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PubMed2001

Spatial and temporal clustering of Salmonella serotypes isolated from adult diarrheic dairy cattle in California.

Electronic records from the California Animal Health and Food Safety Laboratory System between January 1, 1991, and June 30, 1998, were reviewed, and data on 593 Salmonella serotypes isolated from feces or intestinal contents of adult dairy cattle with diarrhea were analyzed to determine spatial and temporal clustering. A statistically significant clustering in space was detected with 10 (Typhimurium, Montevideo, Muenster, Anatum, Give, Menhaden, Kentucky, Agona, Derby, and Newport) of the 13 serotypes examined. Significant temporal clustering was also detected with 10 serotypes (Typhimurium, Montevideo, Muenster, Anatum, Give, Newbrunswick, Menhaden, Kentucky, Derby, and Newport). Six serotypes (Anatum, Menhaden, Montevideo, Muenster, Newbrunswick, and Newport) were significantly spatially and temporally clustered. A difference in temporal and spatial distribution patterns of some serotypes associated with diarrhea in adult dairy in California was found. Knowledge of the specific type of clustering, if present, should improve our understanding of the transmission and control of salmonellosis in the field.

Animals↗
PubMed1990

A survey of causes of bovine abortion occurring in the San Joaquin Valley, California.

The causes of abortion in cattle in the San Joaquin Valley of California were surveyed from submissions to the California Veterinary Diagnostic Laboratory at Tulare. Four hundred sixty-eight abortion cases were examined. Most submissions (89%) were from large drylot dairies, milking an average of 814 cows. Abortion evaluations included necropsy, histopathology, bacteriology, virology, and other immunologic and serologic tests. A specific cause was identified in 29.5% of the abortions. Bacterial infections, most of which were sporadic, accounted for 16% of all abortions. Viral causes and protozoal infections were diagnosed in 5.6% and 3.2% of the abortions, respectively. Fetuses with protozoal infection had histologic lesions of focal nonsuppurative necrotizing encephalitis, and protozoa were detected. Similar histologic lesions were seen in 80 additional fetuses (17.1%), and although an etiologic agent was not identified for these cases, a protozoal infection was suspected.

Abortion, Veterinary↗
PubMed1996

Dairy cattle abortion in California: evaluation of diagnostic laboratory data.

A descriptive study was undertaken on 595 dairy cattle abortion submissions to the California Veterinary Diagnostic Laboratory System from July 1, 1987, to December 31, 1989, to determine the etiologic nature and distribution (seasonal and geographical) of dairy cattle abortion in California as reflected by laboratory submissions. Univariate analysis was performed to characterize abortion-related submissions by farm and laboratory variables, and logistic regression analysis was performed to determine factors that may influence success of abortion diagnosis in the laboratory. The proportions of dairies that submitted abortion-related specimens from northern, central, and southern milksheds during the 2.5-year period were 20.3%, 15.7%, and 13.1%, respectively, and 60% of submissions were from medium-sized (200-999 cows) dairies. Submissions consisted of fetus (58%), placenta (2%), fetus and placenta (12%), and fetus, placenta, and maternal blood (0.84%); fetal tissues and uterine fluid constituted the rest. An apparent pattern in abortion submissions was indicated by a peak in submissions during the winter and summer of 1988 and 1989. Infectious agents were associated with 37.1% of submissions; noninfectious causes, 5.5%, and undetermined etiology, 57.3%. Bacterial abortion accounted for 18% of etiologic diagnoses; protozoal, 14.6%; viral, 3.2%; and fungal, 1.3%. Submissions comprising fetus, placenta, maternal blood, or their combinations were associated with a higher likelihood of definitive diagnosis for abortion than tissues, as were fresher specimens and submissions associated with the second trimester of fetal gestation.

Abortion, Veterinary↗
PubMed1998

Papillomatous digital dermatitis (footwarts) in California dairy cattle: clinical and gross pathologic findings.

Clinical, gross pathologic, and therapeutic studies were performed on a contagious, painful, wart-like digital disease of unknown etiology in California dairy cattle. The disease was called papillomatous digital dermatitis (PDD). Survey indicated that the disease spread geographically throughout southern California over the past few years. In 1991, 31% of herds had papillomatous digital dermatitis, whereas in 1994, 89% were affected. Increased incidence occurred during late spring and summer, 1-3 months after the rainy season. Within-herd morbidity ranged from 0.5% to 12% per month. Study of 93 cows in 10 drylot dairies revealed that 91% had characteristic circumscribed, erosive to papillomatous, intensely painful lesions often surrounded by a ridge of hyperkeratotic skin bearing hypertrophied hairs. Lesions were 2-6 cm across (88%), circular to oval (78%), and raised (59%) and had surfaces that were uniformly erosive and granular (31%), uniformly papillary (28%), or composites of both appearances (41%). Lesions were most frequently seen in lactating heifers (31%) and 3-year-old cows (43%). Clinical signs were characterized by lameness, with walking on toes and clubbing of hooves. Lesions exclusively involved the hind limbs in 82% of cows and the plantar/palmar regions in 84% of cows. Lesions had high (89%) prediliction for plantar/palmar skin bordering the interdigital space. Lesions exclusively involved either the medial or lateral digit in 10% and 28% of cows, respectively. In 50% of cows, both medial and lateral digits of individual limbs were involved; in most cows (31%), lesions apposed each other across the plantar interdigital space, whereas in others (19%), lesions confluently involved the entire plantar/palmar commissural skin folds. In another 12% of cows, lesions were axial. High proportions of lesions showed complete therapeutic responses to antibiotics: parenteral penicillin (9/9) and ceftiofur (41/44), and topical oxytetracycline (4/4). Recurrence or new lesion development occurred in 48% of cows reexamined 7-12 weeks after complete therapeutic response was observed. Overall, the findings indicated that PDD is a distinct disease entity of economic importance in which bacteria may play an important pathogenic role.

Animals↗
PubMedDate not supplied

California provider group report cards: what do they tell us?

The objective of this study was to perform a practical assessment of publicly reported data from 4 reports on California provider groups through the eyes of the consumer. The study compared performance indicator content and rating methodologies, examined the degree of correlation in provider group performance on indicators common to 2 or more reports, and assessed the level of concordance among summary ratings of performance. Comparative analyses revealed significant variation in performance indicator content, data sources, and rating methodologies. Spearman correlation analysis revealed highly correlated group performance on patient satisfaction and member-requested group transfers, poorly correlated performance on breast and cervical cancer screening, and moderately correlated performance on state and regional average scores. Summary ratings applied to these data were only moderately correlated. These findings suggest that competing California provider group report cards produce inconsistent messages about provider quality and may create barriers to use, comprehension, and reliance upon quality information among consumers and other potential users.

Benchmarking↗
PubMed2000

Assessing community change at multiple levels: the genesis of an evaluation framework for the California Healthy Cities Project.

More than 40 cities have participated in the California Healthy Cities Project since its inception in 1988. Because Healthy Cities efforts are community driven, these cities address diverse health and social issues using a wide variety of strategies. This complexity, in addition to the usual difficulties associated with evaluating community interventions, creates many challenges for evaluation. Given the community building and process orientation of Healthy Cities, it may be most appropriate to measure intermediate community changes that have been linked to health outcomes in previous research or, at a minimum, theoretically. The California Healthy Cities evaluation framework conceptualizes change at five levels: individual, civic participation, organizational, interorganizational, and community. The framework, developed collaboratively with Healthy Cities participants, attempts to synthesize current thinking and practice on evaluation of community projects by applying concepts from community capacity/competence, social ecology, and urban planning.

California↗
PubMed2005

Recreational gun use by California adolescents.

Most research on adolescents and firearms focuses on urban populations, handguns, and homicide. This study examines the prevalence and correlates of recreational gun use (RGU)--for hunting or target shooting--among 5,801 community-residing 12- to 17-year-old Californians. Data are from the first statewide California Health Interview Survey (CHIS), and person, design, and population weights were applied to the data. About one fifth (22.4%) of California adolescents report that they have gone hunting or target shooting. Nearly two thirds (62.8%) have hunted with a family member, typically (67.3%) their father. Recreational gun use among adolescents appears to be linked to a few basic demographic characteristics; most notably, male adolescents had an adjusted odds ratio of RGU nearly five times that of female adolescents. Some of the variables associated with RGU are consistent with those for violent gun use; differences, however, suggest that separate approaches to preventing firearm-related injury may be warranted.

Adolescent↗
PubMed2006

HIV/AIDS misconceptions among Latinos: findings from a population-based survey of California adults.

Misconceptions about HIV/AIDS among Latino adults (N = 454) in California were examined using data from a population-based telephone survey conducted in 2000. Common misconceptions concerning modes of HIV transmission included transmission via mosquito or animal bite (64.1%), public facilities (48.3%), or kissing someone on the cheek (24.8%). A composite misconceptions score was constructed. Correlations between the composite measure and other HIV/AIDS-related beliefs were examined. Latinos with a higher level of misconceptions were more likely to report higher self-perceived risk of HIV infection, and discomfort with infected individuals in a school and in a food setting. Results from multiple linear regression analysis indicated that individuals 45 years and older, those who were interviewed in Spanish, and those with lower education or income levels had a higher degree of misconceptions. The results suggest the need for targeted education efforts to reduce HIV/AIDS misconceptions among Latino adults in California.

Acquired Immunodeficiency Syndrome↗
PubMed1999

The California Violence Prevention Initiative: advancing policy to ban Saturday night specials.

The California Violence Prevention Initiative (VPI) was conceived in 1993 as a 5-year, $35 million comprehensive community, media, research, and policy advocacy effort to reduce violence among youth. The VPI included an emphasis on three broad policy areas: shifting society's definition of violence to include a public health perspective, reducing access to alcohol and other drugs, and limiting availability of handguns. For the first 3 years of the VPI, the policy focus was on reducing the availability of handguns to youth through efforts to ban the manufacture and sale of Saturday night specials (SNSs). Prior to the VPI, there were no local SNS bans. Now, there are bans in 41 California jurisdictions, including major population centers. After two vetoes of a statewide legislative ban by the former governor, an SNS ban was signed by a newly elected governor.

Adolescent↗
PubMedDate not supplied

Breast cancer risk in Hispanic agricultural workers in California.

In a registry-based case-control study of breast cancer in farm labor union members in California, 128 breast cancer (BC) cases newly diagnosed in 1988--2001 and 640 cancer-free controls were investigated. Stage and grade of disease at diagnosis were about the same as in the California Hispanic population. Risk of breast cancer was not associated with work with any specific crops or commodities except mushrooms, where the adjusted odds ratio (OR) was 6.00 (95% CI 2.01-18.0). Controlling for covariates, adjusted ORs (and 95% CIs) for breast cancer in quartiles of pesticide use were 1.00, 1.30 (0.73-2.30), 1.23 (0.67-2.27), and 1.41 (0.66-3.02). Chlordane, malathion, and 2,4-D were associated with increased risk. Risk associated with chemical use was stronger in younger women, those with early-onset breast cancer, and those diagnosed earlier (1988--1994).

Adult↗
PubMed2005

Use of dietary supplements by female seniors in a large Northern California health plan.

BACKGROUND: Women aged >or= 65 years are high utilizers of prescription and over-the-counter medications, and many of these women are also taking dietary supplements. Dietary supplement use by older women is a concern because of possible side effects and drug-supplement interactions. The primary aim of this study was to provide a comprehensive picture of dietary supplement use among older women in a large health plan in Northern California, USA, to raise awareness among health care providers and pharmacists about the need for implementing structural and educational interventions to minimize adverse consequences of self-directed supplement use. A secondary aim was to raise awareness about how the focus on use of herbals and megavitamins that has occurred in most surveys of complementary and alternative therapy use results in a significant underestimate of the proportion of older women who are using all types of dietary supplements for the same purposes. METHODS: We used data about use of different vitamin/mineral (VM) supplements and nonvitamin, nonmineral (NVNM) supplements, including herbals, from a 1999 general health survey mailed to a random sample of adult members of a large Northern California health plan to estimate prevalence of and characteristics associated with supplement use among women aged 65-84 (n = 3,109). RESULTS: Based on weighted data, 84% had in the past 12 months used >1 dietary supplement, 82% a VM, 59% a supplement other than just multivitamin or calcium, 32% an NVNM, and 25% an herbal. Compared to white, nonHispanic women, African-Americans and Latinas were significantly less likely to use VM and NVNM supplements and Asian/Pacific Islanders were less likely to use NVNM supplements. Higher education was strongly associated with use of an NVNM supplement. Prevalence did not differ by number of prescription medications taken. Among white, nonHispanic women, multiple logistic regression models showed that college education, good health, belief that health practices have at least a moderate effect on health, and having arthritis or depression significantly increased likelihood of NVNM use, while having diabetes decreased likelihood. CONCLUSIONS: An extremely high proportion of older women are using dietary supplements other than multivitamins and calcium, many in combination with multiple prescription medications. Increased resources should be devoted to helping clinicians, pharmacists, supplement vendors, and consumers become more aware of the safety, effectiveness, and potential side effects of dietary supplements.

Aged↗
PubMed2006

California Men's Health Study (CMHS): a multiethnic cohort in a managed care setting.

BACKGROUND: We established a male, multiethnic cohort primarily to study prostate cancer etiology and secondarily to study the etiologies of other cancer and non-cancer conditions. METHODS/DESIGN: Eligible participants were 45-to-69 year old males who were members of a large, prepaid health plan in California. Participants completed two surveys on-line or on paper in 2002-2003. Survey content included demographics; family, medical, and cancer screening history; sexuality and sexual development; lifestyle (diet, physical activity, and smoking); prescription and non-prescription drugs; and herbal supplements. We linked study data with clinical data, including laboratory, hospitalization, and cancer data, from electronic health plan files. We recruited 84,170 participants, approximately 40% from minority populations and over 5,000 who identified themselves as other than heterosexual. We observed a wide range of education (53% completed less than college) and income. PSA testing rates (75% overall) were highest among black participants. Body mass index (BMI) (median 27.2) was highest for blacks and Latinos and lowest for Asians, and showed 80.6% agreement with BMI from clinical data sources. The sensitivity and specificity can be assessed by comparing self-reported data, such as PSA testing, diabetes, and history of cancer, to health plan data. We anticipate that nearly 1,500 prostate cancer diagnoses will occur within five years of cohort inception. DISCUSSION: A wide variety of epidemiologic, health services, and outcomes research utilizing a rich array of electronic, biological, and clinical resources is possible within this multiethnic cohort. The California Men's Health Study and other cohorts nested within comprehensive health delivery systems can make important contributions in the area of men's health.

Aged↗
PubMed1983

A comparison of the quality of participation of community affiliates and that of universities in the Northern California Oncology Group.

The quality of participation in the performance of clinical trials of university members and community affiliates of the Northern California Oncology Group is evaluated and compared. The data, based on 738 patients on 33 protocols, were collected during a one year period, July 1, 1980--June 30, 1981. The comparisons are made on three types of criteria: accrual distribution, with respect to study phase and modality multiplicity; data quality, generally reflecting protocol adherence; and data completeness. The performance of the community affiliates was found to equal or surpass that of the university members in most measures. Therefore, it is concluded that the community affiliates are functioning as full and valuable participants in the Northern California Oncology Group.

California↗
PubMed2005

Communicating respectfully with American Indian and Alaska natives: lessons from the California Health Interview Survey.

Background. California is home to the largest number of American Indians in the United States, including large numbers of residents who are from tribes outside of the state, in addition to Alaska Natives. In 2000 to 2001, the California Health Interview Survey randomly surveyed, by telephone, approximately 54,122 households throughout the state, focusing on public health and access to health care. Methods. American Indian and Alaska Native cultural competency training materials were developed for the data collection interviewers. Unique cultural and linguistic issues identified were (1) reservation dialect English, (2) the long pause, (3) slow speaking, (4) "walking on words," and (5) a brief review of the importance of collecting tribal heritage information. Conclusions. Since the successful implementation of the competency training, several researchers, practitioners, state agencies, and others have requested and implemented the training materials in their work. In this article, we review the training materials. We hope that these few tips will help others have successful experiences communicating respectfully with American Indian and Alaska Natives.

Alaska↗
PubMed2005

Moyamoya disease in Washington State and California.

The authors identified 298 diagnoses of moyamoya in California and Washington from hospital discharge databases during the period 1987 to 1998. The incidence was 0.086/100,000 persons. The ethnicity-specific incidence rate ratios compared to whites were 4.6 (95% CI: 3.4 to 6.3) for Asian Americans, 2.2 (95% CI: 1.3 to 2.4) for African Americans, and 0.5 (95% CI: 0.3 to 0.8) for Hispanics. The incidence of moyamoya in Washington and California was lower than reported in Japan, but the rate among US Asians is similar.

Adolescent↗
PubMed1996

California's tobacco tax initiative: the development and passage of Proposition 99.

In this case study, we describe and analyze the development and passage of California's tobacco tax initiative, Proposition 99, the Tobacco Tax and Health Promotion Act of 1988. We gathered information from published reports, public documents, personal correspondence, internal memorandums, polling data, and interviews with representatives from organizations that participated in the Proposition 99 campaign. Proposition 99 passed as a result of the efforts of a coalition of voluntary health agencies, medical organizations, and environmental groups. They organized a long-term effort by conducting essential polling, planning strategies, gaining media exposure, developing a coalition, and running a successful campaign to enact the tax by shifting the venue from legislative to initiative politics. To build the coalition that was needed to pass Proposition 99, public health proponents enlisted the help of medical organizations in exchange for additional revenue to be allocated to medical services. By shifting the venue from the legislature to the general public, advocates capitalized on public concern about tobacco and for youth and took advantage of the tobacco industry's low credibility. The passage of Proposition 99, despite a massive campaign against it by the tobacco industry, represents a milestone in the tobacco control and public health fields. From its passage in 1988 through 1993, tobacco use in California declined by 27 percent, which is three times faster than the United States average. As a result, Proposition 99 has served as a national model for other states and the federal government. Although allocation of tobacco tax revenues specifically to health education and prevention was a primary goal during the development and passage of Proposition 99, when the venue shifted back to the legislature for implementation, medical organizations successfully advocated illegal diversions of Proposition 99 tobacco control and research funds to medical services. Organizations seeking to enact Proposition 99-like tobacco tax increases must be prepared to mount aggressive campaigns to pass the initiative in the face of major tobacco industry opposition and then must continue to work to protect the program after passage by voters.

California↗
PubMed2002

Impeding Earl Warren: California's health insurance plan that wasn't and what might have been.

It is widely believed that the turning point for U.S. health insurance came in 1949 when Congress failed to adopt President Harry Truman's proposal for a national system. The possibility that a system of state-level health plans might have emerged before Truman's plan has received little attention. Yet several attempts to enact such a plan were made in California by Governor Earl Warren in the mid-1940s. Had Warren succeeded, the California example might have been emulated by other states and the United States might have evolved a system similar to Canada's provincial programs.

California↗
PubMed1980

The planner as public health resource allocator: post-Proposition 13 county health services in California and the role of the HSAs in budget review and public hearings.

Immediately following adoption of Proposition 13 in California in June of 1978, the state legislature adopted a Bail-Out program which included procedures for monitoring the detrimental effects of disproportionate reductions in public health, inpatient and outpatient county budgets. For a variety of reasons, the methodology and procedures employed failed to reveal the adverse effects of Proposition 13 on health services. This paper deals with the actual and potential role of health systems agencies (HSAs) in monitoring such effects, commenting in public hearings on budget review and, in general, playing a policy analysis role that links local government with the citizenry on the one hand and the state government on the other. In addition to identifying the weakness of the State's monitoring effort in identifying negative effects in program analysis and staffing reductions, the findings point out the limited role of HSAs. Specific recommendations are offered for improvement of HSA involvement in future resource allocation planning in California and the United States as a whole.

California↗