Hypertension affects millions of Americans. Twenty-five years ago, researchers observed that calcium might be inversely related to the development and severity of hypertension. Consequently, several epidemiological, animal, and clinical studies have addressed this potential correlation. Dietary deficiencies or altered calcium metabolism can result in low serum calcium levels. Disturbances in calcium metabolism include increased urinary calcium excretion and abundance of calcium-regulating hormones such as parathyroid hormone and calcitriol. These hormones cause decreases in bone mineral content and increase intracellular calcium in vascular smooth muscle. Increased [Ca2+]i produces contraction and therefore vasoconstriction. Low calcium levels and elevated PTH and calcitriol may also affect blood pressure control by the central and peripheral nervous systems by stimulating the release of norepinephrine (a potent vasoconstrictor) and increasing its post-synaptic effect. Calcium supplementation and/or increased dietary calcium have been used to increase calcium intake. Not all studies have shown a definite inverse correlation between calcium intake and hypertension, however certain patient groups (pregnant women, salt-sensitive hypertensives) clearly benefit from increased calcium intake. Calcium interacts with other nutrients (sodium, potassium, magnesium) in affecting blood pressure. Due to its probable beneficial effects on hypertension, osteoporosis, and other diseases, RDA intake for calcium should be strongly encouraged.

Environmental permitting for transportation projects is complex and time consuming. Communication and sharing of information between permitting agency staff can be inefficient, partially due to staff location in different geographic areas. The establishment of a Multi-Agency Permitting (MAP) Team is a project to demonstrate the advantages of co-locating regulatory staff from multiple agencies in a common office to enhance interpersonal communication and interagency coordination. Effective communication early in project development is key to risk identification and project management and consequently, maintaining the planned schedule and budget. The purpose of the MAP Team is to cooperatively process environmental permits for Washington State Department of Transportation (WSDOT) transportation projects while protecting natural resources in the public interest. Participating agencies hope to demonstrate the efficiency and cost effectiveness of this new concept of focused governmental cooperation. The primary goal is to provide thorough, expedited review of permit applications to ensure that transportation projects are consistent with environmental regulations and agency agreements and policies. Project overview and methodology The State of Washington is investing in strategies intended to streamline environmental regulatory and permit processes. The creation of the MAP Team is one such strategic investment that is designed to demonstrate how WSDOT and regulatory agencies can work together to meet transportation and environmental goals. The MAP Team charter agencies include: WSDOT, Washington State Department of Ecology, Washington Department of Fish and Wildlife, United States Army Corps of Engineers, and King County Department of Development and Environmental Services. MAP Team members are co-located together a minimum of one day a week at the Department of Ecology’s Northwest Regional Office in Bellevue. The MAP Team concept is being tested on approximately 52 transportation projects primarily in western Washington. The MAP Team has been up and running since early November 2003 and is scheduled through June of 2007. After initially defining how to work together, the team began communicating with their customer base in an attempt to make permitting processes more consistent and predictable. The MAP Team has been using this feedback to initiate streamlining opportunities to: define complete application(s), create early project coordination and MAP Team permit processes, identify improvement opportunities within each agency, and to create model business practices that will use existing project experiences to deliver future projects. These investments in early project coordination are being tracked through eight performance measures. The MAP Team model is based on developing a foundation of trust and open communication between a diverse, highly capable group of decision makers from the five agencies. This formula provides an accountable, transparent process that is able to identify risks and opportunities and to address and avoid conflicts early, thereby achieving permit decisions in a predictable and timely manner. Current results To date, the MAP Team has been involved in reviewing permits for over 25 transportation projects. The MAP Team work is being evaluated against a number of performance standards. These include permit processing time, baseline comparisons, agency investments, initiating change, conflict resolution, and meeting customer expectations. Evaluation of these performance standards will be used to determine the success of the MAP Team concept. Recommendations for the future Based on the initial stakeholder feedback from this pilot project, the MAP Team business model appears to be a good investment toward the delivery of transportation improvement projects. Because of this feedback, the MAP Team pilot project, which was to sunset in June 2005, was extended to June 30, 2007. After further evaluation, it is possible that Washington State may institute the MAP Team concept as a permanent business practice with the potential for growth in other transportation, intergovernmental, and private venture applications.