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1.
J Matern Fetal Neonatal Med ; 37(1): 2321486, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38433400

RESUMO

BACKGROUND: The US still has a high burden of preterm birth (PTB), with important disparities by race/ethnicity and poverty status. There is a large body of literature looking at the impact of pre-pregnancy obesity on PTB, but fewer studies have explored the association between underweight status on PTB, especially with a lens toward health disparities. Furthermore, little is known about how weight, specifically pre-pregnancy underweight status, and socio-economic-demographic factors such as race/ethnicity and insurance status, interact with each other to contribute to risks of PTB. OBJECTIVES: The objective of this study was to measure the association between pre-pregnancy underweight and PTB and small for gestational age (SGA) among a large sample of births in the US. Our secondary objective was to see if underweight status and two markers of health disparities - race/ethnicity and insurance status (public vs. other) - on PTB. STUDY DESIGN: We used data from all births in California from 2011 to 2017, which resulted in 3,070,241 singleton births with linked hospital discharge records. We ran regression models to estimate the relative risk of PTB by underweight status, by race/ethnicity, and by poverty (Medi-cal status). We then looked at the interaction between underweight status and race/ethnicity and underweight and poverty on PTB. RESULTS: Black and Asian women were more likely to be underweight (aRR = 1.0, 95% CI: 1.01, 1.1 and aRR = 1.4, 95% CI: 1.4, 1.5, respectively), and Latina women were less likely to be underweight (aRR = 0.7, 95% CI: 0.7, 0.7). Being underweight was associated with increased odds of PTB (aRR = 1.3, 95% CI 1.3-1.3) and, after controlling for underweight, all nonwhite race/ethnic groups had increased odds of PTB compared to white women. In interaction models, the combined effect of being both underweight and Black, Indigenous and People of Color (BIPOC) statistically significantly reduced the relative risk of PTB (aRR = 0.9, 95% CI: 0.8, 0.9) and SGA (aRR = 1.0, 95% CI: 0.9, 1.0). The combined effect of being both underweight and on public insurance increased the relative risk of PTB (aRR = 1.1, 95% CI: 1.1, 1.2) but there was no additional effect of being both underweight and on public insurance on SGA (aRR = 1.0, 95% CI: 1.0, 1.0). CONCLUSIONS: We confirm and build upon previous findings that being underweight preconception is associated with increased risk of PTB and SGA - a fact often overlooked in the focus on overweight and adverse birth outcomes. Additionally, our findings suggest that the effect of being underweight on PTB and SGA differs by race/ethnicity and by insurance status, emphasizing that other factors related to inequities in access to health care and poverty are contributing to disparities in PTB.


Assuntos
Declaração de Nascimento , Nascimento Prematuro , Recém-Nascido , Feminino , Humanos , Gravidez , Etnicidade , Nascimento Prematuro/epidemiologia , Magreza/complicações , Magreza/epidemiologia , Cobertura do Seguro , Parto , California/epidemiologia
2.
Front Public Health ; 12: 1304704, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38425463

RESUMO

Undocumented immigrants experienced high levels of economic insecurity during the COVID-19 pandemic while being excluded from government-based relief and unemployment benefits. In April 2020, California became the first state to offer financial aid to undocumented immigrants through the innovative Disaster Relief Assistance for Immigrants (DRAI) program in collaboration with several community-based organizations (CBOs). However, the process of applying for aid was marked by many implementation challenges, such as intake and language access; however, little data exists on the direct experiences of the undocumented community. This qualitative study examines the experiences of undocumented Asian and Latinx young adults living in California in applying for DRAI through framework of administrative burden. Themes distilled from participant experiences highlight how administrative burden via learning, psychological, and compliance costs shape the ways in which undocumented immigrants navigate policies and programs, such as DRAI. These experiences highlight the need for policymakers to address structural and programmatic administrative burdens in policy development; failure to do so result in detrimental impacts that outweigh financial benefits or cause communities to forgo needed resources.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Imigrantes Indocumentados , Humanos , Adulto Jovem , Imigrantes Indocumentados/psicologia , Pandemias , COVID-19/epidemiologia , California
3.
BMC Oral Health ; 24(1): 332, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38481227

RESUMO

BACKGROUND: In California, preventive dental care is covered by Medi-Cal (California's Medicaid program). However, many beneficiaries do not use their dental benefits. Given that a lack of knowledge about oral health and insurance coverage contributes to this underutilization, promoting the use of dental benefits among eligible individuals via an educational program is imperative. Responding to the particular needs of older immigrants with limited English proficiency, we developed a digital oral health intervention for older Korean-American Medi-Cal enrollees in Los Angeles. This educational intervention is designed to be delivered via computers and the Internet. It consists of a 15-min self-running PowerPoint presentation narrated in Korean with links to additional information on the Internet. The slides contain information about the basic etiology of oral diseases, oral hygiene, common myths about oral health and dental care, Medi-Cal coverage of preventive dental care, and how to find a dental clinic. METHODS: We pilot tested the intervention with 12 participants to examine its feasibility and acceptability. We also obtained participants' qualitative feedback about the intervention. RESULTS: A post-intervention quantitative assessment yielded high participant satisfaction and improved oral health and dental care knowledge. Participant responses to the intervention yielded four themes: (1) content and structure, (2) linguistic and cultural aspects, (3) delivery mode, and (4) additional concerns and suggestions. CONCLUSIONS: Our findings confirm the intervention's feasibility and acceptability and suggest further refinement.


Assuntos
Assistência Odontológica , Medicaid , Estados Unidos , Humanos , Los Angeles , República da Coreia , California
4.
Int J Epidemiol ; 53(2)2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38503548

RESUMO

BACKGROUND: Gastroschisis is a congenital anomaly of the abdominal wall with an unknown aetiology. Recent trends in the prevalence of gastroschisis suggest that changing environmental or behavioural factors may contribute. We examined whether prenatal cannabis use disorder was associated with gastroschisis. METHODS: The Study of Outcomes of Mothers and Infants is a population-based cohort compiled of California birth records that have been linked to Department of Health Care Access and Information hospitalization, emergency department and ambulatory surgery records. We included 2007-19 singleton live births (n = 5 774 656). Cannabis use disorder was measured by diagnosis codes at any visit during pregnancy or at birth. Gastroschisis was measured by diagnosis or surgical repair procedure codes at birth or during the first year of life. RESULTS: The prevalence of cannabis use disorder was about 1%. The prevalence of gastroschisis was 0.14% and 0.06% among those with and without cannabis use disorder, respectively. There were positive associations between cannabis use disorder and gastroschisis when using a multivariable model [adjusted risk ratio (aRR) = 1.3, 95% confidence interval (CI) 1.0, 1.7) and a matched sample approach (aRR = 1.5, 95% CI 1.1, 2.1). The association varied by maternal age and was largest among people aged >34 years (aRR = 2.5, 95% CI 1.0, 5.8). CONCLUSIONS: We confirm findings of a positive association between cannabis exposure and gastroschisis and add that it is strongest when maternal age is greater than 34 years. More investigation into whether the association is causal, and why the association varies by maternal age, is encouraged.


Assuntos
Gastrosquise , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Gravidez , Recém-Nascido , Feminino , Lactente , Humanos , Gastrosquise/epidemiologia , Gastrosquise/diagnóstico , Fatores de Risco , Idade Materna , California/epidemiologia , Abuso de Maconha/epidemiologia , Prevalência
5.
Front Public Health ; 12: 1302144, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38504685

RESUMO

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic's impact on young patients (≤ 26 years) in California. Methods: Annual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient prevalence within different quintiles in Los Angeles County using patient zip codes. Logistic regression analysis using R Project was employed to determine demographic factors associated with concurrent use of stimulants with other controlled substances. Results: There was a notable reduction in prevalence of patients ≤26 years old on stimulants during and after the pandemic per 100,000 people (777 in 2019; 743 in 2020; 751 in 2021). These decreases were more evident among the elementary and adolescent age groups. The most prevalent age group on stimulants were adolescents (12-17 years) irrespective of the pandemic. A significant rise in the number of female patients using stimulants was observed, increasing from 107,957 (35.2%) in 2019 to 121,241 (41.1%) in 2021. New patients initiating stimulants rose from 102,754 in 2020 to 106,660 in 2021, with 33.2% being young adults. In Los Angeles County, there was an increasing trend in patient prevalence from Q1 to Q5 income quintiles among patients ≥6 years. Consistently each year, the highest average income quintile exhibited the highest per capita prevalence. Age was associated with higher risk of concurrent use of benzodiazepines (OR, 1.198 [95% CI, 1.195-1.201], p < 0.0001) and opioids (OR, 1.132 [95% CI, 1.130-1.134], p < 0.0001) with stimulants. Discussion: Our study provides real-world information on dispensing of ADHD stimulants in California youth from 2019 to 2021. The results underscore the importance of optimizing evidence-based ADHD management in pediatric patients and young adults to mitigate disparities in the use of stimulants.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Adulto Jovem , Humanos , Feminino , Adolescente , Criança , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Substâncias Controladas , Estimulantes do Sistema Nervoso Central/uso terapêutico , California/epidemiologia
6.
Cancer Med ; 13(5): e7100, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38491836

RESUMO

INTRODUCTION: California is home to the largest population of Armenians in the United States. The historical categorization of Armenians as 'White' or 'Some Other Race' in population databases has likely masked cancer incidence patterns in this population. This is the first study considering cancer incidence among Armenians in California. METHODS: We used the Armenian Surname List and birthplace information in the California Cancer Registry to identify Armenians with cancer diagnosed during 1988-2019. We calculated proportional incidence ratios (PIR) among Armenians compared with non-Hispanic Whites (NHWs). As an exploratory analysis, we calculated incidence rate ratios (IRR) during 2006-2015 using Armenian population denominators from the American Community Survey (ACS). We selected PIR as our primary method given uncertainty regarding the use of ACS population estimates for rate calculations. RESULTS: There were 27,212 cancer diagnoses among Armenians in California, 13,754 among males and 13,458 among females. Armenian males had notably higher proportions of stomach (PIR = 2.39), thyroid (PIR = 1.45), and tobacco-related cancers including bladder (PIR = 1.53), colorectal (PIR = 1.29), and lung (PIR = 1.16) cancers. Higher proportional incidence of cancers including stomach (PIR = 3.24), thyroid (PIR = 1.47), and colorectal (PIR = 1.29) were observed among Armenian females. Exploratory IRR analyses showed higher stomach (IRR = 1.78), bladder (IRR = 1.13), and colorectal (IRR = 1.12) cancers among Armenian males and higher stomach (IRR = 2.54) cancer among Armenian females. CONCLUSION: We observed higher stomach, colorectal and thyroid cancer incidence among males and females, and tobacco-related cancers among males. Further research is needed to refine Armenian population estimates and understand and address risk factors associated with specific cancers among Armenians in California.


Assuntos
Neoplasias Colorretais , População do Leste Europeu , Neoplasias da Glândula Tireoide , Masculino , Feminino , Humanos , Estados Unidos , Incidência , California/epidemiologia
7.
Environ Sci Technol ; 58(11): 5047-5057, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38437595

RESUMO

The chemical composition of incense-generated organic aerosol in residential indoor air has received limited attention in Western literature. In this study, we conducted incense burning experiments in a single-family California residence during vacancy. We report the chemical composition of organic fine particulate matter (PM2.5), associated emission factors (EFs), and gas-particle phase partitioning for indoor semivolatile organic compounds (SVOCs). Speciated organic PM2.5 measurements were made using two-dimensional gas chromatography coupled with high-resolution time-of-flight mass spectrometry (GC×GC-HR-ToF-MS) and semivolatile thermal desorption aerosol gas chromatography (SV-TAG). Organic PM2.5 EFs ranged from 7 to 31 mg g-1 for burned incense and were largely comprised of polar and oxygenated species, with high abundance of biomass-burning tracers such as levoglucosan. Differences in PM2.5 EFs and chemical profiles were observed in relation to the type of incense burned. Nine indoor SVOCs considered to originate from sources other than incense combustion were enhanced during incense events. Time-resolved concentrations of these SVOCs correlated well with PM2.5 mass (R2 > 0.75), suggesting that low-volatility SVOCs such as bis(2-ethylhexyl)phthalate and butyl benzyl phthalate partitioned to incense-generated PM2.5. Both direct emissions and enhanced partitioning of low-volatility indoor SVOCs to incense-generated PM2.5 can influence inhalation exposures during and after indoor incense use.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Compostos Orgânicos Voláteis , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Material Particulado/análise , Compostos Orgânicos Voláteis/análise , California , Aerossóis/análise
8.
Radiol Technol ; 95(4): 263-270, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38519139

RESUMO

PURPOSE: To assess the patient gonadal shielding practices of radiologic technologists in the state of California. METHODS: A survey invitation was sent via email to registered radiologic technologists in California to collect data to determine whether there were significant associations between gonadal shielding practices and various categorical variables, including patient sex, patient age, body part, availability of gonadal shielding protocols, availability of gonadal shields, and supervisor encouragement. RESULTS: There was a significant association between gonadal shielding protocol availability and supervisor encouragement of using gonadal shielding (P = .005) and between gonadal shielding availability and supervisor encouragement of using gonadal shielding (P < .001). Contrary to other studies in the literature, there was a significant difference between patient sex and the likelihood of gonadal shielding use, with participants indicating that they shield girls and women more often than they shield boys and men (P < .001). DISCUSSION: There was a sex-based difference in the frequency of gonadal shielding usage among the sample in this study. Also, supervisors providing accessible protocols and encouraging gonadal shielding can increase technologists' use of gonadal shielding. CONCLUSION: Gonadal shielding is the current Code of Federal Regulations standard, although most professional and scientific organizations support discontinuing shielding during abdominal and pelvic radiography examinations. Shielding of these areas is more likely to occur with the availability of gonadal shielding, supervisory encouragement, protocols mandating shielding, and state regulations.


Assuntos
Proteção Radiológica , Masculino , Humanos , Feminino , Radiografia , Proteção Radiológica/métodos , California , Equipamentos de Proteção , Doses de Radiação
9.
Environ Health ; 23(1): 31, 2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38519920

RESUMO

BACKGROUND: In early October 2021, thousands of residents in Carson, California began complaining of malodors and headaches. Hydrogen sulfide (H2S), a noxious odorous gas, was measured at concentrations up to 7000 parts per billion (ppb) and remained above California's acute air quality standard of 30 ppb for a month. Intermittent elevations of H2S continued for 3 months. After 2 months of malodor in this environmental justice community, a government agency attributed the H2S to environmental pollution from a warehouse fire. Research has yielded conflicting results on the health effects of H2S exposure at levels that were experienced during this event. This research fills a critical need for understanding how people perceive and experience emergent environmental health events and will help shape future responses. METHODS: Through a community-academic partnership, we conducted 6 focus groups with 33 participants who resided in the Carson area during the crisis. We sought to understand how this incident affected residents through facilitated discussion on topics including information acquisition, impressions of the emergency response, health symptoms, and ongoing impacts. RESULTS: The majority of participants were women (n = 25), identified as Latina/o (n = 19), and rent their homes (n = 21). Participants described difficulty obtaining coherent information about the emergency, which resulted in feelings of abandonment. Most participants felt that local government and healthcare providers downplayed and/or disregarded their concerns despite ongoing odors and health symptoms. Participants described experiencing stress from the odors' unknown health effects and continued fear of future odor incidents. Residents sought to take control of the crisis through information sharing, community networking, and activism. Participants experienced longer term effects from this event, including increased awareness of pollution and reduced trust in local agencies. DISCUSSION: This study demonstrates the necessity of clear, comprehensive, and prompt responses by relevant decisionmakers to chemical emergencies to appropriately address residents' fears, curb the spread of misinformation, and minimize adverse health effects. Participant responses also point to the benefit of supporting horizontal community networks for improved information sharing. By engaging directly with community members, researchers and disaster responders can better understand the various and complex impacts of chemical disasters and can improve response.


Assuntos
Poluição do Ar , Sulfeto de Hidrogênio , Humanos , Masculino , Feminino , Poluição do Ar/análise , Poluição Ambiental , Saúde Ambiental , California
10.
J Environ Manage ; 355: 120396, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38430877

RESUMO

The licensed cannabis industry represents one of the top five most economically valued agricultural commodities in California, yet farming largely remains on remote, environmentally sensitive, "marginal" lands. Using mixed methods, this paper examines the determinants of this marginalization, their embedded elaboration, and their relation to historical policy regimes. We used Generalized Additive Models (GAMs) to determine the most important predictors of licensed cannabis industry development since the inception of a statewide licensing program in 2018 and to compare the distribution of licensed cannabis to other forms of rural agriculture, including vineyards and pasture, to understand landscape factors and environmental sensitivity of land uses. We found that a county's median income and the extent of traditional (non-cannabis) agriculture, as measured by the proportion of on-farm (non-cannabis) employment, were both negatively associated with its amount of licensed cannabis agriculture. Ethnographic data suggests that cannabis is often excluded from traditional agricultural areas, through formal local-level bans, restrictive zoning, high "prime" farmland values, and cultural exclusions from other powerful resource users. The resulting relegation to "marginal" lands foments conflicts with amenity land users and environmentalists, even as it partly supports "legacy" cultivators whose farms were established under prior policy regimes. Results suggest that cannabis is more likely to be grown under conditions that introduce regulatory hurdles, including farming on steeper slopes, with natural streams onsite, and without access to large groundwater aquifers for irrigation. Our findings suggest that failure to allow licensed cannabis farming in traditional agriculture regions has led to a self-fulfilling prophecy wherein cannabis cultivation is largely relegated to environmentally sensitive areas where cultivation activity has an elevated tendency for environmental impacts.


Assuntos
Cannabis , Humanos , Marginalização Social , Fazendas , Agricultura/métodos , California
11.
J Prim Care Community Health ; 15: 21501319241229018, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38323398

RESUMO

BACKGROUND: Disparities in diabetes care quality may have increased for patients with limited English language proficiency (LEP) compared to non-LEP patients during the COVID-19 pandemic. Changes in diabetes care quality for adult LEP and non-LEP patients of community health centers (CHCs) were examined from 2019 to 2020. METHODS: Adults with Type 2 diabetes (n = 15 965) of 88 CHC sites in California and with 1+ visit/year in 2019 and 2020 from OCHIN electronic health record data were included. Multivariable regression models estimated the association of LEP status and changes in diabetes care quality from 2019 to 2020, controlling for patient sociodemographic and clinical characteristics. Interaction terms (LEP × 2020) were used to estimate differential over time changes in (1) blood pressure screening, (2) blood pressure control (<140/90 mm Hg), and (3) hemoglobin A1c control (HbA1c <8%) for LEP versus non-LEP patients. RESULTS: LEP and non-LEP patients with diabetes had comparable blood pressure screening and control in 2019 and in 2020. LEP patients were less likely than non-LEP patients to have their HbA1c under control in 2019 (OR = 0.85, 95% CI = 0.77, 0.96, P = .006) and 2020 (OR = 0.83, 95% CI = 0.75, 0.92, P = .001). There were no differential changes in HbA1c control over time for LEP and non-LEP patients. DISCUSSION: Although LEP patients were less likely than non-LEP patients to have their HbA1c under control, CHCs maintained quality of care equally for LEP and non-LEP patients with diabetes during the early pandemic period.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Adulto , Humanos , Pandemias , Hemoglobinas Glicadas , Barreiras de Comunicação , Qualidade da Assistência à Saúde , Linguística , California , Centros Comunitários de Saúde
12.
JAMA Netw Open ; 7(2): e2356466, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38407907

RESUMO

Importance: Wildfires, intensified by climate change, have known effects on physical health but their effects on mental health are less well characterized. It has been hypothesized that the residential proximity to a large wildfire can exacerbate underlying mental health conditions as evidenced by increased prescriptions of psychotropic medications. Objective: To evaluate the association between the occurrence of large wildfires and the prescription rates of psychotropic medications immediately following the start of the fire. Design, Setting, and Participants: This cohortstudy used an interrupted time-series analysis to compare psychotropic medication prescriptions in the 6 weeks before and after each of 25 wildfires. The setting was California counties within metropolitan statistical areas (MSAs) experiencing large wildfires from 2011 through 2018. Participants included individuals residing in California MSAs with prescriptions of psychotropic medications recorded in the Merative MarketScan Research Database (MarketScan) during the study period. Statistical analysis was performed for these 25 large wildfires occurring between September 2011 and November 2018. Exposure: Residential proximity to large wildfires that burned more than 25 000 acres occurring in a California county within an MSA. Main Outcomes and Measures: Prescriptions of psychotropic medications, including antidepressants, antipsychotics, anxiolytics, hypnotics, and mood-stabilizers, with statins as a negative control outcome. Results: For the study period, prescription data and patient-level attributes were extracted for 7 115 690 unique individuals (annual mean [range]: 889 461 [455 705-1 426 928] individuals) enrolled in MarketScan and residing in fire-affected MSAs. This study found a statistically significant increase in prescriptions of antidepressants (rate ratio [RR], 1.04 [95% CI, 1.01-1.07]), anxiolytics (RR, 1.05 [95% CI, 1.02-1.09]), and mood-stabilizing medications (RR, 1.06 [95% CI, 1.01-1.13]) in the fire period compared with the prefire baseline. However, the prescriptions of antipsychotics, hypnotics, and the negative control outcome, statins, showed no significant association. Conclusions and Relevance: In this cohort study of large California wildfires, the occurrence of wildfire was associated with increased mental health burden as reflected in increased prescription rates of certain psychotropic medications. The findings underscore the need for further scientific examination into the mental health effects of wildfires and the allocation of mental health resources in disaster responses. California experienced a substantial burden of wildfires from 2011 to 2018, and as wildfires become more intense and frequent in the context of anthropogenic climate change, it is increasingly important to understand and address their mental health effects.


Assuntos
Ansiolíticos , Antipsicóticos , Inibidores de Hidroximetilglutaril-CoA Redutases , Incêndios Florestais , Humanos , Estudos de Coortes , Prescrições de Medicamentos , Psicotrópicos/uso terapêutico , Hipnóticos e Sedativos , California/epidemiologia , Antidepressivos/uso terapêutico
13.
Prev Chronic Dis ; 21: E09, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329921

RESUMO

Introduction: Childhood dietary behaviors, including fruit and vegetable intake, are associated with adult health. Most children do not meet daily recommended servings of fruits and vegetables. Less is known about temporal patterns in fruit and vegetable consumption or if they vary by race and ethnicity. We investigated temporal patterns in fruit and vegetable intake among California school-age children and adolescents overall and by race and ethnicity. Methods: We used 2-year cross-sectional datasets from the child and adolescent samples in the California Health Interview Surveys from 2011-2012 through 2019-2020 and modified Poisson regression models to estimate the likelihood of consuming 5 or more servings of fruits and vegetables in 2013-2016 and 2017-2020 compared with 2011-2012. Models controlled for age, race and ethnicity, gender, citizenship status, family income, and adult education and tested for differences by race and ethnicity. The samples included 16,125 children aged 5 to 11 years and 9,672 adolescents aged 12 to 17 years. Results: Overall, 29.3% of children and 25.9% of adolescents reported intake of 5 or more fruits and vegetables per day. Among children, adjusted prevalence ratios (PR) of fruit and vegetable intake were higher in 2013-2016 (PR,1.25; 95% CI, 1.11-1.42) and 2017-2020 (PR,1.13; 95% CI, 0.99-1.30) compared with 2011-2012. Among adolescents, the adjusted prevalence did not differ significantly over time. We found no evidence of differential associations by race and ethnicity for children and adolescents. Conclusion: We found favorable temporal changes in fruit and vegetable consumption among children, but not among adolescents. Monitoring temporal patterns in fruit and vegetable intake remains critical for planning population-level interventions to increase consumption.


Assuntos
Frutas , Verduras , Adulto , Criança , Adolescente , Humanos , Estudos Transversais , Dieta , California/epidemiologia , Comportamento Alimentar
14.
Environ Health Perspect ; 132(2): 25001, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38415616

RESUMO

BACKGROUND: Antimicrobial use in livestock production is considered a key contributor to growing antimicrobial resistance in bacteria. In 2015, California became the first state to enact restrictions on routine antimicrobial use in livestock production via Senate Bill 27 (SB27). SB27 further required the California Department of Food and Agriculture (CDFA) to collect and disseminate data on antimicrobial use in livestock production. OBJECTIVE: The goal of this report is to assess whether CDFA's data release allows us to evaluate how antimicrobial use changed after the implementation of SB27. METHODS: We combine the CDFA data with feed drug concentration ranges from the Code of Federal Regulation to evaluate the spread of plausible antimicrobial use trends. We also estimate antimicrobial consumption rates using data from the National Agricultural Statistical Service (NASS) and compare these to changes in medicated feed production reported by the CDFA. DISCUSSION: We show that CDFA's reported data are insufficient to reliably estimate whether antimicrobial usage has increased or decreased, most notably because no information is provided about the mass of antimicrobials approved for use or medicated feed drug concentrations. After incorporating additional external data on feed drug concentrations, one can at best provide uninformative bounds on the effect of SB27. We find some evidence that antimicrobial use has decreased by incorporating data on national sales of antimicrobials for food-producing animals, but the weakness of this inference underlines the need for improved data collection and dissemination, especially as other states seek to implement similar policies. We provide recommendations on how to improve reporting and data collection under SB27. https://doi.org/10.1289/EHP13702.


Assuntos
Anti-Infecciosos , Gado , Animais , Anti-Infecciosos/farmacologia , Anti-Infecciosos/uso terapêutico , Bactérias , Criação de Animais Domésticos , California , Antibacterianos/farmacologia
15.
Int J Epidemiol ; 53(1)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38309714

RESUMO

BACKGROUND: Paraquat dichloride is currently among the most widely used commercial herbicides in the USA. In the present study, we provide epidemiological assessment of ambient paraquat exposure and Parkinson's disease (PD) risk in a population-based study of PD in agricultural regions of Central California. METHODS: Based on 829 PD patients and 824 community controls, we assessed associations between ambient paraquat dichloride exposure and PD. We estimated residential and workplace proximity to commercial agricultural applications in three California counties since 1974 using the CA pesticide use reporting (PUR) data and land use maps. We evaluated any, duration and average intensity [pounds (0.45 kilograms) per acre per year] of exposure for paraquat in four time windows. RESULTS: Ambient paraquat exposure assessed at both residence and workplace was associated with PD, based on several different exposure measures. The PD patients both lived and worked near agricultural facilities applying greater amounts of the herbicide than community controls. For workplace proximity to commercial applications since 1974, working near paraquat applications every year in the window [odds ratio (OR) = 2.15, 95% confidence interval (CI) = 1.46, 3.19] and a higher average intensity of exposure [per 10 pounds (4.54 kilograms), OR = 2.08, 95% CI = 1.31, 3.38] were both associated with an increased odds of PD. Similar associations were observed for residential proximity (duration: OR = 1.91, 95% CI = 1.30, 2.83; average intensity: OR = 1.72, 95% CI = 0.99, 3.04). Risk estimates were comparable for men and women, and the strongest odds were observed for those diagnosed at ≤60 years of age. CONCLUSION: This study provides further indication that paraquat dichloride exposure increases the risk of Parkinson's disease.


Assuntos
Doença de Parkinson , Praguicidas , Masculino , Humanos , Feminino , Doença de Parkinson/epidemiologia , Paraquat , Agricultura , Suscetibilidade a Doenças , California/epidemiologia
16.
PLoS One ; 19(2): e0296741, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38335164

RESUMO

BACKGROUND: The Supreme Court's decision in Students for Fair Admissions, Inc., v. Harvard College is likely to result in the matriculation of fewer students from historically excluded racial/ethnic groups at more selective colleges and universities and matriculation of more students at less selective colleges and universities. Because of this, it is important to understand how resources for pre-health advising, a modifiable factor that can help increase the diversity of the health workforce, vary across institutions with differing levels of selectivity. Colleges are known to vary in resources, structure, and investment in pre-health advising but data are lacking and there is no estimate of any pre-health advising resource gap. PURPOSE: To quantify availability of advising resources and identify perceived challenges in pre-health advising in California's highly diverse public and select private undergraduate institutions. METHODS: Structured 60-minute Zoom interviews from June 2022 -October 2022 at 18/23 CSU (California State Universities), 9/9 University of California (UC) institutions and 6 select private institutions with varying levels of selectivity. Two investigators independently analyzed interviews using a Grounded Theory Approach. The full study team reviewed transcripts and themes. KEY RESULTS: Pre-health advisor capacity varied greatly across the three types of institutions. CSU: mean = 1 FTE advisor: 24,620 graduates (range: 1: 1,059-1: 150,520); UC mean = 1 FTE advisor: 4,526 graduates (range: 1: 1,912-1: 10,920); private institutions mean = 1 FTE advisor:1,794 graduates (range: 1: 722-1: 5,300). Participants reported common challenges: advising capacity, lack of advisor training, advisor turnover, and student difficulties in accessing clinical opportunities and required coursework. CSU and UC participants noted that these had greatest impact for first generation and racially/ethnically underrepresented students for whom lack of informal professional networks, lack of other mentors, and financial responsibilities complicate college navigation and professional school application. CONCLUSIONS: Students at CSU campuses had 5 times less access to pre-health advising per graduate than UC students, and 13 times less than students at private institutions. Much greater investment is needed in California's public institutions, particularly CSUs, to increase equity in access to advising for pre-health professional students. Research should examine pre-health advising resource capacity in other states, especially those that are now facing race-neutral admissions policies at undergraduate institutions and health professions schools.


Assuntos
Pessoal de Saúde , Estudantes , Humanos , Universidades , California
17.
Viruses ; 16(2)2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38399964

RESUMO

The Citrus yellow vein clearing virus (CYVCV) causes a viral disease that has been reported in some citrus-growing regions in countries in Eurasia including Pakistan, India, Türkiye, Iran, China, and South Korea. Recently, CYVCV was detected in a localized urban area in a town in the middle of California's citrus-growing region and marks the first occurrence of the virus in North America. CYVCV has been reported to be spread by aphid and whitefly vectors and is graft and mechanically transmitted. Hence, it is an invasive pathogen that presents a significant threat to the California citrus industry, especially lemons, which are highly symptomatic to CYVCV. To elucidate the origin of the CYVCV California strain, we used long-read sequencing technology and obtained the complete genomes of three California CYVCV isolates, CA1, CA2, and CA3. The sequences of these isolates exhibited intergenomic similarities ranging from 95.4% to 97.4% to 54 publicly available CYVCV genome sequences, which indicated a relatively low level of heterogeneity. However, CYVCV CA isolates formed a distinct clade from the other isolates when aligned against other CYVCV genomes and coat protein gene sequences as shown by the neighbor network analysis. Based on the rooted Maximum Likelihood phylogenetic trees, CYVCV CA isolates shared the most recent common ancestor with isolates from India/South Asia. Bayesian evolutionary inferences resulted in a spatiotemporal reconstruction, suggesting that the CYVCV CA lineage diverged from the Indian lineage possibly around 1995. This analysis placed the origin of all CYVCV to around 1990, with South Asia and/or Middle East as the most plausible geographic source, which matches to the first discovery of CYVCV in Pakistan in 1988. Moreover, the spatiotemporal phylogenetic analysis indicated an additional virus diffusion pathway: one from South Asia to China and South Korea. Collectively, our phylogenetic inferences offer insights into the probable dynamics of global CYVCV dissemination, emphasizing the need for citrus industries and regulatory agencies to closely monitor citrus commodities crossing state and international borders.


Assuntos
Citrus , Flexiviridae , Filogenia , Teorema de Bayes , Doenças das Plantas , Flexiviridae/genética , Genótipo , California
18.
Am J Health Syst Pharm ; 81(6): 166-167, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38346102
19.
Environ Sci Technol ; 58(9): 4346-4356, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38380834

RESUMO

Ocean disposal of industrial waste from technical DDT [mainly 1,1'-(2,2,2-trichloroethane-1,1-diyl)bis(4-chlorobenzene), or 4,4'-DDT] manufacture occurred historically in the Southern California Bight. However, the paucity of historical records highlights uncertainties as to the mode, location, and timing of disposal or ongoing ecological effects of these wastes. This study combines sampling, chemical analysis, and numerical modeling of deep San Pedro Basin sediments revealing substantial DDT contamination that extends at least 25 km from the mainland. These findings narrate bulk DDT waste disposal to the offshore that peaked in the 1950s, prior to the onset of formal regulations; was agnostic to later-designated disposal sites; and has experienced sluggish transformation. Our findings further indicate an attenuating secondary source for the DDT daughter product, 1-chloro-4-[2,2-dichloro-1-(4-chlorophenyl)ethenyl]benzene (4,4'-DDE), which still deposits into deep San Pedro Basin sediments. While demonstrating the severity of DDT contamination to the region, these findings further define the burial potential of DDT wastes and inform the past, present, and future contamination potential that is needed to understand and predict ecological consequences. This work also points firmly to bulk, not containerized, disposal of DDT waste and to potential alternative contents of collocated waste.


Assuntos
DDT , Resíduos Industriais , DDT/análise , Resíduos Industriais/análise , Monitoramento Ambiental , Oceanos e Mares , California
20.
Environ Sci Pollut Res Int ; 31(14): 21356-21369, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38388979

RESUMO

Earth internal seepage erosion in weathered bedrock under infrequently used hydraulic structures is often overlooked, which causes some solid particles to break away from the solid skeleton, degrading the earth's strength, and even causing unanticipated hydraulic engineering failures. The flood on the Oroville dam spillway in California in 2017 was caused by disturbed water flow due to a crack in the spillway chute caused by internal erosion in poorly weathered bedrock. The abnormal water flow of the spillway in the early stage and subsequent investigation revealed that the main reason for the accident was the insufficient weathered bedrock under the spillway chute. In this study, we formulated a coupled hydro-mechanical mechanism for internal erosion in weathered bedrock during the early stages. Using this model, we conducted an internal erosion numerical simulation at early stage, and the results showed that the physical characteristics of the weathered bedrock were degraded. Our results show the coupling analysis of quantitative computation during the early stage of internal erosion in weathered bedrock, which can provide an early warning method for the occurrence of internal erosion to avoid hydraulic disasters.


Assuntos
Desastres , Geraniaceae , California , Simulação por Computador , Água
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