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PubMedDate not supplied

Pediatric dentists' participation in the California Medicaid program.

PURPOSE: The purpose of this study was to determine pediatric dentists' participation in the California Medicaid program and investigate barriers to participation. METHODS: A 24-question mail-in survey with a follow-up was sent to all pediatric dentists in California with questions including demographics, Medicaid participation, and barriers to participation. Data were analyzed using descriptive statistics, chi-square tests, bivariate analysis, and multivariate logistic regression. RESULTS: Pediatric dentists returned 364 useable mail-in surveys for a response rate of 70%. Forty-five percent participated in the Medicaid program, one third of which would accept all patients and two thirds of which placed some restriction on their participation. Twenty-five percent of respondents had at least 10% Medicaid patients in their practice, and 25% accepted 6 or more new Medicaid patients per month. Dentists in rural areas were significantly more likely than those in urban or suburban areas to accept a new Medicaid patient (P < .05). Eighty-nine percent of all respondents reported low fees and 82% reported broken appointments as important reasons for not participating or limiting participation. CONCLUSIONS: Participation of California pediatric dentists in Medicaid is low compared to other states that have participation studies. Pediatric dentists in rural areas are most likely to participate. Among the reasons that contribute to California dentists not participating in the Medicaid program, the major ones appear to be low fees, broken appointments, and denial of payment.

Adult↗
PubMed2004

The role of health promotion in physical therapy in California, New York, and Tennessee.

BACKGROUND AND PURPOSE: As health care providers, physical therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. The purposes of this study were: (1) to investigate perceptions of practice patterns in 4 focus areas of Healthy People 2010 (disability and secondary conditions by assessing psychological well-being, nutrition and overweight, physical activity and fitness, and tobacco use) and (2) to identify related self-efficacy and outcome expectations in California, New York, and Tennessee. SUBJECTS: A instrument was pilot tested and distributed in 2 waves to 3,500 randomly selected, licensed physical therapists from 3 states: California, New York, and Tennessee. METHODS: Interviews were randomly conducted via telephone with 23 physical therapists in all 3 states until similar responses were identified in order to create the qualitative instrument, which was then pilot tested with 20 physical therapists in California. The total number of qualitative instruments used in the data analyses was 417 (145 from California, 127 from New York, and 145 from Tennessee) or 11.9%. RESULTS: The health promotion behavior most commonly thought to be practiced by physical therapists was assisting patients to increase physical activity (54%), followed by psychological well-being (41%), nutrition and overweight issues (19%), and smoking cessation (17%). Self-efficacy predicted all 4 behaviors beyond the control variables. Minimal state-to-state differences were noted. DISCUSSION AND CONCLUSION: Physical therapists believe they are addressing health promotion topics with patients, although in varying degrees and in lower than desirable percentages based on Healthy People 2010 goals. This study demonstrated that a physical therapist's confidence in being able to perform a behavior (self-efficacy) was the best predictor of perceptions of practice patterns and is an area to target in future interventions.

Adult↗
PubMed2003

Storm effects on regional beach water quality along the southern California shoreline.

Two regional studies conducted during dry weather demonstrated that the Southern California Bight (SCB) shoreline has good water quality, except near areas that drain land-based runoff. Here, we repeat those regional studies 36 h after a rainstorm to assess the influence of runoff under high flow conditions. Two hundred and fifty-four shoreline sites between Santa Barbara, California and Ensenada, Mexico were sampled using a stratified-random sampling design with four strata: sandy beaches, rocky shoreline, shoreline adjacent to urban runoff outlets that flow intermittently, and shoreline adjacent to outlets that flow year-round. Each site was sampled for total coliforms, fecal coliforms (or E. coli), and enterococci. Sixty percent of the shoreline failed water quality standards after the storm compared to only 6% during dry weather. Failure of water quality standards increased to more than 90% for shoreline areas adjacent to urban runoff outlets. During dry weather, most water quality failures occurred for only one of the three bacterial indicators and concentrations were barely above State of California standards; following the storm, most failures were for multiple indicators and exceeded State of California standards by a large margin. The condition of the shoreline in Mexico and the United States was similar following rainfall, which was not the case during dry weather.

Bathing Beaches↗
PubMed1992

Behavioral risk factor survey of Chinese--California, 1989.

During the 1980s, Asians/Pacific Islanders were the fastest growing racial/ethnic group in both the United States and California. In Alameda County (which includes Oakland), California, persons of Chinese origin or ancestry are the largest subgroup (35.6%) among the more than 192,000 Asians. The prevalence of health risk factors for noninfectious health concerns (e.g., heart disease, cancer, and unintentional injuries) in Asian/Pacific Islander populations has not been well defined. To characterize risk factors for selected noninfectious diseases among persons of Chinese origin or ancestry in California, Asian Health Services (a private, nonprofit community health center) and the California Department of Health Services adapted CDC's Behavioral Risk Factor Surveillance System (BRFSS) for use in the Chinese community in Oakland. This report presents data from that survey conducted during June 1989-February 1990.

Adult↗
PubMed1992

Blood lead levels among children in high-risk areas--California, 1987-1990.

In the United States, elevated blood lead levels (BLLs) are a major health risk for children; this risk is totally preventable (1). To better characterize lead poisoning among children at high risk for lead exposure in California, the California Department of Health Services (CDHS) conducted lead-screening surveys that measured lead levels in children's blood, household paint, and soil in three selected high-risk areas in northern, southern, and central California. This report summarizes the survey findings and describes CDHS's efforts to reduce lead exposure among children in California, especially among those in high-risk areas.

California↗
PubMed2004

Over four million California adults age 45 and older have high blood pressure.

Nearly 40% of California adults age 45 and older reported being diagnosed with high blood pressure, according to the 2001 California Health Interview Survey (CHIS 2001). High blood pressure, also called hypertension, is known as "the silent killer" because it often has no symptoms. If left unchecked and untreated, uncontrolled high blood pressure can lead to heart failure, kidney failure, heart attack and stroke. This policy brief provides data of diagnosed high blood pressure rates for California legislative districts and counties for adults age 45 and older. The first of its kind subcounty data in this policy brief are estimates created by a small-area methodology, based on rates from CHIS 2001 that are applied to population data from the 2000 Census and 2002 California Department of Finance.

Aged↗
PubMed2006

Methamphetamine use and HIV risk behaviors among heterosexual men--preliminary results from five northern California counties, December 2001-November 2003.

Methamphetamine (meth) is a highly addictive stimulant that gained widespread popularity in California in the 1980s and has since spread to most regions of the United States, including rural areas. Analyses of survey data among noninjection-drug users from California in the mid-1990s determined that, among heterosexual persons and among men who had sex with men (MSM), meth users reported more sex partners, were less likely to report condom use, and were more likely to report sex in exchange for money or drugs, sex with an injection-drug user, and history of a sexually transmitted disease (STD). Subsequent studies among MSM have indicated an association between meth use and sexual risk behaviors, syphilis infection, and incidence of human immunodeficiency virus (HIV) infection. Subsequent studies among heterosexual populations have been less extensive than those among MSM and often have not used population-based samples nor adjusted for possible confounders. To further assess the association between meth use and high-risk sexual behaviors among heterosexual men, the California Department of Health Services, Office of AIDS, analyzed population-based data from five northern California counties in the HEY-Man (Health Evaluation in Young Men) Study. This report summarizes the results of that analysis, which determined that recent meth use was associated with high-risk sexual behaviors, including sex with a casual or anonymous female partner, anal intercourse, and sex with an injection-drug user. The results suggest the need for states to consider including referrals to meth prevention and treatment programs in their HIV prevention programs and for broader assessment of the relation between meth use and high-risk sexual behaviors.

Adult↗
PubMed1991

Involuntary patients' right to refuse medication: impact of the Riese decision on a California inpatient unit.

On June 22, 1989, the California Supreme Court allowed the Appellate Court decision in the right to refuse treatment case, Riese v. St. Mary's Hospital to stand. The court ruled that absent a judicial determination of incompetence, antipsychotic drugs cannot be administered to involuntarily committed mental patients in non-emergency situations without their informed consent. Much concern was expressed by the California Psychiatric Association and the California Alliance for the Mentally Ill about the decision's negative impact on patient care. In this paper, the authors review the decision, elucidate the anticipated concerns about the impact of the decision, and then describe the decision's actual impact on an acute inpatient unit in California. The authors report that Riese hearings were held on 7 percent of admissions to their locked inpatient facility. Only 1 percent of the patients were found to be competent to refuse medications. The authors give clinical examples of patients who were affected by the Riese decision and review the benefits and risks of this decision from the perspective of actual clinical practice.

Adult↗
PubMed2006

The evolution of California's wild radish has resulted in the extinction of its progenitors.

If two previously isolated taxa mutually assimilate through hybridization and subsequent biparental introgression, and if their introgressed descendants have the same or higher fitness than their parents, then gene flow should result in the local extinction of parental taxa via replacement by hybrid derivatives. These dramatic events may occur rapidly, even in a few generations. Given the speed at which such extinction by hybridization may occur, it may be difficult to identify that the process has occurred. Thus, documented instances of extinction by hybridization are rare, and especially so for cases in which both parents are replaced by the hybrid lineage. Here we report morphological and allozyme evidence for the local extinction of two Raphanus species in California via replacement by their hybrid-derived descendants. The results from a greenhouse experiment demonstrate that California wild radishes have a specific combination of traits from their progenitors, and comparison of our results to that of an earlier report indicate that pure parental types are no longer present in the wild. Our results also show the hybrid-derived lineage has transgressive fruit weight compared to its parents. Allozyme analysis demonstrates that California wild radishes are derived from hybridization between the putative parental species. However, that analysis also demonstrates that California wild radish has now become an evolutionary entity separate from both of its parents. We suggest that the aggressive colonizing behavior of the hybrid-derived lineage probably results from a novel combination of parental traits, rather than genetic variability of the population per se.

Biodiversity↗
PubMed2006

Spatial patterns of Lyme disease risk in California based on disease incidence data and modeling of vector-tick exposure.

Ixodes pacificus, particularly the nymphal life stage, is the primary vector to humans of the Lyme disease agent Borrelia burgdorferi in California. During 2004, we collected I. pacificus nymphs from 78 woodland sites in ecologically diverse Mendocino County, which has a moderately high incidence of Lyme disease. Within this county, nymphal density was elevated in forested areas with a growing degree day range of 2,600-3,000 (10 degrees C base). Using a geographic information systems approach, we identified all areas in California sharing these environmental characteristics and thus projected to pose high acarologic risk of exposure to host-seeking nymphal ticks. Such areas were most commonly detected in the northwestern part of the state and along the Sierra Nevada foothills in the northeast, but the analysis also identified isolated areas with high acarologic risk in southern California. This mirrors the spatial distribution of endemic Lyme disease during 1993-2005; most cases occurred in counties to the northwest (58%) or northeast (26%), whereas fewer cases were reported from southern California (16%). Southern zip-codes from which Lyme disease cases had been reported were commonly located in close proximity to areas with high projected acarologic risk. Overall, Lyme disease incidence in zip code areas containing habitat with high projected acarologic risk was 10-fold higher than in zip code areas lacking such habitat and 27 times higher than for zip code areas without this habitat type within 50 km. A comparison of spatial Lyme disease incidence patterns based on county versus zip code units showed that calculating and displaying disease incidence at the zip code scale is a useful method to detect small, isolated areas with elevated disease risk that otherwise may go undetected.

Animals↗
PubMed2006

Back to the past in California: a temporary retreat to a Tarasoff duty to warn.

The original Tarasoff decision created a duty for California psychotherapists to warn potential victims of their patients. After rehearing the matter two years later, the California Supreme Court, in the landmark second Tarasoff decision, changed the duty to warn to a duty to protect potential victims, with warning as only one of the options for discharging that duty. Despite this change, the Tarasoff duty frequently was referred to erroneously as a duty to warn. This misunderstanding and an ambiguous California immunity statute culminated in "simplified" jury instructions and two appellate court decisions in 2004 in which it was assumed without question that there was a duty to warn, with liability for not doing so regardless of rationale. As a result of persistent lobbying by the California Psychiatric Association and other mental health groups, a recent bill corrected the problem created by the courts, returning the Tarasoff duty to a duty to protect.

California↗
PubMed1992

Behavioral risk factor survey of Vietnamese--California, 1991.

Since 1975, an estimated 979,700 refugees from Vietnam and other Southeast Asian countries have immigrated to the United States (L. Bussert, Office of Refugee Resettlement, U.S. Department of Health and Human Services, personal communication, 1991). Although public health agencies have reported extensively on the occurrence of infectious diseases in these populations (1-4), the prevalence of risk factors for noninfectious health concerns (e.g., heart disease, cancer, and unintentional injuries) have not been well defined. To characterize risk factors for selected noninfectious diseases and injuries among the estimated 280,200 Vietnamese who have relocated to California, the University of California, San Francisco, and the California Department of Health Services developed a Vietnamese-language version of CDC's Behavioral Risk Factor Surveillance System (BRFSS) for use in a computer-assisted telephone interviewing (CATI) system. This report summarizes findings from the 1991 survey and compares them with data for the general California or U.S. population.

Adult↗
PubMed1991

Lifetime Medicaid service utilization and expenditures for AIDS in New York and California.

Several important gaps exists in information on the health care resources used by people with AIDS, including patterns of outpatient care, differences between populations at risk of the disease, and services paid for by Medicaid. To address the shortage of information in these areas, this study examined average Medicaid expenditures and service use for the time period a person has AIDS. The study population was Medicaid enrollees with AIDS in New York and California who died between October 1985 and September 1986. The study focused on the differences between the two states and between four groups that were proxies for at-risk populations: children, women, drug-using men, and non-drug-using men. Mean lifetime Medicaid expenditures were about $30,000 in New York and $20,000 in California. Inpatient use was higher and outpatient service use was lower in New York than in California after controlling for risk group, diagnosis, and Medicaid eligibility group (a proxy for income level). In California, women had higher expenditures and inpatient use than men. In New York, women and drug-using men had higher expenditures and use of inpatient and outpatient services (except home health care) than the non-drug-using men. Children in New York had higher expenditures and hospital use than adults but similar outpatient service use. Multivariate analyses suggest that differences between risk groups were largely attributable to differences in diagnosis and income level (as measured by Medicaid eligibility group).

Acquired Immunodeficiency Syndrome↗
PubMed1990

Immunizing California's children. Effects of current policies on immunization levels.

Data collected by the Immunization Unit of the California Department of Health Services from 1979 to 1987 were analyzed to determine the effects of changes in state policy on the immunization levels of children in California. By December 1986, 90% of all children entering kindergarten in California were adequately immunized, representing a 15% increase from 1979. Although California has shown substantial improvements, it still lags behind the national weighted average. Even with high levels of immunization at kindergarten entry, many toddlers of 7 months and 2 years old remain inadequately immunized. Children immunized solely in the private sector were more adequately immunized than those served by public health clinics; the public-private difference for infants aged 7 months was nearly twofold.

California↗
PubMed1990

The future of family practice training in California.

Although the number of physicians in California has doubled since 1963, the number of family and general practice physicians has declined. The ratio of office-based primary care physicians to population has also decreased. Graduate medical education is funded largely from patient care revenues, but the low rate of reimbursement for ambulatory care makes training in primary care specialties especially dependent on public support. Medicare, the Veterans Administration, and the University of California provide more than $325 million a year in support of graduate medical education in California. Federal and state grant programs provide $5 million a year for family physician training in the state, but appropriations to these programs have been reduced in real terms. California family practice residencies are disproportionately located at county hospitals, where funding shortfalls make them especially vulnerable to cuts in grant programs. Additional resources will be needed if more family physicians are to be trained.

California↗
PubMed1985

Epidemiology of two orbiviruses in California's native wild ruminants: preliminary report.

Between 1978 and 1983 we collected more than 1,500 serum samples from California's native black-tailed deer (Odocoileus hemionus columbianus), 4 races of mule deer (O. h. sp.), tule elk (Cervus elaphus nannodes), Roosevelt elk (C. e. roosevelti), pronghorn antelope (Antilocapra americana), California bighorn sheep (Ovis canadensis californiana), Peninsular bighorn sheep (O. c. cremnobates) and desert bighorn sheep (O. c. nelsoni) and analyzed them for agar gel precipitating (AGP) antibodies to bluetongue (BT) virus (BTV). Various serologic tests for antibodies to a closely-related Orbivirus, epizootic hemorrhagic disease (EHD) virus (EHDV) of deer, were conducted on many herds in most years. Parallel attempts at virus isolation yielded 4 BT serotypes: 10, 11, 13 and 17. EHDV was isolated only twice. The herds sampled were representative of those found in various habitats under various management stages in California. Sampling schemes varied as attempts were made to pinpoint temporal, locational, weather, temperature--related and livestock grazing pressure factors influencing rates of infection. Some disease syndromes associated with isolated BTV and BT antibodies are discussed. This work is the 1st attempt to quantitate the level of Orbivirus infection in wildlife in California.

Animal Population Groups↗
PubMed1977

Agnes Fay Morgan and early nutrition discoveries in California.

Agnes Fay Morgan (1884-1968) and several other California pioneers in nutrition contributed much to the early increase in basic knowledge of nutrition and foods. Dr. Morgan became a member of the faculty in the division of Nutrition at the University of California at Berkeley in 1915. Her academic retirement was in 1954, but she remained active and productive even to the time of her death in 1968. The hallmark of her career was the high standards she established both in training home economists and nutrition investigators and in gaining widespread public recognition of the importance of good nutrition. Also,, she was imaginative and productive in significant research. Such work was directed to the nutrients of California foods and the effects on food values resulting from heat processing and storage. Other major early nutrition scientists in California included Ruth Okey, H. M. Evans, H. S. Olcott, S. Lepkovsky, H. J. Almquist, T. H. Jukes, and E. L. R. Stokstad. Their contributions included major accomplishments in the discovery and/or characterization of vitamin E, vitamin B6, pantothenic acid, and vitamin K.

California↗
PubMed1972

Physician fee indices in California and the U.S. through June 1971.

California physicians' fees increased 2.2 percent in the first half of 1971, according to figures compiled by the Bureau of Research and Planning. Nationally, physicians' fees increased at a faster rate of 3.4 percent during the same period. This was the slowest semi-annual increase in the California Index since the final six months of 1968 when fees increased only 2.0 percent. A decline was also recorded in the rate of price increase for other goods and services in the first half of 1971. Nationally, the "all items" increase amounted to 2.0 percent, and the service component rose 2.1 percent. Also included in this Report is special information on the charging patterns of physicians for office and hospital visits and data on physicians' fees in the Los Angeles and San Francisco Metropolitan Areas. The California Physician Fee Index is a continuing survey conducted by the CMA Bureau of Research and Planning since 1962. The survey questionnaire which lists 26 medical, surgical, radiological, and laboratory procedures, elicits fee information from approximately 1,000 randomly selected physicians. Since June 1970, the procedures on the questionnaire have been listed according to the coding nomenclature used in the 1969 edition of the Relative Value Studies, published by the California Medical Association. Prior to that, the 1964 edition was used to delineate the procedure being surveyed.

California↗