The Planning, Implementation, and Evaluation of California's Inaugural Food Waste Prevention Week.

Preventing food waste can divert food from landfills to feed people, combat climate change, preserve natural resources, and save money. In February 2017, the Nutrition Policy Institute and the Public Health Alliance of Southern California initiated a multisector collaboration among California state agencies to raise awareness about food waste. After development and distribution of a Communications Guide, Food Waste Prevention Week was launched successfully in March 2018, with official support from California's Governor, Secretary of Agriculture, Superintendent of Public Instruction, and other leaders. The multiagency shared messaging campaign was estimated to reach millions, based on unique page views via social and traditional media. In a follow-up survey, partners expressed satisfaction with Food Waste Prevention Week and interest in participating in future efforts. Organizing leaders across multiple sectors to raise awareness about food waste is possible; such efforts can contribute to driving behavioral and structural changes to reduce food waste.

Independent predictors of a clinically significant improvement after lumbar fusion surgery.

BACKGROUND CONTEXT: Multiple studies have determined minimum clinically important difference (MCID) thresholds for EuroQOL-5 Dimensions (EQ-5D) scores in lumbar fusion patients. However, a comprehensive understanding of predictors for a clinically significant improvement (CSI) postoperatively does not exist. PURPOSE: To determine medical, radiographic, and surgical predictors for obtaining a CSI following lumbar fusion surgery. STUDY DESIGN: This is a retrospective review of patients who underwent instrumented lumbar fusion. PATIENT SAMPLE: We included patients who underwent lumbar fusion for any indication between 2008 and 2013. OUTCOME MEASURES: Outcome measures included preoperative and postoperative EQ-5D Index scores. MATERIALS AND METHODS: The medical records of patients who received a lumbar fusion for any indication were retrospectively reviewed to identify patient medical and surgical characteristics. A blinded reviewer assessed radiographs for each patient to examine sagittal alignment following fusion. Multivariable logistic regression was used to model the achievement of a CSI based on two commonly cited MCID values. RESULTS: A total of 231 patients fit the inclusion criteria; 58% exceeded an MCID value for an EQ-5D score of 0.100, and 16% exceeded an MCID value of 0.390. Statistically significant independent predictors of not obtaining a CSI for an MCID threshold of 0.100 included a higher preoperative EQ-5D score (odds ratio [OR]=44.8) and L5-S1 fusion (OR=3.3). For an MCID value of 0.390, a higher preoperative EQ-5D score (OR=2,080.8) and a diagnosis of depression (OR=7.1) were predictive of not achieving a CSI, whereas spondylolisthesis (OR=4.1) was predictive of obtaining a CSI postoperatively. For both MCID values, patients who achieved a CSI had better postoperative quality of life (QOL) scores for all metrics measured, despite worse QOL scores preoperatively. CONCLUSIONS: This study is the first to use a combination of medical, surgical, and postoperative sagittal balance variables as determinants for the achievement of a CSI after lumbar fusion. The awareness of these predictors may allow for better patient selection and surgical approach to decrease the probability of acquiring a poor outcome postoperatively.

Pandemics and health equity: lessons learned from the H1N1 response in Los Angeles County.

BACKGROUND: Pandemic preparedness and response (as with all public health actions) occur within a social, cultural, and historical context of preexisting health disparities and, in some populations, underlying mistrust in government. Almost 200,000 people received H1N1 vaccine at 109 free, public mass vaccination clinics operated by the Los Angeles County Department of Public Health between October 23, 2009, and December 8, 2009. Wide racial/ethnic disparities in vaccination rates were observed with African Americans having the lowest rate followed by whites. METHODOLOGY/PRINCIPAL FINDINGS: Demographic information, including race/ethnicity, was obtained for 163 087 of the Los Angeles County residents who received vaccine. This information was compared with estimates of the Los Angeles County population distribution by race/ethnicity. Rate ratios of vaccination were as follows: white, reference; African American, 0.5; Asian, 3.2; Hispanic, 1.5; Native American, 1.9; and Pacific Islander, 4.3. SIGNIFICANCE: Significant political challenges and media coverage focused on equity in vaccination access specifically in the African American population. An important challenge was community-level informal messaging that ran counter to the "official" messages. Finally, we present a partnership strategy, developed in response to the challenges, to improve outreach and build trust and engagement with African Americans in Los Angeles County.