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PubMed2005

Risk factors associated with development of poxvirus lesions in hospitalized California sea lions.

OBJECTIVE: To identify risk factors that may predispose California sea lions (Zalophus californianus) to development of cutaneous poxvirus nodules during hospitalization in a rehabilitation center. DESIGN: Retrospective case-control study. ANIMALS: 90 California sea lions admitted to a rehabilitation center. PROCEDURE: Hospital records of 275 stranded California sea lions admitted to the rehabilitation center between January 1 and December 31, 2002, were reviewed. All California sea lions (n = 18) that developed > or = 1 cutaneous poxvirus nodule during hospitalization were classified as cases. Seventy-two California sea lions that did not develop poxvirus lesions during hospitalization were randomly selected (control group). The frequencies of various exposure factors prior to admission, at admission, and during hospitalization for cases and control sea lions were compared by use of logistic regression. RESULTS: California sea lions that had previously been admitted to the rehabilitation center were 43 times as likely to develop poxvirus lesions as sea lions admitted for the first time; those with high band neutrophil counts (> 0.69 X 10(3) bands/microL) at admission were 20 times less likely to develop poxvirus lesions than sea lions with counts within reference limits. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that sea lions with a history of prior hospitalization or band neutrophil counts within reference limits at admission were more likely to develop poxvirus lesions during hospitalization. Sea lions with histories of hospitalization should be kept in quarantine and infection control measures implemented to help prevent disease transmission to attending personnel and other hospitalized animals.

Animals↗
PubMed2005

California's minority majority and the White face of nursing.

Of the 33 million people in California, the nation's most populous state, minority groups now constitute the majority of the population. Many sources predict that by 2060, the entire country will mirror the diversity of California today. Like the rest of the country, California is experiencing a critical shortage of nurses that is predicted to increase in the coming years, and California's nursing workforce does not represent the racial and ethnic diversity of the state's population as a whole. If the nursing profession is to thrive in the coming years, educators and leaders must create a way to embrace people from diverse ethnicities and cultures. The purposes of this article are to determine whether ethnic minority groups have different success rates in California nursing programs, whether nursing programs with high percentages of diverse students have differing success rates, and to describe the institutional predictors of on-time completion rates, attrition rates, and NCLEX-RN first-time pass rates in California community colleges.

Attitude of Health Personnel↗
PubMed1999

Unequal access to cadaveric kidney transplantation in California based on insurance status.

OBJECTIVE: To assess the impact of insurance status on access to kidney transplantation among California dialysis patients. STUDY SETTING: California Medicare and Medicaid dialysis populations. STUDY DESIGN: All California ESRD dialysis patients under age 65 eligible for Medicare or Medicaid in 1991 (n = 9,102) took part in this cohort analytic study. DATA COLLECTION: Medicare and California Medicaid Program data were matched to the Organ Procurement and Transplantation Network Kidney Wait List files. PRINCIPAL FINDINGS: Only 31.4 percent of California Medicaid dialysis patients were placed on the kidney transplant waiting list compared to 38.8 percent and 45.0 percent of dually eligible Medicate/Medicaid and Medicare patients, respectively. Compared to the Medicaid population, Medicare enrollees were more likely to be placed on the kidney transplant waiting list (adjusted Relative Risk [RR] = 2.10, Confidence Interval [CI] 1.68, 2.62) as were dually eligible patients (RR = 1.54, CI 1.24, 1.91). Once on the waiting list, however, Medicare enrollment did not influence the adjusted median waiting time to acquire a first cadaveric transplant (p > .05). CONCLUSIONS: California dialysis patients excluded from Medicare coverage, who are disproportionately minority, female, and poor, are much less likely to enter the U.S. transplant system. We hypothesize that patient concerns with potential subsequent loss of insurance coverage as well as cultural and educational barriers are possible explanatory factors. Once in the system, however, insurance status does not influence receipt of a cadaveric renal transplant.

Adolescent↗
PubMedDate not supplied

Regression analysis of pesticide use and breast cancer incidence in California Latinas.

An evaluation of pesticide use data and breast cancer incidence rates in California Hispanic females was conducted via a regression analysis. The analysis used 1988-2000 data from the California Cancer Registry, the population-based cancer registry that monitors cancer incidence and mortality in California. It also used pesticide use data from 1970-1988 from the California Department of Pesticide Regulation. California is the leading agricultural state in the United States, and more than a quarter of all pesticides in the United States are applied there. Hispanic (Latina) females are commonly employed in agricultural operations. The authors performed regression analysis of county-level specific pesticide use data (pounds of active ingredients applied) for two classes of pesticides, organochlorines and triazine herbicides, against the breast cancer incidence rates among Latinas, controlling for age, socioeconomic status, and fertility rates, using negative binomial regression models. A total of 23,513 Latinas were diagnosed with breast cancer in California during the years 1988-1999. Risk of breast cancer was positively and significantly associated with age and socioeconomic status, and inversely and significantly associated with fertility levels. With respect to pesticides, breast cancer was positively associated with pounds of the organochlorines methoxychlor (adjusted incidence rate ratio [IRR] for highest quartile = 1.18; confidence interval [CI] = 1.03-1.35) and toxaphene (IRR = 1.16; CI = 1.01-1.34). No significant associations were found for the triazine herbicides atrazine and simazine.

Adult↗
PubMed1966

Voluntary health insurance coverage in California, 1952 to 1963.

More than seven out of every ten of an estimated civilian population of 17.3 million people in California were covered under some form of voluntary health insurance at the close of 1963. Between 1952 and 1963, the number of Californians covered for hospital expenses increased from 5.7 million to 12.3 million; for surgical expenses from 5.4 million to 11.6 million; and for regular medical expenses from 3.0 million to 10.1 million. THE PERCENTAGE COVERED BY HEALTH INSURANCE ALSO ROSE SIGNIFICANTLY: for hospitalization, from 51.3 to 71.0 per cent; for surgical, from 48.2 to 67.1 per cent; and for regular medical from 27.2 to 57.9 per cent. The rate of increase in hospitalization coverage was slightly higher in California than in the total U.S.; however, the per cent of persons covered remains lower. For surgical coverage, both the rate of increase and the per cent covered are lower in California. For regular medical, growth rates in California and in the U.S. were similar, however the over-all per cent covered is significantly higher in California. Major medical coverage, which has shown the fastest growth rate, covered only 0.4 per cent of the U.S. population in 1952 and 17.1 per cent by the end of 1963. Comparable figures for California are not available.

California↗
PubMed1997

Secular trends in ischemic heart disease mortality in California versus the United States, 1980 to 1991.

We compare the recent trends in ischemic heart disease mortality in California and the United States. Because California was among the first states to have declines in ischemic heart disease mortality, an examination of these recent trends may provide important clues for upcoming national trends. Age-adjusted and -specific ischemic heart disease mortality rates were calculated by sex for persons aged 35 and older during the years 1980 to 1991. Log-linear regression modeling was used to estimate the average annual percentage change in mortality. Between 1980 and 1991, the annual age-adjusted ischemic heart disease mortality declined less in California than in the United States for both women (1.9% versus 3.1%) and men (3.1% versus 3.5%). In California, it increased slightly between 1986 and 1990 for the oldest women and men. The slower rates of decline in mortality of this disease in California compared with the United States and the rising rates among the most elderly Californians suggest that careful attention should be paid to these trends in death rates of and risk factors for this disease in California.

Adult↗
PubMed1998

Health promotion and managed care: surveys of California's health plans and population.

INTRODUCTION: The purpose was to examine whether health-promotion programs offered by California health plans are a serious attempt to improve health status or a marketing device used in an increasingly competitive marketplace. The research examined differences in the coverage, availability, utilization, and evaluation of health-promotion programs in California health plans. METHODS: A mail survey was done of the 35 HMOs (86% response) and 18 health insurance carriers (83% response) licensed to sell comprehensive health insurance in California in 1996 (some plans sell both HMO and PPO/indemnity products). The final sample included 30 commercial HMOs and 20 PPO and indemnity plans. The 1996 California Behavioral Risk Factor Survey (BRFS) of 4,000 adults was used to estimate population participation rates in health-promotion programs. RESULTS: California's HMOs in 1996 offered more comprehensive preventive benefits and health-promotion programs compared to PPO and indemnity plans. HMOs relied on a more comprehensive set of health-education methods to communicate health information to members and were more likely to open their programs to the public. HMOs are also more likely to have developed relationships with community-based and public health providers. Participation in health-promotion programs is low (2%-3%), regardless of plan type, and most health plans limit evaluations to assessment of member satisfaction and utilization. Only 35%-45% of HMOs, and no PPO/indemnity plans, assess the impact of health-promotion programs on health risks and behaviors, health status, or health care costs. CONCLUSION: For the majority of California's PPO and indemnity plans, health promotion is not an integral part of their business. For the majority of HMOs, health-promotion programs are offered primarily as a marketing vehicle. However, a substantial minority of HMOs offer health-promotion programs to achieve other organizational goals of health improvement and cost control.

Adult↗
PubMed1998

Physician supply and medical education in California. A comparison with national trends.

Concerns have been voiced about an impending oversupply of physicians in the United States. Do these concerns also apply to California, a state with many unique demographic characteristics? We examined trends in physician supply and medical education in California and the United States between 1980 and 1995 to better inform the formulation of workforce policies appropriate to the state's requirements for physicians. We found that similar to the United States, California has more than an ample supply of physicians in the aggregate, but too many specialists, too few underrepresented racial/ethnic minority physicians, and poor distribution of physicians across the state. However, recent growth in the supply of practicing physicians and resident physicians per capita in California has been much less dramatic than in the country overall. The state's unusually high rate of population growth has enabled California, unlike the United States as a whole, to absorb large increases in the number of practicing physicians and residents during 1980 to 1995 without substantially increasing the physician-to-population ratio. Due to a projected slowing of the state's rate of population growth, the supply of physicians per capita in the state will begin to rise steeply in coming years unless the state implements prompt reductions in the production of specialists. An immediate 25% reduction in specialist residency positions would be necessary to bring the state's supply of practicing specialists in line with projected physician requirements for the state by 2020. We conclude that major changes will be required if the state's residency programs and medical schools are to produce the number and mix of physicians the state requires. California's medical schools and residency programs will need to act in concert with federal and state government to develop effective policies to address the imbalance between physician supply and state requirements.

California↗
PubMed1999

Life History Differences between Rare and Common Flowering Plant Species of California and the British Isles.

Generalizations about rare and endangered species are important for the development of conservation management policy and for understanding of the nature of rarity. Therefore, we sought such generalizations by statistically comparing eight life history and reproductive traits of rare and common plant species in two better-studied but climatically and geographically distinct Holarctic floras-those of California and the British Isles. Trends were often similar in both floras. Rare and common species differ significantly for a number of characters. In both floras, a woody habit was significantly more frequent for the rare species than the common species. Also, in both floras, monocarpy was less frequent in the rare species, significantly so in California. The rare species of both floras were, on average, significantly shorter in stature than the common species. This trend in stature remained significant when nonwoody species were compared but did not do so for woody species. Rare and common species differed with regard to their frequency of inflorescence structure types, but these differences were not concordant for both floras. The rare species of the British Isles had significantly higher proportions of mixed and polymorphic flower colors; the trend was not significant in California. In both floras, rare species had a higher frequency of many-seeded fruits, significantly so in California. California's rare species had a significantly higher frequency of dehiscent fruits than common species; the trend was reversed and not significant for the British Isles. We found no significant differences for characters associated with fruit dispersal. Finally, in California, the median altitude of the range of the common species was significantly greater than that of the rare species. At present, these correlates cannot be assigned as possible causes or consequences of rarity. Nonetheless, they may represent "high-risk" traits that could be used to identify other species already at risk or potentially at risk of becoming rarer.

Journal Article↗
PubMedDate not supplied

Differences and similarities in sexual and contraceptive knowledge, attitudes, and behavior among Latino male adolescent students in California, United States and Lima, Peru.

To identify the differences and similarities in sexual and contraceptive knowledge, attitudes, and behavior among Latino male adolescent students living in California and Lima. Self-administered, anonymous surveys were completed by Latino male students aged 12-19 participating in California, and by male adolescent students in four high schools in Lima. Both surveys contained similar questions allowing for comparisons regarding sexual activity and contraceptive behavior. The mean age of male students were 16 and 15 years, respectively. More California males reported having engaged in sexual intercourse (69% vs 43%. The sexual debut was 13 years in both samples. More students in California were aware of their risk of pregnancy at first sexual intercourse than in Lima (82% vs 50%). One-third of the California males reported communicating with their partner about sex and contraception to be "easy" as compared to 53% of males in Lima. More students in California reported knowing a place to obtain contraceptives if they need them (85% vs 63%), having ever gotten someone pregnant (29% vs 7%), and having fathered a child (67% vs 16%).

Adolescent↗
PubMed1984

Serological evidence of infection with California serogroup viruses (family Bunyaviridae) in residents of Long Hua, suburb of Shanghai, People's Republic of China.

Sera from 126 residents of Long Hua, a suburb of Shanghai, in the People's Republic of China, were studied. Sera were tested for haemagglutination inhibiting antibodies to alphavirus (eastern equine encephalitis, western equine encephalitis), flavivirus (St. Louis encephalitis, Powassan, dengue) and California serogroup (snowshoe hare) antigens. Flavivirus antibodies were found in 14 (11.1%) and California serogroup antibodies in 5 (3.9%) individuals. Neutralizing antibodies with highest titres to snowshoe hare virus were demonstrated in 3 of the 5 California serogroup reactors. We believe this to be the first report of California serogroup virus antibodies in Chinese residents and the first evidence to suggest that California serogroup viruses may be circulating in the Orient.

Adolescent↗
PubMed2003

Validation of self-reported cancers in the California Teachers Study.

Self-reported cancer data from the California Teachers Study were validated by using California Cancer Registry data. The California Teachers Study cohort consists of 133,479 active and retired California teachers. In 1995-1996, data from a mailed questionnaire were linked to the California Cancer Registry data. Sensitivity and specificity of 11 types of cancer were calculated. Multivariate analyses were conducted to evaluate correlates of false-positive and false-negative reporting. Sensitivities showed great variation by cancer site. The highest sensitivities were observed for breast (96.4%) and thyroid (92.9%) cancers, whereas the lowest sensitivities were those for cervical (44.3%), endometrial (69.1%), and other skin (53.6%) cancers. The sensitivities for in situ cancers (at the time of diagnosis) were considerably lower than those for invasive cancers in about half of the cancer types surveyed. The specificities for individual cancer sites ranged from 90% to 99%; the highest were those for lung cancer, leukemia, and Hodgkin's disease (all 99.9%). The lowest specificity was for other skin cancer (90.2%). In situ stage at diagnosis and older age were significantly associated with false-positive reporting. Age and non-White race were associated with false-negative reporting. These findings suggest that the feasibility of using self-reported data without verification in epidemiologic studies of cancer varies by site.

Adult↗
PubMed1991

Occurrence and evolutionary significance of a California encephalitis-like virus in Aedes squamiger (Diptera: Culicidae).

More than 12,000 Aedes increpitus Dyar and 4,600 Aedes squamiger (Coquillett) were tested for the presence of arboviruses to test the hypothesis that there is a coevolutionary relationship between Aedes (Ochlerotatus) mosquitoes and California serogroup viruses. Five strains of a California encephalitis-like virus were isolated from adults reared from larvae of Ae. squamiger collected in January 1989 from a coastal salt marsh at Morro Bay, San Luis Obispo County, California. Viruses were isolated in Vero cell cultures and serotyped by cross-neutralization tests. These isolates represent the first arboviruses isolated from this species. On the basis of morphology, Aedes squamiger has been included in the Aedes stimulans group of the subgenus Ochlerotatus. Other species within the Ae. stimulans group are vectors of California (CAL) serogroup viruses elsewhere in North America. Analysis of isozyme variability supports the inclusion of Ae. squamiger in the Ae. stimulans group and suggests that coastal populations of Ae. increpitus are the closest California relatives of Ae. squamiger. Recovery of virus from Ae. squamiger reinforces the relationship between CAL serogroup viruses and Aedes (Ocherlotatus) mosquitoes. However, the failure to isolate virus from large samples of Ae. increpitus from coastal and low elevation inland habitats suggests a complex evolutionary history involving both vertical and horizontal transmission mechanisms.

Aedes↗
PubMed2005

Cancer incidence in the Hmong in California, 1988-2000.

The Hmong represent a unique new Southeast Asian immigrant group to the U.S. Approximately 169,000 Hmong reside in the U.S., primarily in California, Minnesota, and Wisconsin. Previous studies of cancer in this population have indicated that Hmong experience an elevated risk of gastric, hepatic, cervical, and nasopharyngeal cancers and experience a reduced risk of breast, prostate, lung, and colorectal cancers. Approximately 65,000 Hmong live in California, where there has been a population-based cancer registry since 1988, and the authors used these data to calculate age-adjusted cancer incidence rates and to examine disease stage and tumor grade at diagnosis. Changes in rates during the period studied also were evaluated. These rates and proportions were compared with rates among the non-Hispanic white (NHW) and Asian/Pacific Islander (API) populations of California. Between 1988 and 2000, a total of 749 Hmong in California were diagnosed with invasive cancer, and the age-adjusted rate of cancer for the Hmong was 284 per 100,000 population, compared with 362.6 and 478 per 100,000 in the API and NHW populations, respectively. The age-adjusted incidence rates of cancer in the Hmong were elevated for hepatic, gastric, cervical, and nasopharyngeal cancers and for leukemia and non-Hodgkin lymphoma (NHL). Rates were lower in the Hmong for colorectal, lung, breast, and prostate cancers. For gastric cancer and lung cancer, age-adjusted rates increased between 1988 and 2000 in the Hmong, although breast cancer incidence declined. Cervical cancer incidence increased, rates of NHL were declining, and rates for colorectal cancer remained steady between 1988 and 2000. The Hmong experienced later disease stage at diagnosis than other API and generally poorer grade of disease at diagnosis. Hmong experienced lower overall invasive cancer incidence rates than API or NHW populations in California. However, they experienced higher rates of hepatic, gastric, cervical, and nasopharyngeal cancers; and, for most types of cancer, they were diagnosed in a later disease stage.

Age Factors↗
PubMed2004

Bioaccumulation of arsenic in marine fish and invertebrates from Alaska and California.

Past studies determined that concentrations of arsenic in the liver of flathead sole from Alaska were generally higher than those found in fish from other locations sampled along the west coast of the United States (Meador et al. 1994). A study was conducted to examine arsenic concentrations and patterns of bioaccumulation in fish and potential prey species from two geographic locations. Flathead sole were collected from four sites in the Gulf of Alaska and white croaker and English sole were collected from five sites in California. Potential prey species from each site were also examined and found to contain high concentrations of arsenic. In California, the sites with the lowest sediment concentrations of arsenic, total organic carbon, and acid-volatile sulfides (AVS) contained invertebrates with the highest tissue concentrations. Regression analysis determined that arsenic in polychaetes was highly correlated to sediment concentrations of arsenic normalized to AVS but was higher overall for the California samples. Even though invertebrates from several of the California sites exhibited much higher concentrations of arsenic than invertebrates from the Alaska sites, liver and muscle tissue from flathead sole collected in Alaska usually exhibited higher concentrations than fish from the California sites. When concentrations of arsenic in fish liver were plotted against concentrations of arsenic in sediment normalized to AVS levels, a very high correlation was obtained for all sites. This suggests that AVS, or some factor correlated with AVS, may have been responsible for controlling arsenic bioaccumulation in these fish species through dietary uptake and exposure to arsenic in water. Based on the available data, it appears that dietary uptake may be related to fish tissue concentrations, but uptake of aqueous arsenic may be responsible for the higher tissue concentrations in fish from Alaska.

Alaska↗
PubMed2003

Genetic diversity of avian infectious bronchitis virus California variants isolated between 1988 and 2001 based on the S1 subunit of the spike glycoprotein.

Twenty-nine isolates of avian infectious bronchitis virus (IBV) recovered from commercial chicken flocks in California between 1988 and 2001 and identified as California variants by serotype and direct automated cycle sequencing of the IBV spike glycoprotein S1 subunit, were further characterized phylogenetically and by nucleotide sequence comparison. California variants were grouped according to production type of chicken, by comparison with public access sequence databases (NCBI GenBank and EMBL), or based on phylogenetic analysis. Fisher's Exact test was used to compare mutations per year, purifying and positive selection, predictive antigenicity, and a > or = 6 bp deletion between California variant groups.A high number of mutations at the nucleotide level ( p = 0.013) and a > or = 6 bp deletion in the nucleotide sequence ( p = 0.006) was significantly associated with broiler-type chickens. However, 88% of significant comparisons at the amino acid level such as purifying and positive selection were seen in layer-type chickens. A pronounced predictive antigenicity in the HVR2 region was also associated with layer-type chickens ( p = 0.001). The study indicates that IBV in California is in a phase of slow evolution with different evolutionary patterns being associated with the production type of chicken.

Amino Acid Sequence↗
PubMed2006

Hospital utilization for injection drug use-related soft tissue infections in urban versus rural counties in California.

Drug related-soft tissue infections (DR-STIs) are a significant source of hospital utilization in inner-city urban areas where injection drug use is common but the magnitude of hospital utilization for DR-STIs outside of inner-city urban areas is not known. We described the magnitude and characteristics of hospital utilization for DR-STIs in urban versus rural counties in California. All discharges from all nonfederal hospitals in California in 2000 with ICD-9 codes for a soft tissue infection and for drug dependence/abuse were abstracted from the California Office of Statewide Health Planning and Development discharge database. There were 4,152 DR-STI discharges in 2000 from hospitals in 49 of California's 58 counties. Residents of 12 large metropolitan counties accounted for 3,598 discharges (87% of total). The majority of DR-STI discharges were from urban safety net hospitals with county indigent programs and Medicaid as the expected payment source and opiate related discharge diagnoses. Hospital utilization for DR-STIs in California is highest in large urban metropolitan counties, although DR-STI discharges are widespread. Increased access to harm reduction services and drug treatment may reduce government health care expenditures by preventing unnecessary hospital utilization for DR-STIs.

Adolescent↗
PubMed2004

Knowledge of emergency contraception among women aged 18 to 44 in California.

OBJECTIVE: The State of California has taken several steps to make emergency contraceptives (ECs) available to women in the state. By using data from the 1999-2001 California Women's Health Survey, we estimated the knowledge of emergency contraception among adult women of reproductive age at risk of pregnancy (n=6209). STUDY DESIGN: This study is based on 3 years of data (1999-2001) from the California Women's Health Survey (CWHS), an annual population-based survey of more than 4000 randomly selected adult women (aged 18 years and older) in California. A total of 6198 women aged 18 to 44 responded to the 2 emergency contraception questions: "To the best of your knowledge, if a woman has unprotected sex is there anything she can do in the 3 days after intercourse that will prevent pregnancy?" and "What can she do?" RESULTS: We find that 38% of California women were able to correctly identify emergency contraception. Most importantly, the women who are most likely to need emergency contraception-those who are at risk of an unintended pregnancy but not using any method of contraception-have among the lowest levels of knowledge (only 29% identified a method of ECs). CONCLUSION: Results show that family planning providers may be reaching their clients, but broader outreach to the public has not yet achieved sufficiently high information levels among women in greatest need of the method.

Adolescent↗