Middle Atlantic States Research Articles

Legislative interventions to increase access to screening mammography.

Although numerous studies have established that breast cancer mortality can be significantly reduced through early detection, only a small percentage of women obtain screening mammograms at intervals recommended by the National Cancer Institute, the American Cancer Society, and other major medical organizations. This paper examines the importance of cost as a barrier to routine screening and the state legislative movement to make screening mammography a basic health insurance benefit. Mammography "knowledge, attitudes, and behavior" studies offer conflicting findings on the extent to which cost enters into the decision to have a mammogram. Women seldom report cost as a major reason for postponing or failing to have a mammogram; yet, descriptive studies show a consistently positive relationship between income and mammography use. State mammography reimbursement laws vary greatly with respect to whether screening mammography is a required or optional benefit, payment limits, and eligibility and referral requirements. Although state-specific data on the percentage of women with private health insurance are not available, 1987 National Medical Expenditure Survey estimates for U.S. Census geographic divisions suggest that the New England, East North Central, West North Central, Middle Atlantic, and Mountain states have the highest percentages of women who are privately-insured and, thus, potentially eligible for legislated mammography benefits. Access to screening mammography also is likely to be influenced by the proportion of employer-sponsored health plans that are self-insured and, therefore, exempt from minimum benefit mandates and the extent to which women are aware of the screening coverage.

Dietary counseling of hypercholesterolemic patients by internal medicine residents.

To assess the knowledge, attitudes, and practices of internal medicine residents concerning dietary counseling for hypercholesterolemic patients. Cross-sectional, self-administered questionnaire survey. Survey conducted August 1989 in seven internal medicine residency programs in four southeastern and middle Atlantic states. All 130 internal medicine residents who were actively participating in outpatient continuity clinic. None. Only 32% of the residents felt prepared to provide effective dietary counseling, and only 25% felt successful in helping patients change their diets. Residents had good scientific knowledge, but the degree of practical knowledge about dietary facts varied. Residents reported giving dietary counseling to 58% of their hypercholesterolemic patients and educational materials to only 35%. Residents who felt more self-confident and prepared to counsel reported more frequent use of effective behavior modification techniques in counseling. Forty-three percent of residents had received no training in dietary counseling skills during medical school or residency. Internal medicine residents know much more about the rationale for treatment for hypercholesterolemia than about the practical aspects of dietary therapy, and they feel ineffective and ill-prepared to provide dietary counseling to patients.

Similarity analysis of hydroid assemblages along a latitudinal gradient in the western North Atlantic

Shallow-water (0–100 m depth) hydroid faunas reported from 26 locations along the western North Atlantic coast between the high Canadian Arctic archipelago and the Caribbean Sea were compared. Species numbers varied widely between locations, but were highest in the tropics and subtropics, lowest in arctic and subarctic waters, and intermediate in mid-latitudes. Percentages of species producing free medusae were lowest in high latitudes, intermediate in low latitudes, and highest in mid-latitudes (especially in estuaries). In a numerical analysis, similar hydroid faunas were identified at locations (i) between the high Canadian Arctic islands and the Strait of Belle Isle off western Newfoundland; (ii) between the Gulf of St. Lawrence and Chesapeake Bay; (iii) between North Carolina and southeastern Florida (south as far as St. Lucie Inlet), and including the northern Gulf of Mexico; (iv) in the Caribbean Sea, together with Dry Tortugas and the oceanic island of Bermuda. The greatest change in hydroid species composition along the coast appeared to occur around Cape Hatteras. An assemblage on the continental shelf off the middle Atlantic states of the United States appeared to be distinct because of its low hydroid diversity. Faunistically, however, its affinities were decidedly with assemblages at locations between the Gulf of St. Lawrence and Chesapeake Bay. In addition to latitudinal changes in faunal composition, dissimilarities in hydroid species assemblages were noted between certain inshore and offshore locations at comparable latitudes. Numerical classification of locations provides additional evidence for delineation of biogeographic regions along the western North Atlantic coast.

Geographic variation in the use of breast-conserving treatment for breast cancer.

In the past decade there has been an increase in the use of treatment designed to conserve the breast for women with breast cancer. The extent to which such treatment has been adopted in various regions of the country and whether characteristics of hospitals and patients predict its use is not known, however. We used national data on Medicare claims for inpatient care provided in 1986 to study 36,982 women 65 to 79 years of age, who had local or regional breast cancer and underwent either mastectomy or breast-conserving treatment (local excision, quadrantectomy, or subtotal mastectomy). Information about the hospitals at which these women were treated was obtained from an American Hospital Association survey. Of the 36,982 women, 12.1 percent had breast-conserving surgery and 87.9 percent had a mastectomy. The frequency of breast-conserving surgery ranged from 3.5 percent to 21.2 percent in various states. The highest rate of use was in the Middle Atlantic states (20.0 percent) and New England (17.2 percent), and the lowest was in the East South Central states (5.9 percent) and the West South Central states (7.3 percent). Breast-conserving treatment was used more often in urban than in rural areas, in teaching hospitals than in nonteaching hospitals, in large hospitals than in small hospitals, and in hospitals with on-site radiation therapy or geriatric services than in others. Most of the geographic variation persisted after adjustment for the characteristics of hospitals and patients for which data were available. There is substantial geographic variation in the use of breast-conserving surgery, which cannot be explained by differences in hospital characteristics. Hospital characteristics that were independently redictive of greater use of breast-conserving surgery were the size of the metropolitan area, the status of the institution as a teaching hospital, and the availability of radiation therapy and geriatric services.

Relations among Moral Reasoning, Locus of Control, and Demographic Variables among College Students

This study was conducted to examine the relationships among Rest's Defining Issues Test, Rotter's Internal-External Locus of Control Scale, and demographic variables. 205 undergraduates from two secular universities and one religious liberal arts college from the Middle Atlantic states were given the Defining Issues Test, the Internal-External Locus of Control Scale, and a demographic questionnaire. The Pearson correlations indicated significant associations between the Defining Issues Test scored for percentage of principled reasoning about moral dilemmas and five demographic variables. Analysis of variance indicated significant differences between the group means for the Defining Issues Test scores on three demographic variables and between the group means for the Internal-External Locus of Control Scale scores on two demographic variables. A stepwise multiple regression analysis using five variables predicted a significant amount of the variance (25%) in the Defining Issues Test scores and two variables that predicted a significant amount of the variance (7%) in the Internal-External Locus of Control Scale scores. The Defining Issues Test is both a developmental and cognitive measure. In addition, the Internal-External Locus of Control Scale scores showed a significant relationship with religious affiliation and with Defining Issues Test scores.

A method to mitigate acid-mine drainage in the Shamokin area, Pennsylvania, U.S.A.

The three anthracite coal fields of eastern Pennsylvania occur in large synclinal basins surrounded by sandstone hogback ridges. The streams draining the coal regions are heavily contaminated by sulfuric acid due to the weathering of pyrite in the abandoned mines and culm. Dams could be built in the water gaps of the streams leaving the basins, forming huge reservoirs. For example, in the western part of the Middle Coal Field (Shamokin-Mt. Carmel area), the construction of four dams would form a reservoir that would inundate practically all the culm banks, abandoned mines, and environmentally abused lands in this coal field. The reservoir (at approximately 410 m elevation) would be approximately 140 sq km in area and could be the source of water for pumped-storage hydroelectricity generation. The water should have moderately good quality and could serve the recreational needs of a vast population of the Middle Atlantic states.

Regional Variation in Hip Fracture: Is It due to Increased Milk Consumption in the North, 50 Years Ago?

In Reply.— Dr Bierlein makes a good point that the decreased incidence of hip fracture in the North is striking, with historical milk and milk product consumption providing an attractive etiologic hypothesis. As we mentioned, however, good data with which to test this hypothesis are, to our knowledge, lacking. We have, however, been able to locate state-specific milk production data dating back to 1909. 1 These data show that of an estimated 7.5 million gallons of milk produced, 3.2 million gallons was produced in the East North Central and West North Central census divisions, and an additional 1.3 million gallons was produced in the Middle Atlantic states. The South Atlantic, East South Central, and West South Central combined to produce an estimated 1.5 million gallons of milk. While these data are suggestive, the association is tenuous at best. Data on milk production may not necessarily reflect milk consumption. For example,

Black and white speech in the southern United States. Evidence from the Linguistic Atlas of the Middle and South Atlantic States. By George Townsend Dorrill

Black and white speech in the southern United States. Evidence from the Linguistic Atlas of the Middle and South Atlantic States. By George Townsend Dorrill

Demersal fish and decapod crustacean fauna of the upper continental slope off Nova Scotia from LaHave to St. Pierre Banks

Four 200-m depth strata were sampled for fish and decapod crustaceans on the upper continental slope (400–1200 m) off Nova Scotia. There was more-or-less continuous replacement of fish fauna with depth. Numerically dominant fishes in the upper two strata (< 800 m) were Sebastes spp., Phycis chesteri, and Glyptocephalus cynoglossus. Predominant fishes in the lower two strata (> 800 m) were Centroscyllium fabricii, Synaphobranchus kaupii, and Coryphaenoides rupestris. Nezumia bairdii was relatively abundant throughout the depth range sampled. The ichthyofauna of the upper slope was similar to that off the Middle Atlantic States and off Newfoundland at comparable depths, but qualitative differences existed in losses of some and additions of other species. Dominant decapod crustaceans in the shallowest stratum (200–400 m) were Pontophilus norvegicus, Plesiopenaeus edwardsianus, and Panalus propinquus. This stratum appeared to be a transition zone between shelf and slope decapod faunas. More species occurred and at higher densities in the deeper strata; predominant were Acanthephyra spp., Pasiphaea tarda, Metacrangon jacqueti, and Sabinea hystrix. The decapod fauna off Nova Scotia is similar to that of the mid-Atlantic Bight but less diverse.

Meteorological analyses of the March 1888 “Blizzard of '88”

Meteorological analyses of the legendary March 11–14, 1888, “Blizzard of '88” are reconstructed from original surface weather observations. The analyses depict the meteorological evolution of the blizzard, which devastated much of the northeastern United States with 25–125‐cm snowfall accumulations over a 1–3‐day period, high winds, and bitter cold. As shown by the surface weather charts, the storm was associated with a slow‐moving cyclone that moved northeastward from the Carolinas to near New England and then performed a loop near southern New England before moving east over the Atlantic Ocean. The interaction of the cyclone with a stationary front that extended from the storm center northward through central New England, separating cool, moist maritime air over eastern New England from very cold Canadian air over western New England and the Middle Atlantic states, may have been crucial for the development of heavy snowfall. Since weather forecasters in 1888 were taken by surprise by the development of the storm, speculations are offered whether the advancements in weather prediction techniques and the generation of computer technology that have taken place over the century following the storm could be successful in forecasting a similar event today.

Planting Date in Relation to Yield and Yield Components of Wheat in the Middle Atlantic Region

AbstractA 2‐yr study was conducted to assess the effects of early and late planting on six soft red winter wheat (Triticum aestivum L.) cultivars. The purpose was to determine if increased flexibility in planting date is possible for modern wheat cultivars grown in the Middle Atlantic states. Wheat was planted 2 wk prior to, on, and 2 wk after the recommended fly‐free planting date at Clarksville (Piedmont Province) and Queenstown (Coastal Plain Province), MD. Grain yield and yield components (spikes per square meter, kernels per spike, and kernel weight) were measured. Planting date × location, and planting date × location × year interactions for grain yield occurred. At Clarksville, there were no significant differences in average grain yield among planting dates the first year, whereas a significant and progressive decline in average grain yield occurred with each delay in planting the second year. At Queenstown, early planted wheat produced a higher grain yield than wheat planted on the recommended and late planting dates the first year, whereas early planted wheat yielded less than wheat seeded on subsequent planting dates the second year. In general, changes in spikes per square meter were the major contributors to the yield differences observed among planting dates at both locations. Individual cultivars were variable in yield performance on the different planting dates. Although there was considerable environmental variation in crop performance, increased flexibility in planting date for winter wheat production in the Middle Atlantic states may be possible for certain wheat cultivars. Cultivar and environmental factors will play a large role in determining the success of such a change in current management practices.

Political Culture and the Pattern of Congressional Politics Under the Articles of Confederation

This article brings a broad tradition of sociocultural analysis, commonly identified with Louis Hartz, Bernard Bailyn, Seymour Martin Lipset, and Daniel J. Elazar, to bear in understanding the pattern and character of congressional politics in the first American national government. This approach, centering on the study of political culture and the role of ideas in shaping the performance of institutions, attempts to place values, or conflicts between alternative value systems, at the heart of discussions of political development and change in Revolutionary America. I deploy both traditional historical argument and quantitative evidence to demonstrate that the three political subcultures described by Elazar-moralistic in New England, individualistic in the Middle Atlantic states, and traditionalistic in the South-provide the basis for an explanation of factional divisions which appeared in the Congress of the Articles of Confederation.

Land and Liberty in American Civil Society

Americans have relied upon freehold land ownership as one of the bases for maintaining individual liberty, adapting different forms of land ownership to that end under different circumstances as the economy, settlement patterns, and general environment have changed through four successive frontier stages of American history. This article identifies the relationship between each frontier stage and prevailing patterns of land ownership as they relate to the maintenance of liberty. These patterns are further delineated by the different political subcultural groupings within the United States, beginning with the distinctive forms of land ownership and organization in New England, the Middle Atlantic states, the South, and the Spanish Southwest. The first three patterns have applied across the American continent, while the fourth has had to find means to survive within the dominant Anglo pattern that invaded the territory covered by the Spanish system. The article notes the relationship between these patterns and federal and state land law and the parallels between those patterns and the biblical approach to land organization and control. It also notes the special importance of land ownership and organization in a polity organized around the principles of territorial democracy.

Descriptive epidemiology from an epizootic of raccoon rabies in the Middle Atlantic States, 1982-1983.

During 1982 and 1983, the Centers for Disease Control and cooperating Middle Atlantic States and local health departments collected data on 1,610 raccoons that were submitted for rabies testing and on 133 persons who received rabies postexposure prophylaxis as a result of exposure to wild animals. Raccoons were found most commonly in yards and residential areas. Raccoons that were killed by private citizens, animal-control personnel, or dogs had the highest positivity rate (70%), and those that were trapped had the lowest (9%). Raccoons that were found during the day or that exhibited abnormal behavior and those that had interacted with a domestic animal were more likely to be rabid. Examination of the data on human exposure disclosed that many exposures could have been avoided or prevented. Almost 50% of postexposure treatments were administered to persons whose actual risk of exposure was low or nonexistent.

Wild Orchids of the Middle Atlantic States.

Wild Orchids of the Middle Atlantic States.

Review of Dorrill (1986): Black and White Speech in the Southern United States. Evidence from the Middle and South Atlantic States

Review of Dorrill (1986): Black and White Speech in the Southern United States. Evidence from the Middle and South Atlantic States

A Note on Armillaria mellea and Armillaria bulbosa from the Middle Atlantic States

Click to increase image sizeClick to decrease image sizeKey Words: Armillaria melleaArmillaria bulbosamorphology

The Linguistic Atlas of the North-Central States: Basic Materials. Microfilm MSS on Cultural Anthropology, 38.200-208. Chicago: Joseph Regenstein Library, University of Chicago. 1976-78. The Linguistic Atlas of the Middle and South Atlantic States and Affiliated Projects: Basic Materials. Microfilm MSS on Cultural Anthropology, 68.360-64, 69.365-369, 71.375-380. Chicago: Joseph Regenstein Library, University of Chicago. 1982-86

The Linguistic Atlas of the North-Central States: Basic Materials. Microfilm MSS on Cultural Anthropology, 38.200-208. Chicago: Joseph Regenstein Library, University of Chicago. 1976-78. The Linguistic Atlas of the Middle and South Atlantic States and Affiliated Projects: Basic Materials. Microfilm MSS on Cultural Anthropology, 68.360-64, 69.365-369, 71.375-380. Chicago: Joseph Regenstein Library, University of Chicago. 1982-86

Names Not on the Map

References Linguistic Atlas of the Middle and South Atlantic States. Ed. Raven I. McDavid, Jr., et al. Chicago: Univ. of Chicago Press, 1980ff. Powell,William S. The North Carolina Gazetteer. Chapel Hill, N.C.: Univ. of North Carolina Press,1976.

Organic Facies and Petroleum Potential of Eastern North American Margin: ABSTRACT

Sufficient data now exist to permit reconstruction of the organic facies for Late Jurassic and middle Cretaceous times when the potential for source rock deposition was greatest on the eastern margin of North America. Three distinct and one mixed organic facies have been mapped for these 2 geologic intervals: facies B (oil-prone) amorphous organic material plus alginite and exinite deposited under marine anoxic conditions, facies C (gas-prone) terrestrial plant debris deposited in mildly oxic environments, facies B-C (waxy oils and gas condensate) mixed facies, and facies D (nonsource) degraded and/or recycled organic material. Distribution of the Late Jurassic organic facies was greatly influenced by the relatively arid subtropical climate and the shelf-edge carbonate End_Page 289------------------------------ bank and reef that existed along most of the margin. Facies C and D are common on the shelf, C being particularly significant on and seaward of Late Jurassic deltas. Two submarine-fan complexes formed off present Nova Scotia and the Middle Atlantic states. Seasonal upwelling plus fan development produced mixed B-C and C facies along the margin. Facies D dominated the deep basin. The middle Cretaceous organic facies reflect profoundly changed conditions from those that existed in the Late Jurassic. The continent had a warm, humid, temperate-tropical climate producing abundant vegetation. Ancestral rivers carried large volumes of detrital plant material to the sea. Thus, facies C is virtually ubiquitous except for the inner shelf and isolated parts of the ocean basin. Active reefs and carbonate-bank development at the shelf break was limited to the low latitudes. In the early Cenomanian, a major transgression substantially broadened the shelf and upwelling probably occurred on the middle shelf. Facies B-C is postulated to exist on the upper slope, locally, and in the basin where anoxia prevailed. Exploration targets for oil are the buried carbonate bank and reef and related fore-reef talus deposits. Secondary objectives are interreef channels and their seaward extensions, the upper parts of submarine fans. The shelf and margin basins are dominated by facies C source rocks. In the Late Jurassic, however, locally ideal conditions permitted deposition of facies B source rocks. End_of_Article - Last_Page 290------------