09-01

    Births to subfertile women, with and without infertility treatment, have been reported to have lower birthweights and shorter gestations, even when limited to singletons. It is unknown whether these decrements are due to parental characteristics or aspects of infertility treatment. The objective of the study was to evaluate the effect of maternal fertility status on the risk of pregnancy, birth, and infant complications. All singleton live births of ≥22 weeks' gestation and ≥350 g birthweight to Massachusetts resident women in 2004-2010 were linked to hospital discharge and vital records. Women were categorized by their fertility status as in vitro fertilization, subfertile, or fertile. Women whose births linked to in vitro fertilization cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System were classified as in vitro fertilization. Women with indicators of subfertility but not treated with in vitro fertilization were classified as subfertile. Women without indicators of subfertility or in vitro fertilization treatment were classified as fertile. Risks of 15 adverse outcomes (gestational diabetes, pregnancy hypertension, antenatal bleeding, placental complications [placenta abruptio and placenta previa], prenatal hospitalizations, primary cesarean delivery, very low birthweight [<1500 g], low birthweight [<2500 g], small-for-gestation birthweight [z-score ≤-1.28], large-for-gestation birthweight [z-score ≥1.28], very preterm [<32 weeks], preterm [<37 weeks], birth defects, neonatal death [0-27 days], and infant death [0-364 days of life]) were modeled by fertility status with the fertile group as reference and the subfertile group as reference, using multivariate log binomial regression and reported as adjusted risk ratios and 95% confidence intervals. The study population included 459,623 women (441,420 fertile, 8054 subfertile, and 10,149 in vitro fertilization). Women in the subfertile and in

  9. Using new satellite based exposure methods to study the association between pregnancy PM₂.₅ exposure, premature birth and birth weight in Massachusetts.

    PubMed

    Kloog, Itai; Melly, Steven J; Ridgway, William L; Coull, Brent A; Schwartz, Joel

    2012-06-18

    Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM₂.₅) levels during pregnancy in Massachusetts for a 9-year period (2000-2008). Building on a novel method we developed for predicting daily PM₂.₅ at the spatial resolution of a 10x10 km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM₂.₅ exposure and birth weight (among full term births) and PM₂.₅ exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Birth weight was negatively associated with PM₂.₅ across all tested periods. For example, a 10 μg/m³ increase of PM₂.₅ exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = -21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01-1.13) for each 10 μg/m3 increase of PM₂.₅ exposure during the entire pregnancy period. The presented study suggests that exposure to PM₂.₅ during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants.

  10. Using new satellite based exposure methods to study the association between pregnancy pm2.5 exposure, premature birth and birth weight in Massachusetts

    PubMed Central

    2012-01-01

    Background Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. Methods We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM2.5) levels during pregnancy in Massachusetts for a 9-year period (2000–2008). Building on a novel method we developed for predicting daily PM2.5 at the spatial resolution of a 10x10km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM2.5 exposure and birth weight (among full term births) and PM2.5 exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Results Birth weight was negatively associated with PM2.5 across all tested periods. For example, a 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = −21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01–1.13) for each 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy period. Conclusions The presented study suggests that exposure to PM2.5 during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants. PMID:22709681

  11. Plymouth Colony, Massachusetts, USA

    NASA Image and Video Library

    1990-03-04

    Site of the original Plymouth Colony in Massachusetts (42.0N, 70.5), This detailed photo is rich in early American history. Plymouth Rock, the Pilgrims first stepping stone on North America and site of Plymouth Colony is located just behind the natural breakwater on the south shore of Plymouth Bay seen in the middle of the photo. The through canal to the south is part of the Intercoastal Canal system. Cape Cod is just south of the canal.

  12. Plymouth Colony, Massachusetts, USA

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Site of the original Plymouth Colony in Massachusetts (42.0N, 70.5), This detailed photo is rich in early American history. Plymouth Rock, the Pilgrims first stepping stone on North America and site of Plymouth Colony is located just behind the natural breakwater on the south shore of Plymouth Bay seen in the middle of the photo. The through canal to the south is part of the Intercoastal Canal system. Cape Cod is just south of the canal.

  13. 77 FR 76585 - Massachusetts Disaster # MA-00052

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... Doc No: 2012-31301] SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13417 and 13418] Massachusetts... an Administrative declaration of a disaster for the Commonwealth of Massachusetts dated 12/11/2012... the disaster: Primary Counties: Hampden. Contiguous Counties: Massachusetts: Berkshire, Hampshire...

  14. Banning tobacco sales in Massachusetts' pharmacies.

    PubMed

    Woodward, Alan C; Henley, Patricia P; Wilson, Donald J

    2012-06-01

    Bans on the sale of tobacco products in pharmacies allow pharmacies to provide health information and services without the conflict of interest posed by concurrent tobacco sales. As health care providers, pharmacies are trusted sources of information for patients. The existence of tobacco products in pharmacies is contrary to their mission as a health care entity. By May 2012, a full 27 Massachusetts municipalities had banned the sale of tobacco products in health care institutions, including pharmacies. These bans covered 30% of the state's population.

  15. Massachusetts proposes widening Medicaid to include HIV.

    PubMed

    1999-03-19

    In a move to expand Medicaid protection to low-income uninsured people soon after they test positive from HIV, Massachusetts Gov. Paul Cellucci has proposed using $10 million from an expected tobacco settlement to provide health care for 2,000 people. The pilot program would include primary care, diagnostics, and prescription medicines. The AIDS Action Committee of Massachusetts and other policy advocates are supporting the Governor's recommendation. The program would cost more than it saves initially, but as health care improves, people would require fewer costly hospital stays. These budget projections are expected to enable the proposal to meet the Federal requirement of a budget neutral Medical program. Contact information is provided.

  16. CETA in Eastern Massachusetts. Final Report.

    ERIC Educational Resources Information Center

    Barocci, Thomas A.; Myers, Charles A.

    A study regarding the implementation of the Comprehensive Employment and Training Act (CETA) in four eastern Massachusetts prime sponsor areas (Cambridge, Lowell, New Bedford, and the Balance of State) was done to (1) examine the impact of the decisions made during the implementation of CETA on manpower services and institutions, program…

  17. The High School Experience in Massachusetts.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Education, Boston. Bureau of Research and Assessment.

    This examination of high schools in Massachusetts raises questions about the meaning of the high school diploma and the role, if any, of state policymakers in influencing its meaning. The study shows: (1) students with different characteristics (e.g., male, female, white, minority) and from different kinds of communities and with different…

  18. Beach slopes of Massachusetts

    USGS Publications Warehouse

    Doran, Kara S.; Long, Joesph W.; Birchler, Justin J.; Weber, Kathryn M.

    2016-01-01

    The National Assessment of Coastal Change Hazards project derives features of beach morphology from lidar elevation data for the purpose of understanding and predicting storm impacts to our nation's coastlines. This dataset defines mean beach slopes along the United States Northeast Atlantic Ocean for Massachusetts for data collected at various times between 2000 and 2013. For further information regarding data collection and/or processing methods refer to USGS Open-File Report 2015–1053 (http://pubs.usgs.gov/of/2015/1053/).

  19. Opportunities and Challenges for Payment Reform: Observations from Massachusetts.

    PubMed

    Mechanic, Robert E

    2016-08-01

    Policy makers and private health plans are expanding their efforts to implement new payment models that will encourage providers to improve quality and deliver health care more efficiently. Over the past five years, payment reforms have progressed faster in Massachusetts than in any other state. The reasons include a major effort by Blue Cross Blue Shield of Massachusetts to implement global payment, the presence of large integrated systems willing to take on financial risk, and a supportive state policy environment. By 2014, thirty-seven percent of Massachusetts's residents enrolled in health plans were covered under risk-based payment models tied to global budgets. But the expansion of payment reform in Massachusetts slowed between 2012 and 2015 because some commercial enrollment shifted from risk-based health maintenance organization products to fee-for-service preferred provider organization (PPO) plans, and the state Medicaid program fell short of its payment reform goals. Provider groups will not fully commit to population-based clinical models if they believe it will result in large reductions in fee-for-service revenue. The use of alternative payment models will accelerate in 2016 when Blue Cross begins implementing PPO payment reforms, but it is unknown how quickly other payers will follow. Massachusetts's experience illustrates the complexity of payment reform in pluralistic health care markets and the need for complementary efforts by public and private stakeholders. Copyright © 2016 by Duke University Press.

  20. Nurses' Perceptions of Barriers and Facilitators Affecting the Shaken Baby Syndrome Education Initiative: An Exploratory Study of a Massachusetts Public Policy.

    PubMed

    Rideout, Leslie

    2016-01-01

    The objective of this study was to assess nurses' perceptions of barriers to and facilitators of implementation of the shaken baby syndrome (SBS)/abusive head trauma (AHT) public policy. A legislative Act providing for the prevention of SBS/AHT was passed in Massachusetts in November 2006. A stipulation of this Act was the provision of a program to educate parents/guardians of newborns about SBS/AHT prevention. A quantitative, cross-sectional research design with a qualitative component was used for this study. Nurses in 13 Massachusetts birthing hospitals were surveyed using a Web-based questionnaire (hosted by Qualtrics, Provo, Utah). Hospital nurses' responses (N = ∼ 922; 155 responded) revealed barriers to and facilitators of SBS/AHT guideline implementation. The disadvantage of Web-based surveys as they relate to the challenges of enlisting cooperation and a lack of direct access to the nurses may have attributed to the low response rate (17%) for this study. The outcomes of logistic regression analyses and themes from the qualitative analysis revealed a lack of SBS/AHT brochures and an inability to provide SBS/AHT education for non-English-speaking parents/guardians as barriers to SBS/AHT education. An atmosphere of supportive leadership facilitated implementation of the SBS/AHT education guidelines by nurses. It is imperative that nurse leadership support be sustained so that nurses have SBS/AHT education resources, an understanding of the SBS/AHT education guidelines, and feedback about the impact of their SBS/AHT education interventions.

  1. Economic Efficiency and Equity in Dams Removal: Case studies in Northeastern Massachusetts Doina Oglavie, Ellen Douglas, David Terkla

    NASA Astrophysics Data System (ADS)

    Oglavie, D. R.; Douglas, E. M.; Terkla, D.

    2009-12-01

    According to American Rivers (www.americanrivers.org), Massachusetts has almost 3,000 dams under state regulation, 296 of which have been classified as high hazard, meaning they pose a serious threat to human life if they should fail. Most of these dams, however, are low head, “run-of-the-river” dams that no longer serve the purpose for which they were built. The presence of these dams has fragmented aquatic and riparian ecosystems, impeded fish passage and generally impacted the natural ecological and hydrological functioning of the streams in which they reside. Dam removal should be considered when a dam no longer serves its function. Although in many cases, the removal of a dam is environmentally beneficial (at least over the long term), sometimes the removal of a dam can incur environmental costs, such as release of contaminants that were sequestered behind the dam. Dam removal is a complex issue especially with respect to privately owned dams. In many cases, dam removal is less costly than dam maintenance or upgrade, hence dam removal decisions tend to be based on purely monetary considerations, and the environmental costs or benefits associated with the dam are not considered. Typically, the main objective for the dam owner is to incur the lowest possible cost (private cost), whether it be operating and maintenance or removal; external costs (environmental degradation) are rarely, if ever, considered, hence the true cost to society is not included in the economic analysis. If dam operation and removal decisions are to be economically efficient, then they have to include both the private costs as well as the external (environmental) costs. The purpose of this work is to 1) attempt to quantify the externalities associated with the maintenance and the removal of dams, 2) assess whether or not the current dam removal evaluation process maximizes social welfare (efficiency and equity) and 3) suggest ways in which this process can be improved by including the

  2. Effectiveness of highway-drainage systems in preventing contamination of ground water by road salt, Route 25, southeastern Massachusetts; description of study area, data collection programs, and methodology

    USGS Publications Warehouse

    Church, P.E.; Armstrong, D.S.; Granato, G.E.; Stone, V.J.; Smith, K.P.; Provencher, P.L.

    1996-01-01

    Four test sites along a 7-mile section of Route 25 in southeastern Massachusetts, each representing a specific highway-drainage system, were instrumented to determine the effectiveness of the drainage systems in preventing contamination of ground water by road salt. One of the systems discharges highway runoff onsite through local drainpipes. The other systems use trunkline drainpipes through which runoff from highway surfaces, shoulders, and median strips is diverted and discharged into either a local stream or a coastal waterway. Route 25 was completed and opened to traffic in the summer of 1987. Road salt was first applied to the highway in the winter of 1987-88. The study area is on a thick outwash plain composed primarily of sand and gravel. Water-table depths range from 15 to 60 feet below land surface at the four test sites. Ground-water flow is in a general southerly direction, approximately perpendicular to the highway. Streamflow in the study area is controlled primarily by ground-water discharge. Background concentrations of dissolved chloride, sodium, and calcium-the primary constituents of road salt-are similar in ground water and surface water and range from 5 to 20, 5 to 10, and 1 to 5 milligrams per liter, respectively. Data-collection programs were developed for monitoring the application of road salt to the highway, the quantity of road-salt water entering the ground water, diverted through the highway-drainage systems, and entering a local stream. The Massachusetts Highway Department monitored road salt applied to the highway and reported these data to the U.S. Geological Survey. The U.S. Geological Survey designed and operated the ground-water, highway- drainage, and surface-water data-collection programs. A road-salt budget will be calculated for each test site so that the effectiveness of the different highway-drainage systems in preventing contamination of ground water by road salt can be determined.

  3. Massachusetts reform plus President Bush's tax credits: a national model?

    PubMed

    Etheredge, Lynn M

    2006-01-01

    The Massachusetts health reform offers an important opportunity for a new federal-state strategy to cover the uninsured. President George Bush's proposed health insurance tax credits could be added to the Massachusetts health reform. The combined plan would include Medicaid expansions; offer workers affordable coverage through competitive insurance markets; and provide federal, state, employer, and individual financing. Many other states might be interested in similar federal-state partnerships for the forty-five million uninsured Americans. Ending the national impasse on coverage needs this kind of bold initiative.

  4. The Cheer Study to Reduce BMI in Elementary School Students: A School-Based, Parent-Directed Study in Framingham, Massachusetts

    ERIC Educational Resources Information Center

    Resnick, Elissa A.; Bishop, Marilyn; O'Connell, Anne; Hugo, Beverly; Isern, Germinal; Timm, Alison; Ozonoff, Al; Geller, Alan C.

    2009-01-01

    Childhood obesity may be lessened by parent-focused interventions. A pilot parent-directed trial with 46 parents of overweight and obese elementary school students was conducted at two ethnically diverse public schools in Framingham, Massachusetts. Parents were randomly assigned to either the Materials Group, which received mailed educational…

  5. Existing Whole-House Solutions Case Study: National Grid Deep Energy Retrofit Pilot, Massachusetts and Rhode Island

    SciTech Connect

    2014-03-01

    Between December, 2009 and December, 2012 42 deep energy retrofit (DER) projects were completed through a pilot program sponsored by National Grid and conducted in Massachusetts and Rhode Island. Thirty-seven of these projects were comprehensive retrofits while five were partial DERs, meaning that high performance retrofit was implemented for a single major enclosure component or a limited number of major enclosure components. Building Science Corporation developed a consistent "package" of measures in terms of the performance targeted for major building components. Pre- and post-retrofit air leakage measurements were performed for each of the projects. Each project also reported information about project costs including identification of energy-related costs. Post-retrofit energy-use data was obtained for 29 of the DER projects, and was analyzed based on the net energy used by the DER project regardless of whether the energy was generated on site or delivered to the site. Based on the community experience, this DER package is expected to result in yearly source energy use near 110 MMBtu/year or approximately 40% below the Northeast regional average. Larger to medium sized homes that successful implement these retrofits can be expected to achieve source EUI that is comparable to Passive House targets for new construction. The community of DER projects show post-retrofit airtightness below 1.5 ACH50 to be eminently achievable.

  6. Phytochelatin production by marine phytoplankton at low free metal ion concentrations: laboratory studies and field data from Massachusetts Bay.

    PubMed Central

    Ahner, B A; Price, N M; Morel, F M

    1994-01-01

    Phytochelatins are small metal-binding polypeptides synthesized by algae in response to high metal concentrations. Using a very sensitive HPLC method, we have quantified phytochelatins from phytoplankton in laboratory cultures at environmentally relevant metal concentrations and in marine field samples. Intracellular concentrations of phytochelatin, in the diatom Thalassiosira weissflogii, exhibit a distinct dose-response relation with free Cd2+ concentration in the medium--not with total Cd(2+)--and are detectable even when the free Cd2+ concentration is less than 1 pM. In Massachusetts Bay, phytochelatin levels (normalized to chlorophyll a) in the particulate fraction are similar to those measured in laboratory cultures exposed to picomolar free Cd2+ concentrations and exhibit a decreasing seaward trend. Incubations of natural samples with added Cd2+ confirmed the induction of the peptides by this metal. Ambient phytochelatin concentrations thus appear to provide a measure of the metal stress resulting from the complex mixture of trace metals and chelators in natural waters. PMID:8078899

  7. Massachusetts Students Receive EPA Money to Conduct Environmental Research

    EPA Pesticide Factsheets

    The U.S. Environmental Protection Agency gave STAR Awards to two doctoral students in Massachusetts for environmental research. Each doctoral student will receive up to $132,000 to support their graduate research and studies.

  8. Collaborations in population-based health research: the 17th annual HMO Research Network Conference, March 23-25, 2011, Boston, Massachusetts, USA.

    PubMed

    Lieu, Tracy A; Hinrichsen, Virginia L; Moreira, Andrea; Platt, Richard

    2011-11-01

    The HMO Research Network (HMORN) is a consortium of 16 health care systems with integrated research centers. Approximately 475 people participated in its 17(th) annual conference, hosted by the Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School. The theme, "Collaborations in Population-Based Health Research," reflected the network's emphasis on collaborative studies both among its members and with external investigators. Plenary talks highlighted the initial phase of the HMORN's work to establish the NIH-HMO Collaboratory, opportunities for public health collaborations, the work of early career investigators, and the state of the network. Platform and poster presentations showcased a broad spectrum of innovative public domain research in areas including disease epidemiology and treatment, health economics, and information technology. Special interest group sessions and ancillary meetings provided venues for informal conversation and structured work among ongoing groups, including networks in cancer, cardiovascular diseases, lung diseases, medical product safety, and mental health.

  9. The Enough Abuse Campaign: building the movement to prevent child sexual abuse in Massachusetts.

    PubMed

    Schober, Daniel J; Fawcett, Stephen B; Bernier, Jetta

    2012-01-01

    This case study describes the Enough Abuse Campaign, a multidisciplinary, statewide effort to prevent child sexual abuse in Massachusetts. The study uses the Institute of Medicine's Framework for Collaborative Community Action on Health to provide a systematic description of the campaign's process of implementation, which includes: (a) developing a state-level infrastructure for child sexual abuse prevention, (b) assessing child sexual abuse perceptions and public opinion, (c) developing local infrastructures in three communities and implementing training programs focused on preventing perpetration of child sexual abuse, (d) facilitating changes in local communities to child-sexual-abuse-related systems, and (e) inviting Massachusetts residents to join an advocacy-based movement to prevent child sexual abuse. This case study concludes with future directions for the campaign and topics for future research related to child sexual abuse.

  10. Statewide air medical transports for Massachusetts.

    PubMed

    Garthe, Elizabeth; Mango, Nicholas K; Prenney, Brad

    2002-01-01

    In 1997, the Massachusetts Department of Public Health (MDPH) established a process to centralize air medical transport information. This database is one of the first statewide, population-based sources for civilian rotary-wing air medical transports (U.S. Coast Guard, police, and military missions are not included). The purpose of this database is to facilitate MDPH review of air medical transport service utilization, with input from a multidisciplinary committee. This article discusses the challenges in producing uniform data from multiple service submissions and presents aggregate "baseline" utilization information for 1996. These data served as a starting point for later studies using data linkage. This indexed article is the first to report statewide, population-based data for all types of air medical helicopter transports. The only other indexed "statewide air medical transport" paper focused on scene transports to trauma centers in Pennsylvania. A previous article by the authors in the July-September 2000 Air Medical Journal provided an overview of air medical transports for fatal motor vehicle crashes for 1 region of the state.

  11. Delineation and Characterization of Furnace Brook Watershed in Marshfield, Massachusetts: A Study of Effects upon Conjunctive Water Use within a Watershed

    NASA Astrophysics Data System (ADS)

    Croll, E. D.; Enright, R.

    2012-12-01

    An understanding of conjunctive use between surface and ground water is essential to resource management both for sustained public use and watershed conservation practices. The Furnace Brook watershed in Marshfield, Massachusetts supplies a coastal community of 25,132 residents with nearly 50% of the town water supply. As with many other coastal communities, development pressure has increased creating a growing demand for freshwater extraction. It has been observed, however, that portions of the stream and Furnace Pond disappear entirely. This has created a conflict between protection of the designated wetland areas and meeting public pressure for water resources, even within what is traditionally viewed as a humid region. Questions have arisen as to whether the town water extraction is influencing this losing behavior by excessively lowering water-table elevations and potentially endangering the health of the stream. This study set out to initially characterize these behaviors and identify possible influences of anthropogenic and natural sources acting upon the watershed including stream flow obstructions, water extraction, and geologic conditions. The initial characterization was conducted utilizing simple, low-cost and minimally intrusive methods as outlined by Lee and Cherry (1978), Rosenberry and LaBaugh (2008) and others during a six week period. Five monitoring stations were established along a 3.0 mile reach of the basin consisting of mini-piezometers, seepage meters, survey elevation base-lines, and utilizing a Marsh-McBirney flow velocity meter. At each station stream discharge, seepage flux rates and hydraulic gradients were determined to develop trends of stream behavior. This methodology had the benefit of demonstrating the efficacy of an intrinsically low-expense, minimally intrusive initial approach to characterizing interactions between surface and ground water resources. The data was correlated with town pumping information, previous geologic

  12. Impact of Expanded Insurance Coverage on Racial Disparities in Vascular Disease: Insights from Massachusetts

    PubMed Central

    Loehrer, Andrew P.; Hawkins, Alexander T.; Auchincloss, Hugh G.; Song, Zirui; Hutter, Matthew M.; Patel, Virendra I.

    2015-01-01

    STRUCTURED ABSTRACT Objective To evaluate the impact of health insurance expansion on racial disparities in severity of peripheral arterial disease. Summary Background Data Lack of insurance and non-white race are associated with increased severity, increased amputation rates, and decreased revascularization rates in patients with peripheral artery disease (PAD). Little is known about how expanded insurance coverage affects disparities in presentation with and management of PAD. The 2006 Massachusetts health reform expanded coverage to 98% of residents and provided the framework for the Affordable Care Act. Methods We performed a retrospective cohort study of non-elderly, white and non-white patients admitted with PAD in Massachusetts (MA) and four control states. Risk-adjusted difference-in-difference models were used to evaluate changes in probability of presenting with severe disease. Multivariable linear regression models evaluated disparities in disease severity before and after the 2006 health insurance expansion. Results Prior to the 2006 MA insurance expansion, non-white patients in both MA and control states had a 12–13 percentage-point higher probability of presenting with severe disease (P<0.001) than white patients. After the expansion, measured disparities in disease severity by patient race were no longer statistically significant in Massachusetts (+3.0 percentage-point difference, P=0.385) while disparities persisted in control states (+10.0 percentage-point difference, P<0.001). Overall, non-white patients in MA had an 11.2 percentage-point decreased probability of severe PAD (P=0.042) relative to concurrent trends in control states. Conclusions The 2006 Massachusetts insurance expansion was associated with a decreased probability of patients presenting with severe PAD and resolution of measured racial disparities in severe PAD in MA. PMID:26587850

  13. Impact of Expanded Insurance Coverage on Racial Disparities in Vascular Disease: Insights From Massachusetts.

    PubMed

    Loehrer, Andrew P; Hawkins, Alexander T; Auchincloss, Hugh G; Song, Zirui; Hutter, Matthew M; Patel, Virendra I

    2016-04-01

    To evaluate the impact of health insurance expansion on racial disparities in severity of peripheral arterial disease. Lack of insurance and non-white race are associated with increased severity, increased amputation rates, and decreased revascularization rates in patients with peripheral artery disease (PAD). Little is known about how expanded insurance coverage affects disparities in presentation with and management of PAD. The 2006 Massachusetts health reform expanded coverage to 98% of residents and provided the framework for the Affordable Care Act. We conducted a retrospective cohort study of nonelderly, white and non-white patients admitted with PAD in Massachusetts (MA) and 4 control states. Risk-adjusted difference-in-differences models were used to evaluate changes in probability of presenting with severe disease. Multivariable linear regression models were used to evaluate disparities in disease severity before and after the 2006 health insurance expansion. Before the 2006 MA insurance expansion, non-white patients in both MA and control states had a 12 to 13 percentage-point higher probability of presenting with severe disease (P < 0.001) than white patients. After the expansion, measured disparities in disease severity by patient race were no longer statistically significant in Massachusetts (+3.0 percentage-point difference, P = 0.385) whereas disparities persisted in control states (+10.0 percentage-point difference, P < 0.001). Overall, non-white patients in MA had an 11.2 percentage-point decreased probability of severe PAD (P = 0.042) relative to concurrent trends in control states. The 2006 Massachusetts insurance expansion was associated with a decreased probability of patients presenting with severe PAD and resolution of measured racial disparities in severe PAD in MA.

  14. Master environmental plan for Fort Devens, Massachusetts

    SciTech Connect

    Biang, C.A.; Peters, R.W.; Pearl, R.H.; Tsai, S.Y. . Energy Systems Div.)

    1991-11-01

    Argonne National Laboratory has prepared a master environmental plan (MEP) for Fort Devens, Massachusetts, for the US Army Toxic and Hazardous Materials Agency. The MEP is an assessment based on environmental laws and regulations of both the federal government and the Commonwealth of Massachusetts. The MEP assess the physical and environmental status of 58 potential hazardous waste sites, including 54 study areas (SAs) that pose a potential for releasing contamination into the environment and 4 areas of concern (AOCs) that are known to have substantial contamination. For each SA or AOC, this MEP describes the known history and environment, identifies additional data needs, and proposes possible response actions. Most recommended response actions consist of environmental sampling and monitoring and other characterization studies. 74 refs., 63 figs., 50 tabs.

  15. Examining Climate Influences and Economic Impacts of Harmful Algal Blooms in Massachusetts: 1993 and 2005

    NASA Astrophysics Data System (ADS)

    Ngo, N.

    2005-12-01

    Although the potential causes of harmful algal blooms (HABs), or red tides, have been studied extensively, the relationships between the environmental drivers and economic impacts have not been fully explored. This paper examined the environmental-economic link by investigating similarities in the environmental conditions leading to the 1993 and 2005 HABs (caused by the dinoflagellate Alexandirum) along the Massachusetts coast, and the resulting effects on shellfish, public health, recreation, tourism, and the commercial shellfish industry in Massachusetts. Environmental influences including sea surface temperature (SST), salinity, precipitation, streamflow, and shellfish toxicity levels were examined for the years 1990 to 2005. Economic impacts on commercial fishery landings (Massachusetts mussel commercial fishery landings and Gloucester commercial fishery landings) were assessed for the years1990 to 2003. The Plume Advection hypothesis was studied and results showed that runoff from the five major rivers that contribute to the Western Maine Coastal Current, the current that carried these cells, peaked in April 1993 and 2005 relative to the mean which varied from river to river. The most intense wind stress coming from the North occurred in April 1993 and May 2005 with speeds of 15-20 m/s. A large decrease in salinity off the Massachusetts coast occurred in May 1993 and measured outside the 68% of 1993 salinity data recorded, and from the information available, in April and May 2005 waters were also less saline. Peaks in shellfish toxicity occurred in early June 1993 at approximately 400 μg toxicity/g shellfish meat and in 2005 at 700 μg toxicity/g shellfish meat. This indicated a lag time between peaks in runoff and toxicity of approximately one month and similarly with decreases in salinity. Runoff also corresponded to a large decrease in salinity during May 1993. Coincidentally, there was also a significant decrease in commercial fishery landings between

  16. Benefits and Costs of Aggressive Energy Efficiency Programs and the Impacts of Alternative Sources of Funding: Case Study of Massachusetts

    SciTech Connect

    Cappers, Peter; Satchwell, Andrew; Goldman, Charles; Schlegel, Jeff

    2010-08-06

    Increased interest by state (and federal) policymakers and regulatory agencies in pursuing aggressive energy efficiency efforts could deliver significant utility bill savings for customers while having long-term implications for ratepayers (e.g. potential rate impacts). Equity and distributional concerns associated with the authorized recovery of energy efficiency program costs may necessitate the pursuit of alternative program funding approaches. In 2008, Massachusetts passed the Green Communities Act which directed its energy efficiency (EE) program administrators to obtain all cost-effective EE resources. This goal has translated into achieving annual electric energy savings equivalent to a 2.4% reduction in retail sales from energy efficiency programs in 2012. Representatives of electricity consumer groups supported the new portfolio of EE programs (and the projected bill savings) but raised concerns about the potential rate impacts associated with achieving such aggressive EE goals, leading policymakers to seek out alternative funding sources which can potentially mitigate these effects. Utility administrators have also raised concerns about under-recovery of fixed costs when aggressive energy efficiency programs are pursued and have proposed ratemaking policies (e.g. decoupling) and business models that better align the utility's financial interests with the state's energy efficiency public policy goals. Quantifying these concerns and identifying ways they can be addressed are crucial steps in gaining the support of major stakeholder groups - lessons that can apply to other states looking to significantly increase savings targets that can be achieved from their own ratepayer-funded energy efficiency programs. We use a pro-forma utility financial model to quantify the bill and rate impacts on electricity customers when very aggressive annual energy efficiency savings goals ({approx}2.4%) are achieved over the long-term and also assess the impact of different

  17. Effects of selected low-impact-development (LID) techniques on water quality and quantity in the Ipswich River Basin, Massachusetts-Field and modeling studies

    USGS Publications Warehouse

    Zimmerman, Marc J.; Barbaro, Jeffrey R.; Sorenson, Jason R.; Waldron, Marcus C.

    2010-01-01

    During the months of August and September, flows in the Ipswich River, Massachusetts, dramatically decrease largely due to groundwater withdrawals needed to meet increased residential and commercial water demands. In the summer, rates of groundwater recharge are lower than during the rest of the year, and water demands are higher. From 2005 to 2008, the U.S. Geological Survey, in a cooperative funding agreement with the Massachusetts Department of Conservation and Recreation, monitored small-scale installations of low-impact-development (LID) enhancements designed to diminish the effects of storm runoff on the quantity and quality of surface water and groundwater. Funding for the studies also was contributed by the U.S. Environmental Protection Agency's Targeted Watersheds Grant Program through a financial assistance agreement with Massachusetts Department of Conservation and Recreation. The monitoring studies examined the effects of (1) replacing an impervious parking lot surface with a porous surface on groundwater quality, (2) installing rain gardens and porous pavement in a neighborhood of 3 acres on the quantity and quality of stormwater runoff, and (3) installing a 3,000-square foot (ft2) green roof on the quantity and quality of stormwater runoff. In addition, the effects of broad-scale implementation of LID techniques, reduced water withdrawals, and water-conservation measures on streamflow in large areas of the basin were simulated using the U.S. Geological Survey's Ipswich River Basin model. From June 2005 to 2007, groundwater quality was monitored at the Silver Lake town beach parking lot in Wilmington, MA, prior to and following the replacement of the conventional, impervious-asphalt surface with a porous surface consisting primarily of porous asphalt and porous pavers. Changes in the concentrations of the water-quality constituents, phosphorus, nitrogen, cadmium, chromium, copper, lead, nickel, zinc, and total petroleum hydrocarbons, were monitored

  18. The effect of the Massachusetts healthcare reform on the uninsured rate of the orthopaedic trauma population.

    PubMed

    Toussaint, Rull James; Bergeron, Stephane G; Weaver, Michael J; Tornetta, Paul; Vrahas, Mark S; Harris, Mitchel B

    2014-08-20

    The 2006 Massachusetts Healthcare Reform (MHR) has resulted in health coverage for 98.1% of residents in Massachusetts. The purpose of this study was to evaluate the effect of MHR on the actual rate of uninsured individuals in the orthopaedic trauma population in the largest metropolitan area of Massachusetts. We also sought to measure the change in uncompensated care following the implementation of MHR. We performed a retrospective review of all patients treated by the orthopaedic trauma services at three of the four level-I trauma centers in Boston from 2003 to 2010. The primary study cohort consisted of all uninsured patients, while the remaining patients were considered to have insurance. The study population was divided into two groups to compare the uninsured rate before and after MHR. Patients from 2006 to 2007 were excluded from the analysis to allow for an enrollment period in subsidized health insurance. A total of 16,338 patients with extremity and pelvic fractures and dislocations were treated from 2003 to 2010. There was a significant decrease in the uninsured rate from 23.8% to 14.4% following MHR (p < 0.001). The post-MHR risk of being uninsured is approximately 0.6 times the pre-MHR risk, with a 95% confidence interval of 0.56 to 0.65. There was also a reduction in the proportion of uncompensated care from 16.7% to 11.5% after MHR. There was an estimated 40% reduction in risk of uninsured individuals in the orthopaedic trauma population in the metropolitan Boston area following MHR. Despite a significant improvement, these results reveal a rate of uninsured individuals fivefold greater than currently reported by the state of Massachusetts and the U.S. government. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  19. Emergency Preparedness Policy and Practice in Massachusetts Hospitals.

    PubMed

    Taschner, Mary A; Nannini, Angela; Laccetti, Margaret; Greene, Martin

    2017-03-01

    Hospital emergency preparedness has evolved in response to and been challenged by threats of terrorism, meteorological disasters, and public health emergencies. In this case study, the authors examined emergency preparedness policy and practice in Massachusetts hospitals following 9/11/2001, identifying areas of success and opportunities for improvement. Using a qualitative descriptive approach, data analysis included the examination of documents and public health policy. Snowball technique was used to recruit nurses, public health policy makers, and other first responder leaders with historical and present knowledge of emergency preparedness policy and practice. Content analysis identified emerging themes and lessons learned. Key findings included the importance of standardized training, the value of interprofessional collaboration and communication across organizations, and the impact of decreased funding and prior incidents. The lessons learned from this case study contribute to the evolving body of knowledge about emergency preparedness for all hospitals and public health facilities, and their community health partners. Emergency preparedness is a dynamic process, and as it continues to evolve, additional research will be needed to standardize training, encourage collaboration, and facilitate communication so that incident response by hospital professionals, including occupational health nurses, and their public health and community partners is more effective.

  20. A field study (Massachusetts, USA) of the factors controlling the depth of groundwater flow systems in crystalline fractured-rock terrain

    NASA Astrophysics Data System (ADS)

    Boutt, David F.; Diggins, Patrick; Mabee, Stephen

    2010-12-01

    Groundwater movement and availability in crystalline and metamorphosed rocks is dominated by the secondary porosity generated through fracturing. The distributions of fractures and fracture zones determine permeable pathways and the productivity of these rocks. Controls on how these distributions vary with depth in the shallow subsurface (<300 m) and their resulting influence on groundwater flow is not well understood. The results of a subsurface study in the Nashoba and Avalon terranes of eastern Massachusetts (USA), which is a region experiencing expanded use of the fractured bedrock as a potable-supply aquifer, are presented. The study logged the distribution of fractures in 17 boreholes, identified flowing fractures, and hydraulically characterized the rock mass intersecting the boreholes. Of all fractures encountered, 2.5% are hydraulically active. Boreholes show decreasing fracture frequency up to 300 m depth, with hydraulically active fractures showing a similar trend; this restricts topographically driven flow. Borehole temperature profiles corroborate this, with minimal hydrologically altered flow observed in the profiles below 100 m. Results from this study suggest that active flow systems in these geologic settings are shallow and that fracture permeability outside of the influence of large-scale structures will follow a decreasing trend with depth.

  1. Access and use of information resources by Massachusetts

    SciTech Connect

    West, C.R.

    1990-12-31

    This paper describes the way in which the Massachusetts Department of Environmental Protection uses risk assessment to implement the state`s environmental laws. It focuses on the Office of Research and Standards, which was created to provide information on adverse health effects of environmental contaminants, to recommend exposure levels, and to direct and manage research programs.

  2. Libraries in Massachusetts: MedlinePlus

    MedlinePlus

    ... this page: https://medlineplus.gov/libraries/massachusetts.html Libraries in Massachusetts To use the sharing features on ... please enable JavaScript. Boston Boston Children's Hospital Medical Library BCH3044 300 Longwood Ave. Boston, MA 02115 617- ...

  3. Contaminant transport in Massachusetts Bay

    USGS Publications Warehouse

    Butman, Bradford

    Construction of a new treatment plant and outfall to clean up Boston Harbor is currently one of the world's largest public works projects, costing about $4 billion. There is concern about the long-term impact of contaminants on Massachusetts Bay and adjacent Gulf of Maine because these areas are used extensively for transportation, recreation, fishing, and tourism, as well as waste disposal. Public concern also focuses on Stellwagen Bank, located on the eastern side of Massachusetts Bay, which is an important habitat for endangered whales. Contaminants reach Massachusetts Bay not only from Boston Harbor, but from other coastal communities on the Gulf of Maine, as well as from the atmosphere. Knowledge of the pathways, mechanisms, and rates at which pollutants are transported throughout these coastal environments is needed to address a wide range of management questions.

  4. 75 FR 3764 - Massachusetts Disaster # MA-00024

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-22

    ... ADMINISTRATION Massachusetts Disaster MA-00024 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 01/15/2010. Incident: Mystic Side Estates Apartment Building Fire. Incident Period: 01/09.... Contiguous Counties: Massachusetts: Essex, Norfolk, Suffolk, Worcester. New Hampshire: Hillsborough. The...

  5. 76 FR 65557 - Massachusetts Disaster #MA-00043

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-21

    ... ADMINISTRATION Massachusetts Disaster MA-00043 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 10/13/2011. ] Incident: Severe Storms and Flooding. Incident Period: 10/04/2011. Effective...: Massachusetts Middlesex, Suffolk. New Hampshire: Hillsborough, Rockingham. The Interest Rates are: Percent For...

  6. 76 FR 40766 - Massachusetts Disaster #MA-00035

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... ADMINISTRATION Massachusetts Disaster MA-00035 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 06/29/2011. Incident: Johnsonia Apartment Building Fire Incident Period: 06/13/2011...: Massachusetts: Franklin, Hampden, Hampshire, Middlesex, Norfolk. Connecticut: Tolland, Windham. New Hampshire...

  7. 77 FR 76584 - Massachusetts Disaster # MA-00051

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ...] Massachusetts Disaster MA-00051 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Massachusetts dated 12/12... Counties: Massachusetts: Franklin, Hampden, Hampshire, Middlesex, Norfolk. Connecticut: Tolland, Windham...

  8. 46 CFR 15.1040 - Massachusetts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Massachusetts. 15.1040 Section 15.1040 Shipping COAST... in Foreign Trade § 15.1040 Massachusetts. The following U.S. navigable waters located within the State of Massachusetts when the vessel is in transit, but not bound to or departing from a port within...

  9. 76 FR 36953 - Massachusetts Disaster #MA-00036

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... ADMINISTRATION Massachusetts Disaster MA-00036 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts (FEMA--1994--DR), dated 06/15/ 2011. Incident: Severe Storms and Tornadoes. Incident Period: 06/01...): Massachusetts: Berkshire, Franklin, Hampshire, Middlesex, Norfolk. Connecticut: Hartford, Litchfield, Tolland...

  10. 75 FR 79064 - Massachusetts Disaster #MA-00030

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... ADMINISTRATION Massachusetts Disaster MA-00030 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 12/07/2010. Incident: Apartment complex fire. Incident Period: 11/21/2010. Effective Date...: Massachusetts: Berkshire, Hampshire, Worcester. Connecticut: Hartford, Litchfield, Tolland. The Interest Rates...

  11. 75 FR 45681 - Massachusetts Disaster #MA-00028.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... ADMINISTRATION Massachusetts Disaster MA-00028. AGENCY: U.S. Small Business Administration. ACTION: Notice... MASSACHUSETTS dated 07/27/2010. Incident: Severe Storms and Flooding. Incident Period: 07/10/2010. DATES...: Massachusetts: Essex, Norfolk, Suffolk, Worcester. New Hampshire: Hillsborough. The Interest Rates are: Percent...

  12. 77 FR 12350 - Massachusetts Disaster #MA-00047

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ... ADMINISTRATION Massachusetts Disaster MA-00047 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 02/21/2012. Incident: Brookline Apartment Building Fire. Incident Period: 01/16/2012... adversely affected by the disaster: Primary Counties: Norfolk. Contiguous Counties: Massachusetts: Bristol...

  13. 77 FR 33263 - Massachusetts Disaster #MA-00048

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... ADMINISTRATION Massachusetts Disaster MA-00048 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 05/29/2012. Incident: Lake Williams Condominium Complex Fire. Incident Period: 04/23/2012... adversely affected by the disaster: Primary Counties: Middlesex. Contiguous Counties: Massachusetts: Essex...

  14. 75 FR 17177 - Massachusetts Disaster #MA-00025

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-05

    ... ADMINISTRATION Massachusetts Disaster MA-00025 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts (FEMA-1895-DR), dated 03/29/ 2010. Incident: Severe Storms and Flooding. Incident Period: 03/12..., Plymouth, Suffolk, Worcester. Contiguous Counties (Economic Injury Loans Only): Massachusetts: Barnstable...

  15. 76 FR 56859 - Massachusetts Disaster #MA-00039

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... ADMINISTRATION Massachusetts Disaster MA-00039 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts (FEMA-4028-DR), dated 09/03/2011. Incident: Tropical Storm Irene. Incident Period: 08/27/2011...: (Economic Injury Loans Only): Massachusetts: Hampden, Hampshire, Worcester. Connecticut: Litchfield. New...

  16. 76 FR 30748 - Massachusetts Disaster #MA-00033

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... ADMINISTRATION Massachusetts Disaster MA-00033 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 05/19/2011. Incident: Apartment Building Fire. Incident Period: 04/30/2011. Effective Date...: Massachusetts: Berkshire, Hampshire, Worcester. Connecticut: Hartford, Litchfield, Tolland. The Interest Rates...

  17. 77 FR 66214 - Massachusetts Disaster # MA-00049

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-02

    ... ADMINISTRATION Massachusetts Disaster MA-00049 AGENCY: U.S. Small Business Administration. ACTION: Notice... Massachusetts dated 10/22/2012. Incident: Severe Storms and Flooding. Incident Period: 09/05/2012. Effective... adversely affected by the disaster: Primary Counties: Bristol. Contiguous Counties: Massachusetts: Norfolk...

  18. EPA Provides State of Massachusetts $63.7 Million for Water Infrastructure Projects

    EPA Pesticide Factsheets

    The U.S. Environmental Protection Agency has awarded $63.7 million to the Commonwealth of Massachusetts to help finance improvements to water projects that are essential to protecting public health and the environment.

  19. Massachusetts Capacity Study Research Brief: Characteristics of the Current Early Education and Care Workforce Serving 3-5 Year-Olds

    ERIC Educational Resources Information Center

    Marshall, Nancy L.; Dennehy, Julie; Johnson-Staub, Christine; Robeson, Wendy Wagner

    2005-01-01

    This research brief outlines the characteristics of the current workforce serving children ages 3-5 years, and begins the discussion of the needs of the field to implement universal preschool in Massachusetts. Specifically, this brief addresses two questions about the workforce: (1) What are the characteristics, including educational…

  20. Lexington and Concord, Massachusetts

    NASA Technical Reports Server (NTRS)

    2007-01-01

    On the night of April 18/19, 1775, Paul Revere rode from Boston to Lexington, Mass., to warn John Hancock and Samuel Adams that the British were coming. On April 19, there was a skirmish on the Battle Green, with shots being fired both from the Battle Green and the nearby Buckman Tavern. After the rout, the British marched on toward Concord. The battle in Lexington allowed the Concord militia time to organize at the Old North Bridge, where they were able to turn back the British and prevent them from capturing and destroying the militia's arms stores.

    This image from the Advanced Spaceborne Thermal Emission and Reflection Radiometer instrument on NASA's Terra satellite, acquired in October 2006, depicts this area of great importance in U.S. history. These two small Massachusetts towns are now dwarfed by Hanscom Air Force Base between them.

    With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra spacecraft. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance.

    The U.S. science

  1. Lexington and Concord, Massachusetts

    NASA Technical Reports Server (NTRS)

    2007-01-01

    On the night of April 18/19, 1775, Paul Revere rode from Boston to Lexington, Mass., to warn John Hancock and Samuel Adams that the British were coming. On April 19, there was a skirmish on the Battle Green, with shots being fired both from the Battle Green and the nearby Buckman Tavern. After the rout, the British marched on toward Concord. The battle in Lexington allowed the Concord militia time to organize at the Old North Bridge, where they were able to turn back the British and prevent them from capturing and destroying the militia's arms stores.

    This image from the Advanced Spaceborne Thermal Emission and Reflection Radiometer instrument on NASA's Terra satellite, acquired in October 2006, depicts this area of great importance in U.S. history. These two small Massachusetts towns are now dwarfed by Hanscom Air Force Base between them.

    With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra spacecraft. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance.

    The U.S. science

  2. Pap smear rates among Haitian immigrant women in eastern Massachusetts.

    PubMed Central

    Green, Eric H.; Freund, Karen M.; Posner, Michael A.; David, Michele M.

    2005-01-01

    OBJECTIVE: Given limited prior evidence of high rates of cervical cancer in Haitian immigrant women in the U.S., this study was designed to examine self-reported Pap smear screening rates for Haitian immigrant women and compare them to rates for women of other ethnicities. METHODS: Multi-ethnic women at least 40 years of age living in neighborhoods with large Haitian immigrant populations in eastern Massachusetts were surveyed in 2000-2002. Multivariate logistic regression analyses were used to examine the effect of demographic and health care characteristics on Pap smear rates. RESULTS: Overall, 81% (95% confidence interval 79%, 84%) of women in the study sample reported having had a Pap smear within three years. In unadjusted analyses, Pap smear rates differed by ethnicity (p=0.003), with women identified as Haitian having a lower crude Pap smear rate (78%) than women identified as African American (87%), English-speaking Caribbean (88%), or Latina (92%). Women identified as Haitian had a higher rate than women identified as non-Hispanic white (74%). Adjustment for differences in demographic factors known to predict Pap smear acquisition (age, marital status, education level, and household income) only partially accounted for the observed difference in Pap smear rates. However, adjustment for these variables as well as those related to health care access (single site for primary care, health insurance status, and physician gender) eliminated the ethnic difference in Pap smear rates. CONCLUSIONS: The lower crude Pap smear rate for Haitian immigrants relative to other women of color was in part due to differences in (1) utilization of a single source for primary care, (2) health insurance, and (3) care provided by female physicians. Public health programs, such as the cancer prevention programs currently utilized in eastern Massachusetts, may influence these factors. Thus, the relatively high Pap rate among women in this study may reflect the success of these

  3. Computer Technology in Massachusetts Schools.

    ERIC Educational Resources Information Center

    Hess, John; Sanders, Jean E., Ed.

    This report focuses on the status and future of computer technology in Massachusetts schools. The report is organized into four major sections. Introductory information is provided in section 1, followed by a framework (section 2) for viewing computer technology. This framework provides information on computer hardware components, computer…

  4. Antidote: Civic Responsibility. Massachusetts Law.

    ERIC Educational Resources Information Center

    Phi Alpha Delta Law Fraternity International, Washington, DC.

    Designed for middle school through high school students, this unit contains eight lesson plans that focus on Massachusetts state law. The state lessons correspond to lessons in the volume, "Antidote: Civic Responsibility. Drug Avoidance Lessons for Middle School & High School Students." Developed to be presented by educators, law…

  5. Censorship in Massachusetts: An Update.

    ERIC Educational Resources Information Center

    Woods, L. B.; O'Brien, Jane E.

    This report updates a 1979 article from the Bay State Librarian about censorship in Massachusetts libraries from 1966 through 1975. Compiled using data from the American Library Association's Office of Intellectual Freedom (OIF), the report provides information about censorship attempts and actions between 1976 and 1982. The definition of…

  6. E-Learning in Massachusetts

    ERIC Educational Resources Information Center

    Graziano, April

    2005-01-01

    This document presents some of the many ways schools are using online technologies. The report illustrates how Massachusetts educators are taking advantage of e-learning opportunities to improve student learning. Educators across the state are using online courses and resources, engaging in online events and projects, and showing interest in…

  7. Massachusetts Special Olympics Poly Hockey.

    ERIC Educational Resources Information Center

    Morrissey, Jim

    Poly Hockey is featured in this manual of instructions for coaches and teachers to use with mentally retarded boys and girls of all ages and ability levels. It is noted that the sport has been supported by the Board of Directors of the Special Olympics and has been used in Massachusetts for over 7 years. Explained is use of the game indoors, and…

  8. Sustained Reduction in HIV Diagnoses in Massachusetts, 2000-2014.

    PubMed

    Cranston, Kevin; John, Betsey; Fukuda, H Dawn; Randall, Liisa M; Mermin, Jonathan; Mayer, Kenneth H; DeMaria, Alfred

    2017-05-01

    To describe secular trends in reported HIV diagnoses in Massachusetts concurrent with treatment access expansion. We characterized cases of HIV infection reported to the Massachusetts HIV/AIDS Surveillance Program between 2000 and 2014 by sex, age, race/ethnicity, and exposure mode. We used Poisson regression to test the statistical significance of trends in diagnoses. Between 2000 and 2014, annual new HIV infections diagnosed in Massachusetts decreased by 47% (P < .001 for trend). We observed significant reductions in diagnoses among women (58% when comparing 2000 with 2014), men (42%), Whites (54%), Blacks (51%), and Hispanics (35%; P < .001 for trend). New diagnoses decreased significantly among men who have sex with men (19%), persons who inject drugs (91%), and heterosexuals (86%; P < .001 for trend). We saw statistically significant downward trends among all men by race/ethnicity, but the trend among Black men who have sex with men was nonsignificant. Sustained reduction in new HIV diagnoses was concurrent with Massachusetts's Medicaid expansion, state health care reform, and public health strategies to improve care access. A contributory effect of expanded HIV treatment and population-level viral suppression is hypothesized for future research.

  9. New Teachers and the Massachusetts Signing Bonus: The Limits of Inducements

    ERIC Educational Resources Information Center

    Liu, Edward; Johnson, Susan Moore; Peske, Heather G.

    2004-01-01

    In 1998, Massachusetts instituted a $20,000 Signing Bonus to address concerns about the supply of quality teachers. This article reports on a longitudinal, qualitative study of the experiences of 13 of the original 59 recipients of the Signing Bonus, and analyzes their responses to various incentives embedded within the Massachusetts Signing Bonus…

  10. The Massachusetts Community Colleges Developmental Education Best Policy and Practice Audit: Final Report

    ERIC Educational Resources Information Center

    Sperling, Charmian

    2009-01-01

    The purpose of this study, funded by Jobs for the Future through a grant to the Massachusetts Community Colleges Executive Office, was to: (1) provide an update on the status of developmental education within Massachusetts community colleges; (2) shed light on the alignment between research-based best practices to advance success among…

  11. Increased Percentage of Passing Grades on the Massachusetts Comprehensive Assessment System after Implementation of Block Scheduling

    ERIC Educational Resources Information Center

    Forman, Eric D.

    2009-01-01

    This study examined one public school system's change in its bell scheduling format from a seven period day to block scheduling. The data collected was from a three year period of the grade 10 students passing the Massachusetts Comprehensive Assessment System exam. Students in Massachusetts must pass the mathematics and English/language arts…

  12. School Awards Programs and Accountability in Massachusetts: Misusing MCAS Scores To Assess School Quality.

    ERIC Educational Resources Information Center

    Wheelock, Anne

    Scores on the Massachusetts Comprehensive Assessment System (MCAS) tests are used to select exemplary schools in Massachusetts, and the schools thus identified can receive awards from three different programs. This study examined the evidence about the use of MCAS scores to assess school quality. These three programs use MCAS to identify exemplary…

  13. Best of Both Worlds: How Massachusetts Vocational Schools Are Preparing Students for College and Careers

    ERIC Educational Resources Information Center

    Bayerl, Katie

    2015-01-01

    "Best of Both Worlds: How Massachusetts Vocational Schools are Preparing Students for College and Careers," highlights the state's policies that promote strong programming. Massachusetts encourages the completion of MassCore, the state's college- and career-ready course of study, incentivizes rigorous academic standards through school…

  14. Profit and non-profit home health care agency outcomes: a study of one state's experience.

    PubMed

    Ellenbecker, C H

    1995-01-01

    The home health care industry, traditionally an industry of non-profit organizations, has increasingly become, as has the rest of the health care industry, invaded by for-profit organizations. The impetus for this invasion was the Omnibus Reconciliation Act (OBRA) of 1980 which encouraged previously restricted for-profit organizations to participate in the Medicare and Medicaid home health care program. Following enactment of OBRA, the number of for-profit organizations grew rapidly and the advantages and disadvantages of their presence in the market has been widely debated. The purpose of this study was to describe differences in behaviors and industry outcomes generated by non-profit and for-profit organizations in Massachusetts. Data for the study was from the Massachusetts State Department of Public Health's Annual Reports of Home Health Agencies. Results suggest that while profit and non-profit agencies behave similarly in many areas, there are areas of difference, with significant differences found in the amount of service delivered and the rates charged.

  15. Health System and Personal Barriers Resulting in Decreased Utilization of HIV and STD Testing Services among At-Risk Black Men Who Have Sex with Men in Massachusetts

    PubMed Central

    Reisner, Sari L.; Bland, Sean; Skeer, Margie; Cranston, Kevin; Isenberg, Deborah; Vega, Benny A.; Mayer, Kenneth H.

    2009-01-01

    Abstract Testing for HIV and other sexually transmitted diseases (STD) remains a cornerstone of public health prevention interventions. This analysis was designed to explore the frequency of testing, as well as health system and personal barriers to testing, among a community-recruited sample of Black men who have sex with men (MSM) at risk for HIV and STDs. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered assessment, with optional voluntary HIV counseling and testing. Logistic regression procedures examined factors associated with not having tested in the 2 years prior to study enrollment for: (1) HIV (among HIV-uninfected participants, n = 145) and (2) STDs (among the entire mixed serostatus sample, n = 197). The odds ratios and their 95% confidence intervals obtained from this analysis were converted to relative risks. (1) HIV: Overall, 33% of HIV-uninfected Black MSM had not been tested for HIV in the 2 years prior to study enrollment. Factors uniquely associated with not having a recent HIV test included: being less educated; engaging in serodiscordant unprotected sex; and never having been HIV tested at a community health clinic, STD clinic, or jail. (2) STDs: Sixty percent had not been tested for STDs in the 2 years prior to study enrollment, and 24% of the sample had never been tested for STDs. Factors uniquely associated with not having a recent STD test included: older age; having had a prior STD; and never having been tested at an emergency department or urgent care clinic. Overlapping factors associated with both not having had a recent HIV or STD test included: substance use during sex; feeling that using a condom during sex is “very difficult”; less frequent contact with other MSM; not visiting a health care provider (HCP) in the past 12 months; having a HCP not recommend HIV or STD testing at their last visit; not having a primary care provider

  16. Variation and Trends in Charges for Pediatric Care in Massachusetts Emergency Departments, 2000-2011.

    PubMed

    Monuteaux, Michael C; Bourgeois, Florence T; Mannix, Rebekah; Samnaliev, Mihail; Stack, Anne M

    2015-10-01

    Emergency department (ED) utilization by children is common and growing more expensive. Tracking trends and variability in ED charges is essential for policymakers who strive to improve the efficiency of the health care system and for payers who prepare health care budget forecasts. Our objective was to examine trends and variability in ED charges for pediatric patients across Massachusetts. This was a comprehensive analysis of the statewide database containing all the visits of children aged 0 to 18 years evaluated in any of the state's EDs from 2000 to 2011, excluding patients with chronic medical conditions and those whose visits resulted in hospital admission. A validated system designed to specifically classify pediatric emergency patients into major diagnostic groups was used. Mean charges as well as interhospital variability of charges over time were examined for the most common diagnostic groups. Seventy-six hospitals provided emergency care in Massachusetts during the study period, with 6,249,923 pediatric patients treated and discharged. Statewide charges significantly increased from 2000 until 2007/2008, before plateauing or decreasing through 2011. There was no evidence that interhospital variability changed over time. With the exception of academic teaching status, no hospital-level factors emerged as consistent predictors of charges. Charges for common pediatric emergency conditions varied widely across Massachusetts EDs, and hospital-level factors by and large could not consistently explain the variability. Although a plateau (and in some cases decrease) of statewide pediatric emergency health care charges was observed after 2007, no evidence was found that interhospital variability decreased. These data may be useful in the ongoing effort to reform the economics of health care delivery systems. © 2015 by the Society for Academic Emergency Medicine.

  17. Rates of Femicide in Women of Different Races, Ethnicities, and Places of Birth: Massachusetts, 1993-2007

    ERIC Educational Resources Information Center

    Azziz-Baumgartner, Eduardo; McKeown, Loreta; Melvin, Patrice; Dang, Quynh; Reed, Joan

    2011-01-01

    To describe the epidemiology of intimate partner violence (IPV) homicide in Massachusetts, an IPV mortality data set developed by the Massachusetts Department of Public Health was analyzed. The rates of death were estimated by dividing the number of decedents over the aged-matched population and Poisson regression was used to estimate the…

  18. Rates of Femicide in Women of Different Races, Ethnicities, and Places of Birth: Massachusetts, 1993-2007

    ERIC Educational Resources Information Center

    Azziz-Baumgartner, Eduardo; McKeown, Loreta; Melvin, Patrice; Dang, Quynh; Reed, Joan

    2011-01-01

    To describe the epidemiology of intimate partner violence (IPV) homicide in Massachusetts, an IPV mortality data set developed by the Massachusetts Department of Public Health was analyzed. The rates of death were estimated by dividing the number of decedents over the aged-matched population and Poisson regression was used to estimate the…

  19. The Politics of Educational Reform in Nineteenth-Century Massachusetts: The Controversy Over the Beverly High School in 1860. Final Report.

    ERIC Educational Resources Information Center

    Vinovskis, Maris A.

    A case study of events involving the Beverly High School (Beverly, Massachusetts) circa 1860 exemplifies educational trends in mid-19th century Massachusetts. The hypothesis is that the political situation in mid-19th century Massachusetts was much more complex than has been suggested by radical revisionsts who tend to interpret educational and…

  20. The Impact of Study Tours in Developing Global-Mindedness among PK-12 Educators in Southeastern Massachusetts

    ERIC Educational Resources Information Center

    DeMello, Mary Ann

    2011-01-01

    College and career readiness requires that PK-12 educators provide a global education, yet many educators have had insufficient professional training to address this need. This mixed methods study investigated the impact of international study tours in the development of global-mindedness among educators participating in a Southeastern…

  1. The Impact of Study Tours in Developing Global-Mindedness among PK-12 Educators in Southeastern Massachusetts

    ERIC Educational Resources Information Center

    DeMello, Mary Ann

    2011-01-01

    College and career readiness requires that PK-12 educators provide a global education, yet many educators have had insufficient professional training to address this need. This mixed methods study investigated the impact of international study tours in the development of global-mindedness among educators participating in a Southeastern…

  2. No Further Action Decision Under CERCLA, Study Area 31, Moore Army Airfield Fire Fighting Training Area, Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    National Priorities List under the Comprehensive Environmental Response, Compensation, and Liability Act ( CERCLA ) as amended by the Superfund ...NLIl U.S. Army Environmental Center NO FURTHER ACTION DECISION UNDER I CERCLA STUDY AREA 31 MOORE ARMY AIRFIELD FIRE FIGHTING TRAINING AREA 3 FORT...RECYCLED PAPER AF AEC Form 󈧱,, 1 Feb 93 replaces THAMA Form 45 which is obsolete. I I I, NO FURTHER ACTION DECISIONU UNDER CERCLA STUDY AREA 313 MOORE

  3. No Further Action Decision Under CERCLA Study Area 43M Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Priorities List under the Comprehensive Environmental Response, Compensation and Liability Act ( CERCLA ) as amended by the Superfund Amendments and...Approwved for public Rl~eease Distribution Unhrnited U.S. Army Environmental Center NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43M HISTORIC...PRINTED ON RECYCLED PAPER 20070502728 AEC Form 45, 1 Feb 93 replaces THAMA Form 󈧱 which is obsolete. NO FURTHER ACTION DECISION UNDER CERCLA STUDY

  4. No Further Action Decision Under CERCLA Study Area 43K Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Compensation and Liability Act ( CERCLA ) as amended by the Superfund Amendments and Reauthorization Act. An Enhanced Preliminary Assessment (PA) was also...DiSTR1BUTION STATEMENT A Approved for Public Release Distribution Unlimited NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43K HISTORIC GAS...Distribution Unlimited U.S. ArmyEnvironmentalCenter NO FURTHER ACTION DECISION UNDER CERCLA STUDY AREA 43K HISTORIC GAS STATION SITES FORT DEVENS,9

  5. Wastewater Engineering and Management Plan for Boston Harbor-Eastern Massachusetts Metropolitan Area EMMA Study. Summary Report.

    DTIC Science & Technology

    1976-03-01

    the costs for achieving • disch ged from the Deer Island and waler quality goals and how best Nut Wand treatment plants. Included in should they be p...achieve the consultant to MDC. A Citizens Advisory Committee Study %nagement (CM) also participated in the study and assisted in the public...ified snd expanded before it is P r a c t i c a b l e Waste Treatment accepted. Pr esent scheduling calls for Technology (BPV.Tr); analysing the

  6. Fiscal Year 1986 program report (Massachusetts Water Resources Research Center)

    SciTech Connect

    Godfrey, P.J.

    1987-09-01

    The FY86 Water Resources Research Center program focused on state and regional research priorities: acid-deposition impacts and drinking-water quality. Water Resources Institute Program (WRIP) support was supplemented by the Massachusetts Division of Fisheries and Wildlife, the Executive Office of Environmental Affairs, and the University of Massachusetts. Four WRIP projects were completed: studies of natural mitigation of acid deposition via sulfate reduction in lakes, the effect of ozone and acid deposition on tree seedlings, corrosion impacts on water quality, and creation of potentially hazardous chlorinated organics by drinking-water treatment. The state Cooperative Aquatic Research Program funded 5 projects. An Aquatic Toxicology Program addressed research, training, and information transfer for the Massachusetts Division of Fisheries and Wildlife. Other information transfer included a monthly water resources center newsletter, a quarterly Acid Rain Monitoring Project newsletter, and acid-rain reports to the media and general public.

  7. Case-control study of bladder cancer in Massachusetts among populations receiving chlorinated and chloraminated drinking water

    SciTech Connect

    Zierler, S.; Feingold, L.; Danley, R.A.; Craun, G.

    1989-01-01

    Studies of the occurrence of bladder cancer in relation to exposure to chlorinated drinking water, in general, have found a small excess frequency of bladder cancer among consumers of chlorinated drinking water. Despite near consistent findings of a small positive association, interpretation of the association has been cautious because of the inability to control for potential confounding by unmeasured differences in surface and ground water, as the index frequently used for exposure to levels of chlorination in drinking water compares chlorinated surface water to unchlorinated ground water. The authors undertook a case-control study to collect detailed data on residential history that was obtained from telephone interviews with informants of 614 individuals who died of primary bladder cancer and 1,074 individuals who died of other causes. The study was based in an area where surface water has been disinfected with either chlorine or a combination of chlorine and ammonia (chloramine) since 1938.

  8. Student and Teacher Perspectives on Channel One: A Qualitative Study of Participants in Massachusetts and Florida Schools.

    ERIC Educational Resources Information Center

    Barrett, Janice M.

    A study of Channel One, the 10 minutes of television news programs and 2 minutes of commercials in classrooms, described the opinions and evaluative comments of participant teachers, librarians, administrators, and students. Individual interviews and focus group discussions were conducted at eight secondary schools (four in Florida and four in…

  9. No Further Action Decision Under CERCLA Study Area 59: Bridge 526. Fort Devens Main Post Site Investigation, Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    National Priorities List under the Comprehensive...address study areas at Fort Devens, including a Master Environmental Plan (Argonne National Laboratory, 1992), an Enhanced Preliminary Assessment (Weston, 1992), and Site Investigation Reports (ABB, 1992 and Arthur D. Little, 1993a)....Environmental Response, Compensation and Liability Act as amended by the Superfund Amendments and Reauthorization Act on December, 21, 1989. In addition,

  10. No Further Action Decision Under CERCLA Study Area 43F Historic Gas Station Sites Fort Devens, Massachusetts

    DTIC Science & Technology

    1995-01-01

    Act ( CERCLA ) as amended by the Superfund Amendments and Reauthorization Act. "An Enhanced Preliminary Assessment (PA) was also performed at Fort Devens...I . Approved ior Public Release Distribution Unlimited I U.S. ArmyEnvironmentalCenter NO FURTHER ACTION DECISION UNDER I CERCLA 3 STUDY AREA 43F...JANUARY 1995 PRINTED ON RECYCLED PAPER 20070502736 AEC Form 45, 1 Feb 93 replaces THAMA Form 45 which is obsolete. NO FURTHER ACTION DECISION UNDER CERCLA

  11. Influenza vaccination among pregnant women--Massachusetts, 2009-2010.

    PubMed

    2013-11-01

    The emergence of the novel influenza A (H1N1) pdm09 (pH1N1) strain in 2009 required a coordinated public health response, especially among high-risk populations. Because pregnant women were at increased risk for influenza-related complications and hospitalization compared with the general population, the American College of Obstetricians and Gynecologists and the Advisory Committee on Immunization Practices recommended pregnant women receive both the pH1N1 vaccine and the annual seasonal vaccine during the 2009-10 influenza season as a safe and effective way of protecting both mother and infant. To describe acceptance, predictors, and barriers to influenza vaccination among pregnant women in Massachusetts during the 2009-10 influenza season, the Massachusetts Department of Public Health (MDPH) analyzed data from supplemental influenza questions on the Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) survey. The results indicated that 67.5% of residents who had live births in Massachusetts during September 2009-May 2010 received the seasonal vaccine, and 57.6% received the pH1N1 vaccine. Women who were non-Hispanic blacks, aged <25 years, Medicaid beneficiaries, or lived in a household with an income at or below the federal poverty level were significantly less likely to receive the seasonal vaccine. For the pH1N1 vaccine, only being non-Hispanic black was associated with being less likely to have been vaccinated. Vaccination rates were significantly higher among women whose provider offered or recommended the seasonal (75.8%) and pH1N1 (68.1%) vaccines compared with those who did not receive a recommendation (32.4% and 8.6%, respectively). Coverage in Massachusetts was among the highest of 29 PRAMS sites and might have reflected strategic efforts by MDPH to support vaccine education and equity across the state.

  12. Multidisciplinary Studies of the Fate and Transport of Contaminants in Ground Water at the U.S. Geological Survey Cape Cod Toxic Substances Hydrology Program Research Site, Massachusetts

    NASA Astrophysics Data System (ADS)

    Leblanc, D. R.; Smith, R. L.; Kent, D. B.; Barber, L. B.; Harvey, R. W.

    2008-12-01

    The U.S. Geological Survey conducts multidisciplinary research on the physical, chemical, and microbiological processes affecting ground-water contaminants of global concern at its Cape Cod Toxic Substances Hydrology Program site in Massachusetts, USA. The work centers on a 6-kilometer-long plume of treated wastewater in a glacial sand and gravel aquifer. The plume is characterized by distinct geochemical zones caused by the biodegradation of organic materials in treated wastewater that was disposed to the aquifer by rapid infiltration during the period 1936-95. A core group of hydrogeologists, geochemists, microbiologists, and geophysicists has been involved in the research effort for more than two decades. The effort has been enhanced by stable funding, a readily accessible site, a relatively simple hydrologic setting, and logistical support from an adjacent military base. The research team uses a three-part approach to plan and conduct research at the site. First, detailed spatial and temporal monitoring of the plume since the late 1970s provides field evidence of important contaminant-transport processes and provides the basis for multidisciplinary, process-oriented studies. Second, ground-water tracer experiments are conducted in various geochemical zones in the plume to study factors that control the rate and extent of contaminant transport. Several arrays of multilevel sampling devices, including an array with more than 15,000 individual sampling points, are used to conduct these experiments. Plume-scale (kilometers) and tracer-test-scale (1- 100 meters) studies are complemented by laboratory experiments and mathematical modeling of flow and reactive transport. Third, results are applied to the treated-wastewater plume, other contaminant plumes at the military base, and other sites nationally to evaluate the applicability of the findings and to point toward further research. Examples of findings to date include that (1) macrodispersivity can be related to

  13. Geological Interpretation of the Sea Floor Offshore of Edgartown, Massachusetts

    USGS Publications Warehouse

    Poppe, L.J.; McMullen, K.Y.; Foster, D.S.; Blackwood, D.S.; Williams, S.J.; Ackerman, S.D.; Moser, M.S.; Glomb, K.A.

    2010-01-01

    Gridded bathymetry and sidescan-sonar imagery together cover approximately 37.3 square kilometers of sea floor in the vicinity of Edgartown Harbor, Massachusetts. Although originally collected for charting purposes during National Oceanic and Atmospheric Administration hydrographic survey H11346, these acoustic data, and the sea-floor stations and seismic-reflection lines subsequently occupied to verify them, 1) show the composition and terrain of the seabed, 2) provide information on sediment transport and benthic habitat, and 3) are part of an expanding series of studies that provide a fundamental framework for research and management (for example, windfarms, pipelines, and dredging) activities along the Massachusetts inner continental shelf.

  14. Cluster of an Unusual Amnestic Syndrome - Massachusetts, 2012-2016.

    PubMed

    Barash, Jed A; Somerville, Nick; DeMaria, Alfred

    2017-01-27

    In November 2015, a neurologist in the Boston, Massachusetts, area reported four cases of an uncommon amnestic syndrome involving acute and complete ischemia of both hippocampi, as identified by magnetic resonance imaging (MRI), to the Massachusetts Department of Public Health (MDPH) (1). A subsequent e-mail alert, generated by the Massachusetts Board of Registration in Medicine and sent to relevant medical specialists (including neurologists, neuroradiologists, and emergency physicians), resulted in the identification of 10 additional cases that had occurred during 2012-2016. All 14 patients (mean and median age = 35 years) had been evaluated at hospitals in eastern Massachusetts. Thirteen of the 14 patients underwent routine clinical toxicology screening at the time of initial evaluation; eight tested positive for opioids, two for cocaine, and two for benzodiazepines. Apart from sporadic cases (2-6), this combination of clinical and imaging findings has been reported rarely. The apparent temporospatial clustering, relatively young age at onset (19-52 years), and associated substance use among these patients should stimulate further case identification to determine whether these observations represent an emerging syndrome related to substance use or other causes (e.g., a toxic exposure).

  15. Building America Case Study: Field Performance of Inverter-Driven Heat Pumps in Cold Climates - Connecticut, Massachusetts, and Vermont

    SciTech Connect

    2015-09-01

    New inverter-driven ASHPs are gaining ground in colder climates. These systems operate at sub-zero temperatures without the use of electric resistance backup. There are still uncertainties, however, about cold-climate capacity and efficiency in cold weather and questions such as measuring: power consumption, supply, return, and outdoor air temperatures, and air flow through the indoor fan coil. CARB observed a wide range of operating efficiencies and outputs from site to site. Maximum capacities were found to be generally in line with manufacturer's claims as outdoor temperatures fell to -10 degrees F. The reasons for the wide range in heating performance likely include: low indoor air flow rates, poor placement of outdoor units, relatively high return air temperatures, thermostat set back, integration with existing heating systems, and occupants limiting indoor fan speed. Even with lower efficiencies than published in other studies, most of the heat pumps here still provide heat at lower cost than oil, propane, or certainly electric resistance systems.

  16. Education Finance Reform, Local Behavior, and Student Performance in Massachusetts

    ERIC Educational Resources Information Center

    Nguyen-Hoang, Phuong; Yinger, John

    2014-01-01

    This study examines the impact on student performance of the education finance reform enacted in 1993 in Massachusetts and of school districts' institutional structure. Estimating education expenditure and demand functions, this study presents evidence that changes in the state education aid following the education reform resulted in significantly…

  17. Compensatory Education in Massachusetts: An Evaluation With Recommendations.

    ERIC Educational Resources Information Center

    Jordan, David C.; Spiess, Kathryn Hecht

    The general objective of this study is to assist in the improvement of compensatory education programs in Massachusetts through modifications of current programs based on evaluations specific enough to permit the formulation of concrete recommendations for improvement. A 10 percent sample of projects was chosen for study as theoretically…

  18. The Many Voices of Education for Bilingual Students in Massachusetts.

    ERIC Educational Resources Information Center

    Brisk, Maria Estela; And Others

    Massachusetts passed the first state legislation mandating bilingual education in 1971, the Transitional Bilingual Education Bill (TBE). This publication contains five case studies that demonstrate how teachers and schools have responded to the needs of their minority group students. The first case study, "Bilingual Education in a Bilingual…

  19. Skylab oral health studies

    NASA Technical Reports Server (NTRS)

    Brown, L. R.; Frome, W. J.; Handler, S.; Wheatcroft, M. G.; Rider, L. J.

    1977-01-01

    Evaluation of Skylab crewmembers for mission related effects on oral health in relation to possible dental injuries provided the following distinctive changes: (1) increased counts of specific anaerobic and streptococcal components; (2) elevations in levels of secretory IgA concurrent with diminutions of salivary lysozyme; and (3) increases in dental calculus and gingival inflammations. The clinical changes are considered to be more influenced by the preexisting state of dental health than by any mission related effects.

  20. Skylab oral health studies

    NASA Technical Reports Server (NTRS)

    Brown, L. R.; Frome, W. J.; Handler, S.; Wheatcroft, M. G.; Rider, L. J.

    1977-01-01

    Evaluation of Skylab crewmembers for mission related effects on oral health in relation to possible dental injuries provided the following distinctive changes: (1) increased counts of specific anaerobic and streptococcal components; (2) elevations in levels of secretory IgA concurrent with diminutions of salivary lysozyme; and (3) increases in dental calculus and gingival inflammations. The clinical changes are considered to be more influenced by the preexisting state of dental health than by any mission related effects.

  1. Trauma-Informed Care in the Massachusetts Child Trauma Project.

    PubMed

    Bartlett, Jessica Dym; Barto, Beth; Griffin, Jessica L; Fraser, Jenifer Goldman; Hodgdon, Hilary; Bodian, Ruth

    2016-05-01

    Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC. © The Author(s) 2015.

  2. National Environmental/Energy Workforce Assessment for Massachusetts.

    ERIC Educational Resources Information Center

    National Field Research Center Inc., Iowa City, IA.

    This report presents existing workforce levels, training programs and career potentials and develops staffing level projections (1976-1982) based on available information for the State of Massachusetts. The study concerns itself with the environmental pollution control areas of air, noise, potable water, pesticides, radiation, solid waste,…

  3. Gun Possession among Massachusetts Batterer Intervention Program Enrollees

    ERIC Educational Resources Information Center

    Rothman, Emily F.; Johnson, Renee M.; Hemenway, David

    2006-01-01

    Batterers with access to firearms present a serious lethal threat to their partners. The purpose of this exploratory study is to estimate the prevalence of and risk markers for gun possession among Massachusetts men enrolled in batterer intervention programs. The authors found that 1.8% of the men reported having a gun in or around their home.…

  4. Family forest owner preferences for biomass harvesting in Massachusetts

    Treesearch

    Marla Markowski-Lindsay; Thomas Stevens; David B. Kittredge; Brett J. Butler; Paul Catanzaro; David Damery

    2012-01-01

    U.S. forests, including family-owned forests, are a potential source of biomass for renewable energy. Family forest owners constitute a significant portion of the overall forestland in the U.S., yet little is known about family forest owners' preferences for supplying wood-based biomass. The goal of this study is to understand how Massachusetts family forest...

  5. Massachusetts Workplace Education Initiative. Year 3 Evaluation. Final Report.

    ERIC Educational Resources Information Center

    Rayman, Paula; And Others

    An evaluation of the Massachusetts Workplace Education Initiative brings together three phases: (1) a pilot outcome study conducted with a sample of six local workplace education programs and featuring the perspectives of workers, labor, and management; (2) program profiles for seven federally funded workplace education programs coordinated by the…

  6. Gun Possession among Massachusetts Batterer Intervention Program Enrollees

    ERIC Educational Resources Information Center

    Rothman, Emily F.; Johnson, Renee M.; Hemenway, David

    2006-01-01

    Batterers with access to firearms present a serious lethal threat to their partners. The purpose of this exploratory study is to estimate the prevalence of and risk markers for gun possession among Massachusetts men enrolled in batterer intervention programs. The authors found that 1.8% of the men reported having a gun in or around their home.…

  7. The Impact of Secondary School Occupational Education in Massachusetts.

    ERIC Educational Resources Information Center

    Conroy, William G., Jr.; Diamond, Daniel E.

    The six-year study examined the impact of various secondary school occupational education programs upon the lifestyle of Massachusetts students, classes of 1969 and 1973. Focusing upon school-labor market relations, the report aims to provide a base for improving policies to prepare and guide students into successful careers. Four substantive…

  8. Tracking and Detracking: High Achievers in Massachusetts Middle Schools

    ERIC Educational Resources Information Center

    Loveless, Tom

    2009-01-01

    This study examines tracking--the practice of grouping students into separate classes or courses based on their prior academic achievement--at the middle-school level, and the percentage of high-achieving students in tracked and untracked schools. It focuses on Massachusetts, a leader in "reforming" tracking, and the changes that have…

  9. Massachusetts Workplace Education Initiative. Year 3 Evaluation. Final Report.

    ERIC Educational Resources Information Center

    Rayman, Paula; And Others

    An evaluation of the Massachusetts Workplace Education Initiative brings together three phases: (1) a pilot outcome study conducted with a sample of six local workplace education programs and featuring the perspectives of workers, labor, and management; (2) program profiles for seven federally funded workplace education programs coordinated by the…

  10. National Environmental/Energy Workforce Assessment for Massachusetts.

    ERIC Educational Resources Information Center

    National Field Research Center Inc., Iowa City, IA.

    This report presents existing workforce levels, training programs and career potentials and develops staffing level projections (1976-1982) based on available information for the State of Massachusetts. The study concerns itself with the environmental pollution control areas of air, noise, potable water, pesticides, radiation, solid waste,…

  11. Sediment quality in the north coastal basin of Massachusetts, 2003

    USGS Publications Warehouse

    Breault, Robert F.; Ashman, Mary S.; Heath, Douglas

    2004-01-01

    The U.S. Geological Survey, in cooperation with the Massachusetts Department of Environmental Protection, completed a reconnaissance-level study of bottom-sediment quality in selected lakes, rivers, and estuaries in the North Coastal Basin of Massachusetts. Bottom-sediment grab samples were collected from 20 sites in the North River, Lake Quannapowitt, Saugus River, Mill River, Shute Brook, Sea Plane Basin, Pines River, and Bear Creek. The samples were tested for various types of potentially harmful contaminants? including 33 elements, 17 polyaromatic hydrocarbons (PAHs), 22 organochlorine pesticides, and 7 polychlorinated biphenyl (PCB) mixtures (Aroclors)?to benthic organisms (bottom-dwelling) and humans. The results were compared among sampling sites, to background concentrations, and to concen-trations measured in other urban rivers, and sediment-quality guidelines were used to predict toxicity at the sampling sites to benthic organisms and humans. Because there are no standards for human toxicity for aquatic sediment, standards for contaminated upland soil were used. Contaminant concentrations measured in sediment collected from the North Coastal Basin generally were equal to or greater than concentrations in sediment from uncontaminated rivers throughout New England. Contaminants in North Coastal Basin sediment with elevated concentrations (above back-ground levels) included arsenic, chromium, copper, lead, nickel, and zinc, some of the PAHs, dichlorodiphenyltrichloro-ethane (DDT) and its metabolites, and dieldrin. No PCBs were measured above the detection limits. Measured concentrations of arsenic, chromium, and lead were also generally greater than those measured in other urban rivers throughout the conter-minous United States. With one exception (arsenic), local con-centrations measured in sediment samples collected from the North Coastal Basin were lower than concentrations measured in sediment collected from two of three urban rivers draining to Boston

  12. 1. Historic American Buildings Survey J. Alexander, Photographer, 1971 MASSACHUSETTS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey J. Alexander, Photographer, 1971 MASSACHUSETTS AVENUE FACADE, 1971 - James C. Hooe House, 2230 Massachusetts Avenue Northwest, Washington, District of Columbia, DC

  13. Relationship between leukemia incidence and residing and/or working near the Pilgrim 1 nuclear power plant in Plymouth, Massachusetts

    SciTech Connect

    Morris, M.S.

    1992-01-01

    To determine whether a strong association between leukemia incidence between 1978 and 1986 and potential for exposure to radiation emitted from the Pilgrim 1 nuclear power plant in Plymouth, Massachusetts was a spurious finding resulting from either (1) failure to account for temporal variation in the level of radioactivity released from the plant or (2) inattention to certain potentially confounding factors, additional age/sex-matched case-control analyses controlled for the effects of socioeconomic status (SES), work history, and cigarette smoking were performed with data collected in the Southeastern Massachusetts Health Investigation -- a study of leukemia among residents aged 13 and older of 22 southeastern Massachusetts towns. None of the additional analyses, including incorporation of emissions data into the exposure-assessment scheme and crude attempts to control for (1) medical-radiation exposure, (2) potential for exposure to pesticides sprayed on cranberry bogs, or (3) workplace exposure to radiation, chemical solvents, dust, or fumes, altered the finding of a statistically significant dose-response relationship between leukemia incidence and potential for exposure to radioactive emissions. The trend in the association over time was not entirely consistent, however, with the hypothesis that unusually large amounts of radioactivity reportedly released from the plant during the mid-1970s were responsible for the observed effects. Recommendations were made for further study of the Plymouth-area population for studies of this problem elsewhere.

  14. Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

    PubMed Central

    Profit, J; Zupancic, J A F; McCormick, M C; Richardson, D K; Escobar, G J; Tucker, J; Tarnow‐Mordi, W; Parry, G

    2006-01-01

    Objective To compare gestational age at discharge between infants born at 30–34+6 weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design Prospective observational cohort study. Setting Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures Gestational age at discharge home. Results The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p  =  0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI −1.2 to 3.0) days earlier in Massachusetts. Conclusions Infants of 30–34+6 weeks gestation at birth admitted and cared for in hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants. PMID:16449257

  15. A vehicle health monitoring system for the Space Shuttle Reaction Control System during reentry. M.S. Thesis - Massachusetts Inst. of Technology

    NASA Technical Reports Server (NTRS)

    Rosello, Anthony David

    1995-01-01

    A general two tier framework for vehicle health monitoring of Guidance Navigation and Control (GN&C) system actuators, effectors, and propulsion devices is presented. In this context, a top level monitor that estimates jet thrust is designed for the Space Shuttle Reaction Control System (RCS) during the reentry phase of flight. Issues of importance for the use of estimation technologies in vehicle health monitoring are investigated and quantified for the Shuttle RCS demonstration application. These issues include rate of convergence, robustness to unmodeled dynamics, sensor quality, sensor data rates, and information recording objectives. Closed loop simulations indicate that a Kalman filter design is sensitive to modeling error and robust estimators may reduce this sensitivity. Jet plume interaction with the aerodynamic flowfield is shown to be a significant effect adversely impacting the ability to accurately estimate thrust.

  16. Linking student performance in Massachusetts elementary schools with the "greenness" of school surroundings using remote sensing.

    PubMed

    Wu, Chih-Da; McNeely, Eileen; Cedeño-Laurent, J G; Pan, Wen-Chi; Adamkiewicz, Gary; Dominici, Francesca; Lung, Shih-Chun Candice; Su, Huey-Jen; Spengler, John D

    2014-01-01

    Various studies have reported the physical and mental health benefits from exposure to "green" neighborhoods, such as proximity to neighborhoods with trees and vegetation. However, no studies have explicitly assessed the association between exposure to "green" surroundings and cognitive function in terms of student academic performance. This study investigated the association between the "greenness" of the area surrounding a Massachusetts public elementary school and the academic achievement of the school's student body based on standardized tests with an ecological setting. Researchers used the composite school-based performance scores generated by the Massachusetts Comprehensive Assessment System (MCAS) to measure the percentage of 3rd-grade students (the first year of standardized testing for 8-9 years-old children in public school), who scored "Above Proficient" (AP) in English and Mathematics tests (Note: Individual student scores are not publically available). The MCAS results are comparable year to year thanks to an equating process. Researchers included test results from 2006 through 2012 in 905 public schools and adjusted for differences between schools in the final analysis according to race, gender, English as a second language (proxy for ethnicity and language facility), parent income, student-teacher ratio, and school attendance. Surrounding greenness of each school was measured using satellite images converted into the Normalized Difference Vegetation Index (NDVI) in March, July and October of each year according to a 250-meter, 500-meter, 1,000-meter, and 2000-meter circular buffer around each school. Spatial Generalized Linear Mixed Models (GLMMs) estimated the impacts of surrounding greenness on school-based performance. Overall the study results supported a relationship between the "greenness" of the school area and the school-wide academic performance. Interestingly, the results showed a consistently positive significant association between the

  17. 75 FR 22874 - Massachusetts Disaster # MA-00027

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... From the Federal Register Online via the Government Publishing Office ] SMALL BUSINESS ADMINISTRATION Massachusetts Disaster MA-00027 AGENCY: U.S. Small Business Administration. ACTION: Notice... for the State of Massachusetts (FEMA-1895-DR), dated 04/22/2010. Incident: Severe storms and flooding...

  18. 76 FR 36952 - Massachusetts Disaster #MA-00037

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Massachusetts Disaster MA-00037 AGENCY: U.S. Small Business Administration. ACTION: Notice... for the State of Massachusetts (FEMA--1994--DR), dated 06/15/2011. Incident: Severe Storms and...

  19. 76 FR 13697 - Massachusetts Disaster #MA-00032

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-14

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Massachusetts Disaster MA-00032 AGENCY: U.S. Small Business Administration. ACTION: Notice... for the State of Massachusetts (FEMA--1959--DR), dated 03/07/2011. Incident: Severe Winter Storm and...

  20. 76 FR 56853 - Massachusetts Disaster #MA-00040

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Massachusetts Disaster MA-00040 AGENCY: U.S. Small Business Administration. ACTION: Notice... for the Commonwealth of Massachusetts (FEMA-4028-DR), dated 09/03/2011. Incident: Tropical Storm Irene...

  1. 77 FR 2600 - Massachusetts Disaster #MA-00046

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Massachusetts Disaster MA-00046 AGENCY: U.S. Small Business Administration. ACTION: Notice... for the State of Massachusetts (FEMA-4051-DR), dated 01/06/2012. Incident: Severe Storm and Snowstorm...

  2. Bringing Chinese Immersion to Western Massachusetts

    ERIC Educational Resources Information Center

    Wang, Kathleen

    2009-01-01

    This article describes the Pioneer Valley Chinese Immersion Charter School (PVCICS), a regional public charter school in western Massachusetts, which opened in 2007 and the only Chinese immersion school in New England. The school draws students from over twenty-five towns and cities in a predominantly rural area of Massachusetts that includes the…

  3. Massachusetts Small MS4 General Permit | Stormwater ...

    EPA Pesticide Factsheets

    2017-08-28

    The 2016 Massachusetts Small MS4 General Permit was signed April 4, 2016 and will become effective July 1, 2017. The final permit reflects modifications to the 2014 draft small MS4 general permit released for comment on September 30, 2014 and replaces the 2003 small MS4 general permit for MS4 operators within the Commonwealth of Massachusetts.

  4. Bringing Chinese Immersion to Western Massachusetts

    ERIC Educational Resources Information Center

    Wang, Kathleen

    2009-01-01

    This article describes the Pioneer Valley Chinese Immersion Charter School (PVCICS), a regional public charter school in western Massachusetts, which opened in 2007 and the only Chinese immersion school in New England. The school draws students from over twenty-five towns and cities in a predominantly rural area of Massachusetts that includes the…

  5. Linguicism and Racism in Massachusetts Education Policy

    ERIC Educational Resources Information Center

    Viesca, Kara Mitchell

    2013-01-01

    The paper presents a frame analysis of Massachusetts state policy regarding the education of multilingual learners and their teachers through the lens of critical race theory (CRT). My analysis suggests that even though current policy in Massachusetts is framed in terms of the overarching goals of educational quality and equality, in reality it…

  6. Effects of low-impact-development (LID) practices on streamflow, runoff quantity, and runoff quality in the Ipswich River Basin, Massachusetts-A Summary of field and modeling studies

    USGS Publications Warehouse

    Zimmerman, Marc J.; Waldron, Marcus C.; Barbaro, Jeffrey R.; Sorenson, Jason R.

    2010-01-01

    Low-impact-development (LID) approaches are intended to create, retain, or restore natural hydrologic and water-quality conditions that may be affected by human alterations. Wide-scale implementation of LID techniques may offer the possibility of improving conditions in river basins, such as the Ipswich River Basin in Massachusetts, that have run dry during the summer because of groundwater withdrawals and drought. From 2005 to 2008, the U.S. Geological Survey, in a cooperative funding agreement with the Massachusetts Department of Conservation and Recreation, monitored small-scale installations of LID enhancements designed to diminish the effects of storm runoff on the quantity and quality of surface water and groundwater. Funding for the studies also was contributed by the U.S. Environmental Protection Agency's Targeted Watersheds Grant Program through a financial assistance agreement with Massachusetts Department of Conservation and Recreation. The monitoring studies examined the effects of * replacing an impervious parking-lot surface with a porous surface on groundwater quality, * installing rain gardens and porous pavement in a neighborhood of 3 acres on the quantity and quality of stormwater runoff, and * installing a 3,000-ft2 (square-foot) green roof on the quantity and quality of rainfall-generated roof runoff. In addition to these small-scale installations, the U.S. Geological Survey's Ipswich River Basin model was used to simulate the basin-wide effects on streamflow of several changes: broad-scale implementation of LID techniques, reduced water-supply withdrawals, and water-conservation measures. Water-supply and conservation scenarios for application in model simulations were developed with the assistance of two technical advisory committees that included representatives of State agencies responsible for water resources, the U.S. Environmental Protection Agency, the U.S. Geological Survey, water suppliers, and non-governmental organizations. From June

  7. Evidence-Based Health Promotion in Nursing Homes: A Pilot Intervention to Improve Oral Health

    ERIC Educational Resources Information Center

    Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter

    2016-01-01

    Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…

  8. Evidence-Based Health Promotion in Nursing Homes: A Pilot Intervention to Improve Oral Health

    ERIC Educational Resources Information Center

    Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter

    2016-01-01

    Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…

  9. Study Guide in Health Economics.

    ERIC Educational Resources Information Center

    Dawson, George; Jablon, Bert

    Prepared to assist students at Empire State College in developing learning contracts for the study of the economics of health care delivery, this study guide discusses various aspects of the topic, suggests student projects, and provides an extensive bibliography. First, introductory material discusses the relationship of economics to health care…

  10. Sexual orientation and sexual behavior: results from the Massachusetts Behavioral Risk Factor Surveillance System, 2002-2006.

    PubMed

    Keyes, Susan M; Rothman, Emily F; Zhang, Zi

    2007-01-01

    Few population-based surveys in the United States include sexual orientation as a demographic variable. As a result, estimating the proportion of the U.S. population that is gay, lesbian, or bisexual (GLB) is a substantial challenge. Prior estimates vary widely, from 1-21%. In 2001, questions on sexual orientation and sexual behavior were added to the Massachusetts Behavioral Risk Factor Surveillance System (MA BRFSS) and have been asked continually since that time. The purpose of this study was to determine the prevalence of adults in Massachusetts identifying as GLB and providing a demographic description of this group. The study also examined the correlation of reported sexual behavior and sexual identity within this group. Overall, 1.9% of Massachusetts adults identified as gay or lesbian and 1.0% of Massachusetts adults identified as bisexual. Of those identifying as gay or lesbian, 95.4% reported sexual behavior concordant with this identification, and 99.4% of respondents identifying as heterosexual reported behavior concordant with heterosexual sexual orientation. Among those reporting a GLB sexual orientation, men were more likely than women to identify as gay, and women were more likely than men to identify as bisexual. Younger adults (18-25 years old) were more likely than people in other age groups to identify as bisexual. Respondents with 4 or more years of education were more likely to identify as gay or lesbian than those in all other education categories. The addition of sexual orientation to population-based surveys will allow for research on the health of GLB adults and provide critical information for those charged with the creation of public policy regarding sexual orientation.

  11. Shallow geology, sea-floor texture, and physiographic zones of Vineyard and western Nantucket Sounds, Massachusetts

    USGS Publications Warehouse

    Baldwin, Wayne E.; Foster, David S.; Pendleton, Elizabeth A.; Barnhardt, Walter A.; Schwab, William C.; Andrews, Brian D.; Ackerman, Seth D.

    2016-09-02

    Geologic, sediment texture, and physiographic zone maps characterize the sea floor of Vineyard and western Nantucket Sounds, Massachusetts. These maps were derived from interpretations of seismic-reflection profiles, high-resolution bathymetry, acoustic-backscatter intensity, bottom photographs/video, and surficial sediment samples collected within the 494-square-kilometer study area. Interpretations of seismic stratigraphy and mapping of glacial and Holocene marine units provided a foundation on which the surficial maps were created. This mapping is a result of a collaborative effort between the U.S. Geological Survey and the Massachusetts Office of Coastal Zone Management to characterize the surface and subsurface geologic framework offshore of Massachusetts.

  12. Massachusetts Substance Use Disorder Treatment Organizations' Perspectives on the Affordable Care Act: Changes in Payment, Services, and System Design.

    PubMed

    Quinn, Amity E; Stewart, Maureen T; Brolin, Mary; Horgan, Constance M; Lane, Nancy E

    2017-01-01

    The Affordable Care Act (ACA) expanded insurance benefits and coverage for substance use disorder (SUD) treatment and encouraged delivery and payment reforms. Massachusetts passed a similar reform in 2006. This study aims to assess Massachusetts SUD treatment organizations' responses to the ACA. Organizational interviews addressing challenges of and responses to the ACA were conducted in person June-December 2014 with 31 leaders at 12 treatment organizations across Massachusetts. Many organizations were affiliated with medical or social services and offered a range of SUD services. Sampling was based on services offered (detoxification only, detoxification and outpatient, outpatient only). Framework analysis was used. Challenges identified were considered similar to ongoing challenges, not unique to the ACA. Organizations experienced insurance expansions in 2006 and faced new challenges, including insurance coverage, payment arrangements, expansion of services, and system design. System design efforts included care coordination/integration, workforce development, and health information technology. Differences in responses related to connections with medical and social service organizations. Many organizations engaged in efforts to respond to changing policies by expanding capacity and services. Offering a range of SUD treatment (e.g., detoxification and outpatient) and affiliating with a medical organization could enable organizations to respond to new insurance, delivery, and payment reforms.

  13. Electric industry restructuring in Massachusetts

    SciTech Connect

    Wadsworth, J.W.

    1998-07-01

    A law restructuring the electric utility industry in Massachusetts became effective on November 25, 1997. The law will break up the existing utility monopolies into separate generation, distribution and transmission entities, and it will allow non-utility generators access to the retail end user market. The law contains many compromises aimed at protecting consumers, ensuring savings, protecting employees and protecting the environment. While it appears that the legislation recognizes the sanctity of independent power producer contracts with utilities, it attempts to provide both carrots and sticks to the utilities and the IPP generators to encourage renegotiations and buy-down of the contracts. Waste-to-energy contracts are technically exempted from some of the obligations to remediate. Waste-to-energy facilities are classified as renewable energy sources which may have positive effects on the value to waste-to-energy derived power. On November 25, 1997, the law restructuring the electric utility industry in Massachusetts became effective. The law will have two primary effects: (1) break up the existing utility monopolies into separate generation, distribution and transmission entities, and (2) allow non-utility generators access to the retail end-user market.

  14. Association between local indoor smoking ordinances in Massachusetts and cigarette smoking during pregnancy: a multilevel analysis

    PubMed Central

    Nguyen, K H; Wright, R J; Sorensen, G; Subramanian, S V

    2012-01-01

    Objective To estimate the association between local clean indoor air ordinances and prenatal maternal smoking across 351 municipalities in Massachusetts before the 2004 statewide ban and to test the effect of time since ordinance adoption on the association. Methods The authors linked 2002 birth certificate data of women who gave birth in the state and reported a Massachusetts residence (n=67 584) to a database of indoor smoking ordinances in all municipalities. Multilevel regression models accounting for individual- and municipality-level variables estimate the associations between the presence of local smoking ordinances, strength of the ordinances, time since ordinance adoption and prenatal smoking. Results Compared with those living in municipalities with no ordinances, women living in municipalities with a smoking ordinance had lower odds of prenatal smoking (OR=0.72, CI=0.53 to 0.98). No effect was found for 100% smoke-free ordinances. For the analyses testing the effect of time, pregnant women living in municipalities with ordinances enacted >2 years were less likely to smoke than those in municipalities with more recent (<1 year) ordinances. Conclusions Preventing smoking among women of reproductive age is a public health priority. This study suggests that indoor smoking ordinances were associated with lower prenatal smoking prevalence and the favourable effect increased over time. Findings highlight the public health benefit of tobacco control policies. PMID:22166267

  15. Characteristics of Fentanyl Overdose - Massachusetts, 2014-2016.

    PubMed

    Somerville, Nicholas J; O'Donnell, Julie; Gladden, R Matthew; Zibbell, Jon E; Green, Traci C; Younkin, Morgan; Ruiz, Sarah; Babakhanlou-Chase, Hermik; Chan, Miranda; Callis, Barry P; Kuramoto-Crawford, Janet; Nields, Henry M; Walley, Alexander Y

    2017-04-14

    Opioid overdose deaths in Massachusetts increased 150% from 2012 to 2015 (1). The proportion of opioid overdose deaths in the state involving fentanyl, a synthetic, short-acting opioid with 50-100 times the potency of morphine, increased from 32% during 2013-2014 to 74% in the first half of 2016 (1-3). In April 2015, the Drug Enforcement Agency (DEA) and CDC reported an increase in law enforcement fentanyl seizures in Massachusetts, much of which was believed to be illicitly manufactured fentanyl (IMF) (4). To guide overdose prevention and response activities, in April 2016, the Massachusetts Department of Public Health and the Office of the Chief Medical Examiner collaborated with CDC to investigate the characteristics of fentanyl overdose in three Massachusetts counties with high opioid overdose death rates. In these counties, medical examiner charts of opioid overdose decedents who died during October 1, 2014-March 31, 2015 were reviewed, and during April 2016, interviews were conducted with persons who used illicit opioids and witnessed or experienced an opioid overdose. Approximately two thirds of opioid overdose decedents tested positive for fentanyl on postmortem toxicology. Evidence for rapid progression of fentanyl overdose was common among both fatal and nonfatal overdoses. A majority of interview respondents reported successfully using multiple doses of naloxone, the antidote to opioid overdose, to reverse suspected fentanyl overdoses. Expanding and enhancing existing opioid overdose education and prevention programs to include fentanyl-specific messaging and practices could help public health authorities mitigate adverse effects associated with overdoses, especially in communities affected by IMF.

  16. The Role of Community Education in Increasing Knowledge of Breast Health and Cancer: Findings from the Asian Breast Cancer Project in Boston, Massachusetts.

    PubMed

    Berger, Samantha; Huang, Chien-Chi; Rubin, Carolyn L

    2017-03-01

    In the past decade, cancer rates have significantly decreased in the USA, but breast cancer survival is lower in Asian American women, likely due to lower rates of screening behaviors in Asian Americans compared to other ethnicities, which could lead to later stage cancer diagnosis and increased mortality. This paper reports on the Asian Breast Cancer (ABC) Project, a three-phase peer-led community program designed to promote cancer prevention by improving breast cancer screening rates among Chinese and Vietnamese women in the Greater Boston area. The three phases of planning and coalition building, community health worker training, and the community workshop intervention are described. The workshop intervention was evaluated by comparing pre- and post-workshop questionnaires evaluating knowledge about breast cancer screening and prevention. Two hundred fifty-two women participated in the program across 14 workshops. Each participant completed questionnaires about demographics, access to health care, and a five-item self-administered questionnaire about breast cancer knowledge. Results showed that the majority of the women had received a clinical breast exam or mammogram in the past 12 months (69 and 59 %, respectively), and older women were more likely to get a mammogram (85 %) or clinical breast exams (74 %) compared to younger women. Eighty-one percent of women were interested in reminder systems. Baseline knowledge was high for three survey questions about mammograms and breast cancer risk (88-97 %). For questions with fewer correct answers at baseline, knowledge about the meaning of lumps in the breast significantly increased (69 to 80 % correct, p < 0.0001), as well as knowledge about frequency of clinical breast exam (48 to 67 % correct, p < 0.0001). This pilot project indicated a partial effectiveness of the community workshop in a population with high baseline knowledge. The education workshop increased knowledge about breast lumps and

  17. Technology Solutions Case Study: Long-Term Monitoring of Mini-Split Ductless Heat Pumps in the Northeast, Devens and Easthampton, Massachusetts

    SciTech Connect

    2015-07-01

    Transformations, Inc., has extensive experience building high-performance homes - production and custom - in a variety of Massachusetts locations and uses mini-split heat pumps (MSHPs) for space conditioning in most of its homes. The use of MSHPs for simplified space-conditioning distribution provides significant first-cost savings, which offsets the increased investment in the building enclosure. In this project, the U.S. Department of Energy Building America team Building Science Corporation evaluated the long-term performance of MSHPs in 8 homes during a period of 3 years. The work examined electrical use of MSHPs, distributions of interior temperatures and humidity when using simplified (two-point) heating systems in high-performance housing, and the impact of open-door/closed-door status on temperature distributions.

  18. New Whole-House Solutions Case Study: Fort Devens: Cold Climate Market-Rate Townhomes Targeting HERS Index of 40, Harvard, Massachusetts

    SciTech Connect

    2013-11-01

    Achieving aggressive energy efficiency targets requires tight coordination and clear communication among owners, designers, builders, and subcontractors. For this townhome project, MassDevelopment, the quasi-governmental agency owner, selected Metric Development of Boston, teaming with Building America team Consortium for Advanced Residential Buildings (CARB) and Cambridge Seven Architects, to build very high performing market-rate homes. Fort Devens is part of a decommissioned army base in working-class Harvard, Massachusetts, approximately one hour northwest of Boston. The team proposed 12 net zero energy-ready townhomes that were also designed to achieve a Home Energy Rating System (HERS) Index Score of 41 before adding renewables. The team carefully planned the site to maximize solar access, daylighting, and efficient building forms.

  19. Sediment quality and polychlorinated biphenyls in the Lower Neponset River, Massachusetts, and implications for urban river restoration

    USGS Publications Warehouse

    Breault, Robert F.; Cooke, Matthew G.; Merrill, Michael

    2004-01-01

    Efforts to restore fish passage, habitat, and recreational use of the Neponset River, a tributary to Boston Harbor, Massachusetts, have raised concerns about the sediment, water, and biota quality of the river. Consequently, the U.S. Geological Survey, in cooperation with the Massachusetts Executive Office of Environmental Affairs Department of Fish and Game Riverways Program and the U.S. Environmental Protection Agency, studied sediment and water quality, with a specific focus on polychlorinated biphenyls, in the Neponset River. Sediment samples were collected throughout the Neponset River and tested for elements and organic compounds including polyaromatic hydrocarbons, organochlorine pesticides, and polychlorinated biphenyls. Although enriched compared to background concentrations, sediment quality in the Neponset River was generally better than that of other urban rivers in the United States, except with respect to one constituent, polychlorinated biphenyls. Concentrations of lead, some polyaromatic hydrocarbons, and polychlorinated biphenyls in the sediment may be toxic to aquatic organisms and may pose a risk to human health. The sediment quality also fails to meet the minimum requirements set by the Commonwealth of Massachusetts for lined landfill disposal. The locations of the source(s) of polychlorinated biphenyls to the Neponset River were determined by means of congener analysis from PISCES passive water-column samplers. The PISCES data indicate a sharp increase in polychlorinated biphenyl concentrations and a substantial shift in congener pattern downstream of one PISCES sampling location near Fairmont Avenue, Boston, Massachusetts. This result indicates that the area upstream of this sampling location may be the location of a historical source of polychlorinated biphenyls to the Neponset River. The present (2003) source to the water column may likely be PCB contaminated sediment.

  20. Agricultural Health Study

    Cancer.gov

    A prospective cohort study of commercial pesticide applicators, farmers and farmers' spouses in Iowa and North Carolina conducted in collaboration between the NIH and the U.S. Evironmental Protection Agency

  1. Agricultural Health Study

    MedlinePlus

    ... North Carolina or Iowa. Participants classified as "private pesticide applicators" are farmers or nursery workers. The study also includes a small percentage of "commercial pesticide applicators" from Iowa who work for pest control ...

  2. Vitamin D deficiency among newly resettled refugees in Massachusetts.

    PubMed

    Penrose, Katherine; Hunter Adams, Jo; Nguyen, Thinh; Cochran, Jennifer; Geltman, Paul L

    2012-12-01

    Previous studies have indicated that vitamin D deficiency is widespread among immigrants and refugees. This study sought to determine the prevalence of vitamin D deficiency among a large and diverse cohort of refugees in Massachusetts to assess its significance for routine refugee health screening of refugees. 25-hydroxyvitamin D levels for 2,610 refugees screened between 2007 and 2009 were used to estimate vitamin D status and to examine the relationship between deficiency or insufficiency and age, gender, regional origin, and season of testing. Among those tested, 78 % were either vitamin D insufficient or deficient. Insufficiency or deficiency was most prevalent in refugees from the Middle East (89 %) and lowest in those from the Caribbean (59 %). Risk was higher among women than among men from some regions, such as the Middle East, but not others. For women, the likelihood of deficiency increased with age, while for men, the likelihood of deficiency was similar for preschool children and men at the height of their working years. The high overall prevalence of vitamin D deficiency suggests that empiric supplementation or treatment may be preferred to testing until more is known about the long-term epidemiology of vitamin D deficiency and its consequences.

  3. Professional Nursing in State Service: Needs and Recommendations. A Skills Inventory of Registered Nurses Employed by the Commonwealth of Massachusetts.

    ERIC Educational Resources Information Center

    Woods, Barbara

    This study analyzed factors in attracting and recruiting professional nurses into Massachusetts state service. Although Massachusetts had relatively many registered nurses (RN), 45% were inactive. Resulting shortages were great, especially in state hospitals. All agencies had high turnover, with impending staffing crises in some agencies because…

  4. Does the "marriage benefit" extend to same-sex union?: Evidence from a sample of married lesbian couples in Massachusetts.

    PubMed

    Ducharme, Jamie K; Kollar, Marilou M

    2012-01-01

    This study investigated the relationship between wellbeing and marital quality in a married lesbian sample from Massachusetts. Two hundred twenty five (225) participants responded to this mailed survey study. Participants completed a demographic questionnaire, the Dyadic Adjustment Scale (DAS), and the World Health Organization Quality of Life-Brief Instrument (WHOQOL-Bref). DAS scores were a strong predictor of reported wellbeing in all quality of life domains including physical, psychological, and financial wellbeing. Results support the finding in the heterosexual marriage literature that healthy marriage is associated with distinct wellbeing benefits for lesbian couples. Implications of these findings are discussed.

  5. Overweight and obesity in Massachusetts: epidemic, hype or policy opportunity?

    PubMed

    Lewis, Katharine Kranz; Man, Lynne H

    2007-01-23

    In 2005, more than 56 percent of Massachusetts adults were overweight, a 40 percent increase from rates reported in 1990. Overall, nearly 21 percent of Massachusetts adults are obese. Both Blacks and Hispanics in the state are more likely than whites to be both overweight and obese, whereas Asians are the least likely to be overweight or obese. Nationally, rates of overweight and obesity are even higher. Obesity is a risk factor for multiple serious health problems in adults, including heart disease, hardening of the arteries, high cholesterol, high blood pressure, certain types of cancer, stroke, diabetes, muscle and bone disorders and gallbladder disease. In Massachusetts, it is estimated that direct costs for obesity-related medical expenditures came to a total of $1.8 billion (4.7% of total medical expenditures) in 2003. Medical expenditures for obese people are estimated to be 25-27% higher than normal weight people, and 44% higher among people who are very obese. Costs are largely attributed to higher rates of coronary heart disease, hypertension and diabetes, and longer hospital stays. Indirect costs associated with obesity approached $3.9 billion in 1995 reflecting 39.2 million lost workdays, 239 million restricted activity days, 89.5 million hospital bed-days, and 62.6 million physician visits. Causes of obesity include the wide availability of unhealthy foods, increased consumption, changing eating habits, high-calorie beverages, advertising and lack of physical activity. Although a number federal, state and local programs, policies and initiatives aimed at curbing the obesity epidemic have been implemented, more needs to be done. What is the responsibility of government in curbing the obesity epidemic, and how much of the burden should be left up to the individual? These important questions will be discussed at the Massachusetts Health Policy Forum on January 23, 2007. Overweight and obesity continue to climb steadily in the United States among both

  6. Governing Healthcare through Performance Measurement in Massachusetts and the Netherlands

    PubMed Central

    Van der Wees, Philip J.; der Sanden, Maria W.G. Nijhuis-van; van Ginneken, Ewout; Ayanian, John Z.; Schneider, Eric C.; Westert, Gert P.

    2016-01-01

    Massachusetts and the Netherlands have implemented comprehensive health reforms, which have heightened the importance of performance measurement. The performance measures addressing access to health care and patient experience are similar in the two jurisdictions, but measures of processes and outcomes of care differ considerably. In both jurisdictions, the use of health outcomes to compare the quality of health care organizations is limited, and specific information about costs is lacking. New legislation in both jurisdictions led to the establishment of institutes to monitor the quality of care, similar mandates to make the performance of health care providers transparent, and to establish a shared responsibility of providers, consumers and insurers to improve the quality of health care. In Massachusetts a statewide mandatory quality measure set was established to monitor the quality of care. The Netherlands is stimulating development of performance measures by providers based on a mandatory framework for developing such measures. Both jurisdictions are expanding the use of patient-reported outcomes to support patient care, quality improvement, and performance comparisons with the aim of explicitly linking performance to new payment incentives. PMID:24138729

  7. Governing healthcare through performance measurement in Massachusetts and the Netherlands.

    PubMed

    Van der Wees, Philip J; Nijhuis-van der Sanden, Maria W G; van Ginneken, Ewout; Ayanian, John Z; Schneider, Eric C; Westert, Gert P

    2014-05-01

    Massachusetts and the Netherlands have implemented comprehensive health reforms, which have heightened the importance of performance measurement. The performance measures addressing access to health care and patient experience are similar in the two jurisdictions, but measures of processes and outcomes of care differ considerably. In both jurisdictions, the use of health outcomes to compare the quality of health care organizations is limited, and specific information about costs is lacking. New legislation in both jurisdictions led to the establishment of public agencies to monitor the quality of care, similar mandates to make the performance of health care providers transparent, and to establish a shared responsibility of providers, consumers and insurers to improve the quality of health care. In Massachusetts a statewide mandatory quality measure set was established to monitor the quality of care. The Netherlands is stimulating development of performance measures by providers based on a mandatory framework for developing such measures. Both jurisdictions are expanding the use of patient-reported outcomes to support patient care, quality improvement, and performance comparisons with the aim of explicitly linking performance to new payment incentives. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Evaluating OSHA's ethylene oxide standard: exposure determinants in Massachusetts hospitals.

    PubMed Central

    LaMontagne, A D; Kelsey, K T

    2001-01-01

    OBJECTIVES: This study sought to identify determinants of workplace exposures to ethylene oxide to assess the effect of the Occupational Safety and Health Administration's (OSHA's) 1984 ethylene oxide standard. METHODS: An in-depth survey of all hospitals in Massachusetts that used ethylene oxide from 1990 through 1992 (96% participation, N = 90) was conducted. Three types of exposure events were modeled with logistic regression: exceeding the 8-hour action level, exceeding the 15-minute excursion limit, and worker exposures during unmeasured accidental releases. Covariates were drawn from data representing an ecologic framework including direct and indirect potential exposure determinants. RESULTS: After adjustment for frequencies of ethylene oxide use and exposure monitoring, a significant inverse relation was observed between exceeding the action level and the use of combined sterilizer-aerators, an engineering control technology developed after the passage of the OSHA standard. Conversely, the use of positive-pressure sterilizers that employ ethylene oxide gas mixtures was strongly related to both exceeding the excursion limit and the occurrence of accidental releases. CONCLUSIONS: These findings provide evidence of a positive effect of OSHA's ethylene oxide standard and specific targets for future prevention and control efforts. PMID:11236406

  9. Dewatering General Permit (DGP) for Massachusetts & New ...

    EPA Pesticide Factsheets

    2017-08-28

    The Notice of Availability of the Final NPDES General Permit for Dewatering Activity Discharges in Massachusetts (MAG070000) and New Hampshire (NHG070000) was published in the Federal Register on October 7, 2008.

  10. AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiologic study of a large cohort of pesticide applicators and their spouses in Iowa and North Carolina. The Pesticide Exposure Study is a sub-study to evaluate exposure factors and to provide data to assess exposure cla...

  11. AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiologic study of a large cohort of pesticide applicators and their spouses in Iowa and North Carolina. The Pesticide Exposure Study is a sub-study to evaluate exposure factors and to provide data to assess exposure cla...

  12. Genotyping Analyses of Tuberculosis Cases in U.S.- and Foreign-Born Massachusetts Residents

    PubMed Central

    Miller, Ann C.; Suruki, Robert; Corkren, Edward; Etkind, Sue; Driscoll, Jeffrey; McGarry, Michael; Nardell, Edward

    2002-01-01

    We used molecular genotyping to further understand the epidemiology and transmission patterns of tuberculosis (TB) in Massachusetts. The study population included 983 TB patients whose cases were verified by the Massachusetts Department of Public Health between July 1, 1996, and December 31, 2000, and for whom genotyping results and information on country of origin were available. Two hundred seventy-two (28%) of TB patients were in genetic clusters, and isolates from U.S-born were twice as likely to cluster as those of foreign-born (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.69, 3.12). Our results suggest that restriction fragment length polymorphism analysis has limited capacity to differentiate TB strains when the isolate contains six or fewer copies of IS6110, even with spoligotyping. Clusters of TB patients with more than six copies of IS6110 were more likely to have epidemiologic connections than were clusters of TB patients with isolates with few copies of IS6110 (OR 8.01, 95%; CI 3.45,18.93). PMID:12453348

  13. Type of disinfectant in drinking water and patterns of mortality in Massachusetts.

    PubMed

    Zierler, S; Danley, R A; Feingold, L

    1986-11-01

    Chlorination has been the major strategy for disinfection of drinking water in the United States. Concern about the potential health effects of the reaction by-products of chlorine has prompted use of alternative strategies. One such method is chloramination, a treatment process that does not appear to have carcinogenic by-products, but may have less potent biocidal activity than chlorination. We examined the patterns of mortality of residents in Massachusetts who died between 1969 and 1983 and lived in communities using drinking water that was disinfected either by chlorine or chloramine. Comparison of type of disinfectant among 51,645 cases of deaths due to selected cancer sites and 214,988 controls who died from cardiovascular, cerebrovascular, or pulmonary disease, or from lymphatic cancer showed small variation in the patterns of mortality. Bladder cancer was moderately associated with residence at death in a chlorinated community (mortality odds ratio = 1.7, 95% confidence interval = 1.3-2.2) in a logistic regression analysis using controls who died from lymphatic cancer. A slight excess of deaths from pneumonia and influenza was observed in communities whose residents drank chloraminated water compared to residents from chlorinated communities, as well as to all Massachusetts residents (standardized mortality ratio = 118, 95% confidence interval = 116-120 for chloraminated communities, and standardized mortality ratio = 98, 95% confidence interval = 95-100 for chlorinated communities). These results are intended to be preliminary and crude descriptions of the relationship under study.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Type of disinfectant in drinking water and patterns of mortality in Massachusetts

    SciTech Connect

    Zierler, S.; Danley, R.A.; Feingold, L.

    1986-11-01

    Chlorination has been the major strategy for disinfection of drinking water in the United States. Concern about the potential health effects of the reaction by-products of chlorine has prompted use of alternative strategies. One such method is chloramination, a treatment process that does not appear to have carcinogenic by-product, but may have less potent biocidal activity than chlorination. The authors examined the patterns of mortality of residents in Massachusetts who died between 1969 and 1983 and lived in communities using drinking water that was disinfected either by chlorine or chloramine. Comparison of type of disinfectant among 51,645 cases of deaths due to selected cancer sites and 214,998 controls who died from cardiovascular, cerebrovascular, or pulmonary disease, or from lymphatic cancer showed small variation in the patterns of mortality. Bladder cancer was moderately associated with residence at death in a chlorinated community in a logistic regression analysis using controls who die from lymphatic cancer. A slight excess of deaths from pneumonia and influenza was observed in communities whose residents drink chloraminated water compared to residents from chlorinated communities, as well as to all Massachusetts residents. These results are intended to be preliminary and crude descriptions of the relationship under study. The serious potential for misclassification of exposure status and errors in death certificate classification of cause of death affect the interpretability of the overall evidence that patterns of mortality are similar according to disinfectant in drinking water.

  15. Firefighter heart presumption retirements in Massachusetts 1997-2004.

    PubMed

    Holder, Jonathan D; Stallings, Leonard A; Peeples, Lynne; Burress, John W; Kales, Stefanos N

    2006-10-01

    "Heart Presumption" legislation is common throughout North America. We sought to study Massachusetts firefighters retiring with heart disability awards. The authors conducted a retrospective review of Massachusetts firefighters: 362 receiving Heart Presumption pensions (1997-2004) and a comparison group of 310 professionally active firefighters. Of retirements, 77% were due to coronary heart disease and 23% for other cardiovascular conditions. Only 42% of the retirements were related to discrete on-duty events. Fire suppression (odds ratio = 51, 95% confidence interval = 12-223) and alarm response (odds ratio = 6.4, 95% confidence interval = 2.5-17) were associated with markedly higher risks of duty-related heart retirement events than nonemergency activities. Cardiovascular risk factor prevalence was high among all retiree subgroups and significantly greater than among control firefighters in almost all cases. Our study supports calls for improved cardiovascular prevention and risk reduction strategies among firefighters.

  16. Hospitalization Records as a Tool for Evaluating Performance of Food- and Water-Borne Disease Surveillance Systems: A Massachusetts Case Study

    PubMed Central

    Mor, Siobhan M.; DeMaria Jr., Alfred; Naumova, Elena N.

    2014-01-01

    We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR) and surveillance to hospitalization ratios (SHR) by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial “signal” depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR). Periodic assessment of SHR has potential in assessing the performance of surveillance systems. PMID:24740304

  17. Hospitalization records as a tool for evaluating performance of food- and water-borne disease surveillance systems: a Massachusetts case study.

    PubMed

    Mor, Siobhan M; DeMaria, Alfred; Naumova, Elena N

    2014-01-01

    We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR) and surveillance to hospitalization ratios (SHR) by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial "signal" depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR). Periodic assessment of SHR has potential in assessing the performance of surveillance systems.

  18. Massachusetts coverage expansion associated with reduction in primary care utilization among Medicare beneficiaries.

    PubMed

    Bond, Amelia M; White, Chapin

    2013-12-01

    To examine whether expanding coverage for the nonelderly affects primary care utilization among Medicare beneficiaries. Zip code-level files from Dartmouth Atlas for Massachusetts and surrounding states, including Medicare utilization for 2005 (pre expansion) and 2007 (post expansion), and health insurance coverage for 2005. We use two zip code-level outcomes: arc percent change in primary care visits per Medicare beneficiary per year, and percentage point change in the share of beneficiaries with one or more primary care visits. We use a regression-based difference-in-difference analysis that compares Massachusetts with surrounding states, and zip codes with high, medium, and low uninsurance rates in 2005. The 2005 uninsurance rates correspond to the size of Massachusetts' coverage expansion. We use propensity scores for identification of comparable zip codes and for weighting. In areas of Massachusetts with the highest uninsurance rates-where insurance expansion had the largest impact-visits per beneficiary fell 6.9 percent (p < .001) relative to areas of Massachusetts with the smallest uninsurance rates. The expansion of coverage for the nonelderly reduced primary care visits, but it did not reduce the percent of beneficiaries with at least one visit. These results could imply restricted access, increased efficiency, or some blend. © Health Research and Educational Trust.

  19. Bullying among middle school and high school students--Massachusetts, 2009.

    PubMed

    2011-04-22

    Multiple studies have documented the association between substance use, poor academic achievement, mental health problems, and bullying. A small but growing body of research suggests that family violence also is associated with bullying. To assess the association between family violence and other risk factors and being involved in or affected by bullying as a bully, victim, or bully-victim (those who reported being both bullies and victims of bullying), the Massachusetts Department of Public Health and CDC analyzed data from the 2009 Massachusetts Youth Health Survey. This report summarizes the results of that analysis, which showed significant differences in risk factors for persons in all three bullying categories, compared with persons who reported being neither bullies nor victims. The adjusted odds ratios (AORs) for middle school students for being physically hurt by a family member were 2.9 for victims, 4.4 for bullies, and 5.0 for bully-victims, and for witnessing violence in the family were 2.6, 2.9, and 3.9, respectively, after adjusting for potential differences by age group, sex, and race/ethnicity. For high school students, the AORs for being physically hurt by a family member were 2.8 for victims, 3.8 for bullies, and 5.4 for bully-victims, and for witnessing violence in the family were 2.3, 2.7, and 6.8, respectively. As schools and health departments continue to address the problem of bullying and its consequences, an understanding of the broad range of associated risk factors is important for creating successful prevention and intervention strategies that include involvement by families.

  20. Shoaling of nonlinear internal waves in Massachusetts Bay

    USGS Publications Warehouse

    Scotti, A.; Beardsley, R.C.; Butman, B.; Pineda, J.

    2008-01-01

    The shoaling of the nonlinear internal tide in Massachusetts Bay is studied with a fully nonlinear and nonhydrostatic model. The results are compared with current and temperature observations obtained during the August 1998 Massachusetts Bay Internal Wave Experiment and observations from a shorter experiment which took place in September 2001. The model shows how the approaching nonlinear undular bore interacts strongly with a shoaling bottom, offshore of where KdV theory predicts polarity switching should occur. It is shown that the shoaling process is dominated by nonlinearity, and the model results are interpreted with the aid of a two-layer nonlinear but hydrostatic model. After interacting with the shoaling bottom, the undular bore emerges on the shallow shelf inshore of the 30-m isobath as a nonlinear internal tide with a range of possible shapes, all of which are found in the available observational record. Copyright 2008 by the American Geophysical Union.

  1. Massachusetts Career Development Institute in Partnership with the Geriatric Authority of Holyoke, Massachusetts. Final Report.

    ERIC Educational Resources Information Center

    Massachusetts Career Development Inst., Springfield.

    The Massachusetts Career Development Institute (MCDI) refined and expanded the existing program of Workplace Education at the Geriatric Authority of Holyoke (GAH), Massachusetts. The 18-month program provided educational and support services on site to 60 employees at the GAH. Classes were held in English as a second language, adult basic…

  2. Exclusion of Pregnancy Benefits Violates State Law--Massachusetts Commission against Discrimination v. Massachusetts Electric Co.

    ERIC Educational Resources Information Center

    Rumrill, Robert Bentley

    1979-01-01

    The Massachusetts court held that the exclusion of pregnant women from a disability program was facially discriminatory because pregnancy alone was the determinative criterion. Available from Suffolk University Law Review Office, 41 Temple Street, Boston, Massachusetts 02114; sc $3.50. (Author/IRT)

  3. Factors influencing riverine fish assemblages in Massachusetts

    USGS Publications Warehouse

    Armstrong, David S.; Richards, Todd A.; Levin, Sara B.

    2011-01-01

    The U.S. Geological Survey, in cooperation with the Massachusetts Department of Conservation and Recreation, Massachusetts Department of Environmental Protection, and the Massachusetts Department of Fish and Game, conducted an investigation of fish assemblages in small- to medium-sized Massachusetts streams. The objective of this study was to determine relations between fish-assemblage characteristics and anthropogenic factors, including impervious cover and estimated flow alteration, relative to the effects of environmental factors, including physical-basin characteristics and land use. The results of this investigation supersede those of a preliminary analysis published in 2010. Fish data were obtained for 669 fish-sampling sites from the Massachusetts Division of Fisheries and Wildlife fish-community database. A review of the literature was used to select fish metrics - species richness, abundance of individual species, and abundances of species grouped on life history traits - responsive to flow alteration. The contributing areas to the fish-sampling sites were delineated and used with a geographic information system to determine a set of environmental and anthropogenic factors that were tested for use as explanatory variables in regression models. Reported and estimated withdrawals and return flows were used together with simulated unaltered streamflows to estimate altered streamflows and indicators of flow alteration for each fish-sampling site. Altered streamflows and indicators of flow alteration were calculated on the basis of methods developed in a previous U.S. Geological Survey study in which unaltered daily streamflows were simulated for a 44-year period (water years 1961-2004), and streamflow alterations were estimated by use of water-withdrawal and wastewater-return data previously reported to the State for the 2000-04 period and estimated domestic-well withdrawals and septic-system discharges. A variable selection process, conducted using principal

  4. Spatial analysis of gastroschisis in Massachusetts and Texas

    PubMed Central

    Yazdy, Mahsa M.; Werler, Martha M.; Anderka, Marlene; Langlois, Peter H.; Vieira, Veronica M.

    2014-01-01

    Purpose Previous research has suggested gastroschisis, a congenital malformation, may be linked to environmental or infectious factors and cases can occur in clusters. The objective of this study was to identify geographic areas of elevated gastroschisis risk. Methods Cases of gastroschisis were identified from birth defect registries in Massachusetts and Texas. Random samples of live births were selected as controls. Generalized additive models were used to create a continuous map surface of odds ratios (OR) by smoothing over latitude and longitude. Maternal age, race/ethnicity, education, cigarette smoking, and insurance status (MA only) were assessed for confounding. We used permutation tests to identify statistically significant areas of increased risk. Results An area of increased risk was identified in north-central Massachusetts, but was not significant after adjustment (p-value=0.07; OR=2.0). In Texas, two statistically significant areas of increased risk were identified after adjustment (p-value=0.02; OR=1.3 and 1.2). Texas had sufficient data to assess the combination of space and time, which identified an increased risk in 2003 and 2004. Conclusion This study suggests there were areas of elevated gastroschisis risk in Massachusetts and Texas that cannot be explained by the risk factors we assessed. Additional exploration of underlying artifactual, environmental, infectious, or behavioral factors may further our understanding of gastroschisis. PMID:25454289

  5. Spatial analysis of gastroschisis in Massachusetts and Texas.

    PubMed

    Yazdy, Mahsa M; Werler, Martha M; Anderka, Marlene; Langlois, Peter H; Vieira, Veronica M

    2015-01-01

    Previous research has suggested gastroschisis, a congenital malformation, may be linked to environmental or infectious factors and cases can occur in clusters. The objective of this study was to identify geographic areas of elevated gastroschisis risk. Cases of gastroschisis were identified from birth defect registries in Massachusetts and Texas. Random samples of live births were selected as controls. Generalized additive models were used to create a continuous map surface of odds ratios (ORs) by smoothing over latitude and longitude. Maternal age, race/ethnicity, education, cigarette smoking, and insurance status (MA only) were assessed for confounding. We used permutation tests to identify statistically significant areas of increased risk. An area of increased risk was identified in North Central Massachusetts but was not significant after adjustment (P value = .07; OR = 2.0). In Texas, two statistically significant areas of increased risk were identified after adjustment (P value = .02; OR = 1.3 and 1.2). Texas had sufficient data to assess the combination of space and time, which identified an increased risk in 2003 and 2004. This study suggests there were areas of elevated gastroschisis risk in Massachusetts and Texas, which cannot be explained by the risk factors we assessed. Additional exploration of underlying artifactual, environmental, infectious, or behavioral factors may further our understanding of gastroschisis. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013.

    PubMed

    Taylor, Alex M; Nigrovic, Lise E; Saillant, Meredith L; Trudell, Emily K; Proctor, Mark R; Modest, Jonathan R; Vernacchio, Louis

    2015-09-01

    To characterize trends in health care utilization and costs for children diagnosed with concussion or minor head injury within a large pediatric primary-care association. We conducted a retrospective cohort analysis from 2007 through 2013 examining all outpatient medical claims related to concussion and minor head injury from 4 commercial insurance companies for children 6-21 years of age who were patients within a large pediatric independent practice association located throughout eastern Massachusetts. Health care visits for concussion and minor head injury increased more than 4-fold during the study period, with primary-care and specialty clinics experiencing the greatest increases in the rate of visits while emergency department visits increased comparatively less. These increases were accounted for by both the proportion of children diagnosed with concussion or minor head injury (1.3% of all children in 2007 vs 3.3% in 2013) and the number of encounters per diagnosed patient (1.0 encounters per patient in 2007 vs 1.7 in 2013). Although the overall population costs devoted to care for concussion or minor head injury increased 34%, the cost per individual diagnosed child decreased 31%. Over the past 7 years, health care encounters for children diagnosed with concussion or minor head injury increased substantially in eastern Massachusetts. Care for these injuries increasingly shifted from the emergency department to primary-care and specialty providers. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. The new era of payment reform, spending targets, and cost containment in Massachusetts: early lessons for the nation.

    PubMed

    Mechanic, Robert E; Altman, Stuart H; McDonough, John E

    2012-10-01

    As its 2012 session drew to a close, the Massachusetts legislature passed a much-anticipated cost control bill. The bill sets annual state spending targets, encourages the formation of accountable care organizations, and establishes an independent commission to oversee health care system performance. It is Massachusetts's third law to address health spending since the state's landmark health insurance coverage reforms in 2006. The 2012 legislation is a notable step beyond other recent cost control efforts. Although it lacks strong mechanisms to enforce the new spending goals, it creates a framework for increased regulation if spending trends fail to moderate. Massachusetts's experience provides several lessons for state and federal policy makers. First, implementing near-universal coverage, as is planned under the Affordable Care Act for 2014, will increase pressure on government to begin controlling overall health care spending. Second, introduction of cost control measures takes time: Massachusetts enacted a series of incremental but increasingly strong laws over the past six years that have gradually increased its ability to influence health spending. Finally, the effectiveness of new cost control laws will depend on changes in providers' and insurers' behavior; in Massachusetts, private market activity has had a complementary impact on the pace of health system change.

  8. Health Insurance Expansion and Treatment of Pancreatic Cancer: Does Increased Access Lead to Improved Care?

    PubMed Central

    Loehrer, Andrew P; Chang, David C; Hutter, Matthew M; Song, Zirui; Lillemoe, Keith D; Warshaw, Andrew L; Ferrone, Cristina R

    2015-01-01

    Background Pancreatic cancer is increasingly common and poised to become the second leading cause of cancer deaths by the year 2020. Surgical resection is only chance for cure yet significant disparities in resection rates exist by insurance status. The 2006 Massachusetts health care reform serves as natural experiment to evaluate the unknown impact of health insurance expansion on treatment of pancreatic cancer. Study Design Using the Agency for Healthcare Research and Quality State Inpatient Databases, this cohort study examines non-elderly, adult patients with no insurance, private coverage, or government-subsidized insurance plans who were admitted with pancreatic cancer in Massachusetts and three control states. Primary outcome was change in pancreatic resection rates. Difference-in-difference models were used to show impact of Massachusetts health care reform on resection rates for pancreatic cancer, controlling for confounding factors and secular trends. Results Prior to the Massachusetts reform, government-subsidized and self-pay patients (GSSP) had significantly lower rates of resection than privately-insured patients. The 2006 Massachusetts health reform was associated with a 15% increased rate of admission with pancreatic cancer (P=0.043) and a 67% increased rate of surgical resection (P=0.043) compared to control states. Measured disparities in likelihood of resection by insurance status decreased in Massachusetts while remaining unchanged in control states. Conclusions The 2006 Massachusetts health care reform was associated with increased resection rates for pancreatic cancer compared to control states. Our findings provide hopeful evidence that increased insurance coverage may help improve equity in pancreatic cancer treatment. Additional studies are needed to evaluate the longevity of these findings and generalizability in other states. PMID:26611798

  9. 76 FR 1337 - Asian Longhorned Beetle; Additions to Quarantined Areas in Massachusetts and New York

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... portion of Worcester County, MA, to the list of quarantined areas in Sec. 301.51-3(c) and by updating the... Quarantined Areas in Massachusetts and New York AGENCY: Animal and Plant Health Inspection Service, USDA... Worcester County, MA, to the list of quarantined areas and updating the description of the quarantined...

  10. Establishing a Practice-Based Research Network: Lessons from the Massachusetts Experience

    ERIC Educational Resources Information Center

    Pulcini, Joyce; Sheetz, Anne; DeSisto, Marie

    2008-01-01

    This article describes the recently established Massachusetts School Nurse Research Network (MASNRN) which has a mission of establishing a practice-based research network (PBRN) comprised of a representative, collaborative group of professional school nurses, nurse academicians, and other interested parties for whom school health is a priority.…

  11. Evaluation Report for the Massachusetts Workplace Literacy Consortium. National Workplace Literacy Program Wave 6, Year 3.

    ERIC Educational Resources Information Center

    Sperazi, Laura; DePascale, Charles A.

    The Massachusetts Workplace Literacy Consortium sought to upgrade work-related literacy skills at 22 partner sites in the state. Members included manufacturers, health care organizations, educational institutions, and labor unions. In its third year, the consortium served 1,179 workers with classes in English for speakers of other languages, adult…

  12. EPA Provides Brownfields Grants to Western Massachusetts Communities

    EPA Pesticide Factsheets

    Today, the U.S. Environmental Protection Agency celebrated the recipients of seven Brownfields grants in western Massachusetts. This year, entities in western Massachusetts received $2.4 million for assessment and cleanup of Brownfields sites.

  13. 75 FR 51239 - University of Massachusetts Amherst, et al.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... International Trade Administration University of Massachusetts Amherst, et al.; Notice of Consolidated Decision... Avenue., NW., Washington, DC. Docket Number: 10-044. Applicant: University of Massachusetts Amherst... University, Boone, NC 28608. Instrument: Electron Microscope. Manufacturer: JEOL, Ltd., Japan. Intended...

  14. Risk of breast cancer following exposure to tetrachloroethylene-contaminated drinking water in Cape Cod, Massachusetts: reanalysis of a case-control study using a modified exposure assessment

    PubMed Central

    2011-01-01

    Background Tetrachloroethylene (PCE) is an important occupational chemical used in metal degreasing and drycleaning and a prevalent drinking water contaminant. Exposure often occurs with other chemicals but it occurred alone in a pattern that reduced the likelihood of confounding in a unique scenario on Cape Cod, Massachusetts. We previously found a small to moderate increased risk of breast cancer among women with the highest exposures using a simple exposure model. We have taken advantage of technical improvements in publically available software to incorporate a more sophisticated determination of water flow and direction to see if previous results were robust to more accurate exposure assessment. Methods The current analysis used PCE exposure estimates generated with the addition of water distribution modeling software (EPANET 2.0) to test model assumptions, compare exposure distributions to prior methods, and re-examine the risk of breast cancer. In addition, we applied data smoothing to examine nonlinear relationships between breast cancer and exposure. We also compared a set of measured PCE concentrations in water samples collected in 1980 to modeled estimates. Results Thirty-nine percent of individuals considered unexposed in prior epidemiological analyses were considered exposed using the current method, but mostly at low exposure levels. As a result, the exposure distribution was shifted downward resulting in a lower value for the 90th percentile, the definition of "high exposure" in prior analyses. The current analyses confirmed a modest increase in the risk of breast cancer for women with high PCE exposure levels defined by either the 90th percentile (adjusted ORs 1.0-1.5 for 0-19 year latency assumptions) or smoothing analysis cut point (adjusted ORs 1.3-2.0 for 0-15 year latency assumptions). Current exposure estimates had a higher correlation with PCE concentrations in water samples (Spearman correlation coefficient = 0.65, p < 0.0001) than estimates

  15. 'May issue' gun carrying laws and police discretion: Some evidence from Massachusetts.

    PubMed

    Hemenway, David; Hicks, James G

    2015-08-01

    In almost all states in the United States, to carry a concealed handgun legally requires a permit from the police. Many states have changed from may-issue laws (where the local police chief has discretion about to whom to issue a license) to shall-issue laws (where the police chief must issue a permit if the applicant passes a computerized federal background check). Studies conflict on the effect on crime. None considered the situation in may-issue states when police used discretion and refused to issue a permit. We provide suggestive evidence from a December 2013 survey of police chiefs in Massachusetts' 351 cities and towns. Of the 121 responding police chiefs, a large majority favored retaining police discretion. Chiefs issued few discretionary denials - median 2 per year, citing providing false information, a history of assault (often domestic violence), a history of drug or alcohol abuse, or of mental-health issues as the most common reasons for denial.

  16. 78 FR 27413 - Massachusetts; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... SECURITY Federal Emergency Management Agency Massachusetts; Emergency and Related Determinations AGENCY... declaration of an emergency for the Commonwealth of Massachusetts (FEMA-3362-EM), dated April 17, 2013, and... Massachusetts resulting from explosions on April 15, 2013, are of sufficient severity and magnitude to warrant...

  17. 78 FR 5476 - Massachusetts; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ... SECURITY Federal Emergency Management Agency Massachusetts; Major Disaster and Related Determinations... Presidential declaration of a major disaster for the Commonwealth of Massachusetts (FEMA-4097-DR), dated... Commonwealth of Massachusetts resulting from Hurricane Sandy during the period of October 27 to November 8...

  18. 76 FR 67245 - Massachusetts Disaster Number MA-00040

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... ADMINISTRATION Disaster Declaration 12803 and 12804 Massachusetts Disaster Number MA-00040 AGENCY: U.S. Small... of a major disaster for Public Assistance Only for the Commonwealth of Massachusetts (FEMA-4028-DR... Massachusetts, dated 09/03/2011, is hereby amended to include the following areas as adversely affected by the...

  19. 75 FR 25305 - Massachusetts Disaster Number MA-00025

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... ADMINISTRATION Massachusetts Disaster Number MA-00025 AGENCY: U.S. Small Business Administration. ACTION... Commonwealth of Massachusetts (FEMA-1895-DR), dated 03/29/2010. Incident: Severe Storms and Flooding. Incident... Commonwealth of Massachusetts, dated 03/29/2010 is hereby amended to establish the incident period for this...

  20. Transitioning English Language Learners in Massachusetts: An Exploratory Data Review

    ERIC Educational Resources Information Center

    Massachusetts Department of Elementary and Secondary Education, 2012

    2012-01-01

    The Massachusetts Department of Elementary and Secondary Education commissioned this paper to explore several questions about students who are English language learners (ELL) in Massachusetts: (1) For how many years is a typical ELL student in Massachusetts classified as limited English proficient (LEP)?; (2) How much variation is there in a the…

  1. 75 FR 25305 - Massachusetts Disaster Number MA-00027

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... ADMINISTRATION Massachusetts Disaster Number MA-00027 AGENCY: U.S. Small Business Administration. ACTION... Assistance Only for the Commonwealth of Massachusetts (FEMA-1895-DR), dated 04/22/2010. Incident: Severe... disaster declaration for Private Non-Profit organizations in the Commonwealth of Massachusetts, dated 04/22...

  2. 76 FR 72961 - Massachusetts; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... SECURITY Federal Emergency Management Agency Massachusetts; Emergency and Related Determinations AGENCY... declaration of an emergency for the Commonwealth of Massachusetts (FEMA-3343-EM), dated November 1, 2011, and... Massachusetts resulting from a severe storm during the period of October 29-30, 2011, are of sufficient severity...

  3. 77 FR 2989 - Massachusetts; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... SECURITY Federal Emergency Management Agency Massachusetts; Major Disaster and Related Determinations... Presidential declaration of a major disaster for the Commonwealth of Massachusetts (FEMA-4051-DR), dated... Commonwealth of Massachusetts resulting from a severe storm and snowstorm during the period of October 29-30...

  4. 76 FR 44346 - Massachusetts; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-25

    ... SECURITY Federal Emergency Management Agency Massachusetts; Major Disaster and Related Determinations... Presidential declaration of a major disaster for the Commonwealth of Massachusetts (FEMA-1994-DR), dated June... Massachusetts resulting from severe storms ] and tornadoes on June 1, 2011, is of sufficient severity and...

  5. 77 FR 68796 - Massachusetts; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    .... FEMA-3350-EM; Docket ID FEMA-2011-0001] Massachusetts; Emergency and Related Determinations AGENCY... declaration of an emergency for the Commonwealth of Massachusetts (FEMA-3350-EM), dated October 28, 2012, and... follows: I have determined that the emergency conditions in the Commonwealth of Massachusetts resulting...

  6. 75 FR 39059 - Massachusetts Disaster Number MA-00025

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-07

    ... ADMINISTRATION Massachusetts Disaster Number MA-00025 AGENCY: U.S. Small Business Administration. ACTION... Commonwealth of Massachusetts (FEMA-1895-DR), dated 03/29/2010. Incident: Severe Storms and Flooding. Incident... Massachusetts, dated 03/29/2010 is hereby amended to extend the deadline for filing applications for physical...

  7. 75 FR 55810 - Massachusetts; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-14

    ... SECURITY Federal Emergency Management Agency Massachusetts; Emergency and Related Determinations AGENCY... declaration of an emergency for the Commonwealth of Massachusetts (FEMA-3315-EM), dated September 2, 2010, and... Massachusetts resulting from Hurricane Earl beginning on September 1, 2010, and continuing, are of sufficient...

  8. 76 FR 31323 - Distrigas of Massachusetts LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... Energy Regulatory Commission Distrigas of Massachusetts LLC; Notice of Application Take notice that on May 18, 2011, Distrigas of Massachusetts LLC (DOMAC), 20 City Square, Suite 3, Charlestown, MA 02129...) terminal in Everett, Massachusetts, (HVWIR Project), all as more fully set forth in the application, which...

  9. 75 FR 18518 - Massachusetts; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-12

    ... SECURITY Federal Emergency Management Agency Massachusetts; Major Disaster and Related Determinations... Presidential declaration of a major disaster for the Commonwealth of Massachusetts (FEMA-1895-DR), dated March... Massachusetts resulting from severe storms and flooding beginning on March 12, 2010, and continuing, is of...

  10. 78 FR 27414 - Massachusetts; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... SECURITY Federal Emergency Management Agency Massachusetts; Major Disaster and Related Determinations... Presidential declaration of a major disaster for the Commonwealth of Massachusetts (FEMA-4110-DR), dated April... ``Stafford Act''), as follows: I have determined that the damage in the Commonwealth Massachusetts resulting...

  11. 75 FR 30872 - Massachusetts Disaster Number MA-00025

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ... ADMINISTRATION Massachusetts Disaster Number MA-00025 AGENCY: U.S. Small Business Administration. ACTION... of Massachusetts (FEMA-1895-DR), dated 03/ 29/2010. Incident: Severe Storms and Flooding. Incident... INFORMATION: The notice of the President's major disaster declaration for the State of Massachusetts, dated 03...

  12. 76 FR 61729 - Massachusetts; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... SECURITY Federal Emergency Management Agency Massachusetts; Major Disaster and Related Determinations... Presidential declaration of a major disaster for the Commonwealth of Massachusetts (FEMA-4028-DR), dated... Commonwealth of Massachusetts resulting from Tropical Storm Irene during the period of August 27-29, 2011, is...

  13. Local and Cumulative Impervious Cover of Massachusetts Stream Basins

    USGS Publications Warehouse

    Brandt, Sara L.; Steeves, Peter A.

    2009-01-01

    Impervious surfaces such as paved roads, parking lots, and building roofs can affect the natural streamflow patterns and ecosystems of nearby streams. This dataset summarizes the percentage of impervious area for watersheds across Massachusetts by using a newly available statewide 1-m binary raster dataset of impervious surface for 2005. In order to accurately capture the wide spatial variability of impervious surface, it was necessary to delineate a new set of finely discretized basin boundaries for Massachusetts. This new set of basins was delineated at a scale finer than that of the existing 12-digit Hydrologic Unit Code basins (HUC-12s) of the national Watershed Boundary Dataset. The dataset consists of three GIS shapefiles. The Massachusetts nested subbasins and the hydrologic units data layers consist of topographically delineated boundaries and their associated percentage of impervious cover for all of Massachusetts except Cape Cod, the Islands, and the Plymouth-Carver region. The Massachusetts groundwater-contributing areas data layer consists of groundwater contributing-area boundaries for streams and coastal areas of Cape Cod and the Plymouth-Carver region. These boundaries were delineated by using groundwater-flow models previously published by the U.S. Geological Survey. Subbasin and hydrologic unit boundaries were delineated statewide with the exception of Cape Cod and the Plymouth-Carver Region. For the purpose of this study, a subbasin is defined as the entire drainage area upstream of an outlet point. Subbasins draining to multiple outlet points on the same stream are nested. That is, a large downstream subbasin polygon comprises all of the smaller upstream subbasin polygons. A hydrologic unit is the intervening drainage area between a given outlet point and the outlet point of the next upstream unit (Fig. 1). Hydrologic units divide subbasins into discrete, nonoverlapping areas. Each hydrologic unit corresponds to a subbasin delineated from the

  14. The campaign to raise the tobacco tax in Massachusetts.

    PubMed

    Heiser, P F; Begay, M E

    1997-06-01

    Question 1 raised the Massachusetts state tobacco tax to fund tobacco education programs. This paper examines the process of qualifying and passing Question 1. Information was gathered from internal memoranda, meeting minutes, newspaper articles, internal documents, letters, newsletters, news and press releases, and personal interviews. Data about campaign contributions were obtained from the Massachusetts Office of Campaign and Political Finance. Three factors help explain why Question 1 passed: (1) the policy environment was favorable because of the social unacceptability of smoking; (2) the activists assembled a large coalition of supporters; and (3) the activists countered industry claims that the new tax would hurt small business and lower-income smokers and would be wasted by the legislature. The ballot initiative passed despite the industry's $7 million campaign to defeat it. The apparent influence of the tobacco industry on the legislature was the driving force behind the decision of public health activists to qualify Question 1. Moving policy-making out of the legislature into the public arena widened the scope of conflict and enabled public health activists to win.

  15. Eleven-year descriptive analysis of closed court verdicts on medical errors in Spain and Massachusetts.

    PubMed

    Giraldo, Priscila; Sato, Luke; Martínez-Sánchez, Jose M; Comas, Mercè; Dwyer, Kathy; Sala, Maria; Castells, Xavier

    2016-08-30

    To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012. We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement. Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts. This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Eleven-year descriptive analysis of closed court verdicts on medical errors in Spain and Massachusetts

    PubMed Central

    Giraldo, Priscila; Sato, Luke; Martínez-Sánchez, Jose M; Comas, Mercè; Dwyer, Kathy; Sala, Maria; Castells, Xavier

    2016-01-01

    Objectives To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012. Design, setting and participants We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement. Results Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts. Conclusions This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution. PMID:27577585

  17. Long-Term Oceanographic Observations in Western Massachusetts Bay Offshore of Boston, Massachusetts: Data Report for 1989-2002

    USGS Publications Warehouse

    Butman, Bradford; Bothner, Michael H.; Alexander, P. Soupy; Lightsom, Frances L.; Martini, Marianna A.; Gutierrez, Benjamin T.; Strahle, William S.

    2004-01-01

    This data report presents long-term oceanographic observations made in western Massachusetts Bay at two locations: (1) 42 deg 22.6' N., 70 deg 47.0' W. (Site A, 33 m water depth) from December 1989 through December 2002 (figure 1), and (2) 42 deg 9.8' N., 70 deg 38.4' W. (Site B, 21 m water depth) from October 1997 through December 2002. Site A is approximately 1 km south of the new ocean outfall that began discharging treated sewage effluent from the Boston metropolitan area into Massachusetts Bay on September 6, 2000. These long-term oceanographic observations have been collected by the U.S. Geological Survey (USGS) in partnership with the Massachusetts Water Resources Authority (MWRA) and with logistical support from the U.S. Coast Guard (USCG - http://www.uscg.mil). This report presents time series data through December 2002, updating a similar report that presented data through December 2000 (Butman and others, 2002). In addition, the Statistics and Mean Flow sections include some new plots and tables and the format of the report has been streamlined by combining yearly figures into single .pdfs. Figure 1 (PDF format) The long-term measurements are planned to continue at least through 2005. The long-term oceanographic observations at Sites A and B are part of a USGS study designed to understand the transport and long-term fate of sediments and associated contaminants in the Massachusetts bays. (See http://woodshole.er.usgs.gov/project-pages/bostonharbor/ and Butman and Bothner, 1997.) The long-term observations document seasonal and inter-annual changes in currents, hydrography, and suspended-matter concentration in western Massachusetts Bay, and the importance of infrequent catastrophic events, such as major storms or hurricanes, in sediment resuspension and transport. They also provide observations for testing numerical models of circulation. This data report presents a description of the field program and instrumentation, an overview of the data through

  18. Tobacco use by Massachusetts public college students: long term effect of the Massachusetts Tobacco Control Program.

    PubMed

    Rigotti, N A; Regan, S; Majchrzak, N E; Knight, J R; Wechsler, H

    2002-06-01

    To assess tobacco use among Massachusetts public college students and compare students who attended high school in Massachusetts and were exposed to the Massachusetts Tobacco Control Program (MTCP) with students who attended high school outside Massachusetts and were unexposed to the programme. Analysis of the 1999 Massachusetts College Alcohol Survey. Four year public colleges and universities in Massachusetts (n = 11). 1252 randomly selected students (response rate 56%). Self report of current (past 30 day), past year, and lifetime use of cigarettes, cigars, and smokeless tobacco. One third of students had used a tobacco product in the past month and 46.4% had used tobacco in the past year. Cigarettes accounted for most of this tobacco use. Total tobacco use was higher among males than females but cigarette smoking did not differ by sex. Tobacco use was lower among athletes and higher among students who used alcohol or marijuana. Current tobacco use was lower among public college students who had attended high school in Massachusetts compared with those who attended high school in another state (31.5% v 42.6%, p = 0.006). This difference persisted after adjustment for age, sex, race, parental education, and students' college residence (adjusted odds ratio (OR) 0.67, 95% confidence interval (CI) 0.46 to 0.97, p = 0.034). Tobacco use is common among Massachusetts public college students. Students who were exposed to the MTCP during high school are less likely to use tobacco than their peers who were not exposed to this programme. The MTCP may have reduced tobacco use among this group of young adults.

  19. Integrated solid waste management of Springfield, Massachusetts

    SciTech Connect

    1995-11-01

    The subject document reports the results of an in-depth investigation of the fiscal year 1993 cost of the city of Springfield, Massachusetts, integrated municipal solid waste management (IMSWM) system, the energy consumed to operate the system, and the environmental performance requirements for each of the system`s waste-processing and disposal facilities. The document reports actual data from records kept by participants. Every effort was made to minimize the use of assumptions, and no attempt is made to interpret the data reported. Analytical approaches are documented so that interested analysts may perform manipulation or further analysis of the data. As such, the report is a reference document for Municipal Solid Waste management professionals who are interested in the actual costs and energy consumption, for a 1-year period, of an operating IMSWM system. The report is organized into two main parts. The first part is the executive summary and case study portion of the report. The executive summary provides a basic description of the study area and selected economic and energy information. Within the case study are detailed descriptions of each component operating during the study period; the quantities of solid waste collected, processed, and marketed within the study boundaries; the cost of managing MSW in Springfield; an energy usage analysis; a review of federal, state, and local environmental requirement compliance; a reference section; and a glossary of terms. The second part of the report focuses on a more detailed discourse on the above topics. In addition, the methodology used to determine the economic costs and energy consumption of the system components is found in the second portion of this report. The methodology created for this project will be helpful for those professionals who wish to break out the costs of their own integrated systems.

  20. Severe Maternal Morbidity and the Use of Assisted Reproductive Technology in Massachusetts.

    PubMed

    Belanoff, Candice; Declercq, Eugene R; Diop, Hafsatou; Gopal, Daksha; Kotelchuck, Milton; Luke, Barbara; Nguyen, Thien; Stern, Judy E

    2016-03-01

    To assess whether risk of severe maternal morbidity at delivery differed for women who conceived using assisted reproductive technology (ART), those with indicators of subfertility but no ART ("subfertile"), and those who had neither ART nor subfertility ("fertile"). This retrospective cohort study was part of the larger Massachusetts Outcomes Study of Assisted Reproductive Technology. To construct the Massachusetts Outcomes Study of Assisted Reproductive Technology database and identify ART deliveries, we linked ART treatment records to birth certificates and maternal and infant hospitalization records occurring in Massachusetts between 2004 and 2010. An algorithm of International Classification of Diseases, 9th Revision, Clinical Modification diagnosis and procedure codes identified severe maternal morbidity. We used logistic generalized estimating equations to estimate odds of severe maternal morbidity associated with fertility status, adjusting for maternal demographic and health factors and gestational age, stratifying on plurality and method of delivery. The prevalence of severe maternal morbidity among this population (n=458,918) was 1.16%. The overall, crude prevalences of severe maternal morbidity among fertile, subfertile, and ART deliveries were 1.09%, 1.44%, and 3.14%, respectively. The most common indicator of severe maternal morbidity was blood transfusion. In multivariable analyses, among singletons, ART was associated with increased odds of severe maternal morbidity compared with both fertile (vaginal: adjusted odds ratio [OR] 2.27, 95% confidence interval [CI] 1.78-2.88; cesarean: adjusted OR 1.67, 95% CI 1.40-1.98, respectively) and subfertile (vaginal: adjusted OR 1.97, 95% CI 1.30-3.00; cesarean: adjusted OR 1.75, 95% CI 1.30-2.35, respectively) deliveries. Among twins, only cesarean ART deliveries had significantly greater severe maternal morbidity compared with cesarean fertile deliveries (adjusted OR 1.48, 95% CI 1.14-1.93). Women who

  1. Massachusetts Science and Technology Engineering Curriculum Framework

    ERIC Educational Resources Information Center

    Massachusetts Department of Education, 2006

    2006-01-01

    This 2006 "Massachusetts Science and Technology/Engineering Curriculum Framework" provides a guide for teachers and curriculum coordinators regarding specific content to be taught from PreK through high school. Following this "Organization" chapter, the "Framework" contains the following sections: (1) Philosophy and…

  2. All Our Children: Massachusetts Kids Count 1994.

    ERIC Educational Resources Information Center

    Diamond, Franna, Ed.

    This Kids Count report examines statewide trends from 1990 to 1994 in the well-being of Massachusetts' children. The statistical portrait is based on indicators of well-being in five areas: (1) economic well-being of children and their families, including child poverty rate, family income, job loss, earnings of male high school dropouts and…

  3. University of Massachusetts Amherst: An Innovative Partnership

    ERIC Educational Resources Information Center

    McClure, William S.; Miller, Marla R.

    2011-01-01

    In 2009 the University of Massachusetts Amherst (UMass Amherst), in collaboration with Hancock Shaker Village (HSV), created a new two-year master's degree in historic preservation and architectural conservation for professionals in the field. Combining university courses with training and classes on site at a national historic landmark, the…

  4. 21 CFR 808.71 - Massachusetts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of “used hearing aid” in § 801.420(a)(6) of this chapter. (b) The following Massachusetts medical... hearing aid. [45 FR 67326, Oct. 10, 1980] ..., Chapter 93, Section 72, to the extent that it requires a hearing test evaluation for a child under the age...

  5. 40 CFR 81.322 - Massachusetts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... River X Attleboro X New Bedford X Taunton X All other cities and towns X Metropolitan Boston AQCR... Pittsfield X All other cities and towns X Central Massachusetts AQCR: Worcester X Athol X Gardner X Grafton X Leominster X Millbury X Shrewsbury X All other cities and towns X Merrimack Valley AQCR: Haverhill X Lawrence...

  6. 40 CFR 81.322 - Massachusetts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... River X Attleboro X New Bedford X Taunton X All other cities and towns X Metropolitan Boston AQCR... Pittsfield X All other cities and towns X Central Massachusetts AQCR: Worcester X Athol X Gardner X Grafton X Leominster X Millbury X Shrewsbury X All other cities and towns X Merrimack Valley AQCR: Haverhill X Lawrence...

  7. 40 CFR 81.322 - Massachusetts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... River X Attleboro X New Bedford X Taunton X All other cities and towns X Metropolitan Boston AQCR... Pittsfield X All other cities and towns X Central Massachusetts AQCR: Worcester X Athol X Gardner X Grafton X Leominster X Millbury X Shrewsbury X All other cities and towns X Merrimack Valley AQCR: Haverhill X Lawrence...

  8. 78 FR 25336 - Massachusetts Disaster #MA-00054

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-30

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Massachusetts Disaster MA-00054 AGENCY: U.S. Small Business Administration. ACTION: Notice...: 01/21/2014. ADDRESSES: Submit completed loan applications to: U.S. Small Business...

  9. Forest statistics for Massachusetts: 1985 and 1998

    Treesearch

    Carol L. Alerich; Carol L. Alerich

    2000-01-01

    A statistical report on the fourth forest inventory of Massachusetts (1997-1998.) Findings are dispayed in 67 tables containing estimates of forest area numbers of trees, wildlife habitat, timber volume, growth, change, and biomass. Data are presented at two levels: state and county.

  10. Forest Statistics for Massachusetts--1972 and 1985

    Treesearch

    David R. Dickson; Carol L. McAfee; Carol L. McAfee

    1988-01-01

    A statistical report on the third forest survey of Massachusetts (1984). Findings are displayed in 76 tables containing estimates of forest area, numbers of trees, timber volume, tree biomass, and timber products output. Data are presented at two levels: state and county.

  11. 40 CFR 81.322 - Massachusetts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AREAS FOR AIR QUALITY PLANNING PURPOSES Section 107 Attainment Status Designations § 81.322... Pittsfield X All other cities and towns X Central Massachusetts AQCR: Worcester X Athol X Gardner X Grafton X Leominster X Millbury X Shrewsbury X All other cities and towns X Merrimack Valley AQCR: Haverhill X...

  12. Closing the Massachusetts Public Training Schools

    ERIC Educational Resources Information Center

    Behn, Robert D.

    1976-01-01

    Examines the closing of the Massachusetts public training schools, using it as a successful example of public policy termination. Describes how the barriers to policy termination were overcome and the replacement policy was consolidated, and evaluates the termination tactics and the new policy. Available from Elsevier Scientific Publishing…

  13. Closing the Massachusetts Public Training Schools

    ERIC Educational Resources Information Center

    Behn, Robert D.

    1976-01-01

    Examines the closing of the Massachusetts public training schools, using it as a successful example of public policy termination. Describes how the barriers to policy termination were overcome and the replacement policy was consolidated, and evaluates the termination tactics and the new policy. Available from Elsevier Scientific Publishing…

  14. Massachusetts Regional Alignment Workshops: Final Report

    ERIC Educational Resources Information Center

    Conley, David T.; McGaughy, Charis; Ward, Terri; Martinez, Mary

    2008-01-01

    In April 2008, the Massachusetts Department of Elementary and Secondary Education (DESE) contracted with the Educational Policy Improvement Center (EPIC) to facilitate a series of regional workshops and provide technical assistance to strengthen efforts to improve college readiness for all students. This final report summarizes these activities…

  15. Live Site Demonstrations - Massachusetts Military Reservation

    DTIC Science & Technology

    2014-09-26

    MetalMapper Sensor; Advanced electromagnetic induction ; UXO; Classification; Live Site Demonstration; Massachusetts Military Reservation 16. SECURITY...Berkeley UXO Discriminator CD cultural debris CIA Central Impact Area cm centimeter DAQ data acquisition computer EMI electromagnetic induction ...advanced electromagnetic induction sensors developed specifically for discrimination on real sites under operational conditions. • Investigate in

  16. Massachusetts' "Hancock" Case and the Adequacy Doctrine

    ERIC Educational Resources Information Center

    Costrell, Robert

    2006-01-01

    The Hancock school finance case put the adequacy doctrine to its strictest test yet, to see if even a national educational leader such as Massachusetts could be found in constitutional violation. The doctrine failed this test, as the court found in favor of the defendants due to the vigorous reform program since 1993. The court credited the…

  17. Jacobson v Massachusetts at 100 years: police power and civil liberties in tension.

    PubMed

    Gostin, Lawrence O

    2005-04-01

    A century ago, the US Supreme Court in Jacobson v Massachusetts upheld the exercise of the police power to protect the public's health. Despite intervening scientific and legal advances, public health practitioners still struggle with Jacobson's basic tension between individual liberty and the common good. In affirming Massachusetts' compulsory vaccination law, the Court established a floor of constitutional protections that consists of 4 standards: necessity, reasonable means, proportionality, and harm avoidance. Under Jacobson, the courts are to support public health matters insofar as these standards are respected. If the Court today were to decide Jacobson once again, the analysis would likely differ--to account for developments in constitutional law--but the outcome would certainly reaffirm the basic power of government to safeguard the public's health.

  18. Medicaid expansion initiative in Massachusetts: enrollment among substance-abusing homeless adults.

    PubMed

    Zur, Julia; Mojtabai, Ramin

    2013-11-01

    We assessed whether homeless adults entering substance abuse treatment in Massachusetts were less likely than others to enroll in Medicaid after implementation of the MassHealth Medicaid expansion program in 1997. We used interrupted time-series analysis in data on substance abuse treatment admissions from the Treatment 0Episode Data Set (1992-2009) to evaluate Medicaid coverage rates in Massachusetts and to identify whether trends differed between homeless and housed participants. We also compared Massachusetts data with data from 17 other states and the District of Columbia combined. The percentage of both homeless and housed people entering treatment with Medicaid increased approximately 21% after expansion (P = .01), with an average increase of 5.4% per year over 12 years (P = .01). The increase in coverage was specific to Massachusetts, providing evidence that the MassHealth policy was the cause of this increase. Findings provide evidence in favor of state participation in the Medicaid expansion in January 2014 under the Affordable Care Act and suggest that hard-to-reach vulnerable groups such as substance-abusing homeless adults are as likely as other population groups to benefit from this policy.

  19. Blood Lead Levels of Refugee Children Resettled in Massachusetts, 2000 to 2007

    PubMed Central

    van Wijngaarden, Edwin; Fisher, Susan G.; Korfmacher, Katrina S.; Campbell, James R.; Fernandez, I. Diana; Cochran, Jennifer; Geltman, Paul L.

    2011-01-01

    Objectives. We described elevated blood lead level (BLL; ≥ 10 μg/dL) prevalence among newly arrived refugee children in Massachusetts. We also investigated the incidence of BLL increases and BLLs newly elevated to 20 μg/dL or higher in the year following initial testing, along with associated factors. Methods. We merged data from the Massachusetts Department of Public Health's Refugee and Immigrant Health Program and the Childhood Lead Poisoning Prevention Program on 1148 refugee children younger than 7 years who arrived in Massachusetts from 2000 to 2007. Results. Elevated BLL prevalence was 16% among newly arrived refugee children. The rate ratio for BLL elevation to 20 μg/dL or higher after arrival was 12.3 (95% confidence interval [CI] = 6.2, 24.5) compared with children in communities the state defines as high-risk for childhood lead exposure. Residence in a census tract with older housing (median year built before 1950) was associated with a higher rate of BLL increases after resettlement (hazard ratio = 1.7; 95% CI = 1.2, 2.3). Conclusions. Refugee children are at high risk of lead exposure before and after resettlement in Massachusetts. A national surveillance system of refugee children's BLLs following resettlement would allow more in-depth analysis. PMID:21088268

  20. Looking for the uninsured in Massachusetts? Check opioid dependent persons seeking detoxification.

    PubMed

    Stein, M D; Bailey, G L; Thurmond, P; Paull, N

    2014-03-01

    We examined the rate of uninsurance among persons seeking detoxification at a large drug treatment program in Massachusetts in 2013, five years after insurance mandates. We interviewed three hundred and forty opioid dependent persons admitted for inpatient detoxification in Fall River, Massachusetts. Potential predictors of self-reported insurance status included age, gender, ethnicity, employment, homelessness, years of education, current legal status, and self-perceived health status. Participants mean age was 32 years, 71% were male, and 87% were non-Hispanic Caucasian. Twenty-three percent were uninsured. In the multivariate model, the odds of being uninsured was positively associated with years of education (OR=1.22, 95% CI=1.03; 1.46, p<.05), higher among males than females (OR=2.63, 95% CI=1.33; 5.20, p<.01), and inversely associated with age (OR=0.94, 95% CI=0.90; 0.98, p<.01). Opioid dependent persons recruited from a detoxification program in Massachusetts are uninsured at rates far above the state average. With the arrival of the Affordable Care Act, drug treatment programs in Massachusetts and nationally will be important sites to target to expand health coverage. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Race Differences in Mental Health Service Access in a Secure Male Juvenile Justice Facility

    ERIC Educational Resources Information Center

    Dalton, Richard F.; Evans, Lisa J.; Cruise, Keith R.; Feinstein, Ronald A.; Kendrick, Rhonda F.

    2009-01-01

    This study examined whether African American and Caucasian male youths had similar rates of referral to mental health services in a juvenile justice secure facility when controlling for differences obtained in the initial screening and assessment process. Data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Initial Health Care…

  2. Race Differences in Mental Health Service Access in a Secure Male Juvenile Justice Facility

    ERIC Educational Resources Information Center

    Dalton, Richard F.; Evans, Lisa J.; Cruise, Keith R.; Feinstein, Ronald A.; Kendrick, Rhonda F.

    2009-01-01

    This study examined whether African American and Caucasian male youths had similar rates of referral to mental health services in a juvenile justice secure facility when controlling for differences obtained in the initial screening and assessment process. Data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Initial Health Care…

  3. The Cost and Quality of Full-Day Year-Round Early Care and Education in Massachusetts: Infant and Toddler Classrooms

    ERIC Educational Resources Information Center

    Marshall, Nancy L.; Creps, Cindy L.; Burstein, Nancy R.; Roberts, Joanne; Glantz, Frederic B.; Robeson, Wendy Wagner

    2004-01-01

    The Massachusetts Cost and Quality Study assessed the quality and costs of early care and education services in Massachusetts, the relationship between quality and costs, and the relationship between the family income of children served and the quality of care provided by early care and education programs. This report presents the findings from…

  4. Balancing Quality Early Education and Parents' Workforce Success: Insights from the Urban Institute's Assessment of the Massachusetts Subsidized Child Care System. Research Report

    ERIC Educational Resources Information Center

    Adams, Gina; Katz, Michael

    2015-01-01

    This report examines the Massachusetts child care subsidy system's balance between providing quality early childhood education and providing workforce support for parents. It is based on qualitative and quantitative data and findings from several studies conducted as part of a legislatively mandated assessment of the Massachusetts subsidized child…

  5. Health communication in primary health care -a case study of ICT development for health promotion.

    PubMed

    Mahmud, Amina Jama; Olander, Ewy; Eriksén, Sara; Haglund, Bo Ja

    2013-01-30

    Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate

  6. Health communication in primary health care -A case study of ICT development for health promotion

    PubMed Central

    2013-01-01

    Background Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health

  7. Defining Workplace Literacy Education in Massachusetts. A Survey of Workplace Literacy Education Programs in Massachusetts, Conducted in September and October 1989.

    ERIC Educational Resources Information Center

    Rosen, David J.; Kale, Cerci

    A survey of 42 Massachusetts workplace literacy programs was conducted in fall 1989 to determine whether the programs generally fit a standard definition of workplace literacy derived from "A Guide to Developing Instruction for Workforce Literacy Programs" by Jorie W. Philippi. The study's seven-item questionnaire included the definition…

  8. A Path Analysis of Factors Influencing Racial Differences on the Massachusetts Youth Screening Instrument-Version 2

    ERIC Educational Resources Information Center

    McCoy, Henrika

    2011-01-01

    Thousands of juveniles with mental health disorders enter the juvenile justice system every year. The Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) is often used to assess them. The disproportionate numbers of African American youth in the juvenile justice system and the large numbers of youth with mental health needs necessitate…

  9. A Path Analysis of Factors Influencing Racial Differences on the Massachusetts Youth Screening Instrument-Version 2

    ERIC Educational Resources Information Center

    McCoy, Henrika

    2011-01-01

    Thousands of juveniles with mental health disorders enter the juvenile justice system every year. The Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) is often used to assess them. The disproportionate numbers of African American youth in the juvenile justice system and the large numbers of youth with mental health needs necessitate…

  10. A future without health? Health dimension in global scenario studies.

    PubMed Central

    Martens, Pim; Huynen, Maud

    2003-01-01

    This paper reviews the health dimension and sociocultural, economic, and ecological determinants of health in existing global scenario studies. Not even half of the 31 scenarios reviewed gave a good description of future health developments and the different scenario studies did not handle health in a consistent way. Most of the global driving forces of health are addressed adequately in the selected scenarios, however, and it therefore would have been possible to describe the future developments in health as an outcome of these multiple driving forces. To provide examples on how future health can be incorporated in existing scenarios, we linked the sociocultural, economic, and environmental developments described in three sets of scenarios (special report on emission scenarios (SRES), global environmental outlook-3 (GEO3), and world water scenarios (WWS)) to three potential, but imaginary, health futures ("age of emerging infectious diseases", "age of medical technology", and "age of sustained health"). This paper provides useful insights into how to deal with future health in scenarios and shows that a comprehensive picture of future health evolves when all important driving forces and pressures are taken into account. PMID:14997242

  11. Walden Pond, Massachusetts: Environmental Setting and Current Investigations

    USGS Publications Warehouse

    Colman, John A.; Waldron, Marcus C.

    1998-01-01

    as plant nutrients, organic matter, and soil are leached and eroded from the surrounding watershed. This process is known as eutrophication. The term 'cultural eutrophication' refers to an accelerated form of the natural process in which extra soil and nutrients are derived from people's use of fertilizer, rerouting of surface drainage, and disposal of domestic and industrial waste. Cultural eutrophication can lead to excessive growth of aquatic plants, pond filling by decayed plants and eroded soils, reduced water clarity, and depletion of dissolved oxygen in deep water with subsequent loss of cold-water fish habitat. In order to document the longterm ecological health of Walden Pond, the U.S. Geological Survey (USGS), working in cooperation with the Massachusetts Department of Environmental Management (MDEM), is investigating factors that could contribute to cultural eutrophication of Walden. Through measurements of mass balance of nutrients and oxygen in the pond's deep water, the investigation will establish a baseline data set on Walden's trophic state, which is a measure of the pond's ability to support plant growth. The baseline data will be used to detect trends and give early warning of trophic changes or trophic response to pond remediation projects. This Fact Sheet provides background information on the environmental setting, limnological features, and cultural eutrophication of Walden Pond, and describes the joint USGS/MDEM study.

  12. Elementary Particle Physics Experiment at the University of Massachusetts, Amherst

    SciTech Connect

    Brau, Benjamin; Dallapiccola, Carlo; Willocq, Stephane

    2013-07-30

    In this progress report we summarize the activities of the University of Massachusetts- Amherst group for the three years of this research project. We are fully engaged in research at the energy frontier with the ATLAS experiment at the CERN Large Hadron Collider. We have made leading contributions in software development and performance studies for the ATLAS Muon Spectrometer, as well as on physics analysis with an emphasis on Standard Model measurements and searches for physics beyond the Standard Model. In addition, we have increased our contributions to the Muon Spectrometer New Small Wheel upgrade project.

  13. High-resolution geophysical data from the sea floor surrounding the Western Elizabeth Islands, Massachusetts

    USGS Publications Warehouse

    Pendleton, Elizabeth A.; Twichell, David C.; Foster, David S.; Worley, Charles R.; Irwin, Barry J.; Danforth, William W.

    2011-01-01

    Geophysical and geospatial data were collected in the nearshore area surrounding the western Elizabeth Islands, Massachusetts on the U.S. Geological Survey research vessel Rafael during September 2010 in a collaborative effort between the U.S. Geological Survey and the Massachusetts, Office of Coastal Zone Management. This report describes the results of the short-term goals of this collaborative effort, which were to map the geology of the inner shelf zone of the western Elizabeth Islands and study the geologic processes that have contributed to its evolution. Data collected during the survey include: Bathymetric and sidescan-sonar data, chirp seismic-reflection data , sound velocity profiles, and navigation data. The long-term goals of this project are to provide high-resolution geophysical data that will support research on the influence of sea-level change and sediment supply on coastal evolution and inventory subtidal marine habitat type and distribution within the coastal zone of Massachusetts.

  14. Evolution of Massachusetts Physician Attitudes, Knowledge, and Experience Regarding the Use of Antiretrovirals for HIV Prevention

    PubMed Central

    White, Jaclyn M.; Mimiaga, Matthew J.; Krakower, Douglas S.

    2012-01-01

    Abstract The Center for the AIDS Programme of Research in South Africa (CAPRISA) 004 and Pre-exposure Prophylaxis Initiative (iPrEx) studies demonstrated that topical or oral chemoprophylaxis could decrease HIV transmission. Yet to have an appreciable public health impact, physicians will need to be educated about these new HIV prevention modalities. Massachusetts physicians were recruited via e-mail to complete an online survey of their knowledge and use of HIV prevention interventions. Data were collected before (July–December, 2010) (n=178) and after (December, 2010–April, 2011) (n=115) the release of iPrEx data. Over the two time intervals, knowledge of oral PrEP significantly increased (79% to 92%, p<0.01), whereas knowledge about topical microbicides was already high (89% pre-iPrEx). Post-iPrEx, specialists were more knowledgeable about oral PrEP (p<0.01) and topical microbicides (p<0.001) than generalists. The majority of the respondents would prefer to prescribe topical microbicides (75%) than oral PrEP (25%; p<0.001), primarily because they perceived fewer side effects (95%). Respondents indicated that PrEP should be available if it were a highly effective, daily pill; however, ongoing concerns included: potential drug resistance (93%), decreased funds for other forms of HIV prevention (88%), medication side effects (83%), and limited data regarding PrEP's clinical efficacy (75%). Participants indicated that formal CDC guidelines would have the greatest impact on their willingness to prescribe PrEP (96%). Among Massachusetts physicians sampled, chemoprophylaxis knowledge was high, but current experience was limited. Although topical gel was preferred, responses suggest a willingness to adapt practices pending additional efficacy data and further guidance from normative bodies. Educational programs aimed at incorporating antiretroviral chemoprophylaxis into physicians' HIV prevention practices are warranted. PMID:22694239

  15. Smoke and mirrors: how Massachusetts diverted millions in tobacco tax revenues

    PubMed Central

    Ritch, W.; Begay, M.

    2001-01-01

    OBJECTIVE—This study examines the politics of appropriating Question 1 tobacco tax revenues in the first budget year after Massachusetts voters passed the ballot initiative in 1992. The initiative increased the tobacco tax on cigarettes by 25 cents per pack and on smokeless tobacco by 25% of the wholesale price.
METHODS—Data were collected from newspapers, letters, memoranda, budgets, press releases, legislative floor debates, government documents, legislative journals, personal interviews, and tobacco industry documents that were downloaded from the Tobacco Archives internet site.
RESULTS—During the first budget year, programmes mentioned by the initiative that were not exclusively tobacco related accounted for 27% of total Question 1 expenditures, while 50% of the revenues were allocated for programmes that were neither mentioned by the initiative nor provided any tobacco education, prevention, and cessation services. Only 23% of Question 1 funds were appropriated for programmes that provided exclusively tobacco education, prevention, and cessation services. Question 1 revenues were also used to supplant funding for pre-existing programmes, which was explicitly prohibited by the initiative. The first budget year became the template for Question 1 appropriations in subsequent fiscal years.
CONCLUSION—Politics did not end after voters passed Question 1. Public health advocates lacked a strategy and budget plan to influence the appropriation of Question 1 funds after the passage of this ballot initiative.


Keywords: Massachusetts; Question 1; tobacco tax PMID:11740020

  16. Implementation of a siting methodology for utility size WECS in western Massachusetts and northwestern Connecticut

    SciTech Connect

    Kirchhoff, R.H.; Kaminsky, F.C.

    1981-01-01

    This paper describes a long term research project by Northeast Utilities and the University of Massachusetts to identify candidate sites for utility size wind energy systems in Western Massachusetts and Northwestern Connecticut. A generalized methodology is described for identifying the candidate sites. This methodology includes the use of biological wind prospecting, data collection with TALA kites, computerized wind mapping with MATHEW, and the installation of long run data collection stations. This paper also describes the use of a mass consistent flow model known as MATHEW in developing computerized wind maps for selected regions of the area under study.

  17. Fiscal year 1987 program report (Massachusetts Water Resources Research Center). Annual report

    SciTech Connect

    Godfrey, P.J.

    1988-12-01

    The 1987-88 Massachusetts WRRC program (Federal FY87) focused on areas of high priority for the state and region: acid-deposition impacts, minimization of nitrate ground-water contamination, drinking water pricing, and proposed water diversion from a 'Wild and Scenic' river. The Water Resources Institute Program (WRIP) projects studied central Massachusetts cloud and fog acidity, peat use in rural sewage systems to minimize nitrate ground-water contamination, and determination of true water costs to help plan new sources or infrastructure renovation.

  18. Continuing the Creativity and Connections: The Massachusetts Initiative to Update the Nurse of the Future Nursing Core Competencies.

    PubMed

    Sroczynski, Maureen; Conlin, Genevieve; Costello, Eileen; Crombie, Patricia; Hanley, Diane; Tobin, Marie; Welsh, Diane

    This article describes the collaborative effort of nursing education and practice to update the Massachusetts Nurse of the Future Nursing Core Competencies. The Nurse of the Future Nursing Core Competencies were published in 2010. With the establishment of the Massachusetts Action Coalition, a primary goal was to continue to promote the integration of these competencies into all education and practice settings throughout Massachusetts and share this process with other states. Through an updated literature review and consultation with subject matter experts, the Nurse of the Future Competency Committee developed a process to ensure that significant practice advances were reflected in each of the competencies. The updated Nurse of the Future Nursing Core Competencies were published in March 2016. The updated competencies capture the knowledge, attitudes, and skills needed for all nurses to create a culture of health across the continuum of health care.

  19. Hospital Differences in Cesarean Deliveries in Massachusetts (US) 2004–2006: The Case against Case-Mix Artifact

    PubMed Central

    Cáceres, Isabel A.; Arcaya, Mariana; Declercq, Eugene; Belanoff, Candice M.; Janakiraman, Vanitha; Cohen, Bruce; Ecker, Jeffrey; Smith, Lauren A.; Subramanian, S. V.

    2013-01-01

    Objective We examined the extent to which differences in hospital-level cesarean delivery rates in Massachusetts were attributable to hospital-level, rather than maternal, characteristics. Methods Birth certificate and maternal in-patient hospital discharge records for 2004–06 in Massachusetts were linked. The study population was nulliparous, term, singleton, and vertex births (NTSV) (n = 80,371) in 49 hospitals. Covariates included mother's age, race/ethnicity, education, infant birth weight, gestational age, labor induction (yes/no), hospital shift at time of birth, and preexisting health conditions. We estimated multilevel logistic regression models to assess the likelihood of a cesarean delivery Results Overall, among women with NTSV births, 26.5% births were cesarean, with a range of 14% to 38.3% across hospitals. In unadjusted models, the between-hospital variance was 0.103 (SE 0.022); adjusting for demographic, socioeconomic and preexisting medical conditions did not reduce any hospital-level variation 0.108 (SE 0.023). Conclusion Even after adjusting for both socio-demographic and clinical factors, the chance of a cesarean delivery for NTSV pregnancies varied according to hospital, suggesting the importance of hospital practices and culture in determining a hospital's cesarean rate. PMID:23526952

  20. Massachusetts Inpatient Medicaid Cost Response to Increased Supplemental Nutrition Assistance Program Benefits.

    PubMed

    Sonik, Rajan Anthony

    2016-03-01

    To investigate the impact of an increase in Supplemental Nutrition Assistance Program (SNAP) benefits on Medicaid costs and use in Massachusetts. Using single and multigroup interrupted time series models, I examined the effect of an April 2009 increase in SNAP benefits on inpatient Medicaid cost and use patterns. I analyzed monthly Medicaid discharge data from 2006 to 2012 collected by the Massachusetts Center for Health Information and Analysis. Inpatient costs for the overall Massachusetts Medicaid population grew by 0.55 percentage points per month (P < .001) before the SNAP increase. After the increase, cost growth fell by 73% to 0.15 percentage points per month (-0.40; P = .003). Compared with the overall Medicaid population, cost growth for people with the selected chronic illnesses was significantly greater before the SNAP increase, as was the decline in growth afterward. Reduced hospital admissions after the SNAP increase drove the cost declines. Medicaid cost growth fell in Massachusetts after SNAP benefits increased, especially for people with chronic illnesses with high sensitivity to food insecurity.