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Previous research shows that large, densely populated urban areas have higher rates of child victimization that have persisted over time. However, few investigations have inquired about the processes that produce and sustain hot and cold spots of child victimization. As a result, the mechanisms that produce the observed spatial clustering of child victimization, and hence "why" harms against children tend to cluster in space, remains unknown. Does the likelihood of being a victim of violence in one location depend on a similar event happening in a nearby location within a specified timeframe? Rather, are child victims of violence more likely to reside in suboptimal neighborhood conditions? This paper aims to present an analytical and theoretical framework for distinguishing between these locational (point) processes to determine whether the empirical spatial patterns undergirding child victimization are more reflective of the "spread" via contagion (i.e., dependency) or whether they are produced by neighborhood structural inequality resulting from spatial heterogeneity. To detect spatial dependence, we applied the inhomogeneous K -function to Los Angeles Medical Examiner data on child homicide victim locations while controlling for regional differences in victimization events (i.e., heterogeneity). Our analysis found strong evidence of spatial clustering in child victimization at small spatial scales but inhibition at larger scales. We further found limited support for the spatiotemporal clustering of child victimization indicative of a contagion effect. Overall, our results support the role of neighborhood structural vulnerability in the underlying mechanisms producing patterns of child victimization across Los Angeles County. We conclude by discussing the policy implications for understanding this spatial patterning in geographical context and for developing effective and targeted preventive interventions. [ABSTRACT FROM AUTHOR]

Background: Youth mental health needs have worsened following COVID-19. Rising demand for school mental health services is straining capacity. Several states have added policies requiring mental health education, yet these vary widely and barriers to operationalization exist. Purpose: This paper explores the onerous landscape of mental health education and makes the case for the education framework of mental health literacy (MHL), derived from health literacy (HL), as the North Star of universal mental health education. Methods: A scan of mental health education policies was conducted, and two state case studies were included. California requires middle- and high-school integration with existing health education, and Delaware requires K-12 mental health education allowing for integration with existing social, emotional, and behavioral wellbeing initiatives within schools' multi-tiered system of supports. Results: Thirty-six state policies were identified, with over 80% explicitly related to health education. Policies varied across multiple dimensions including scope and clarity, target audience, requirement conditions, and resources. Discussion: Barriers and opportunities are discussed, including a national effort, The Mental Health Literacy Collaborative (MHLC), focused on the benefits of MHL education. Translation to Health Education Practice: Findings offer health educator opportunities for planning, leadership, and advocacy toward implementing MHL education in schools. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

Massive amounts of fly ash (FA) are dumped carelessly leading to a negative influence on the environment. However, FA contains several advantages when it is used in geotechnical engineering and civil engineering projects which not only dispose of waste but also improve sustainability. In addition to offering a promising solution to the disposal issue, the use of waste materials in civil engineering projects also offers an affordable substitute for conventional materials which preserves natural resources. Many scholars' studies show how FA is used and how it affects the geotechnical characteristics of the soil. Despite extensive research, the assessment of FA's suitability is complicated due to the chemical composition of FA which varies significantly between sources. This variability can affect how FA interacts with different soil types, leading to inconsistent results in terms of soil improvement and geotechnical properties. Therefore, a comprehensive review is required that compiles all effective data and gives the user simple instructions about using FA. This article reviews the current state of the art research on the physical properties of FA, chemical composition of different countries FA, Atterberg limit, compaction properties, California bearing ratio, unconfined compressive strength, shear strength compression, and swelling index. Results showed that adding FA to soil increased its geotechnical qualities, but the effect depends on the type of soil and specific conditions, such as moisture content, compaction, and the percentage of FA added. The higher percentages of FA led to a decline in geotechnical characteristics. The assessment, therefore, advises that FA may be added up to optimum percentages which generally 20% depending on its source and chemical composition. [ABSTRACT FROM AUTHOR]

Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations—that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over side effects. This study also found two general types of parents—those who treat vaccines the same and those with varying opinions about each vaccine. Results from this study demonstrate the family- and community-oriented nature of NHPI communities, suggesting that future interventions target not only parents but also their families and communities to cultivate vaccine acceptance through social networks. Furthermore, addressing all three vaccines during well-child visits may benefit parents who view each vaccine as separate entities with individual pros and cons. Such interventions could contribute toward reducing the burdens of particularly chronic health disparities. [ABSTRACT FROM AUTHOR]

Providing consumers with safe, nutritious food is a common goal shared by the produce industry, the public health community, government agencies, and academia. To this end, these stakeholders have adopted a collaborative approach to address the challenge of improving the safety of food commonly eaten by infants and children. On 24 to 26 October 2023, Western Growers, in collaboration with federal and state government agencies, organized a pilot workshop in Salinas, CA, focused on cadmium in carrots and spinach grown in Arizona and California. Following a day of touring carrot and leafy green fields, workshop attendees participated in 2 days of panel discussions and presentations on cadmium toxicology and health effects, the nutritional benefits of carrots and spinach, Arizona's and California's carrot and spinach production practices, current research on plant uptake of cadmium, and mitigation methods and strategies. Panel discussions focused on obstacles that hinder adoption of methods to reduce cadmium, industry-regulator trust and communication, confidential data sharing, and industryacademia collaborative research. This article is a summary of workshop proceedings highlighting the stakeholders' expectations and roles as perceived by the attendees and essential support needed for continuous improvement going forward. [ABSTRACT FROM AUTHOR]

Virtual clinical services became the primary treatment modality in a large U.S. HMO psychiatry department during the COVID-19 pandemic. A mixed methods quality improvement project was developed to address psychosis, severe anxiety, and stressors unique to COVID-19 and sheltering in place. The purpose was to determine if a virtual 10-week pilot program combining psychoeducation, skills-based training, experiential exercises using third-wave CBT, and process questions would decrease symptoms and hospitalization rates and improve quality of life. Pre- and postmeasure scores on pandemic-related stress (the PRSF), perceived stress (PSS), and general patient health (PHQ-9) were gathered from five patients in the Department of Psychiatry at Kaiser Permanente in Oakland, California. Qualitative interviews explored patients' perceptions of program benefits. Mean, median, and range on the pre- and postprogram assessments and paired samples t tests for means were calculated. Quantitative results were not statistically significant: p = 0.32 (Revised PRSF), p = 0.34 (PSS), p = 0.94 (PHQ-9). In interviews, most participants reported a decrease in pandemic-related stress. Half reported a decrease in general perceived stress. Half reported no change. Self-assessment reflected perceptions of benefits from this 10-week program, using words such as useful and important. The virtual program helped relieve pandemic-related stress and improved overall quality of life. The results show promise for expanding the program to other hospitals providing services for this diagnostic population., Competing Interests: Declarations. Conflict of Interest: We have no known conflict of interest to disclose. Ethical Approval: Federal regulations require institutional review board (IRB) review and approval for human subject research. This article details a quality improvement project, which does not require IRB oversight. Quality improvement (QI) and quality assurance projects always involve human subjects but only have to be submitted for IRB for review if they meet the definition of research. Consistent with Nerenz et al. (2003) and the VCU Office of the Vice President for Research and Innovation (n.d.), strictly QI activities do not require IRB oversight. This manuscript reflects a QI project that was mandated by the named clinic as part of its operations, to update the clinical case management program to reflect current literature, and did not involve randomization as the participants were already established in the clinical case management program., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This paper examines how Stanford Hospital, a Level I trauma centre serving the metropolitan region of California's Bay Area, manages an acute surge of patients from a mass casualty incident, specifically within the context of the crowded and overburdened US emergency medicine system. The authors offer practical considerations for the rapid creation of space and bandwidth during an acute surge of injured patients as well as best practices for reorganising daily systems to care for those patients efficiently. The study also discusses how past mass casualty incidents were examined for lessons learned in order to build and refine the response plan at Stanford Hospital, with input from a multidisciplinary committee.

Understanding the heterogeneity in autonomous vehicle (AV) crash patterns is crucial for enhancing the safety and public acceptance of autonomous transportation systems. In this paper, 584 AV collision reports from the California Department of Motor Vehicles (CA DMV) were first extracted and augmented by a highly automatic and fast variable extraction framework. Crash damage severities, classified as none, minor, moderate, and major, were set as the dependent variables. Factors including crash, road, temporal, vehicle, and environment characteristics were identified as potential determinants. To account for the heterogeneity inherent in crash data and identify key factors influencing the damage severity in AV crashes, a methodology integrating the latent class analysis and multinomial logit model was employed. Two heterogeneous clusters were determined based on the skewed distributions of vehicle status and driving mode. The model estimation results indicate a positive association between severe crash damage and some risk factors, such as head-on, intersection, multiple vehicles, dark with street lights, dark without street lights, and early morning. This study also reveals significant differences among the variables influencing the damage severity across two distinct subclasses. Moreover, partitioning the AV crash dataset into heterogeneous subsets facilitates the identification of critical factors that remain obscured when the dataset is analyzed as a whole, such as the evening indicator. This paper not only enhances our understanding of AV crash patterns but also paves the way for safer AV technology., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Despite the prevalence and significant concern of COVID-19 in maternal and offspring health, little is known about the impact of COVID-19 during pregnancy on newborn immunity and neurodevelopment. This study aimed to examine 1) the relationship between maternal COVID-19 during pregnancy and newborn immune profiles and investigate the 2) associations between specific newborn immune profiles and the risk of subsequent diagnosis of a neurodevelopmental disorder (NDD) among children with prenatal exposure to COVID-19. Newborn dried bloodspots (NBS) from 545 children born at Kaiser Permanente Northern California between January 2020 and September 2021 (460 [223 males, 237 females] to COVID-19-infected [COVID+] mothers; 85 [45 males, 40 females] to COVID-19-uninfected [COVID-] mothers) were used to profile newborn immune molecules via a 42-plex cytokine/chemokine assay. Among the 460 children born to COVID+ mothers, 73 (47 males, 27 females) were later diagnosed with an NDD. In the first set of analyses examining the association between maternal COVID-19 infection during pregnancy and newborn immune profile, the results adjusted for covariates but uncorrected for multiple comparisons showed that newborns of COVID+ mothers had significantly higher levels of IL-22 (estimate [est.] = 0.16, 95 % Cl 0.01, 0.3, p = 0.04) and GM-CSF (est. = 0.27, 95 % Cl 0.09, 0.46, p = 0.004) compared to newborns of COVID- mothers. These differences were no longer statistically significant after multiple comparison adjustments. In the second analysis exploring the association between newborn profile and later diagnosis of NDD among newborns born to COVID+ mothers, the results adjusted for covariates revealed an association between higher neonatal levels of IL-22 (hazard ratio [HR] = 0.49, 95 % Cl 0.33, 0.75, p = 0.001) and lower risk of a later diagnosis of an NDD, which remained significant after multiple comparison adjustments (p = 0.04). Other neonatal cytokines/chemokines/growth factors such as sCD40L (HR = 0.7, 95 % Cl 0.57, 0.9, p = 0.009), IP-10 (HR = 0.46, 95 % Cl 0.25, 0.83, p = 0.009), MIG (HR = 0.52, 95 % Cl 0.3, 0.9, p = 0.02), FLT-3L (HR = 0.45, 95 % Cl 0.24, 0.83, p = 0.01), PDGF AB/BB (HR = 0.56, 95 % Cl 0.36, 0.99, p = 0.046), VEGF (HR = 0.57, 95 % Cl 0.34, 0.98, p = 0.04), and IL-4 (HR = 0.48, 95 % Cl 0.26, 0.93, p = 0.03) were no longer statistically significant after multiple comparison adjustments. Despite the imbalance between the number of COVID-19 exposed and unexposed newborns in this study cohort, our novel findings enhance our understanding of the potential impact of maternal COVID-19 infection during pregnancy on the developing neonatal immune system. Our findings highlight the role of immune molecules, beyond those considered to be pro-inflammatory, that may be crucial in maternal and newborn immunity against COVID-19 infection during pregnancy. Furthermore, our results suggest that reduced levels of neonatal immune molecules in newborns of COVID + mothers may be linked to an increased risk of a subsequent diagnosis of an NDD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Multisystem inflammatory syndrome in children (MIS-C) is a rare condition occurring after SARS-CoV-2 infection in children under 21 years of age. Children (5-17 years) with MIS-C meeting the Centers for Disease Control (CDC) case definition were reported via California's passive disease surveillance system. Incidence of MIS-C was compared in unvaccinated and Pfizer-BioNTech vaccinated children aged 12-17 and 5-11 years. In the 12-17 year-old age group, there were 66 new cases among 872,936 unvaccinated children and 7 new cases among 2,117,575 vaccinated children. In the 5-11 year-old age group, there were 51 new cases among 2,113,725 unvaccinated children and 9 new cases among 1,221,293 vaccinated children. Compared with vaccinated children, the incident rate ratio of MIS-C was higher among unvaccinated children in both the 12-17-year-old group (22.9, 95 % confidence interval [CI]: 10.5-49.8, p < 0.0001) and the 5-11-year-old group (3.3, 95 % CI: 1.6-6.7, p = 0.0004). While MIS-C is rare, our results suggest that vaccination with the Pfizer-BioNTech vaccine is protective against MIS-C., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Chloe Le Marchand MD reports financial support was provided by California Department of Public Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Some interventions for smoking cessation such as quit smoking aids show sex-specific effects on outcomes, but behavioral interventions such as mindfulness-based interventions (MBIs) for smoking cessation lack formal reporting of sex-intervention tests of interaction to date. To address this gap, we conducted a secondary analysis of a RCT dataset (N = 213), recruiting participants from California, to statistically test a sex-intervention interaction effect on complete 7-day point prevalence abstinence (PPA), proportion of days abstinent, and daily cigarettes smoked. Smoking was assessed using the timeline follow back method spanning the four weeks following a daily 14-day app-based intervention and a planned smoking quit date immediately following the intervention phase. All models adjusted for baseline nicotine dependence. The study groups had comparable sex proportions (MBI: 56 % female; control: 55 % female) and the ratio of outcome assessment completion by group was not dependent on sex. Adjusted analyses revealed a significant sex-intervention interaction effect for daily cigarettes smoked ([female coded 1]: two-way interaction effect IRR = 0.59, 95 % CI: 0.46-0.77, p < 0.0001; effect for female: IRR = 0.68, 95 % CI: 0.57-0.81, effect for male: IRR = 1.14, 95 % CI: 0.95-1.37), but not for complete 7-day PPA ([female coded 1] two-way interaction effect OR = 1.24, 95 % CI: 0.31-4.89, p = 0.76) or proportion of total days abstinent ([female coded 1] two-way interaction effect OR = 1.97, 95 % CI: 0.53-7.37, p = 0.31). Females, but not males, allocated to a daily app-based MBI with a quit plan and quit aid workbook smoked fewer cigarettes per day compared to females in the control group. Males, but not females, showed significantly less use of the MBI app compared to the control app., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Most of the US population is exposed to per- and polyfluorinated substances (PFAS) through various environmental media and these sources of PFAS exposure coupled with disproportionate co-localization of PFAS-polluting facilities in under-resourced communities may exacerbate disparities in PFAS-associated health risks., Method: We leveraged two cohorts in Southern California with 8 PFAS concentrations measured in plasma. We obtained PFAS water testing data from the Third Unregulated Contaminant Monitoring Rule and state monitoring data, census tract-level information on food access using the Food Access Research Atlas, the location of Superfund sites on the National Priorities List, and data on facilities known to release PFAS pollutants. These data were then spatially linked to the participants' home addresses., Results: In the first cohort, we found that detections of PFOS, PFOA, and PFHxS in drinking water were associated with 1.54 ng/mL (95% CI: 0.77, 2.32), 0.47 ng/mL (0.25, 0.68), and 1.16 ng/mL (0.62, 1.71) increase in plasma PFOS, PFOA, and PFHxS. The presence of Superfund sites was associated with higher plasma concentrations of PFOS, PFHxS, PFPeS, and PFHpS (betas [95% CIs]: 0.96 [0.21, 1.71], 0.9 [0.22, 1.58], 0.04 [0.02, 0.06] and 0.05 [0.02, 0.09], respectively). Each additional PFAS-polluting facility present in the neighborhood was associated with a 0.9 ng/mL (0.03, 0.15) increase in the concentration of PFOS. In the other cohort, we found that the presence of Superfund sites was associated with higher plasma PFDA, PFHpS, PFOS (betas [95% CIs]: 0.03 [0.01, 0.06], 0.05 [0.01, 0.09], and 1.96 [0.31, 3.62]). Neighborhood low access to food was associated with a 2.51 ng/mL (0.7, 4.31) increase in plasma PFOS, 0.6 ng/mL (0.16, 1.06) increase in plasma PFOA and 0.06 (0.02, 0.1) increase in plasma PFHpS., Conclusion: Reducing sources of PFAS exposure in under-resourced neighborhoods may help reduce disparities in human exposure levels., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr Chatzi has served as an expert consultant for plaintiffs in litigation related to PFAS-contaminated drinking water. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)