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PubMed1992

Serologic survey for brucellosis in feral swine, wild ruminants, and black bear of California, 1977 to 1989.

A retrospective analysis of brucellosis serologic testing results in eight wildlife species in California from 1977 to 1989 was done. Samples were collected from 5,398 live-captured or hunter-killed animals and tested by combinations of up to six serologic tests for antibodies to Brucella spp. Twenty-three of 611 (3.8%) feral swine (Sus scrofa), one of 180 (0.6%) black bear (Ursus americanus), one of 355 (0.3%) California mule deer (Odocoileus hemionus californicus), and one of 1,613 (0.06%) blacktail deer (Odocoileus hemionus columbianus) samples were considered reactors. Suspect serologic reactions occurred in three of 619 (0.5%) desert bighorn sheep (Ovis canadensis nelsoni) and one of 355 (0.3%) California mule deer samples. Brucellosis is not considered an important wildlife health problem in California except in feral swine.

Animals↗
PubMed1998

Ehrlichia spp. in cervids from California.

Blood samples from six mule deer (Odocoileus hemionus hemionus), 15 black-tailed deer (O. hemionus columbianus), and 29 elk (Cervus elaphus nannodes) were assayed for human monocytic and human granulocytic ehrlichiosis (HGE) by polymerase chain reaction (PCR), DNA sequencing, and serology to determine whether or not cervids are involved in the maintenance of these potential human pathogens in California (USA). The deer were sampled in August to October 1992-95. The 29 tule elk from Point Reyes National Seashore were sampled in August 1997. All deer were seronegative for antibodies to HGE/Ehrlichia equi, while the E. equi seroprevalence among elk was 17%. The 16S rDNA PCR prevalence in deer was 38% (in mule deer and black-tailed deer) for Ehrlichia-like sp. of white-tailed deer, 5% (one black-tailed deer only) for E. equi, and 0% for E. chaffeensis. The PCR prevalence in elk was 0% for Ehrlichia-like sp. of white-tailed deer, 31% for E. equi, and 0% for E. chaffeensis. The E. equi from two positive elk samples was successfully propagated in HL-60 cell cultures. DNA sequencing confirmed that the Ehrlichia-like sp. sequences from deer in California were closely related to sequences reported from white-tailed deer from Oklahoma and Georgia. The E. equi strain from deer and elk resembled other E. equi strains from California. These results suggest that cervids may be important in the natural maintenance of E. equi in California.

Animals↗
PubMed2000

Antibodies to selected disease agents in translocated wild turkeys in California.

Wild turkeys (Meleagris gallopavo) trapped within California (n = 715) or imported into California from other states (n = 381) from 1986 to 1996 were tested for exposure to certain disease agents. Prevalence of antibody to Mycoplasma gallisepticum, Mycoplasma meleagridis, Salmonella pullorum, Salmonella typhimurium, Newcastle disease virus, and avian influenza virus was low (0-4%) for wild turkeys trapped within California. With the exception of antibody prevalence to M. meleagridis of 33%, the same was true for wild turkeys imported into California from other states. Antibody prevalence to Mycoplasma synoviae was 8-10% for both groups.

Agglutination Tests↗
PubMed2001

Pneumocystosis in wild small mammals from California.

Cyst forms of the opportunistic fungal parasite Pneumocystis carinii were found in the lungs of 34% of the desert shrew, Notiosorex crawfordi (n = 59), 13% of the ornate shrew, Sorex ornatus (n = 55), 6% of the dusky-footed wood rat, Neotoma fuscipes (n = 16), 2.5% of the California meadow vole, Microtus californicus (n = 40), and 50% of the California pocket mouse, Chaetodipus californicus (n = 2) caught from southern California between February 1998 and February 2000. Cysts were not found in any of the harvest mouse, Reithrodontomys megalotis (n = 21), California mouse, Peromyscus californicus (n = 20), brush mouse, Peromyscus boylii (n = 7) or deer mouse, Peromyscus maniculatus (n = 4) examined. All infections were mild; extrapulmonary infections were not observed. Other lung parasites detected were Hepatozoon sp./spp. from M. californicus and Notiosorex crawfordi, Chrysosporium sp. (Emmonsia) from M. californicus, and a nematode from S. ornatus.

Animal Diseases↗
PubMed1998

In California, Medi-Cal managed care is superior to Medi-Cal fee-for-service.

This is a comparative analysis of California's "experiment" in Medi-Cal managed care. It compares managed care to fee-for-service in the area of quality. In March 1993, the California State Department of Health Services issued a State Strategic Plan for Medi-Cal Managed Care. The goal: to transfer the delivery of care for the majority of the state's Medi-Cal population from a predominantly fee-for-service payment system to capitated managed care. The state of California has steadily increased its commitment to the large-scale expansion of managed care within the Medi-Cal Program in order to improve beneficiaries' access to quality preventative and primary health care while acting as a prudent purchaser of services. This study examines one Local Initiative--Inland Empire Health Plan--created as a not-for-profit, joint powers, public entity by Riverside and San Bernardino counties, California.

California↗
PubMedDate not supplied

An inventory of ambulance service regulatory programs in California.

INTRODUCTION: Ambulance regulation in California is the responsibility of numerous agencies on the state and local levels. OBJECTIVE: By identifying and analyzing the variety of programs used in one state, this study establishes a framework for evaluation of state and local regulatory programs elsewhere. METHODS: This study surveyed all California local EMS agencies (LEMSAs: California's equivalent of regional EMS organizations) to identify the types of regulatory programs used, the foci of these programs (e.g., equipment and personnel), and their application (e.g., public and private providers). All data acquired were analyzed using population parameters rather than inferential statistics. FINDINGS: A response rate of 100% was obtained. Among the regulatory tools used are ordinances, contracts, and franchises. Regulatory standards vary widely as do their applications. Large counties and those that operate their own LEMSA have more extensive regulatory programs than do smaller counties and those who participate in multicounty agencies. Many of the enforcement mechanisms available are weak. CONCLUSION: This study suggests several policy implications for California and other states. The wide variation in the types of regulatory programs and the standards that are used suggest that the purpose and impact of regulatory programs should be studied further. The decentralization of the ambulance regulatory program and the lack of integration of ambulance regulations into EMS system planning also raise policy questions. In addition, the role of multicounty EMS agencies, as it relates to regulation of ambulance services, should be reviewed.

Ambulances↗
PubMed1999

[School health education in California. The policies and contents of The Health Framework].

This paper introduces school health education activities in California. We focus on The Health Framework published by the California Department of Education. It describes the policies, objectives, and contents of health education for California public schools. This framework emphasizes health literacy for students and a comprehensive school health system that supports effective health education and make health an important priority at the school. The nine content areas presented by the framework describe health concepts, skills, and behaviors important for students. We analyzed this framework and its background including the trend of school health education in the United States and other health education related activities in California. Finally we compared the framework with school health education in Japan.

Adolescent↗
PubMed1999

Firearm-associated deaths and hospitalizations--California, 1995-1996.

During 1995-1996, 27% of recorded injury-related deaths in California involved firearms (California Department of Health Services [CDHS], unpublished data, 1995-1996). In 1996, CDHS began passive surveillance of "severe" firearm-related injuries (i.e., resulting in death or hospitalization) with resources provided by the California Wellness Foundation. To characterize firearm-related injuries in California, CDHS analyzed death records and hospital discharge records for 1995 and 1996 (the most recent years for which population data are available to calculate rates). This report summarizes the results of the analysis, which indicate that most of the 21,985 firearm-related injuries and deaths resulted from assault.

Adolescent↗
PubMed2000

The validity of information on "race" and "Hispanic ethnicity" in California birth certificate data.

OBJECTIVE: To evaluate the validity of racial/ethnic information in California birth certificate data. DATA SOURCES: Computerized birth certificate data and postpartum interviews with California mothers. STUDY DESIGN AND DATA COLLECTION: Birth certificates were matched with face-to-face structured postpartum interviews with 7,428 mothers to compare racial/ethnic information between the two data sources. Interviews were conducted in Spanish or English during delivery stays at 16 California hospitals, 1994-1995. PRINCIPAL FINDINGS: The sensitivity of racial/ethnic classification in birth certificate data was very high (94 percent to 99 percent) for African Americans, Asians/Pacific Islanders, Europeans/Middle Easterners, and Latinas (Hispanics). For Native Americans, however, the sensitivity was only 54 percent. The positive predictive value of birth certificate classification of race/ethnicity was high for all racial/ethnic groups (96 percent to 97 percent). CONCLUSIONS: Despite limited training of birth clerks, the maternal racial/ethnic information in California birth certificate data appears to be a valid measure of self-identified race and Hispanic ethnicity for groups other than Native Americans.

Adolescent↗
PubMed2000

Declines in lung cancer rates--California, 1988-1997.

Cigarette smoking is the leading cause of lung and bronchus cancer (1). During 1988-1997, per capita cigarette smoking in California declined more than twice as rapidly compared with the rest of the country (2). To characterize lung cancer incidence in California, data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program were compared with data from the population-based California Cancer Registry (CCR). This report summarizes the results of that analysis, which indicated that during 1988-1997, age-adjusted lung cancer incidence rates in California declined significantly compared with stable incidence rates for the combined SEER area of five states and three metropolitan areas.

California↗
PubMed2001

California as a model.

One of every three persons who starts smoking falls ill and dies prematurely because he or she smoked. Smoking has been causally linked to heart disease, cancer, and respiratory diseases and continues to be the number one preventable cause of death in this country. To prevent these deaths and the incidence of these diseases, California's Tobacco Control Program was established in 1989 specifically to reduce tobacco use in the state. The strategy of the program is to "denormalize" tobacco. This strategy emphasizes three areas of programmatic activity: to counter pro-tobacco influences, to reduce exposure to environmental tobacco smoke, and to reduce access to tobacco products, with a focus on both social and commercial sources. A fourth priority area, cessation, is considered more of an outcome. California's Tobacco Control Program has touched the life of every Californian. Adult smoking prevalence in the state has gone from approximately 11% lower than the rest of the nation in 1988 to 20% lower in 1996. There are now approximately one million fewer smokers in California than would have been expected. Overall, per capita cigarette consumption has fallen by more than 50%. Seventy percent of adult smokers reported that they tried to quit in the last year. Exposure to secondhand smoke has plummeted. California's lung and bronchus cancer incidence is already declining at a significantly higher rate than that seen elsewhere in the nation. Youth smoking rates have also declined significantly. However, contrary to the message of its massive public relations campaign, the tobacco industry has not changed its stripes after the national tobacco settlement. They are still aggressively marketing their products to teenagers, ethnic minority groups, and young adults. They need to be combatted with renewed vigor by a vigilant health community.

Adolescent↗
PubMed2001

Reimbursement for complimentary/alternative medicine by California HMOs.

Beginning in the 1990s, researchers indicate a growing acceptance of complementary/alternative medicine in America. In this 1999 study, we surveyed California HMOs to determine the extent they reimburse for the following complementary/alternative therapies: nutrition counseling, chiropractic, acupuncture, massage and herbal medicine, as well as whether they require these providers to be licensed or otherwise credentialed. As hypothesized, California HMOs are more likely to reimburse for each of these therapies vs. an aggregate of 13 western U.S. states of which California is one. California's huge and competitive HMO market may be a factor.

California↗
PubMed2002

Introduction of Aedes albopictus (Skuse) in southern California and potential for its establishment.

Isolated incidences of Aedes albopictus in the continental U.S. were reported as early as 1946 and the first incidence in California was reported in 1972. These introductions were referred to as "isolated incidences" because very few immatures were observed in used tires shipped from Southeast Asia. The first major discovery of a large population and subsequent establishment of Ae. albopictus in the U.S. was reported in 1986 from Houston, TX, in a shipment of used tires from Japan. In early June 2001, infestations of this species associated with containerized oceanic shipments of "lucky bamboo" (Dracaena spp.) packaged in standing water were introduced into southern California from mainland south China. Focal points of infestation are currently at the wholesale nurseries in southern as well as northern California. A control protocol for adulticiding and larviciding has been implemented by the Greater Los Angeles County Vector Control District. Surveys are presently being conducted by local vector control agencies in southern and northern California to determine the extent of infestation. Potential forAe. albopictus establishment is discussed.

Aedes↗
PubMed1956

The California morbidity survey; a progress report.

In May of 1954 the California State Department of Public Health began a one-year household sample survey covering the health status of the population of California. Preliminary results from the survey indicate that chronic conditions cause approximately three-quarters of the disability in the California population, while acute conditions are responsible for the remainder. Acute upper respiratory tract disorders account for about half of the total disability from acute conditions. In the older population group, there is a greater amount of disability outside than within metropolitan areas. No significant differences in disability status appear between recent migrants to California and longer term residents. Forthcoming results from the survey, answering more detailed questions, will provide information needed by a number of private and state agencies.

Acute Disease↗
PubMed1957

The California Tumor Registry: a summary report on the cancer experience in 36 hospitals.

The California Tumor Registry was started in 1947. It consists of case abstracts of medical records on neoplasm patients seen in 40 hospitals in California and now contains data on more than 159,000 cases, with 15,000 new cases being added each year. Follow-up reports are requested annually on each case not known to be dead. The Registry is designed to (1) promote the continuing care of the patient, (2) to evaluate cancer control methods, (3) to advance knowledge of the epidemiology of cancer, and (4) to suggest leads for laboratory and clinical research. From a series of 110,628 neoplasm cases reported to the California Tumor Registry in 1942-1954, data are presented on 76,499 cancer cases initially diagnosed in reporting hospitals. Histopathologic confirmation, age, sex, stage, treatment, follow-up, and survival of cancer patients are discussed. Use of the Registry information for analyzing cancer experience for epidemiological study and for evaluation of treatment methods are also described. The report is intended to illustrate the types of data that can be obtained from the California Tumor Registry. More comprehensive reports on specific aspects of cancer control will be forthcoming.

California↗
PubMed1962

Tax-supported medical care for California's children--where should it be going?

The multiplication of separate governmental agencies providing health services to California's children, the increasing difficulties in staffing tax-supported health agencies and the recent studies of the quality of care under these programs, have all pointed to an urgent need for prompt decisions on certain basic questions about the function of tax-supported medical care for children of dependent families. Fourteen separate kinds of health services are currently provided through public funds at an annual cost to California taxpayers of $52,000,000. These funds underwrite an uncoordinated, fragmented, patchwork quilt of medical care for some 500,000 children. Coordination and integration of these services through "one door" with uniform eligibility requirements and maximum utilization of private physicians' services that meet appropriate standards is needed now. California physicians have an urgent responsibility to provide leadership in the development of more effective and more economical organization and distribution of higher quality medical care services for California's children dependent on public support.

California↗
PubMed2003

Evaluation of tuberculosis contact investigations in California.

OBJECTIVE: To estimate the burden of tuberculosis (TB) contact investigations in California, assess outcomes and effectiveness, and identify performance gaps. METHODS: Aggregate program management reports were used to examine contact investigations conducted for pulmonary TB cases reported between 1 July 1999 and 30 June 2000 in California. Findings were compared to national objectives, and performance gaps were identified. Costs were estimated, and effectiveness of TB case detection and prevention was assessed. RESULTS: A total of 2032 acid-fast bacilli sputum smear-positive and sputum smear-negative/culture-positive cases was reported; 17774 contacts were elicited, and 15582 (88%) contacts were evaluated. TB disease and latent tuberculosis infection (LTBI) were diagnosed in 111 (<1%) and 4609 (30%) contacts, respectively; 1958 (43%) contacts with LTBI completed treatment. Costs of contact investigations were estimated at dollars 4.8 million; 81% of expected TB cases were detected, but only 35% of cases expected to occur within 2 years following the investigation were prevented. CONCLUSIONS: California's performance did not meet national objectives for contact evaluation or treatment completion; improved effectiveness of contact investigations in California is needed. Although analysis of existing contact investigation surveillance data provided a macro-level view of performance gaps, expanded surveillance data are required to inform interventions.

California↗
PubMed2004

Patterns of alcohol consumption and breast cancer risk in the California Teachers Study cohort.

Alcohol consumption of approximately two drinks or more per day has been associated with elevated breast cancer risk in the California Teachers Study cohort as well as in many other populations. The objective of this analysis is to examine effects of age at drinking and drinking patterns and to identify effect modifiers. Of the 103,460 at-risk cohort members, age <85, who resided in California and completed the baseline alcohol assessment, 1,742 were diagnosed with invasive breast cancer after joining the cohort and before January 2001. Incident breast cancers were identified through the California Cancer Registry and follow-up for death and confirmation of continued California residence used various sources. Multivariate Cox proportional hazards regression models were used to estimate relative risks (RRs). Elevated breast cancer risk was most evident for recent drinking [RR = 1.28, 95% confidence interval (CI): 1.06-1.54 for >/=20 g/day versus nondrinkers], with no clear pattern for consumption during earlier periods of life. This elevation in risk was 32% among postmenopausal women (95% CI: 1.06-1.63) and 21% among pre/perimenopausal women (95% CI: 0.76-1.92). Highest risks associated with heavy alcohol consumption were observed among postmenopausal women with a history of biopsy-diagnosed benign breast disease (RR = 1.97, 95% CI: 1.39-2.79 compared to nondrinkers without benign breast disease) or who had used combination hormone replacement therapy (HRT) (RR = 2.24, 95% CI: 1.59-3.14 compared to nondrinkers who never used HRT). Recent alcohol consumption equivalent to two or more drinks per day increases the risk of invasive breast cancer, with the greatest RRs observed among heavy drinkers who are also postmenopausal and have a history of benign breast disease or who use HRT.

Adolescent↗