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By: Neal H Cohen, MD, MS, MPH

• Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California

https://profiles.ucsf.edu/neal.cohen

The wells involved were stripper wells with minimal volume and declining production allergy symptoms cat dander buy 18 gm nasonex nasal spray. In your June 29 allergy shots going on vacation 18 gm nasonex nasal spray with mastercard,2013 Fuel-fix article allergy treatment runny nose generic nasonex nasal spray 18 gm overnight delivery, Ethanol follies continue with Domestic and Alternative fuels allergy elimination buy generic nasonex nasal spray 18 gm, you wrote, "Unexpected in 2007, the historic upsurge in domestic oil and natural gas has brought the U. Our country is blessed with diverse and abundant energy sources among which ethanols are making an increasingly significant contribution. In your June 29, 2013 Fuel-fix article, Ethanol follies continue with Domestic and Alternative foels, you wrote, "It is time to repeal the renewable fuel standard -not to expand or entrench this market distortion. Genuine snake oil, in fact, might be a more thermodynamically efficient source than natural gas or com. As you know, recently the President clearly communicated his support for the Renewable Fuel Standard. This work was based on the highest standards of risk assessment and science to ensure the protection of public health and the environment in Texas. Please refer to the footnoted or attached documents when responding to each sub-part of this question. For each sub-part below, please indicate if the statement is inaccurate or accurate, and, if inaccurate, please provide documentation supporting your response: i. You were present at the 2004 meeting ofthe Texas Water Advisory Council referenced in ii. As previously noted, this report could be fairly characterized as a report from state leadership. The calculation procedure referenced in ii was maintained for several more years after 2004. When asked later about this matter, reports indicate that you stated "the decision to continue the subtraction was a good one. Hartnett-White, on August 15, 2017, just days before Hurricane Harvey devastated your home state of Texas, President Trump made an "infrastructure" announcement that included the repeal of the 2015 Federal Flood Risk Management Standard. The rule President Trump repealed would have ensured that federally-funded projects in a floodplain, such as roads, bridges, hospitals, and other infrastructure, are built to withstand extreme weather and flooding driven by climate change. If confirmed, will you support putting back in place a standard for federally-funded infrastructure projects and post-disaster rebuilding that takes into account foreseeable flood risk? You served in the Administration of then-Governor Rick Perry as Chair of the Texas Commission on Environmental Quality. Recently, Secretary Perry stated that fossil fuels can prevent sexual assault in the context of electrifYing African villages. I do agree that adequate lighting can provide a safer environment for the public at large. Between 2000 and 2017 the average number of billion dollar disasters has jumped to nearly 8 per year. Do you still believe that we are not seeing more frequent or more intense weather events? Yes, I do, because the increase in weather-related damages is not due to worsening weather, but rather the rapid increase in prosperity, personal possessions, and infrastructure, especially in our coastal areas. Hurricane Harvey has raised questions about how poor planning and a lack of good floodplain management makes Houston more vulnerable to excessive flooding when it is inundated by large amounts of rainfall. However, I believe we need to ensure that as we develop land and create more impervious surface we need to ensure storm water controls are properly designed to control increased runoff from heavy rain events which can makes these flooding events worse. Regardless of whether you think climate change is caused by human activity or not, is it wise to ignore the impacts of extreme weather and sea level rise when investing federal dollars in infrastructure projects built in floodplains? You state in your paper, Fossil Fuels: the Moral Case, that "environmental quality remains an unaffordable luxury for much of the developing world. Clean air and clean water should not be a luxury but can become unaffordable in some societies, such as third world economies, when the price of energy is too high. Having access to affordable and reliable electricity is necessary to power drinking water and waste water treatment plants. If you are confirmed as the Chair of Council on Environmental Quality, you will be responsible for coordinating federal environmental efforts in the United States with federal agencies to develop environmental and energy policies and initiatives. Therefore, your understanding of the most basic science of climate change science will be essential to your role in the regulation of greenhouse gases. In the first volume of Fourth National Climate Assessment (found here: science20 l7. The last few years have also seen record-breaking, climate-related weather extremes, and the last three years have been the warmest years on record for the globe.

Just as the slaves were enticed from the South in order to allergy symptoms lungs order nasonex nasal spray 18gm on-line stop the aid which they could give to allergy forecast arkansas discount nasonex nasal spray 18gm with mastercard rebels allergy consultants best nasonex nasal spray 18gm, in the same way the land of masters who ran away or were absent aiding the rebellion was seized; and this large body of land was the nucleus of the proposal to allergy symptoms in infants generic 18gm nasonex nasal spray fast delivery furnish forty acres to each emancipated slave family. The scheme was further advanced when Sherman, embarrassed by the number of Negroes who followed him from Atlanta to the sea and gathered around him in Savannah and South Carolina, as a war measure settled them upon the abandoned Sea Islands and the adjacent coast. Confiscated property was in some cases condemned or sold on order of the Federal courts for unpaid taxes, and the title vested in the United States. This land was in Virginia, Georgia, South Carolina, Louisiana, North Carolina, Kentucky and Tennessee. The Bureau intended to divide up this land and allot it to the freedmen and the white refugees, but much of it was tied up with leases, and, after all, despite the large amount, there was never enough to give the freedmen alone an acre apiece. A million acres among a million farmers meant nothing, and from the beginning there was need of from 25 to 50 million acres more if the Negroes were to be installed as peasant farmers. Against any plan of this sort was the settled determination of the planter South to keep the bulk of Negroes as landless laborers and the deep repugnance on the part of Northerners to confiscating individual property. Even Thaddeus Stevens was not able to budge the majority of Northerners from this attitude. Added to this was the disinclination of the United States to add to its huge debt by undertaking any large and costly social adjustments after the war. Motives of this sort may have been in the minds of some Northern whites, but so far as the Negroes were concerned, their demand for a reasonable part of the land on which they had Surprise and ridicule has often It of Negroes for land. On the other hand, to have given each one of the million Negro free families a forty-acre freehold would have made a basis of real democracy in the United States that might easily have transformed the modern world. The law of June 21, i860, opened public land in Alabama, Mississippi, Missouri, Arkansas and Florida; but comparatively few of the freedmen could take advantage of this offer. The Bureau gave some assistance in transporting families, but most of the Negroes had neither stock nor farm implements, and the whites in those localities bitterly opposed their settling. Only about 4,000 families out of nearly four million people acquired homes under this act. General Howard came to Charleston to make arrangements, and the story is characteristic "At first," said a witness, "the people hesitated, but soon as the meaning struck them that they must give up their little homes and gardens and work for others, there was a general worked for a quarter of a - murmuring of dissatisfaction. Negroes were dispossessed, the revenue of the Bureau reduced; many schools had to be discontinued. The Bureau became no longer self-supporting and its whole policy was that the "great plantations changed. In December, 1865, the Bureau had 768,590 acres of land; in 1868, there were only 139,644 acres left, and much of this unimproved and For a long time there still persisted the idea that the government was going to make a distribution of land. The rumor was that this was to be made January 1, 1865, and for months before that Negroes all over the South declined to make contracts for work and were accordingly accused of laziness and insubordination. The restoration of the lands not only deprived Negroes in various ways of a clear path toward livelihood, but greatly discouraged them and broke their faith in the United States Government. These disappointments and discouragements did not for a moment stop the individual efforts of exceptional and lucky Negroes to get hold of land, and the cheapness of the land enabled them to make purchases on a considerable scale where they could get hold of a money wage. In South Carolina, the gradual subdivision of the land showed that poor people, colored and white, were slowly getting hold of the divided plantations. Virginia Negroes acquired between 80,000 and 100,000 acres of land during the late sixties and early seventies. There were soon a few prosperous Negro farmers with 400 to 1,000 acres of land and some owners of considerable city property. Georgia Negroes had bought, by 1875, 396,658 acres of land, assessed at $1,263,902, and added to this they had town and city property assessed at $1,203,202. Of Arkansas in 1875, Nordhoff said: "Of the forty thousand Negro voters in the State, it is believed that at least one in twenty owns either a farm, or a house town. After all they to owned in 1870 less than one-tenth of the land which they have possessed, and the wages of nine-tenths of the black were low and seldom paid in cash or with regularity. Wesley gives figures showing annual wages in Southern states to have ranged from $89 to $150 in 1867 and 1868. In every Southern state, the let- South from 1868 ting people to 1876 stressed more and more the anomaly of who had no property vote away the wealth of the rich. The they strongest statement of the case against the black legislature of South Carolina was that they paid almost no taxes upon property, who for the most part had only had the right to hold property since 1866.

Obesity There exists a consistent and persistent increase in the numbers of children and adults that are overweight or obese over the past 40 years allergy medicine prescribed by doctors nasonex nasal spray 18 gm line. The dramatic and consistent increase in obesity may be attributable to allergy medicine for kids under 6 generic nasonex nasal spray 18 gm on-line a decline in price of energy-dense foods allergy symptoms night sweats generic 18gm nasonex nasal spray otc, an increase in price of low-energy allergy symptoms hearing loss purchase 18gm nasonex nasal spray with mastercard, healthful foods, greater access to fast food outlets that offer lowcost, energy dense foods, an increase in sedentary behaviors and a decline in physical activity (McAllister et al. The increase in body weight is not a challenge solely relegated to the United States or other more developed countries, but rather a worldwide occurrence. Because obesity is a global health concern, it was the center of attention for the 1997 World Health Organization Consultation on Obesity (hereafter referred to as consultation). The consultation attracted experts from across the globe and different organizations. The consultation also addressed the growing evidence that obesity is a global concern and is increasing worldwide. Table 1 reflects the trend in prevalence of obesity in the United States by survey1. This percent increases if you include the number of adults who were overweight, bringing the prevalence of overweight and obese adults to 68. In 2013, the southern region of the United States had the highest obesity rates compared to other regions in the U. Additionally, of the top ten states with the highest obesity rates, nine of them call the south, "home" (Levi et al. Obesity is a complex problem explained by many factors including food security and behavioral factors (Campbell, 1991; Kumanyika, 2002). For simplicity and continuity, overweight will be hereafter referred to as "obese". Food Security Access to nutritious foods became an international focus as a result of the world food crisis of 1972. The crisis lasted for two years and called attention to the global inequities of access to nutritious foods. The 1974 World Food Conference brought the issue of food security to the forefront and established that food security consists of three parts: 1) food access, 2) food availability, and 3) food use. Because food access is one component of food security (World Food Summit, 1996; World Health Organization, 2014) researchers began to use "food access" and "food security" (or "food insecurity") interchangeably to describe the availability of foods or a state of hunger. The interest sparked a desire to accurately define food security in such a way that captures the nature of the problem. Many different researchers and experts set out to define "food security" between 1975 and 1996; which resulted in many definitions of the concept. At the conclusion of the World Food Summit of 1996 an additional definition of food security was established. Experts decided that food security exists "when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life". Table 3 is a collection of the numerous definitions of food security and food insecurity that have been identified from 1975 to 1996. Food Access Factors With a number of established operational definitions for food security, the World Health Organization (2014) proposed a definition for food access. Along with the introduction of physical access to the definition of food access, several measures of physical access have emerged. While some studies focus on physical proximity to food outlets (Block, Scribner & DeSalvo, 2004; Dai & Wang, 2011; McCracken, Sage & Sage, 2012), other studies include mode of transportation as well as physical proximity to food outlets (Jiao, Moudon, Ulmer, Hurvitz & Drewnowski, 2012). The use of various measures of physical access suggests that there is no consensus about the operational definition of food access. For simplicity and consistency, I combine the various measures of physical access into one category, environmental factors and economic access measures are categorized as economic factors. As previously mentioned, food security and food access have been used interchangeably in research. The Food, Conservation and Energy Act of 2008 (The 2008 Farm Bill) brought the issues of food access and chronic illness to light on the national stage. With research connecting limited food access for low-income families and the growing prevalence of chronic illnesses among those with limited food access, the bill was to improve access to nutritious foods for lowincome families. Moreover, as a result of no significant reductions in obesity, a body of research aimed to examine the obesity and food access (defined by environmental and economic factors) relationship has emerged (Chou, Grossman & Saffer, 2004; Ver Ploeg, Chang & Lin, 2004; Sturm & Datar, 2005; Powell & Chaloupka, 2011; Sandy, Liu, Ottensmann, Tchernis, Wilson & Ford, 2011; Swinburn, Sacks, Hall, McPherson, Finegood, Moodie & Gortmaker, 2011).

Home weatherization programs operated by the State and some California utilities address the indoor emissions from combustion appliances and the building ventilation system allergy testing back purchase nasonex nasal spray 18 gm on line. In addition allergy symptoms 6 months order nasonex nasal spray 18gm on-line, the Commission is beginning to allergy forecast uk generic nasonex nasal spray 18gm visa consider energy efficiency programs for existing buildings allergy treatment 3 antifungal nasonex nasal spray 18gm with visa. The Commission develops and periodically updates energy efficiency standards for the design and construction of new buildings, appliances, and insulation materials. These minimum ventilation rates are typically met by a mechanical ventilation system that includes duct systems, control systems, and air filters. The minimum ventilation rate based on the number of occupants: "15 cfm per person times the expected number of occupants. However, the expected number of occupants may not be assumed to be less than one half the maximum occupant load for existing purposes in Chapter 10 of the California Building Code. The system and its controls must be capable of: 1) supplying the minimum ventilation rate at all times the building is occupied, and 2) providing one-hour preoccupancy flushing at full occupancy ventilation rates, or at 3 air changes per hour or more. Such control systems have not been widely used in California, and it is not clear how well this requirement has been implemented. For the upcoming 2005 nonresidential Title 24 standards, the Commission required "acceptance testing" of demand control ventilation systems before occupancy, to ensure that the system performs as designed. The Title 24 nonresidential standards also include an option for natural ventilation rather than mechanical ventilation. In 1978, the Commission adopted residential building design standards that required extensive caulking, weatherstripping, and sealing to reduce air infiltration in new low-rise homes. The sealing of duct work not only reduces natural air infiltration, but also unintentional infiltration of pollutant sources from spaces adjacent to the home, such as crawlspaces, garages, vehicle traffic, and local woodburning. Compliance credit for additional reductions in building air leakage reduction can be obtained by wrapping the building shell with an infiltration barrier, but this measure is optional. Specifies minimum opening areas for operable windows, but does not require actual operation window or maintenance of operability. Energy credits for "unusually tighr construction are not allowed unless: 1) air leakage is measured by an approved home energy rater using a blower door test method, 2) additional outdoor air is provided continuously by mechanical ventilation, and 3) combustion appliances such as furnaces and waters heaters that use indoor air for combustion are not installed. The mechanical system may be either an independent system with its own fan, filter, and ductwork, or it may be integrated with a larger central air system. A few other states have already required mechanical ventilation systems for new homes. For example, the State of Washington (2003) adopted the Ventilation and Indoor Air Quality Standard as part of its energy efficiency standards for new home design and construction. This standard requires continuous, whole-house ventilation, and exhaust ventilation by low-noise fans in the bathroom and kitchen. Such strategies may involve weatherlzation and duct sealing in existing buildings, which would affect the levels of indoor-air pollutants produced by indoor pollutant sources such as combustion appliances and building materials and the levels of indoor moisture produced by human activiities and other indoor sources. This no-fee program installs insulation, weather-stripping, caulking, duct sealant, furnaces, and air conditioners as needed in low-income homes, both renter- and owner-occupied. This minimum leakage rate is based on modeling of the amount of leakage typically needed to provide 0. Inspect and test combustion appliances, venting systems, and ductwork, as discussed above under Section 4. New federal buildings such as office buildings and residential buildings must meet federal design standards for energy efficient design, but federal policy has been to comply with local building standards where they are more stringent. Although California energy efficiency standards have long been more stringent than federal standards, the state and federal building ventilation standards are similar, except that new federal standards for new single family homes include mechanical ventilation. These standards are enforced in California by the Manufactured Housing Section of the Department of Housing and Community Development. The formaldehyde emission requirements for wood products are discussed in Section 4. The current standard requires such a whole-house ventilation system and exhaust ventilation for kitchens and bathrooms. However, a large study of newer manufactured hones in the Pacific Northwest found that many homes received much less than 0. Department of Energy is funding research to improve the energy and indoor air quality performance of manufactured housing (Lubliner and Gordon, 1990). Many of these guidelines go beyond current regulatory requirements, but some are eventually incorporated into the regulations of government agencies. Concern has sometimes been expressed regarding the validity and effectiveness of such standards in protecting public health and welfare.

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References:

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