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PubMed2004

An unusual genotype of Toxoplasma gondii is common in California sea otters (Enhydra lutris nereis) and is a cause of mortality.

Toxoplasma gondii-associated meningoencephalitis is a significant disease of California sea otters (Enhydra lutris nereis), responsible for 16% of total mortality in fresh, beachcast carcasses. Toxoplasma gondii isolates were obtained from 35 California otters necropsied between 1998 and 2002. Based on multi-locus PCR-restriction fragment length polymorphism and DNA sequencing at conserved genes (18S rDNA, ITS-1) and polymorphic genes (B1, SAG1, SAG3 and GRA6), two distinct genotypes were identified: type II and a novel genotype, here called type x, that possessed distinct alleles at three of the four polymorphic loci sequenced. The majority (60%) of sea otter T. gondii infections were of genotype x, with the remaining 40% being of genotype II. No type I or III genotypes were identified. Epidemiological methods were used to examine the relationship between isolated T. gondii genotype(s) and spatial and demographic risk factors, such as otter stranding location and sex, as well as specific outcomes related to pathogenicity, such as severity of brain inflammation on histopathology and T. gondii-associated mortality. Differences were identified with respect to T. gondii genotype and sea otter sex and stranding location along the California coast. Localised spatial clustering was detected for both type II (centred within Monterey Bay) and x (centred near Morro Bay)-infected otters. The Morro Bay cluster of type x-infected otters overlaps previously reported high-risk areas for sea otter infection and mortality due to T. gondii. Nine of the 12 otters that had T. gondii-associated meningoencephalitis as a primary cause of death were infected with type x parasites.

Animals↗
PubMed2006

Perceived knowledge, attitudes, and practices of California registered dietitians regarding dietary supplements.

A convenience sample of California registered dietitians (RDs) (n=253) completed a survey investigating the perceived knowledge, attitudes, and practices of RDs who had or had not received formal training in use of dietary supplements. We also examined whether differences existed between RDs registered before or after 1997, when the American Dietetic Association began requiring that dietetics curricula include basic knowledge of dietary supplements. Statistical analysis included analysis of variance and chi2 analysis. Among this sample of RDs from California, those registered before 1997 (n=194) were more likely (P<0.05) to agree that they are knowledgeable regarding supplement use, safety, interactions, and contraindications than those registered after 1997 (n=46), and were more likely (P<0.05) to assess client use. Among this sample of RDs from California, those reporting that they had received formal training in dietary supplements (n=145) were more likely (P<0.05) than those who had no formal training in supplement use (n=105) to agree that they are comfortable discussing supplements with the public; are knowledgeable regarding uses, safety, interactions, and contraindications of supplements; and assess client use. Providing RDs professional education opportunities on supplements continues to be warranted.

Allied Health Personnel↗
PubMed2006

Socio-demographic and cultural comparison of overweight and obesity risk and prevalence in adolescents in Southern California and Wuhan, China.

PURPOSE: This study performed parallel analyses on two large samples of seventh graders living in Los Angeles, California and in Wuhan, China to make direct comparisons of overweight and obesity risks in Western and Eastern cultural environments. METHODS: Two representative samples of 1772 and 1896 seventh grade students were randomly selected from the public or parochial middle schools in the greater Los Angeles area of Southern California in the United States, and public schools in Wuhan city of China. Two body mass index (BMI) references recently established by the U.S. National Center for Health Statistics (NCHS) and the International Obesity Task Force (IOTF), respectively, were used to define overweight (85th < or = BMI < 95th percentile) and obesity (BMI > or = 95th percentile). Logistic regressions were conducted to examine relationships between socioeconomic status (SES) and obesity risk. RESULTS: The prevalence rates of combined overweight and obesity in Los Angeles and in Wuhan were 43.1% and 12.1%, respectively, by the US-NCHS reference, and 45.8% and 11.9%, respectively, by the IOTF reference. Chinese-American adolescents had higher prevalence rates for overweight and obesity than those from China. SES was positively related to the risk of overweight and obesity in the Chinese sample, whereas a negative association was found in Southern California adolescents. Urbanicity was significantly positively related to higher overweight and obesity prevalence. CONCLUSION: Different overweight and obesity prevalence estimates and SES effects were observed for American and Chinese adolescent samples. Research on the underlying mechanisms is needed to help us to set up a tailored program for obesity prevention in Eastern and Western cultural environments.

Adolescent↗
PubMed2004

Evaluation of California's graduated driver licensing program.

PROBLEM: California's graduated driver licensing (GDL) program was implemented to reduce the high crash risk of teenage drivers. The program enhancements made in 1998 were evaluated in this study using methods that rule out the noticeable downward trend in California teen's fatal/injury crash rates as a possible explanation for any observed crash reductions that could otherwise be mistaken for program effects. METHOD: Monthly per capita fatal/injury crash rates for 15-to-17-year-olds and proportional representations of 16-17-year-olds' nighttime and passenger crashes were analyzed using intervention time series analysis. RESULTS: After removing trend, seasonality, and transition effects in the data, no overall reductions in fatal/injury crashes for 15-17-year-olds or 16-year-olds (separately) were found to be associated with the 1998 program enhancements, suggesting no overall exposure reduction effect of the longer instruction permit period nor increased competency associated with the higher number of required practice hours. However, the 12-month nighttime and 6-month passenger restrictions were found to be associated with annual savings of 55 and 816 fatal/injury crashes, respectively. DISCUSSION: Finding no overall impact of the 1998 GDL enhancements was not surprising given findings of an earlier survey suggesting that California teens and parents were largely already practicing program requirements prior to implementation and were not fully complying with the program requirements afterwards. Though the observed crash savings associated with the restrictions were of modest size, this is the first study to evidence a direct positive impact of the passenger restriction component of GDL programs. Larger reductions could be realized if the nighttime restriction started earlier and parents/law enforcement could be motivated to better enforce these restrictions. IMPACT ON INDUSTRY: The findings provide support for passenger and nighttime restriction components of GDL programs.

Accidents, Traffic↗
PubMed2005

Analysis of responses of Long Beach, California residents to the Smoke-free Bars Law.

OBJECTIVES: We investigated survey responses to the Smoke-free Bars Law by residents of Long Beach, California (population 460,000), a city that reflects the state's diverse population. The research specifically aimed to determine: (1) residents' approval for the 1998 California Smoke-free Bars Law when it was implemented; and (2) changes in approval between baseline and 2-year follow-up. Data were also assessed for the demographic characteristics of the respondents and whether the respondents were self-acknowledged smokers or non-smokers. STUDY DESIGN: A random telephone survey was conducted in 1998 and 2000 in Long Beach to determine the degree of community support for the 1998 state law that prohibited smoking in all workplaces including alcohol-serving establishments. The numbers analysed were 784 in 1998 and 1237 in 2000. METHODS: Statistical analyses used in this research included univariate frequency distributions and logistic regression for 1998 and 2000. RESULTS: The major findings were as follows. Overall community approval for the 1998 state law increased from 65.2% in 1998 to 72.6% in 2000. Over this period, the rate of approval by smokers increased from 20.6% to 37.1%, and the rate of approval by non-smokers increased from 74.5% to 80.3%. CONCLUSIONS: The general public in a large city in California strongly approve of the prohibition of smoking in all indoor public places. This strong endorsement has major public health implications.

Adult↗
PubMed2005

A comparison of the non-essential elements cadmium, mercury, and lead found in fish and sediment from Alaska and California.

Concentrations of three non-essential elements (cadmium (Cd), mercury (Hg), and lead (Pb)) were determined in sediment and fish from several locations in Alaska (AK) and California (CA) and used to examine differences in bioaccumulation within and between geographic locations. We analyzed tissue (liver, muscle, gill, and stomach contents) from white croaker (Genyonemus lineatus) and English sole (Pleuronectes vetulus) in California and flathead sole (Hippoglossoides elassodon) in Alaska, in addition to several species of invertebrates (mercury only). As found in previous work on arsenic (As) [Meador et al., 2004], Cd in fish liver exhibited a negative correlation with sediment concentrations. No such correlations were found for Hg and Pb when fish liver and sediment were compared; however, these metals did exhibit a positive relationship between liver and organic carbon normalized sediment concentrations, but only for the CA sites. Sediment concentrations of Hg at the AK sites were lower than those for the CA sites; however, AK invertebrates generally bioaccumulated more Hg than CA invertebrates. Conversely, Hg bioaccumulation was higher in CA fish. Even though ratios of total metal/acid volatile sulfides (AVS) in sediment were one to two orders of magnitude higher for the AK sites, bioaccumulation of these elements was much higher in fish from the CA sites. Bioaccumulation factors ([liver]/[sediment]) (BAFs) were highest at relatively clean sites (Bodega Bay and Monterey), indicating that elements were more bioavailable at these sites than from more contaminated locations. The observation of high BAFs for As in fish from Alaska and low BAFs for the California fish, but reversed for Cd, Hg, and Pb in this study, implies that differences in fish species are less important than the unique geochemical features at each site that control bioavailability and bioaccumulation and the potential sources for each element. Additionally, these data were also used to examine the metal depletion hypothesis, which describes the inverse relationship between elements and organic contaminants documented in some monitoring studies. Our results suggest that the enhanced bioavailability of the metals at some uncontaminated sites is the main determinant for the inverse correlation between metal and organic contaminants in tissue.

Acids↗
PubMed2005

Population-level history of the wrentit (Chamaea fasciata): implications for comparative phylogeography in the California Floristic Province.

The phylogeography of a variety of species has been studied within the California Floristic Province; however, few studies have examined genetic variation in bird species across the entire region. This study uses mitochondrial DNA data to investigate the phylogeography of the wrentit (Chamaea fasciata), a sedentary bird native to scrub and chaparral habitats of this region. Analysis of molecular variance shows geographic structure, and maximum likelihood, Bayesian, and parsimony analyses consistently identify six main clades that are each restricted geographically. Nested clade phylogeographic analyses infer an overall range expansion for the entire cladogram, and a range expansion is also inferred from the mismatch distribution. Thus, our results suggest that the wrentit was isolated into southern refugia during the Pleistocene and has undergone a recent range expansion. Southern refugia and a range expansion were also identified in a previous study of the California thrasher (Toxostoma redivivum). The wrentit did not show marked divergence between northern and southern California defined by the Transverse Ranges, a pattern seen in a variety of other taxa within this region, including some birds.

Animals↗
PubMed2005

Pap smear use in California: are we closing the racial/ethnic gap?

BACKGROUND: Minority women continue to be disproportionately affected by cervical cancer. Minority population groups at high risk for cervical cancer may be failing to fully comply with screening recommendations. The use of Pap smears among women in California was evaluated to identify ethnic groups at higher risk for noncompliance with cervical cancer screening. METHODS: Cross-sectional analysis of 2001 California Health Interview Survey data. Logistic regression was used to assess the independent contribution of race/ethnicity to the use of Pap smears. RESULTS: Hispanic (aPR = 1.03, 95% CI 1.02-1.05) and Black (aPR = 1.03, 95% CI 1.001-1.06) women are more likely to report a Pap smear in the past 3 years as compared to White women. Asians were the least likely to report cervical cancer screening despite a more favorable sociodemographic profile. Screening rates varied among Hispanic or Asian subgroups; Mexicans, Vietnamese, Chinese, and South Asians are particularly underserved. CONCLUSIONS: In contrast to the country as a whole, Hispanic women in California are more likely to report a recent Pap smear as compared to White women. However, racial/ethnic disparities in Pap smear use persist; Asian women are the least likely to report cervical cancer screening as compared to any other group.

Asian↗
PubMed2005

Increasing excise taxes on cigarettes in California: a dynamic simulation of health and economic impacts.

BACKGROUND: California raised cigarette excise taxes in 1999, and may generate additional health and economic benefits by raising them further. METHODS: A dynamic computer simulation model follows births, deaths, migration, aging, and changes in smoking status for the entire population of California over 75 years to estimate the cumulative health and economic outcomes of these changes under several excise tax rate conditions (up to 100% price increase). RESULTS: A 20% tax-induced cigarette price increase would reduce smoking prevalence from 17% to 11.6% with large gains in cumulative life years (14 million) and QALY's (16 million) over 75 years. Total spending on cigarettes by consumers would increase by 270 million dollars in that span (all going to tax revenue), and those who reduce the number of years spent as a smoker would spend 12.5 billion dollars less on cigarettes. Total smoking-related medical costs would drop by 188 billion dollars. These benefits increase greatly with larger tax increases, with which tax revenues continue to rise even as smoking prevalence falls. CONCLUSIONS: Even considering benefits from the 1999 increase, California has not yet maximized the potential of excise taxes to lessen the negative impacts of smoking. Additional tax increases would provide added health benefits and revenue to the state.

California↗
PubMed2002

Traffic safety and the switch to a primary seat belt law: the California experience.

This study explores whether the change of an existing seat belt law from secondary to primary enforcement enhances traffic safety. In particular, we examine traffic fatalities and injuries in California from 1988 to 1997. During the first half of this period, California law provided for secondary enforcement of its mandatory seat belt law, but in 1993 it upgraded the law to primary enforcement. Controlling for the number of motor vehicle collisions, a Box-Tiao intervention analysis of the time series is used to compare the monthly fatalities and injuries before and after the change in the enforcement provision. The results show that California experienced an improvement in traffic safety in terms of a significant reduction in injuries, but the change in enforcement provision had no statistically significant impact on fatalities.

Accidents, Traffic↗
PubMed1977

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Incidence of myocardial infarction and death from coronary heart disease.

The incidence of myocardial infarction and death from coronary heart disease was studied in defined samples of 45 to 68 year old Japanese men in Japan, Hawaii and California. The incidence rate was lowest in Japan where it was half that observed in Hawaii (P less than 0.01). The youngest men in the sample in Japan were at particularly low risk. The incidence among Japanese men in California was nearly 50 percent greater than that of Japanese in Hawaii (P less than 0.05). A striking increase in the incidence of myocardial infarction appears to have occurred in the Japanese who migrated to the United States; this increase is more pronounced in California than in Hawaii.

Age Factors↗
PubMed2000

Incidence trends for colorectal cancer in California: implications for current screening practices.

PURPOSE: The sensitivities of different screening methods for precancerous adenomas may affect the anatomical distribution of colorectal cancers. We used statewide data from California to describe time trends in the distribution of colorectal carcinoma. SUBJECTS AND METHODS: Between 1988 and 1996, 110,378 cases of colorectal cancer were recorded in the California Cancer Registry database. Tumors proximal to, but not including, the sigmoid colon were termed "right-sided." The remaining tumors, excluding the anus, were termed "left-sided." Multivariable analyses were used to determine the effects of age, sex, and race on changes in tumor location over time. RESULTS: During the study period, the annual incidence of colorectal cancer decreased steadily, from 200 to 162 cases per 100,000 residents. The decrease in left-sided tumors was about twice that observed on the right (-24.3% vs -11.6%). This disparity remained significant when adjusted for age, sex, and race (P = 0.0001). CONCLUSION: The incidence of colorectal cancer in California is decreasing, particularly for left-sided (distal) tumors. Current screening recommendations, which emphasize examination of the distal colon, may need to be expanded to include the entire colon.

Age Distribution↗
PubMed2002

Determination of hexavalent chromium at the level of the California Public Health Goal by ion chromatography.

Chromium is a primary drinking water contaminant in the USA with hexavalent chromium, Cr(VI), being the most toxic form of the metal. As a required step in developing a revised state drinking water standard for chromium, the California Department of Health Services recently issued a new Public Health Goal (PHG) of 2.5 microg/l for total chromium and 0.2 microg/l for Cr(VI). Hexavalent chromium can be determined (as chromate) by ion chromatography, as described in US Evironmental Protection Agency Method 218.6; however, the method as originally published does not allow sufficient sensitivity for analysis at the California PHG level of 0.2 microg/l. Modification of the conditions described in Method 218.6, including the use of a lower eluent flow-rate, larger reaction coil, and larger injection volume, significantly increases the method sensitivity. The modified method, which uses IonPac NG1 and AS7 guard and analytical columns, an eluent of 250 mM ammonium sulfate-100 mM ammonium hydroxide operated at 1.0 ml/min, a 1000 microl injection volume, and postcolumn reaction with 2 mM diphenylcarbazide-10% methanol-0.5 M sulfuric acid (using a 750 microl reaction coil) followed by UV-Vis detection at 530 nm, permits a method detection limit for chromate of 0.02 microg/l. This results in a quantitation limit of 0.06 microg/l, which is more than sufficient for analysis at the California PHG level. Calibration is linear over the range of 0.1-10 microg/l and quantitative recoveries (>80%) are obtained for chromate spiked at 0.2 microg/l in drinking water. The modified method provides acceptable performance, in terms of chromate peak shape and recovery, in the presence of up to 1000 mg/l chloride or 2000 mg/l sulfate.

Calibration↗
PubMed2001

Trace metals in fish and invertebrates of three California coastal Wetlands.

Metal concentrations were measured in selected fish and invertebrate species from Mugu Lagoon, Malibu Lagoon and Ballona Wetlands in southern California in order to assess the extent of metal contamination in these three wetlands. Ranges of element concentrations (in microgram/g) found in biota were: Zn 12-650; Cu 1.9-440; Ni < 1-37; Cr < 1-55; Pb < 0.5-6.8; As < 1-8.5; Se < 1-3.8; Cd < 0.2-0.90; and Ag < 0.3-5.9. Relative to previous studies of California biota, the highest metal concentrations found were for chromium and nickel. The highest levels were in one of the two bottom-dwelling fish (juvenile Leptocottus armatus) (55 micrograms/g) and the two water-column fish sampled (Fundulus parvipinnis and Atherinops affinis) (30 and 24 micrograms/g). At Ballona Lagoon, elevated levels of copper and silver were found in the bivalve Tagelus californianus (440 and 5.9 micrograms/g). Chromium and nickel appeared to be most persistent in fish from Mugu (4.6-55 and 2.6-37 micrograms/g), the most northern site and an active military base, and Ballona (< 1-30 and < 1-16 micrograms/g), believed to be the most metal-contaminated site. Compared to previously measured metal concentrations in species of California coastal waters, these regions revealed higher levels of chromium, nickel, silver, arsenic, zinc, copper and, to a lesser extent, cadmium and selenium. Chromium and silver were present at high enough levels at all three sites to be considered environmental health hazards.

Animals↗
PubMed2003

Elements in fish of Malibu Creek and Malibu Lagoon near Los Angeles, California.

Our aim was to assess whether past discharges from a wastewater treatment plant increased metal pollutant loads in stream mobile species in a one-day baseline sampling study that included a coastal wetland. Mosquitofish (Gambusia affinis) of two sizes, black bullhead (Ameiurus melas), and crayfish (Pacifastacus leniusculus) were collected from Malibu Creek, and California killifish (Fundulus parvipinnis) of three sizes, as well as arroyo chub (Gila orcutti) were sampled from Malibu Lagoon near Los Angeles, California. Species from each locality were pooled by length, homogenized, digested by microwave wet ashing, and analyzed by simultaneous inductively coupled plasma atomic emission spectroscopy for 27 elements. Lagoon killifish 2.0-3.5 cm long contained levels of arsenic and lead above the levels for 95% of California fish, the EDL95. Black bullhead upstream of the discharge contained elevated levels of As, Cr and Se. Young mosquitofish <3 cm in length upstream of the discharge differed greatly in the order of abundance of their elements relative to larger mosquitofish and to other species collected. More sampling than this baseline study allowed was needed to determine if the wastewater treatment plant was a pollution source.

Animals↗
PubMed2003

The economic burden of gynecologic cancers in California, 1998.

OBJECTIVE: Our aim was to estimate the direct and indirect costs of gynecologic cancers including cervical, ovarian, and uterine cancer in California in 1998. METHODS: Hospitalization costs, including costs of primary and secondary diagnoses of each of the gynecologic cancers, are derived from the California Patient Discharge dataset. Charges are converted to costs using hospital-specific cost-to-charge ratios and an imputed cost for HMO hospitalizations. Other direct medical costs are derived from the 1997 Medical Expenditure Panel Survey. Indirect mortality costs are the product of the number of deaths and the expected value of a female's future earnings, including an imputed value of housekeeping services. RESULTS: The total cost of the three gynecologic cancers in California is estimated at $624 million for 1998. Indirect costs or losses in productivity due to premature death are twice the direct medical care costs. Hospitalization inpatient costs account for more than half of total direct costs for each of these cancers. Total costs for ovarian cancer are highest among the three cancers. CONCLUSIONS: The estimates presented here highlight the need for studies that identify cost-effective screening methods and the relationship between treatment protocols and outcomes. The methods presented here could be used to develop stage- or treatment-specific costs that would be useful for such analyses. Only through early detection and more effective management of gynecologic cancers can there be a reduction in the morbidity, premature death, and high costs of cervical, ovarian, and uterine cancers.

Adolescent↗
PubMed2002

Investigation of Bartonella infection in ixodid ticks from California.

A total of 1253 ixodid ticks (254 tick pools) collected between the end of 1995 and the spring of 1997 from six California counties (El Dorado, Los Angeles, Orange, Santa Cruz, Shasta and Sonoma) were examined for the presence of Bartonella DNA by PCR of the citrate synthase gene. Of 1,119 adult Ixodes pacificus ticks tested, 26 (11.6%) of 224 pools, each containing five ticks, were positive (minimum percentage of ticks harboring detectable Bartonella DNA, 2.3%). Bartonella PCR-positive ticks were identified in five counties but none of the ticks from Los Angeles County was positive. Among 47 nymphal I. pacificus ticks collected in Sonoma County, one (10%) positive pool out of 10 pools was identified (minimum percentage of ticks harboring detectable Bartonella DNA, 2.1%). Among the 54 Dermacentor occidentalis grouped in 12 pools from Orange County, one pool (8.3%) was PCR positive for Bartonella and similarly one pool (14.3%) was positive among the 30 Dermacentor variabilis ticks grouped in seven pools. None of the three D. occidentalis from El Dorado County were positive. None of the nine tick pools positive for Ehrlichia phagocytophila were positive for Bartonella. Following our previous findings of Bartonella PCR-positive adult I. pacificus ticks in central coastal California, this is the first preliminary report of the presence of Bartonella DNA in I. pacificus nymphs and in Dermacentor sp. ticks. Distribution of Bartonella among ixodid ticks appears widespread in California.

Animals↗
PubMed2003

DUI recidivism: a comparison of Mexican Americans and whites in a northern California county.

OBJECTIVE: While Hispanic offenders for driving under the influence of alcohol (DUI) in California are more likely to have a history of multiple offenses compared to whites, little is known about characteristics associated with DUI recidivism in either ethnic group. Demographic and DUI conviction characteristics associated with DUI recidivism are analyzed among Mexican American and white DUI offenders in a Northern California county. METHOD: A sample of 459 primarily Mexican Americans and 490 whites were randomly selected from records supplied by the California Department of Motor Vehicles (DMV) on over 16,000 DUI offenders in the county during a 3-year period. DMV data on DUI convictions in the 1- and 5-year period preceding the identifying DUI offense and the year following the identifying offense (the recidivism conviction) were analyzed. RESULTS: Rates of recidivism were significantly lower for Mexican Americans (5%) compared to whites (11%) who were arrested for DUI but not convicted, but higher for those convicted (12% vs. 5%). While conviction status of the identifying DUI offense was not predictive of recidivism among Mexican Americans, a DUI conviction in the preceding year was significantly predictive. Among white arrestees, receiving a conviction was significantly, and negatively, predictive of recidivism, but among those who were convicted, a previous DUI conviction in the last year was predictive of recidivism. Referral to a DUI treatment program was not a significant predictor of recidivism among those convicted in either ethnic group. CONCLUSIONS: The data suggest that conviction for a DUI may not play the same role in the likelihood of subsequent DUI convictions for Mexican Americans as for whites, and this difference may need to be considered in DUI treatment programs. Additional research on ethnic differences in DUI offenses and recidivism over longer periods of follow-up is needed to determine ethnic-specific intervention and prevention strategies for DUI.

Adult↗