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PubMedDate not supplied

12-county program: screening of 34,318 women for cervical cancer in California, 1975-78.

The California Department of Health Services conducted a cervical cancer screening program in 12 counties where local health agencies provided the screening services. A major purpose of the study was to screen women at high risk of cervical cancer and to assure that women with abnormal results on cervical cytology testing obtained appropriate diagnostic workup and treatment. A total of 34,318 women were screened, and 7,811 returned for up to 3 annual rescreening examinations. Final cytologic results were 33,658 normal, 100 unsatisfactory, and 560 abnormal smears. Of the abnormal smears, 484 were indicative of cervical dysplasia, 41 of in situ cervical cancer and 22 of invasive cervical cancer. In 13 women, endometrial cancer was suspected. Complete followup information on diagnostic evaluation and treatment was obtained for 80 percent of the women with abnormal Pap test results. Histological confirmation of neoplasia was reported for 173 women. The diagnoses were cervical dysplasia in 108, cervical cancer in 58 (49 in situ, 9 invasive) and endometrial cancer in 7. The program reached greater proportions of older women, the less affluent, women of Spanish origin and oriental women and a smaller proportion of blacks than were present in the general female population of California.

Adult↗
PubMed1980

Pet ownership in rural Northern California (El Dorado County).

Demographic and economic aspects of pet ownership were studied in 488 households in El Dorado County, California, from May to July 1971. About 60% of households owned dogs or cats, and pet ownership was most prevalent (75%) in two small residential communities in the western end of the county. Among dogs, Poodle and German Shepherd Dog were the most popular breeds; about 36% of the females in the sample were spayed, but only 6% of the males were castrated. Approximately one third of all cats had been neutered. Reported use of veterinary services was higher for dogs (79%) than for cats (53%). The results of the survey indicated pet ownership is most likely to be found in households with children, where the head of household is employed, generally confirming findings from earlier surveys in Yolo, Alameda, and Contra Costa Counties (all in northern California) and later surveys in Champaign County, Illinois, and Garland, Tex. Some community health findings were included for El Dorado County and nearby Yolo County. In these two counties, cancer was reported more frequently by adults without pets (3.9% of those greater than or equal to 65 years old) than by pet owners (1.8% of those greater than or equal to 65 years old). Among children less than 5 years old, "frequent diarrhea" was reported more commonly in homes without pets (9.5% vs 2.6%; P less than 0.01). On the other hand, pet-owning adults, 16 to 64 years of age, living in rural areas or areas with generally lower than average incomes reported "frequent headaches" (21%) more frequently than did adults without pets (17%; P less than 0.025%) who resided in the same areas.

Adolescent↗
PubMed1995

Redescription of Argulus melanostictus (Branchiura: Argulidae), a parasite of California grunion (Leuresthes tenuis: Atherinidae), with notes regarding chemical control of A. melanostictus in a captive host population.

Adult male and female Argulus melanostictus Wilson, 1935 are redescribed based on detailed examinations of a syntype and recently obtained specimens of both sexes collected from California grunion, Leuresthes tenuis, captured in nearshore Pacific waters at Monterey, California. A 14-16-hr seawater bath containing 0.5 microliter/L trichlorfon administered once weekly for 3 wk killed A. melanostictus while not noticeably harming grunion.

Animals↗
PubMedDate not supplied

California's "5 a day--for better health!" campaign: an innovative population-based effort to effect large-scale dietary change.

The annual toll of diet-related diseases in the United States is similar to that taken by tobacco, but less progress has been achieved in reaching the Public Health Service's Healthy People 2000 objectives for improving food consumption than for reducing tobacco use. In 1988, the California Department of Health Services embarked upon an innovative multi-year social marketing program to increase fruit and vegetable consumption. The 5 a Day--for Better Health! Campaign had several distinctive features, including its simple, positive, behavior-specific message to eat 5 servings of fruits and vegetables every day as part of a low-fat, high fiber diet; its use of mass media; its partnership between the state health department and the produce and supermarket industries; and its extensive use of point-of-purchase messages. Over its nearly three years of operation in California, the 5 a Day Campaign appears to have raised public awareness that fruits and vegetables help reduce cancer risk, increased fruit and vegetable consumption in major population segments, and created an ongoing partnership between public health and agribusiness that has allowed extension of the campaign to other population segments, namely children and Latino adults. In 1991 the campaign was adopted as a national initiative by the National Cancer Institute and the Produce for Better Health Foundation. By 1994, over 700 industry organizations and 48 states, territories, and the District of Columbia were licensed to participate. Preventive medicine practitioners and others involved in health promotion may build upon the 5 a Day Campaign experience in developing and implementing efforts to reach the nation's dietary goals.

California↗
PubMed1995

Ciguatera fish poisoning. A southern California epidemic.

Ciguatera fish poisoning results from the bioconcentration of a variety of toxins produced by marine dinoflagellates. Signs and symptoms vary widely, but it usually presents as gastrointestinal and neurologic complaints beginning shortly after the ingestion of fish containing the toxins. Symptoms may persist for months and sometimes even years. Although cases have been reported throughout the United States, epidemics are most common along tropical and subtropical coasts and usually involve the ingestion of large carnivorous fish. We review the literature and report the first epidemic of 25 cases of ciguatera fish poisoning presenting to area hospitals in Southern California that were successfully tracked by the Department of Health Services and isolated to fish caught off the coast of Baja California, Mexico.

Adolescent↗
PubMed1995

California physicians' willingness to care for the poor.

Although generalist physicians appear to be more likely than specialists to provide care for poor adult patients, they may still perceive financial and nonfinancial barriers to caring for these patients. We studied generalist physicians' attitudes toward caring for poor patients using focus groups and used the results to design a survey that tested the generalizability of the focus group findings. The focus groups included a total of 24 physicians in 4 California communities; the survey was administered to a random sample of 177 California general internists, family physicians, and general practitioners. The response rate was 70%. Of respondents, 77% accepted new patients with private insurance; 31% accepted new Medicaid patients, and 43% accepted new uninsured patients. Nonwhite physicians were more likely to care for uninsured and Medicaid patients than were white physicians. In addition to reimbursement, nonfinancial factors played an important role in physicians' decisions not to care for Medicaid or uninsured patients. The perception of an increased risk of being sued was cited by 57% of physicians as important in the decision not to care for Medicaid patients and by 49% for uninsured patients. Patient characteristics such as psychosocial problems, being ungrateful for care, and noncompliance were also important. Poor reimbursement was cited by 88% of physicians as an important reason not to care for Medicaid patients and by 77% for uninsured patients. Policy changes such as universal health insurance coverage and increasing the supply of generalist physicians may not adequately improve access to care unless accompanied by changes that address generalist physicians' financial and nonfinancial concerns about providing care for poor patients.

Adult↗
PubMed1995

[Engineering aspects of seismic behavior of health-care facilities: lessons from California earthquakes].

The construction of health-care facilities is similar to that of other buildings. Yet the need to function immediately after an earthquake, the helplessness of the many patients and the high and continuous occupancy of these buildings, require that special attention be paid to their seismic performance. Here the lessons from the California experience are invaluable. In this paper the behavior of California hospitals during destructive earthquakes is briefly described. Adequate structural design and execution, and securing of nonstructural elements are required to ensure both safety of occupants, and practically uninterrupted functioning of equipment, mechanical and electrical services and other vital systems. Criteria for post-earthquake functioning are listed. In view of the hazards to Israeli hospitals, in particular those located along the Jordan Valley and the Arava, a program for the seismic evaluation of medical facilities should be initiated. This evaluation should consider the hazards from nonstructural elements, the safety of equipment and systems, and their ability to function after a severe earthquake. It should not merely concentrate on safety-related structural behavior.

California↗
PubMedDate not supplied

Effectiveness of the California 1990-1991 tobacco education media campaign.

The California Department of Health Services conducted a $28,600,000 tobacco education media campaign in 1990 and 1991. An independent evaluation of the media campaign featured four waves of data-gathering, one prior to the campaign's beginning and three at intervals thereafter. In all, 29,264 students in grades 4-12 and 6,785 adult smokers provided data for the evaluation. Through telephone interviews for adults and written questionnaires for students, these participants supplied information so that each person could be classified as exposed or unexposed to the media campaign's advertisements. Five criterion variables were used in the evaluation: campaign awareness, tobacco use, smokers' intention to quit, nonsmokers' intention to start, and attitudes toward smoking. Based chiefly on the differences between the results of waves 1 and 4, we believe the media campaign had a number of positive effects on California students. For adult smokers, the results were mixed.

Adolescent↗
PubMed1994

The effect of the 1992 California motorcycle helmet use law on motorcycle crash fatalities and injuries.

OBJECTIVE: To determine the effects of the California motorcycle helmet use law on statewide fatalities and a large sample of nonfatal injuries before and after law implementation. DESIGN: Police reports and death certificates were collected for motorcycle crash fatalities in California for 1991 (prelaw) and 1992 (postlaw). Official counts of registered motorcycles provided a statewide basis for exposure to a motorcycle crash. Autopsy results were collected for fatalities in 11 counties. Hospital records were reviewed for nonfatal injuries in 28 hospitals in 10 of the 11 counties. Police reports were linked to injury data for the riders. SUBJECTS AND PATIENTS: A total of 850 fatalities and injury data for 547 fatally injured riders and 3252 nonfatally injured patients. MAIN OUTCOME MEASURES: Changes in number and rates among statewide fatalities were estimated. The number and pattern of head injuries in fatally and nonfatally injured motorcycle riders were evaluated. RESULTS: After implementation of the helmet use law, statewide motorcycle crash fatalities decreased by 37.5%, from 523 fatalities in 1991 to 327 in 1992, more than 37%, and an estimated 92 to 122 fatalities were prevented. Motorcycle fatality rates were reduced by 26.5%, from 70.1 per 100,000 registered motorcycles in 1991 to 51.5 per 100,000 in 1992. Head injuries decreased significantly among both fatally and nonfatally injured motorcyclists. CONCLUSION: Enactment of an unrestricted helmet law significantly reduces the incidence of motorcycle crash fatalities and the number and severity of head injuries.

Accidents, Traffic↗
PubMed1994

The impact of California Proposition 99, a major anti-smoking law, on cigarette consumption.

In 1988, California voters enacted Proposition 99, increasing the tax on cigarettes by 25 cents per pack, effective January 1989. Monthly sales data reported by the California State Board of Equalization between 1984 and 1991, adjusted for seasonal variation and time trend, show that consumption of cigarettes in January 1989 was about 25 percent less than would have been expected in the absence of the tax. By December 1989 consumption was reduced to 9.5 percent below the pre-Proposition trend, an amount sustained throughout 1991. Additional taxation and a different form of taxation on cigarettes may further be considered.

Adolescent↗
PubMed1994

The use of serologic tests for Lyme disease in a prepaid health plan in California.

OBJECTIVE: To determine the reason(s) why serologic tests for Lyme disease are performed, who initiates the test requests, and how the test results are used in a clinical setting. DESIGN: Retrospective cohort. SETTING: Prepaid health plan in northern California. PATIENTS: Consecutive sample of 117 patients for whom at least one serologic test for Lyme disease was performed during a 3-month period. MAIN OUTCOME MEASURES: Reason for ordering and result of the serologic test, differential diagnoses, and treatment. RESULTS: One of 117 patients had antibodies to Borrelia burgdorferi. Fifty-six percent of test requests were initiated by the physician and 35% by the patient. Of 66 tests ordered by the physician, 20% were performed because of suspected early Lyme disease, 6% as follow-up of a tick bite, 2% to confirm a prior history of Lyme disease, 14% as a workup for arthritis, and 60% as one of a battery of laboratory tests for vague symptoms. Of 41 tests initiated by the patient, 51% were performed because of a history of a tick bite. The reasons for ordering 10 tests were undetermined. CONCLUSION: Only 19% of all serologic tests for Lyme disease were performed because the physician suspected Lyme disease in the patient. Particularly in light of the low probability of contracting Lyme disease in California, it appears that this serologic test is being overused. Indiscriminate testing increases health care costs and does not appear to affect treatment decisions. Education is needed regarding the limitations of this serologic test.

California↗
PubMedDate not supplied

Public health and the media in California: a survey of local health officers.

Increasingly, public health interventions are dependent on effective health communications. There are, however, few data examining the relationship and interactions between local public health officers and representatives of the media in the literature. This study sought to collect data on the quality and quantity of interactions between California's 62 local health officers and the media. A survey form was sent to the health officers representing all 58 county and four city health departments in the State of California to assess the extent of media interaction, the existence of institutional media policies, the professional and personal character of media relations, the perceived accuracy of media reporting, use of the media for health education and advocacy, the availability of training in media relations for staff members, and whether media interaction facilitated or impeded achievement of public health objectives. Differences in responses according to the population of the political jurisdiction also were assessed. With 87 percent of the health officers responding, 51 percent reported 10 years or more experience interacting with the media; 65 percent said they dealt with the print media mostly on a daily, twice weekly, or weekly basis. In only 19 jurisdictions were there written policies on media relations, but in 43, media releases undergo a pre-release review. Most health officers characterized media relations as reactive, and 80 percent said they were appropriate and had an educational impact. Media interactions were largely believed to be of benefit to the public and were not generally perceived as adversarial. Health officers were of the opinion that media representatives could become more technically and scientifically knowledgeable on public health issues but also indicated that they or their own public health staff would benefit from continuing education on managing media relations. Eighty-six percent stated that the media strongly or moderately facilitate the achievement of public health objectives. Further study of this important component of public health practice is warranted.

California↗
PubMedDate not supplied

Serotypes of Salmonella isolated from California turkey flocks and their environment in 1984-89 and comparison with human isolates.

Serotypes of Salmonella from turkeys and their environment identified at the California Veterinary Diagnostic Laboratory System (CVDLS) between 1984 and 1989 are reported. Between 1988 and 1989, Salmonella serotypes from turkeys were compared from two sources: from routine submissions to the CVDLS (primarily associated with the National Poultry Improvement Plan), and from a random sample of turkey farms conducted by the National Animal Health Monitoring System (NAHMS). Serotype isolation frequencies were ver similar under these two systems. Serotypes identified most frequently under both systems were (listed from most to least frequent): Salmonella kentucky, S. anatum, S. heidelberg, S. reading, and S. senftenberg. This isolation pattern was different from that found in humans in California; only S. heidelberg was relatively common in both humans and turkeys during this period.

Animals↗
PubMedDate not supplied

Regionalization of infant transports: the southern California experience and its implications. I: Referral pattern.

The development and implementation of neonatal intensive care services have been essential components of perinatal regionalization during the past two decades. The transport of critically ill infants to regional neonatal intensive care units has played an important role in improving neonatal outcome. This article presents a profile of Southern California's 10-year infant transport experience (1979 through 1988) in terms of the following indicators: transport volume, cross-county referrals, distance travelled, referral pattern, and birth weight pattern. Findings point to the necessity of focusing attention on several critical issues confronting Southern California's neonatal services in the 1990s. They include adequacy of tertiary or intermediate bed capacity in neonatal intensive care units; appropriateness of existing infant referral practices; impact of maternal-fetal transports; availability of financing resources; and overall differences in morbidity and mortality rates between transported and nontransported infants in subpopulations.

Birth Weight↗
PubMedDate not supplied

[The circulation of the California encephalitis complex and Batai viruses in the Lake Baikal region (serological research data)].

The serological materials of the indigenous population and cattle suggest that there are viral foci of a complex of California encephalitis with the circulation of viruses of Inkoo, Tahyna [correction of Tyagin], and the white hare. The results of examining the residents of Irkutsk also suggest that there are urban viral foci of a complex of California encephalitis. The epidemiological potential of the natural foci of Batai virus is insignificant in the Baikal region.

Animals↗
PubMed1996

Use of a data-based approach by a health maintenance organization to identify and address physician barriers to pediatric vaccination--California, 1995.

Based on a vaccination coverage assessment during January-May 1994, 44% of 2-year-olds enrolled in the southern California health plan of a national health maintenance organization (HMO) were up-to-date at their second birthday for the complete series of recommended vaccinations (4:3:1:1 series). This coverage level was low compared with the levels for some other health plans in the HMO (range: 39%-85% for the 41 other health plans). The assessment had been recommended by the National Committee for Quality Assurance (a national accreditation body for HMOs) and data had been obtained for analysis from the 1993 Health Plan Employer Data and Information Set (HEDIS), which is a standardized set of health-plan performance measurements including selected preventive services (e.g., mammography, cervical cancer screening, eye examinations for persons with diabetes, cholesterol screening, and pediatric vaccination). To assist the southern California health plan in developing interventions for increasing coverage, in May 1995, the HMO's national research center conducted a study to determine possible causes for the low pediatric vaccination coverage level. This report summarizes the findings of the analysis and illustrates the use of a data-based approach to assist in solving problems related to low vaccination coverage in a managed-care setting.

California↗
PubMed1996

Compliance with the Clinical Laboratory Improvement Amendments of 1988 for hemoglobin screening--California, 1995.

The Clinical Laboratory Improvement Amendments of 1988 (CLIA) established standards for improving the quality of clinical laboratory testing in the United States. One intent of CLIA was the regulation of smaller, provider-based laboratories, such as those operated by health-care providers in the Child Health and Disability Prevention (CHDP) program. In 1995, in conjunction with an assessment of county-specific variations in prevalence rates of anemia, the California Department of Health Services conducted a mail survey of CHDP providers to assess compliance with CLIA regulations for hemoglobin screening. This report summarizes the results of that survey, which indicate that, in California, many CHDP providers do not comply with CLIA-mandated quality-assurance practices for hemoglobin screening in their clinical laboratories.

California↗
PubMedDate not supplied

Independent evaluation of the California Tobacco Education Program.

OBJECTIVE: To monitor the implementation of tobacco control programs and research in accordance with California's Proposition 99, approved by the voters in 1988, which increased the state's cigarette tax by 25 cents and designated one quarter of the increased revenue-approximately $100 million per year-to develop statewide media campaigns and to fund local health departments, community-based organizations, schools, and agencies working with high risk populations. METHODS: The authors evaluated the extent and the effectiveness of the implementation independently with standardized forms developed to track any tobacco-related information and activities, local media campaigns, changes in local policies and ordinances, training sessions, and prevention and cessation programs. Activities were reported on the forms to the authors monthly or quarterly. RESULTS: The evaluation indicated that local health departments, community-based organizations, and other group produced an exceedingly high volume of diverse tobacco control activities throughout the state. They reached a variety of ethnic groups and high risk populations with their programs. The data also show that local health departments and competitive grantees responded with an overall shift in their approach to tobacco control and moved from interventions focused primarily on individual people to broader, more community- and environment-oriented interventions. Additionally, analysis of the wholesale tobacco tax revenues revealed that per capita purchasing continued to decline in California at a rate greater than in the rest of the United States. CONCLUSION: The evaluation demonstrated that Proposition 99 accomplished much of what it set out to do-reducing tobacco prevalence, reaching out to underserved populations, and heightening the awareness of the dangers of environmental tobacco smoke.

Adolescent↗