Peer support and mobile health for perinatal mental health: A scoping review.

BACKGROUND: Up to one in five women experience perinatal depression and/or anxiety with profound negative consequences for mothers and families. Peer support interventions have the potential to effectively prevent perinatal mental health conditions. Meanwhile, mobile health has gained popularity and plays a significant role in enhancing maternal health services. However, little is known about the availability of mobile health combined with peer support for supporting perinatal mental health. This scoping review aimed to map the relevant literature and gain insights into the available evidence on mobile health and peer support for perinatal mental health, to identify gaps and inform opportunities for future research. METHODS: A scoping review of the literature was conducted. The search strategy included five databases: CIANHL, Scopus, PsycInfo, PubMed, and ScienceDirect for the period from 2007 to 2022. RESULTS: Eight studies met the inclusion criteria, including features of online support strategies, effectiveness, and attitudes of women about peer support with mobile health. The results showed decreased depressive scores and provided a positive experience for women. Strong satisfaction with accessibility and flexibility of mobile health was found when combined with the peer support features. Additional emotional support tools (e.g., mindfulness-based activities) were likely to be acceptable to women and beneficial to mobile health. CONCLUSIONS: Understanding the context of peer support and mobile health informs the potential to support perinatal mental health. Further research in this growing area is needed to test the effectiveness of peer support in combination with mobile health intervention for supporting perinatal mental health.

Midwifery continuity of care for women with perinatal mental health conditions: A cohort study from Australia.

BACKGROUND: Perinatal mental health (PMH) conditions are associated with adverse outcomes such as maternal suicide, preterm birth and longer-term childhood sequelae. Midwifery continuity of care (one midwife or a small group of midwives) has demonstrated benefits for women and newborns, including a reduction in preterm birth and improvements in maternal anxiety/worry and depression. AIM: To determine if midwifery care provided through a Midwifery Group Caseload Practice model is associated with improved perinatal outcomes for women who have anxiety and depression and/or other perinatal mental health conditions. An EPDS ≥ 13, and/or answered the thought of harming myself has occurred to me and/or women who self-reported a history compared to standard models of care (mixed midwife/obstetric fragmented care). METHODS: A retrospective cohort study using data routinely collected via an electronic database between 1 January 2018 31st of January 2021. The population were women with current/history of PMH, who received Midwifery Caseload Group Practice (MCP), or standard care (SC). Data were analysed using descriptive statistics for maternal characteristics and logistic regression for birth outcomes. One-to-one matching of the MCP group with the SC group was based on propensity scores. RESULTS: 7,359 births were included MCP 12% and SC 88%. Anxiety was the most common PMH with the same proportion affected in MCP and SC. Adjusted odds of preterm birth and adverse perinatal outcomes were lower in the MCP group than the SC group (aOR (95%CI): 0.77 (0.55, 1.08) and 0.81 (0.68, 0.97), respectively) and higher for vaginal birth and full breastfeeding (aOR (95% CI): 1.87 (1.60, 2.18) and 2.06 (1.61, 2.63), respectively). In the matched sample the estimate of a relationship between MCP and preterm birth (aOR (95% CI): 0.88 (0.56, 1.42), adverse perinatal outcomes (aOR (95% CI): 0.83 (0.67, 1.05)) and breastfeeding at discharge (aOR (95% CI): 1.82 (1.30, 2.51)), stronger for vaginal birth (aOR (95% CI): 2.22 (1.77, 2.71)). CONCLUSION: This study supports positive associations between MCP and breastfeeding and vaginal birth. MCP was also associated with lower risk of adverse perinatal outcomes, though in the matched sample with a smaller sample size, the confidence interval included 1. The direction of the association MCP and preterm birth was negative (protective). However, in the matched sample analysis, the confidence interval was wide, and the finding was also consistent with no benefit from MCP. Randomised controlled trials are required to answer questions around preterm birth and adverse perinatal outcomes and further research is being planned.

Coastal eutrophication drives acidification, oxygen loss, and ecosystem change in a major oceanic upwelling system.

Global change is leading to warming, acidification, and oxygen loss in the ocean. In the Southern California Bight, an eastern boundary upwelling system, these stressors are exacerbated by the localized discharge of anthropogenically enhanced nutrients from a coastal population of 23 million people. Here, we use simulations with a high-resolution, physical-biogeochemical model to quantify the link between terrestrial and atmospheric nutrients, organic matter, and carbon inputs and biogeochemical change in the coastal waters of the Southern California Bight. The model is forced by large-scale climatic drivers and a reconstruction of local inputs via rivers, wastewater outfalls, and atmospheric deposition; it captures the fine scales of ocean circulation along the shelf; and it is validated against a large collection of physical and biogeochemical observations. Local land-based and atmospheric inputs, enhanced by anthropogenic sources, drive a 79% increase in phytoplankton biomass, a 23% increase in primary production, and a nearly 44% increase in subsurface respiration rates along the coast in summer, reshaping the biogeochemistry of the Southern California Bight. Seasonal reductions in subsurface oxygen, pH, and aragonite saturation state, by up to 50 mmol m-3, 0.09, and 0.47, respectively, rival or exceed the global open-ocean oxygen loss and acidification since the preindustrial period. The biological effects of these changes on local fisheries, proliferation of harmful algal blooms, water clarity, and submerged aquatic vegetation have yet to be fully explored.

A cross-sectional survey of Australian healthcare professionals' confidence, evidence-based knowledge and guideline use for antenatal asthma management.

BACKGROUND: Asthma is one of the most common chronic health conditions experienced during pregnancy and is associated with numerous adverse maternal and perinatal outcomes. AIMS: To better understand the confidence, evidence-based knowledge and guideline use among healthcare professionals around Australia commonly involved in providing antenatal care for women with asthma. MATERIALS AND METHODS: An online, cross-sectional survey was developed and distributed to maternity carers (obstetricians and midwives), primary carers (general practitioners and general practice nurses) and respiratory specialists (respiratory physicians and respiratory nurses). Self-reported confidence and use of clinical guidelines were recorded. Evidence-based knowledge was assessed with 13 questions relating to four clinical scenarios that covered recommendations from national and international guidelines. RESULTS: Primary carers and respiratory specialists were more confident in providing antenatal asthma care, more likely to use clinical guidelines and scored significantly higher in evidence-based knowledge of antenatal asthma management than maternity carers (P < 0.01 and P < 0.001, respectively). There was no significant difference in evidence-based knowledge among healthcare professionals from metropolitan, regional and rural backgrounds. However, healthcare professionals who used clinical guidelines scored significantly higher than those who did not (P < 0.0001). CONCLUSION: Greater utilisation of clinical guidelines could improve the evidence-based knowledge of maternity carers. However, the absence of antenatal asthma management in obstetric- and maternity-specific guidelines poses a potential barrier that needs to be addressed. Furthermore, the development of multidisciplinary antenatal clinics, staffed by respiratory nurses and/or physicians, could improve outcomes for pregnant women with asthma who are not undertaking shared care.

Fractional exhaled nitric oxide-based asthma management: The feasibility of its implementation into antenatal care in New South Wales, Australia.

BACKGROUND: The use of fractional exhaled nitric oxide (FeNO)-based asthma management during pregnancy can significantly reduce asthma exacerbations in non-smoking pregnant women. The feasibility of implementing this strategy into antenatal care has not been explored. AIMS: To examine the feasibility of implementing FeNO-based asthma management into antenatal clinics in New South Wales (NSW) Australia. MATERIALS AND METHODS: Semi-structured face-to-face interviews with video elicitation were conducted with healthcare professionals (HCPs) providing antenatal care in one of two hospital-based antenatal clinics in NSW, Australia. The video shown demonstrated the use of the FeNO instrument and other aspects of the management strategy, in antenatal care. Interviews were recorded, transcribed and analysed using qualitative content analysis. RESULTS: A total of 20 interviews were conducted with 15 midwives, four obstetricians, and one general practitioner. Two main themes and ten sub-themes arose: Getting a number (sub-themes: engaging, technically easy, objective, predictive, reassuring); and Resourcing (sub-themes: time and timing, systems, staff, education and cost). Comments included: 'It's easy, fast and effective' and 'the main barrier is time'. All HCPs felt capable of facilitating the FeNO-based management strategy, with appropriate education, and were willing to undertake this strategy, saying: '…it would be perfectly acceptable for a midwife or doctor to do it'; also, 'they don't necessarily need to see a physician, it's something that midwives would take on generally…'. CONCLUSION: Participants in this study considered FeNO-based asthma management for pregnant women to be a feasible addition to antenatal care following appropriate provision of resources and education.

Inhaled corticosteroid use during pregnancy among women with asthma: A systematic review and meta-analysis.

BACKGROUND: Studies demonstrate the prescription rate for inhaled corticosteroids (ICS) decreases in early pregnancy, possibly increasing exacerbation risk. This could be related to non-adherence to prescribed asthma medication or medication cessation by the patient or doctor. ICS use during pregnancy has not previously been summarized in a systematic review. OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the use of ICS during pregnancy among asthmatic women, specifically: (1) the prevalence of use, (2) changes of use during pregnancy compared with pre-pregnancy and (3) medication adherence among ICS users. METHODS: We systematically searched literature in Embase, MEDLINE, CINAL and Cochrane, using terms related to asthma, pregnancy and medication use. All English articles reporting ICS among pregnant women with asthma were included. Prevalence, changes in ICS use during pregnancy and ICS adherence were pooled using STATA (version 15.0, StataCorp USA). RESULTS: A total of 4237 references were retrieved in the initial search. Screening and review led to the inclusion of 52 articles for one or more aims (Aim 1: N = 45; Aim 2, N = 13; and Aim 3, N = 5). The pooled prevalence of ICS use during pregnancy was 41% (95%CI 36%-45%); 49% (95%CI 44%-55%) in Europe, 39% (95%CI 32%-47%) in Australia and 34% (95%CI 27%-41%) in North America. In eight prescription databases, ICS prescription rates lowered in the first trimester of pregnancy, compared with pre-pregnancy, increased in the second trimester and decreased in the third trimester. Five studies reported ICS adherence among pregnant women, using four measures of self-reported non-adherence. In two comparable studies, pooled ICS non-adherence was 40% (95%CI 36%-44%). CONCLUSIONS: The prevalence of ICS use among pregnant women with asthma is 41% and varies widely between countries and continents, and prescription rates for ICS change throughout pregnancy. More studies are needed to investigate ICS adherence during pregnancy in women with asthma.

Small drains, big problems: the impact of dry weather runoff on shoreline water quality at enclosed beaches.

Enclosed beaches along urban coastlines are frequent hot spots of fecal indicator bacteria (FIB) pollution. In this paper we present field measurements and modeling studies aimed at evaluating the impact of small storm drains on FIB pollution at enclosed beaches in Newport Bay, the second largest tidal embayment in Southern California. Our results suggest that small drains have a disproportionate impact on enclosed beach water quality for five reasons: (1) dry weather surface flows (primarily from overirrigation of lawns and ornamental plants) harbor FIB at concentrations exceeding recreational water quality criteria; (2) small drains can trap dry weather runoff during high tide, and then release it in a bolus during the falling tide when drainpipe outlets are exposed; (3) nearshore turbulence is low (turbulent diffusivities approximately 10(-3) m(2) s(-1)), limiting dilution of FIB and other runoff-associated pollutants once they enter the bay; (4) once in the bay, runoff can form buoyant plumes that further limit vertical mixing and dilution; and (5) local winds can force buoyant runoff plumes back against the shoreline, where water depth is minimal and human contact likely. Outdoor water conservation and urban retrofits that minimize the volume of dry and wet weather runoff entering the local storm drain system may be the best option for improving beach water quality in Newport Bay and other urban-impacted enclosed beaches.

"A safe space"; A statewide evaluation of Midwifery Antenatal and Postnatal Service (MAPS) using the quality maternal newborn care, evidence informed framework.

BACKGROUND: The World Health Organization recommends Midwifery Continuity of Care (MCoC) due to the consistent improvements in outcomes for mothers and babies. Surveys from the United Kingdom and Australia reported large numbers of midwives are unable to commit to the on call component required to provide MCoC across the continuum. To address this challenge a modified MCoC model called Midwifery Antenatal and Postnatal Services (MAPS) has been introduced. The aim of this study was to evaluate MAPS services in six sites across one State in Australia. METHODS: A multi-site qualitative descriptive study was undertaken framed by the Quality Maternal Newborn Care (QMNC) Framework. The QMNC framework was used to develop focus group questions for data collection, and as a lens for analysing data. Data were collected via focus groups from midwives and women at six sites ranging from metropolitan to regional and rural settings and thematically analysed. FINDINGS: Participants (n=80) included women (n=28), midwives (n=44) and MAPS managers (n=8). This paper reports the findings from the women and midwives, presented under three themes: Getting onto the program, Knowing the story and Building confidence by sharing information. Each theme had subthemes and the findings were aligned either positively or negatively with the QMNC framework. CONCLUSION: This study found the MAPS model aligns in positive ways with the QMNC quality care framework with some recommendations to improve quality care. Midwives want to provide continuity of care and MAPS is a useful model for providing continuity through the antenatal and postnatal periods.

Cross-shore transport and eddies promote large scale response to urban eutrophication.

A key control on the magnitude of coastal eutrophication is the degree to which currents quickly transport nitrogen derived from human sources away from the coast to the open ocean before eutrophication develops. In the Southern California Bight (SCB), an upwelling-dominated eastern boundary current ecosystem, anthropogenic nitrogen inputs increase algal productivity and cause subsurface acidification and oxygen (O 2 ) loss along the coast. However, the extent of anthropogenic influence on eutrophication beyond the coastal band, and the physical transport mechanisms and biogeochemical processes responsible for these effects are still poorly understood. Here, we use a submesoscale-resolving numerical model to document the detailed biogeochemical mass balance of nitrogen, carbon and oxygen, their physical transport, and effects on offshore habitats. Despite management of terrestrial nutrients that has occurred in the region over the last 20 years, coastal eutrophication continues to persist. The input of anthropogenic nutrients promote an increase in productivity, remineralization and respiration offshore, with recurrent O 2 loss and pH decline in a region located 30-90 km from the mainland. During 2013 to 2017, the spatially averaged 5-year loss rate across the Bight was 1.3 mmol m - 3 O 2 , with some locations losing on average up to 14.2 mmol m - 3 O 2 . The magnitude of loss is greater than model uncertainty assessed from data-model comparisons and from quantification of intrinsic variability. This phenomenon persists for 4 to 6 months of the year over an area of 278,40 km 2 ( ∼ 30% of SCB area). These recurrent features of acidification and oxygen loss are associated with cross-shore transport of nutrients by eddies and plankton biomass and their accumulation and retention within persistent eddies offshore within the SCB.

Web-based training in family advocacy.

OBJECTIVE: To examine the efficacy of an interactive multimedia intervention that teaches advocacy skills to people caring for a family member with traumatic brain injury. PARTICIPANTS: A total of 201 individuals (control, n = 97; treatment, n = 104) providing support to a family member with traumatic brain injury. DESIGN: Randomized controlled study. MAIN MEASURES: Caregiver knowledge, skill application, behavioral intention, and overall life satisfaction. INTERVENTION: The Brain Injury Partners program, a Web site focused on advocacy, communication skills, and resources for families affected by brain injury. RESULTS: Univariate analyses revealed that compared with the control group, the Brain Injury Partners group reported statistically significant higher adjusted means for application, knowledge, and attitudes scales immediately postintervention and at follow-up. Satisfaction with life, assessed at follow-up but not posttest, was not significant. DISCUSSION: This study demonstrated the effectiveness of a Web-based intervention to teach effective skills to caregivers advocating for a family member with traumatic brain injury.

Are pregnant women with asthma receiving guideline-recommended antenatal asthma management? A survey of pregnant women receiving usual care in Australia.

BACKGROUND: Asthma affects 12.7% of pregnant women in Australia. Key recommendations for asthma management during pregnancy include: 4-6 weekly review of lung function, medications, written asthma action plan, inhaler device technique, current asthma control and triggers; smoking cessation and vaccination advice. It is unknown if these key recommendations are provided to pregnant women with asthma in Australia. AIM: To explore usual antenatal asthma management (usual care) in Australia and the inclusion of key recommendations. METHOD: Pregnant women with asthma were invited to complete an online survey distributed in 2 antenatal clinics and via social media platforms from July 2017-Jan 2019. RESULTS: The survey was completed by 142 pregnant women with asthma. 87(61%) were enrolled in an asthma management clinical trial and were therefore not receiving 'usual' care. Data presented is from 55(39%) women receiving usual care at survey completion. Of these women, 36% did not have their asthma reviewed during their pregnancy, 31% had a written asthma action plan, 11% had lung function assessed, 38% had an asthma medication review and 35% had their inhaler technique reviewed. 65% were not questioned about their asthma symptoms, 85% were not asked about asthma triggers, 96% were not given information about vaccinations and 95% did not receive smoking cessation information. CONCLUSIONS: Overall, the key recommendations for antenatal asthma management were not always provided for this sample of pregnant women receiving usual care. Improved knowledge and implementation of these key recommendations by health professionals may alter this situation and improve maternal and infant outcomes.

Factors that Influence Women's Decision on the Mode of Birth After a Previous Caesarean Section: A Meta-ethnography.

Background: Caesarean section (CS) rates are continuing to rise worldwide. Elective repeat CS (ERCS) greatly contribute to the rising rate which increases unnecessary risks of maternal and neonatal morbidity and mortality. Vaginal birth after caesarean (VBAC) is a safe mode of birth for most women; however, uptake remains low. Our objective is to find the factors that influence women's decision-making to support informed choices for the mode of next birth after caesarean section (NBAC). Methods: A literature search was conducted in CINAHL, Maternity and Infant Care, Embase, EmCare, Cochrane Library and Medline databases. Primary, qualitative, peer reviewed, English language research articles were assessed according to inclusion/exclusion criteria. Articles were systematically assessed for inclusion or exclusion. Included studies were assessed using the Critical Appraisal Skills Programme qualitative studies checklist, Noblit and Hare's seven-step meta-ethnography approach synthesised themes. Results: Fourteen primary research articles were included. Six studies on 287 women focused on VBAC, and eight studies examined both VBAC and ERCS with 1861 women and 311 blogs. Thematic analysis yielded four primary themes: Influence of health professionals, impact of previous birth experience, optimal experience, and being in control. Conclusion: This meta-ethnography highlights health professionals' influence on women's decision making. To assist in decision-making, women need supportive health professionals who provide the current evidence-informed information about risks and benefits of each mode of birth. Health professionals need skills to provide supportive shared decision-making, debrief women regarding indications for their primary caesarean, and address issues of safety, fear, and expectations of childbirth.

Barriers and Facilitators to Cardiovascular Disease Prevention Following Hypertensive Disorders of Pregnancy in Primary Care: Cross-Sectional Surveys.

Women with a history of hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease (CVD). Guidelines recommend that women diagnosed with HDP should be advised of their increased CVD risk, have regular blood pressure monitoring by their general practitioner (GP), and adopt healthy lifestyle behaviours. However, within Australia, the current practice in primary health care is unknown. The aim of this study was to describe current practices, barriers, and facilitators to the provision of CVD preventative services for women after HDP in the primary care setting and to identify potential strategies to support GPs in providing recommended care. Separate cross-sectional online surveys were undertaken with 35 GPs and 105 women with a history of HDP. Surveys included both closed- and open-ended questions. Closed-ended questions were analysed using basic descriptive statistics, and open-ended questions were themed and tallied. The survey of GPs revealed that GPs are more likely to assess traditional CVD risk markers than lifestyle risk factors or HDP history. GPs identified a lack of resources and skills as barriers to providing CVD preventative care post-HDP. The survey with women after HDP revealed that women with a history of HDP are more likely to be assessed for blood pressure than lifestyle CVD risk factors, and that the women's barriers to obtaining care included difficulty obtaining an appointment and time required for attending appointments. Strategies to improve CVD preventative care were consistent between surveys, where 70% of GPs and 59% of women chose 'increasing women's awareness of increased CVD risk' and 67% of GPs and 55% of women chose 'improving communication between hospitals and primary care' as their preferred strategies. While the findings suggest that women with a history of HDP are receiving advice consistent with guidelines for traditional CVD risk markers, such as blood pressure, they are less likely to receive CVD preventative care for lifestyle or female-specific CVD risk factors.

Scrutinizing surficial sediment along a 600-km-long urban coastal zone: Occurrence and risk assessment of fipronil and its three degradates.

Contamination in the coastal zone is closely linked to urbanization and has become a global issue. The coastal aquatic environment is the terminal sink for many chemicals; however, little is known about the occurrence and variation among habitats as well as integrative toxicity for pesticides, i.e., fipronil, and its three major degradates (-desulfinyl, -sulfide, and -sulfone, fiproles hereafter) in sediments in urban coastlines. In the present study, we report results of a random stratified survey for fiproles in surficial sediments in five embayment habitats (strata) along the Southern California Bight (SCB), USA coastline. Fiproles were present in a small areal extent (6.8%) of the SCB embayment, and detected in 14 out of 174 stations with a total concentration of the four analytes ranging from 0.50 to 17.5 µg/kg dry weight. The area-weighted mean concentrations were 3.16 ± 3.37, 0.584 ± 0.558, 0.071 ± 0.103, and 0.005 ± 0.009 µg/kg in brackish estuaries, estuaries, bays, and marinas, respectively, with the results below the detection limits in ports. Fipronil sulfone had the greatest detection frequency (8.05%) and highest mean concentration (3.24 ± 3.36 µg/kg) among the four compounds. A screening-level deterministic risk assessment for invertebrates found that, region-wide, fiproles generally posed an insignificant to low acute risk to the amphipod Eohaustorius estuarius in 7.36% of the SCB embayment area. In addition, high risk to the midge Chironomus dilutus was found in 77.5% of the fiproles-detectable area in the brackish estuary stratum that is a part of the Los Angeles River. Fipronil sulfone was identified as the major contributor of these effects. The results of this study establish a baseline of occurrence and toxicity potential for fiproles in coastal sediments of southern California.

Midwives providing woman-centred care during the COVID-19 pandemic in Australia: A national qualitative study.

BACKGROUND: The COVID-19 pandemic has caused isolation, fear, and impacted on maternal healthcare provision. AIM: To explore midwives' experiences about how COVID-19 impacted their ability to provide woman-centred care, and what lessons they have learnt as a result of the mandated government and hospital restrictions (such as social distancing) during the care of the woman and her family. METHODS: A qualitative interpretive descriptive study was conducted. Twenty-six midwives working in all models of care in all states and territories of Australia were recruited through social media, and selected using a maximum variation sampling approach. Data were collected through in-depth interviews between May to August, 2020. The interviews were recorded, transcribed verbatim, and thematically analysed. FINDINGS: Two overarching themes were identified: 'COVID-19 causing chaos' and 'keeping the woman at the centre of care'. The 'COVID-19 causing chaos' theme included three sub-themes: 'quickly evolving situation', 'challenging to provide care', and 'affecting women and families'. The 'Keeping the woman at the centre of care' theme included three sub-themes: 'trying to keep it normal', 'bending the rules and pushing the boundaries', and 'quality time for the woman, baby, and family unit'. CONCLUSION: Findings of this study offer important evidence regarding the impact of the pandemic on the provision of woman-centred care which is key to midwifery philosophy. Recommendations are made for ways to preserve and further enhance woman-centred care during periods of uncertainty such as during a pandemic or other health crises.

A baseline of terrestrial freshwater and nitrogen fluxes to the Southern California Bight, USA.

Time series were compiled of terrestrial nitrogen, phosphorus, carbon, iron, and silica fluxes to the Southern California Bight (SCB), a U.S. West Coast embayment (Sutula et al., 2021). Monitoring data and model output were used to construct a baseline of inputs from direct point source (PS) discharges of wastewater treatment (WWT) effluent (via ocean outfalls) and PS, non-point and natural sources from coastal rivers. The baseline covers 1971-2017 for large WWT plants discharging >50 million gallons per day (MGD) and 1997-2017 for small WWT plants and rivers. PS are the dominant nitrogen source, with contributions of 70% of the total annual freshwater discharge and 95% of nitrogen loads. WWT upgrades have reduced organic nitrogen loads by 73% since 1971. Inorganic nitrogen loads have generally held constant (35-40 Gg y-1) for the large WWT plants. This baseline represents a period prior to extensive wastewater and stormwater recycling that is increasing in the region.

Dataset of terrestrial fluxes of freshwater, nutrients, carbon, and iron to the Southern California bight, U.A.A.

The Southern California Bight (SCB) is an upwelling-dominated, open embayment on the U.S. West Coast and receives discharges of anthropogenically-enhanced freshwater, nutrients, carbon, and other materials. These inputs include direct point sources discharged from wastewater treatment (WWT) plants via ocean outfalls and point, non-point, and natural sources discharged via coastal rivers. We assembled a daily time series over 1971-2017 of discharges from large WWT plants ≥ 50 million gallon per day (MGD) and 1997-2017 from small WWT plants and coastal rivers. Constituents include nitrogen, phosphorus, organic carbon, alkalinity, iron, and silica. Data from research studies, several government and non-government agency databases containing discharge monitoring reports, river flow gauges, and other collateral information were compiled to produce this dataset. Predictive models and expert analysis addressed unmonitored sources and data gaps. The time series of terrestrial discharge and fluxes are provided with location of coastal discharge point or tributary. The data are deposited in a repository found in Sutula et al. [1].

Regional assessment of contaminant bioaccumulation in sport fish tissue in the Southern California Bight, USA.

Marine recreational fisheries in California are economically and culturally important; however, consumption of contaminated seafood may be a human health risk. The California Environmental Protection Agency Office of Environmental Health Hazard Assessment developed Advisory Tissue Levels (ATLs) to be used in developing consumption recommendations protecting the health of fish consumers. This study characterizes extent and magnitude of bioaccumulation of contaminants in sport fish in Southern California relative to ATLs. Most zones exceeded the ATL for mercury corresponding to consumption of not more than 3 servings per week in one or more target species. A third of zones exceeded the ATL for total polychlorinated biphenyls (PCBs) corresponding to consumption of not more than 7 servings per week. However, neither mercury nor total PCBs exceeded the most restrictive, "do not consume", thresholds in measured tissues. Contaminant concentrations in fish tissues have remained the same or decreased since a similar survey in 2009.

Persistent domoic acid in marine sediments and benthic infauna along the coast of Southern California.

Blooms of the diatom genus Pseudo-nitzschia occur annually in the Southern California Bight (SCB), and domoic acid (DA) associated with these events can contaminate fisheries, presenting both human and wildlife health risks. Recent studies have suggested that marine sediments may act as a reservoir for DA, extending the risk of food web contamination long after water column blooms have ended. In this study, we conducted a regional assessment of the extent and magnitude of DA in the benthic environment, and monthly observations of sediments and benthic infauna at multiple stations over a 16-month period. DA was widespread in continental shelf sediments of the SCB. The toxin was detected in 54% of all shelf habitats sampled. Detectable concentrations ranged from 0.11 ng/g to 1.36 ng/g. DA was consistently detected in benthic infauna tissues over the monthly timeseries, while the DA concentrations in sediments during the same period were commonly below detection or at low concentrations. The presence of DA in the benthic environment did not always have an apparent water column source, raising the possibility of lateral transport, retention/preservation in sediments or undetected blooms in subsurface waters. In most cases, DA was detected in tissues but not in the co-located surface sediments. Coarse taxonomic sorting of the infauna revealed that the accumulation of DA varied among taxa. We observed that DA was widespread among lower trophic level organisms in this study, potentially acting as a persistent source of DA to higher trophic levels in the benthos.

The effectiveness of a bicycle safety program for improving safety-related knowledge and behavior in young elementary students.

OBJECTIVE: The purpose of this study was to evaluate the "Bike Smart" program, an eHealth software program that teaches bicycle safety behaviors to young children. METHODS: Participants were 206 elementary students in grades kindergarten to 3. A random control design was employed to evaluate the program, with students assigned to either the treatment condition (Bike Smart) or the control condition (a video on childhood safety). Outcome measures included computer-based knowledge items (safety rules, helmet placement, hazard discrimination) and a behavioral measure of helmet placement. RESULTS: Results demonstrated that regardless of gender, cohort, and grade the participants in the treatment group showed greater gains than control participants in both the computer-presented knowledge items (p > .01) and the observational helmet measure (p > .05). CONCLUSIONS: Findings suggest that the Bike Smart program can be a low cost, effective component of safety training packages that include both skills-based and experiential training.