Exploring the distributional environmental justice implications of an air quality monitoring network in Los Angeles County.

Non-governmental air quality monitoring networks include low-cost, networked air pollution sensors hosted at homes and schools that display real-time pollutant concentration estimates on publicly accessible websites. Such networks can empower people to take health-protective actions, but their unplanned organization may produce an uneven spatial distribution of sensors. Barriers to acquiring sensors may disenfranchise particular social groups. To test this directly, we quantitatively examine if there are social inequalities in the distribution of sensors in a non-governmental air quality monitoring network (PurpleAir) in Los Angeles County, California. We paired sociodemographic data from the American Community Survey and estimates of PM2.5 concentrations from the USEPA's Downscaler model at the census tract level (n = 2203) with a sensors per capita (SPC) variable, which is based on population proximity to PurpleAir sensors (n = 696) in Los Angeles County. Findings from multivariable generalized estimating equations (GEEs) controlling for clustering by housing age and value reveal patterns of environmental injustice in the distribution of PurpleAir sensors across Los Angeles County census tracts. Tracts with higher percentages of Hispanic/Latino/a and Black residents and lower median household income had decreased SPC. There was a curvilinear (concave) relationship between the percentage of renter-occupants and SPC. Sensors were concentrated in tracts with greater percentages of adults and seniors (vs. children), higher occupied housing density, and higher PM2.5 pollution. Results reveal social inequalities in the self-organizing PurpleAir network, suggesting another layer of environmental injustice such that residents of low-income and minority neighborhoods have reduced access to information about local air pollution.

Communities of color are disproportionately exposed to long-term and short-term PM2.5 in metropolitan America.

We conducted a novel investigation of neighborhood-level racial/ethnic exposure disparities employing measures aligned with long-term and short-term PM2.5 air pollution benchmarks across metropolitan contexts of the contiguous United States, 2012-2016. We used multivariable generalized estimating equations (GEE) to quantify PM2.5 exposure disparities based on the census tract composition of people of color (POC) and POC groups (Hispanic/Latina/x/o, Black, Asian). We examined eight census tract-level measures of longer-to-shorter term exposures derived from data on modeled daily ambient PM2.5 concentrations. We found associations between increased POC composition and greater exposure to all PM2.5 measures, with associations strengthening across measures of longer-to-shorter term exposures. In a GEE with a negative binomial distribution, a standard deviation increase in POC composition predicted a 0.6% increase (incidence rate ratio (IRR): 1.006, 95% confidence interval (CI): 1.005-1.008) in the number of days PM2.5 concentrations were ≥5 µg/m3 (longest-term benchmark). In a GEE with an inverse Gaussian distribution, a standard deviation increase in POC composition predicted a 0.110 µg/m3 (1.0%) increase (B: 0.110, 95% CI: 0.076-0.143) in mean PM2.5 concentration. In GEEs with a negative binomial distribution, the effect of a standard deviation increase in POC composition on exposure strengthened to 2.6% (IRR:1.026, 95% CI:1.017-1.035), 3.4% (IRR:1.034, 95% CI:1.022-1.047), 4.2% (IRR:1.042, 95% CI:1.025-1.058), 16.2% (IRR:1.162, 95% CI:1.117-1.210), 22.7% (IRR:1.227, 95% CI:1.137-1.325) and 28.3% (IRR:1.283, 95% CI:1.144-1.439) with respect to the number of days PM2.5 concentrations were ≥10, 12, 15, 25, 35 and 55.5 µg/m3. POC group models indicated exposure disparities based on greater Hispanic/Latina/x/o, Asian, and Black composition. Evidence for stronger POC associations with shorter-term (higher concentration) PM2.5 exceedances suggests that reducing PM2.5 would attenuate racial/ethnic exposure disparities.

Patterns of distributive environmental inequity under different PM2.5 air pollution scenarios for Salt Lake County public schools.

Previous studies have cataloged social disparities in air pollution exposure in US public schools with respect to race/ethnicity and socioeconomic status. These studies rely upon chronic, averaged measures of air pollution, which fosters a static conception of exposure disparities. This paper examines PM2.5 exposure disparities in Salt Lake County (SLC), Utah public schools under three different PM2.5 scenarios-relatively clean air, a moderate winter persistent cold air pool (PCAP), and a major winter PCAP-with respect to race/ethnicity, economic deprivation, student age, and school type. We pair demographic data for SLC schools (n = 174) with modelled PM2.5 values, obtained from a distributed network of sensors placed through a community-university partnership. Results from generalized estimating equations controlling for school district clustering and other covariates reveal that patterns of social inequality vary under different PM2.5 pollution scenarios. Charter schools and schools serving economically deprived students experienced disproportionate exposure during relatively clean air and moderate PM2.5 PCAP conditions, but those inequalities attenuated under major PCAP conditions. Schools with higher proportions of racial/ethnic minority students were unequally exposed under all PM2.5 pollution scenarios, reflecting the robustness of racial/ethnic disparities in exposure. The findings speak to the need for policy changes to protect school-aged children from environmental harm in SLC and elsewhere.

Evaluation of chiropractic students' knowledge and attitudes following pain interventions: A randomized educational trial at 2 institutions.

OBJECTIVE: To examine chiropractic students' attitudes regarding knowledge of pain neuroscience, chronic pain, and patient-centered care before and after educational interventions. Secondarily, this study aimed to compare measures of these skills between cohorts at different timepoints throughout training programs. METHODS: Using stratified randomization, 281 Year 3 chiropractic students at 2 institutions were allocated into 1 of 3 educational interventions and served as active-control comparison groups: pain neuroscience education, chronic pain education, or patient-centered care. Participants completed validated surveys regarding their experience with the education interventions immediately pre- and post-lecture and 12 weeks after completion. For further comparison, surveys were also completed by 160 Year 1 students and 118 Year 2 students at 1 of the institutions. Independent sample t tests and 1-way analysis of variance were used for data analysis. RESULTS: All Year 3 lecture groups showed immediate improvements (pain neuroscience education: 3.99 + 3.09/100, p = .18 [95% CI: 10.10 to -1.77]; chronic pain education: 0.42 + 0.74/7, p = .02 [95% CI: 0.72 to 0.07]; patient-centered care: 0.25 + 0.12/6, p = .05 [95% CI: 0.12-0.51]), but these were not sustained at the 12-week follow-up (pain neuroscience education: -6.25 + 4.36/100, p = .15 [95% CI: 14.93 to -2.42]; chronic pain education: 0.33 + 0.16/7, p = .19 [95% CI, 0.66 to 0.01]; patient-centered care: 0.13 + 0.13/6, p = .30 [95% CI: 0.41 to -0.13]). Compared to active controls, only the patient-centered care group showed an immediate statistically significant difference. CONCLUSIONS: While this study found that immediate improvement in targeted competencies is possible with focused interventions, they were not sustained long term.

Environmental Injustice, Tree Canopy Cover, and Academic Proficiency at Utah Public Primary Schools.

Background: Tree canopy cover has mental and physical health benefits for children, yet distributional environmental injustices in tree canopy cover near schools are rarely investigated. Some evidence suggests that tree canopy coverage positively influences aggregated school-level children's academic proficiency metrics. There is a lack of research if canopy cover moderates the negative effect of particulate matter on academic proficiency. Methods: We linked data on schools from the National Center for Education Statistics, Utah's Student Assessment of Growth and Excellence, the National Land Cover Database, and the U.S. Environmental Protection Agency. We used generalized estimating equations, which account for non-normally distributed data and clustering, to analyze data from the 2015 to 2016 school year. Results: Greater school social disadvantage (higher percentages of students qualifying for free/reduced price meals and higher percentages of racial/ethnic minority students) was significantly associated with reductions in tree canopy cover within 1000 m and 500 m of the school. Greater tree canopy coverage at 1000 m and 500 m was significantly associated with a lower percentage of students testing below proficient on year-end math and language arts exams. Additional days of peak fine particulate matter were associated with higher percentages of students testing below proficient in math. Discussion: Socially disadvantaged primary schools in Utah were surrounded by less canopy cover. There was a protective effect of tree canopy cover on academic proficiency in math and language arts. Conclusion: Findings suggest targeting carefully designed tree planting efforts at socially disadvantaged schools and testing interventions involving tree planting and changes in academic proficiency.

Effects of PM2.5 on Third Grade Students' Proficiency in Math and English Language Arts.

Fine particulate air pollution is harmful to children in myriad ways. While evidence is mounting that chronic exposures are associated with reduced academic proficiency, no research has examined the frequency of peak exposures. It is also unknown if pollution exposures influence academic proficiency to the same degree in all schools or if the level of children's social disadvantage in schools modifies the effects, such that some schools' academic proficiency levels are more sensitive to exposures. We address these gaps by examining the percentage of third grade students who tested below the grade level in math and English language arts (ELA) in Salt Lake County, Utah primary schools (n = 156), where fine particulate pollution is a serious health threat. More frequent peak exposures were associated with reduced math and ELA proficiency, as was greater school disadvantage. High frequency peak exposures were more strongly linked to lower math proficiency in more advantaged schools. Findings highlight the need for policies to reduce the number of days with peak air pollution.

Micafungin activity against Candida bloodstream isolates: effect of growth medium and susceptibility testing method.

An excellent correlation between micafungin MICs were demonstrated against Candida bloodstream isolates (n = 200) by the Sensititre YeastOne and National Committee for Clinical Laboratory Standards M27-A2 methods. Use of antibiotic medium 3 (2%) dextrose improved micafungin activity and was not associated with paradoxical growth as noted with 3 Candida isolates tested using RPMI (2%) dextrose.