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Forty-four pairs of Mexican-heritage and European-heritage US children were asked to characterize differences between two contrasting cultural patterns of working together in video clips that showed a) Mexican Indigenous-heritage children working together by collaborating, helping, observing others, and using nonverbal as well as verbal communication, and b) middle-class European-American children working alone and using predominantly verbal communication. Through experience in two cultural settings, bilingual Mexican-heritage US children may become familiar with these contrasting cultural patterns that have been identified in research. Mexican-heritage US children characterized the clips in ways that corresponded with researchers' descriptions more often than did European-heritage children, when discussing working together and helping but not when discussing communication. The children from the two backgrounds differed in their treatment of talk. In addition to talking more overall, half of the European-heritage US children considered talk a requirement for working together or helping, excluding nonverbal communication as a way of working together or helping. In contrast, the Mexican-heritage US children included nonverbal communication as a means of working together and helping, and some seemed to include nonverbal communication as a form of talking.

Telehealth training may benefit parents' use of early intervention for children with autism spectrum disorder (ASD). This study is one of the few randomized trials to compare telehealth parent training in the Early Start Denver Model (P-ESDM) with a community treatment-as-usual, early intervention program. Parents were randomized to 12 weekly 1.5-hr videoconferencing sessions with website access to P-ESDM learning resources or to monthly 1.5-hr videoconferencing sessions with website access to alternative resources to support their intervention. Telehealth training facilitated higher parent fidelity gains and program satisfaction for more of the P-ESDM than the community group at the end of the 12-week training and at follow-up. Children's social communication skills improved for both groups regardless of parent fidelity. Findings suggest the feasibility of telehealth training with improved parent intervention usage and satisfaction from the program. However, the impact of these effects on children's development over time is yet to be understood.

This paper is a content analysis of political flyers and messages developed by Religious Right campaigns between 1974 and 2013 to fight legislation supportive of lesbian, gay, bisexual, and transgender (LGBT) individuals. The analysis focuses on 16 campaigns in which Religious Right groups made claims about transgender adults and children. In these messages (n = 60), transgender children are presented as similar to adults; campaigns frame these children as immutably gendered, confused, and sexually predatory. This research advances the body of literature on the adultification of minority children. I argue that transgender girls are adultified and sexualized rather than framed as innocent or imperiled, which perpetuates cisgender domination of transgender people.

Background: Sexual assault and/or sexual harassment during military service (military sexual trauma (MST)) can have medical and mental health consequences. Most MST research has focused on reproductive-aged women, and little is known about the long-term impact of MST on menopause and aging-related health. Objective: Examine associations of MST with menopause and mental health outcomes in midlife women Veterans. Design: Cross-sectional. Participants: Women Veterans aged 45–64 enrolled in Department of Veterans Affairs (VA) healthcare in Northern California between March 2019 and May 2020. Main Measures: Standardized VA screening questions assessed MST exposure. Structured-item questionnaires assessed vasomotor symptoms (VMS), vaginal symptoms, sleep difficulty, depressive symptoms, anxiety symptoms, and posttraumatic stress disorder (PTSD) symptoms. Multivariable logistic regression analyses examined associations between MST and outcomes based on clinically relevant menopause and mental health symptom thresholds. Key Results: Of 232 participants (age = 55.95 ± 5.13), 73% reported MST, 66% reported VMS, 75% reported vaginal symptoms, 36% met criteria for moderate-to-severe insomnia, and almost half had clinically significant mental health symptoms (33% depressive symptoms, 49% anxiety, 27% probable PTSD). In multivariable analyses adjusted for age, race, ethnicity, education, body mass index, and menopause status, MST was associated with the presence of VMS (OR 2.44, 95% CI 1.26–4.72), vaginal symptoms (OR 2.23, 95% CI 1.08–4.62), clinically significant depressive symptoms (OR 3.21, 95% CI 1.45–7.10), anxiety (OR 4.78, 95% CI 2.25–10.17), and probable PTSD (OR 6.74, 95% CI 2.27–19.99). Results did not differ when military sexual assault and harassment were disaggregated, except that military sexual assault was additionally associated with moderate-to-severe insomnia (OR 3.18, 95% CI 1.72–5.88). Conclusions: Exposure to MST is common among midlife women Veterans and shows strong and independent associations with clinically significant menopause and mental health symptoms. Findings highlight the importance of trauma-informed approaches to care that acknowledge the role of MST on Veteran women's health across the lifespan. [ABSTRACT FROM AUTHOR]

Increased interest in renewable energy has fostered development of wind and solar energy facilities globally. However, energy development sometimes has negative environmental impacts, such as wildlife fatalities. Efforts by regional land managers to balance energy potential while minimizing fatality risk currently rely on datasets that are aggregated at continental, but not regional scales, that focus on single species, or that implement meta-analyses that inappropriately use inferential statistics. We compiled and summarized fatality data from 87 reports for solar and wind facilities in the Mojave and Sonoran Deserts region of southern California within the Desert Renewable Energy Conservation Plan area. Our goal was to evaluate potential temporal and guild-specific patterns in fatalities, especially for priority species of conservation concern. We also aimed to provide a perspective on approaches interpreting these types of data, given inherent limitations in how they were collected. Mourning doves (Zenaida macroura), Chukar (Alectoris chukar) and California Quail (Callipepla californica), and passerines (Passeriformes), accounted for the most commonly reported fatalities. However, our aggregated count data were derived from raw, uncorrected totals, and thus reflect an absolute minimum number of fatalities for the monitored period. Additionally, patterns in the raw data suggested that many species commonly documented as fatalities (e.g., waterbirds and other nocturnal migrants, bats) are rarely counted during typical pre-construction use surveys. This may explain the more commonly observed mismatch between pre-construction risk assessment and actual fatalities. Our work may serve to guide design of future scientific research to address temporal and spatial patterns in fatalities and to apply rigorous guild-specific survey methodologies to estimate populations at risk from renewable energy development. [ABSTRACT FROM AUTHOR]

To validate a culturally tailored 7-day beverage intake questionnaire for Latino children (BIQ-L). Cross-sectional. Federally qualified health center in San Francisco, CA. Latino parents and their children aged 1–5 years (n = 105). Parents completed the BIQ-L for each child and three 24-hour dietary recalls. Participants' height and weight were measured. Correlations between the mean intake of beverages in 4 categories as determined by the BIQ-L and three 24-hour dietary recalls were assessed. Multivariable linear regression examined the association between sugar-sweetened beverages (SSB) servings as determined by the BIQ-L and child body mass index z-score. Mean daily intake of SSB (r = 0.52, P < 0.001), 100% fruit juice (r = 0.45, P < 0.001), flavored milk (r = 0.7, P < 0.001), and unflavored milk (r = 0.7, P < 0.001) from the BIQ-L were correlated with intake assessed via three 24-hour dietary recalls. In the multivariable model, weekly servings of SSBs were associated with child body mass index z-score (β = 0.15, P = 0.02). Culturally specific beverages comprised 38% of the SSB intake reported on the BIQ-L. The BIQ-L is a valid tool for assessing beverage intake among Latino children aged 1–5 years. The inclusion of culturally specific beverages is critical for accurately assessing beverage intake among Latino children. [ABSTRACT FROM AUTHOR]

Managing for the effects of climate change on species whose populations are currently imperiled requires detailed knowledge of the relationship between their demographic rates and climate variables. We sought this information for the West Coast breeding population of snowy plover (Charadrius nivosus), which was federally listed as threatened in 1993 due to substantial declines in the numbers of plovers breeding along the coast and in the number of sites occupied for breeding. Snowy plovers employ a serially polygamous breeding system in which the male typically tends chicks to independence. This unusual breeding system is favored by male‐biased sex ratios in local populations. As part of a multispecies study of the effect of climate change on population growth, we used mark–capture models to examine climate drivers of adult survival for 1219 snowy plovers banded at Monterey Bay over 38 years and known to overwinter on the surrounding north‐central California outer coast. Nonclimate variables, including sex and unmeasured annual mortality risks (e.g., predator abundance), were the primary factors affecting adult survival. However, there is evidence that cold weather, particularly extended cold snaps with daily low temperatures below 2°C and daily high temperatures below 10°C, decreases overwinter survival. Exceptionally cold winters had a particularly strong effect on adult female plovers, contributing to the male‐biased adult sex ratios. Future winter climate on the north‐central California coast is projected to be generally warmer with fewer and shorter cold snaps. Reduced mortality from cold winter weather may mitigate other threats faced by plovers, such as anthropogenically enhanced predator populations, habitat loss, and accelerated sea level rise, while altering the adult sex ratio and potentially shifting the evolutionary landscape maintaining the plover's unusual breeding system. [ABSTRACT FROM AUTHOR]

Growing evidence has linked early trauma with severe psychiatric consequences. Posttraumatic stress disorder (PTSD) is a potentially debilitating mental health condition found among some youth in foster care and foster care alumni. However, the current child welfare practice response has not met the demands in both assessment and intervention. This critical review aims to use the evidence to reshape the child welfare response to trauma in children and adolescents. We begin with research on the psychiatric consequences of child maltreatment and issues related to diagnostic assessment for PTSD. Next, we compare major foster care/alumni studies showing considerably higher rates of PTSD among young foster care recipients and alumni than among nationally comparable groups. To inform practice on childhood trauma, we then summarize current evidence-based interventions showing effectiveness with PTSD. Finally, we address new dimensions, such as gene-environment research, posttraumatic growth, and implications for reshaping child welfare practice and foster care.

This research uses two different measurement operations to examine contemporary stereotypes of Asians, Blacks, and Whites held by an ethnically diverse sample of teachers. Data were drawn from a sample of 188 teachers representing over 160 schools in Southern California. Consistent with previous research, participants endorsed a "model minority" stereotype of Asians with regard to intelligence, academic striving, introversion, and rule compliance. Contrary to expectation, there was substantial congruence in the degree of uniformity and favorableness of the stereotypic traits associated with Blacks and Whites, with participants' revealing both strong positive and negative trait associations. The use of both open-ended and fixed-format measurement strategies revealed some method variation in the assessment of participants racial beliefs, with the open-ended format suggesting more complex and heterogeneous racial representations. Results are discussed in terms of methodological issues in stereotype assessment and implications for reducing the impact of racial biases in psychoeducational evaluations.

Background: The interaction between cancer diagnoses and COVID‐19 infection and outcomes is unclear. We leveraged a state‐wide, multi‐institutional database to assess cancer‐related risk factors for poor COVID‐19 outcomes. Methods: We conducted a retrospective cohort study using the University of California Health COVID Research Dataset, which includes electronic health data of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) at 17 California medical centers. We identified adults tested for SARS‐CoV‐2 from 2/1/2020–12/31/2020 and selected a cohort of patients with cancer. We obtained demographic, clinical, cancer type, and antineoplastic therapy data. The primary outcome was hospitalization within 30d after the first positive SARS‐CoV‐2 test. Secondary outcomes were SARS‐CoV‐2 positivity and severe COVID‐19 (intensive care, mechanical ventilation, or death within 30d after the first positive test). We used multivariable logistic regression to identify cancer‐related factors associated with outcomes. Results: We identified 409,462 patients undergoing SARS‐CoV‐2 testing. Of 49,918 patients with cancer, 1781 (3.6%) tested positive. Patients with cancer were less likely to test positive (RR 0.70, 95% CI: 0.67–0.74, p < 0.001). Among the 1781 SARS‐CoV‐2‐positive patients with cancer, BCR/ABL‐negative myeloproliferative neoplasms (RR 2.15, 95% CI: 1.25–3.41, p = 0.007), venetoclax (RR 2.96, 95% CI: 1.14–5.66, p = 0.028), and methotrexate (RR 2.72, 95% CI: 1.10–5.19, p = 0.032) were associated with greater hospitalization risk. Cancer and therapy types were not associated with severe COVID‐19. Conclusions: In this large, diverse cohort, cancer was associated with a decreased risk of SARS‐CoV‐2 positivity. Patients with BCR/ABL‐negative myeloproliferative neoplasm or receiving methotrexate or venetoclax may be at increased risk of hospitalization following SARS‐CoV‐2 infection. Mechanistic and comparative studies are needed to validate findings. [ABSTRACT FROM AUTHOR]

To understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on parental perceptions of health behaviors and food insecurity among children with overweight and obesity living in San Francisco and to assess the relationship between food insecurity and dietary intake during the pandemic. Parents of children ages 4 to 12 in San Francisco with body mass index ≥85th percentile measured at a clinic visit at a Federally Qualified Health Center or academic practice from January 1st to March 15th, 2020 were eligible to participate. Parents completed a survey reporting on child health behaviors and household food insecurity prior to and since the start of the pandemic. Survey items were abstracted from validated surveys with adaptations. Regression models evaluated associations between food insecurity and dietary intake variables. Most participants (n = 145) were publicly insured (90%), Latino (77%), and spoke Spanish at home (70%). Parents perceived that child mean daily nonacademic screen time was higher during the pandemic compared to before (3.8 hours vs 1.6 hours). Mean daily physical activity was reported to be lower compared to prior to the pandemic (1 hour vs 1.8 hours). On average, reported bedtime shifted 1.6 hours later. Food insecurity increased significantly but was not associated with intake of fruits, vegetables, sugar-sweetened beverages, or foods with added sugar during the pandemic. Parents of children with overweight or obesity in San Francisco perceive increased child screen time, decreased physical activity and later bedtimes during the COVID-19 pandemic. Findings suggest a need for policies that support healthy lifestyle behaviors among low-income children during the pandemic. [ABSTRACT FROM AUTHOR]

The 2020 wildfire season was devastating to the Western United States and affected the region’s NICUs. In this study, we ask the question, “what tools/strategies do medical professionals deem as important and most helpful as they are preparing for wildfire disaster response?” It is a follow up to our previous study: Learning fromWildfire Disaster Experience in California NICUs. We reevaluated how California NICUs dealt with the 2020 wildfires and expanded to Oregon and Southwest (SW)Washington NICUs. We conducted a survey with eleven Oregon and SWWashington NICUs about their wildfire evacuation preparedness. We also interviewed two neonatologists about their wildfire disaster experience evacuating their NICU or preparing to evacuate. Our findings suggest there is more work needed to fully prepare NICUs for wildfire disasters. We hope that by bringing light to the strategies used by affected clinicians, we can educate and support future NICU disaster preparedness responses. [ABSTRACT FROM AUTHOR]

Objective: This study sought to extend findings from previous studies of the association between having had interpersonal contact with individuals with mental illness and the desire to avoid contact with them (i.e., social distance).Methods: The authors used a longitudinal design with a representative sample of 1,057 California adults who completed a survey in 2013 (wave 1) and 2014 (wave 2). Bivariable and multivariable logistic regression analyses were used to test whether demographic characteristics and changes in past-year contact with individuals with mental illness affected perceptions of the dangerousness of individuals with mental illness and willingness to move next door to someone with mental illness.Results: An increase in contact with someone with mental illness between the two waves was associated with a decrease in unwillingness to move nearby a person with mental illness, even after the analysis accounted for contact and unwillingness at wave 1 (odds ratio [OR]=0.51, 95% confidence interval [CI]=0.31-0.84). Wave 1 beliefs that persons with mental illness are dangerous were associated with unwillingness to move nearby (OR=3.81, 95% CI=2.29-6.35) but changes in beliefs about dangerousness were not (OR=0.71, 95% CI=0.42-1.19).Conclusions: Increased naturally occurring contact with individuals with mental illness appears to decrease unwillingness to move near a person with mental illness for as long as 1 year after the contact. Housing and services that aim to integrate individuals with mental illness into the community should consider strategies that include contact with individuals with mental illness to counter community opposition. [ABSTRACT FROM AUTHOR]

Investigative genetic genealogy (IGG) is a new technique for identifying criminal suspects that has sparked controversy. The technique involves uploading a crime scene DNA profile to one or more genetic genealogy databases with the intention of identifying a criminal offender's genetic relatives and, eventually, locating the offender within the family tree. IGG was used to identify the Golden State Killer in 2018 and it is now being used in connection with hundreds of cases in the USA. Yet, as more law enforcement agencies conduct IGG, the privacy implications of the technique have come under scrutiny. While these issues deserve careful attention, we are concerned that their discussion is, at times, based on misunderstandings related to how IGG is used in criminal investigations and how IGG departs from traditional investigative techniques. Here, we aim to clarify and sharpen the public debate by addressing four misconceptions about IGG. We begin with a detailed description of IGG as it is currently practiced: what it is and—just as important—what it is not. We then examine misunderstood or not widely known aspects of IGG that are potentially confusing efforts to have constructive discussions about its future. We conclude with recommendations intended to support the productivity of those discussions. [ABSTRACT FROM AUTHOR]

Objective: To assess trends in consumption of soda, sweetened fruit drinks/sports drinks and any sugar-sweetened beverage (SSB) from 2013 to 2016 among all children in California aged 2-5 and 6-11 years and by racial-ethnic group.Design: Serial cross-sectional study using the California Health Interview Survey (CHIS).Setting: CHIS is a telephone survey of households in California designed to assess population-level estimates of key health behaviours. Previous research using CHIS documented a decrease in SSB consumption among children in California from 2003 to 2009 coinciding with state-level policy efforts targeting child SSB consumption.Participants: Parents of children in California aged 2-11 years (n 4901 in 2013-2014; n 3606 in 2015-2016) were surveyed about the child's consumption of soda and sweetened fruit drinks/sports drinks on the day prior.Results: Among 2-5-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB remained stable. Sweetened fruit drink/sports drink consumption was higher than soda consumption in this age group. Latino 2-5- year-olds were more likely to consume any SSB in both 2013-2014 and 2015-2016 compared with Whites. Among 6-11-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB also remained stable over time. Latino and African-American 6-11-year-olds were more likely to consume an SSB in 2013-2014 compared with White children.Conclusions: SSB consumption among children in California was unchanged from 2013 to 2016 and racial-ethnic disparities were evident. Increased policy efforts are needed to further reduce SSB consumption, particularly among children of Latino and African-American backgrounds. [ABSTRACT FROM AUTHOR]

Wildfires have been affecting California greatly, and vulnerable patients in neonatal intensive care units (NICUs) are not exempt. Our aim was to learn how personnel working in NICUs of California hospitals handled issues of neonatal transfer during wildfire disasters in recent years, with an ultimate goal to share lessons learned with healthcare teams on disaster preparedness. We identified California fires through newspaper articles and the CalFire.gov list. We determined which hospitals were affected and contacted members of the healthcare team through connections via the California Perinatal Quality Care Collaborative (CPQCC) database. We audio recorded interviews over phone or remote conferencing software or by written survey. We coded and analyzed transcripts and survey responses. While describing disaster preparedness, equipment (such as bassinets and backpacks), ambulance access/transport and documentation/charting were noted as important and essential. Teamwork, willingness to do other tasks that are not part of typical job descriptions, and unconventional strategies contribute to the success of keeping NICU babies safe when California wildfire strikes. Healthcare teams developed ingenious and surprising ways to evacuate NICU babies [ABSTRACT FROM AUTHOR]

Objective: To develop an evidence-based clinical practice guideline (CPG) through a broad-based consensus process on best practices for chiropractic management of patients with chronic musculoskeletal (MSK) pain. Design: CPG based on evidence-based recommendations of a panel of experts in chronic MSK pain management. Methods: Using systematic reviews identified in an initial literature search, a steering committee of experts in research and management of patients with chronic MSK pain drafted a set of recommendations. Additional supportive literature was identified to supplement gaps in the evidence base. A multidisciplinary panel of experienced practitioners and educators rated the recommendations through a formal Delphi consensus process using the RAND Corporation/University of California, Los Angeles, methodology. Results: The Delphi process was conducted January–February 2020. The 62-member Delphi panel reached consensus on chiropractic management of five common chronic MSK pain conditions: low-back pain (LBP), neck pain, tension headache, osteoarthritis (knee and hip), and fibromyalgia. Recommendations were made for nonpharmacological treatments, including acupuncture, spinal manipulation/mobilization, and other manual therapy; modalities such as low-level laser and interferential current; exercise, including yoga; mind–body interventions, including mindfulness meditation and cognitive behavior therapy; and lifestyle modifications such as diet and tobacco cessation. Recommendations covered many aspects of the clinical encounter, from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral. Appropriate referral and comanagement were emphasized. Conclusions: These evidence-based recommendations for a variety of conservative treatment approaches to the management of common chronic MSK pain conditions may advance consistency of care, foster collaboration between provider groups, and thereby improve patient outcomes. [ABSTRACT FROM AUTHOR]

One of the strongest biological impacts of climate change has been the movement of species poleward and upward in elevation. Yet, what is not clear is the extent to which the spatial distribution of locally adapted lineages and ecologically important traits may also shift with continued climate change. Here, we take advantage of a transplant experiment mimicking up‐slope seed dispersal for a suite of ecologically diverse populations of yellow monkeyflower (Mimulus guttatus sensu lato) into a high‐elevation common garden during an extreme drought period in the Sierra Nevada mountains, California, USA. We use a demographic approach to quantify fitness and test for selection on life history traits in local versus lower‐elevation populations and in normal versus drought years to test the potential for up‐slope migration and phenotypic selection to alter the distribution of key life history traits in montane environments. We find that lower‐elevation populations tend to outperform local populations, confirming the potential for up‐slope migration. Although selection generally favored some local montane traits, including larger flowers and larger stem size at flowering, drought conditions tended to select for earlier flowering typical of lower‐elevation genotypes. Taken together, this suggests that monkeyflower lineages moving upward in elevation could experience selection for novel trait combinations, particularly under warmer and drier conditions that are predicted to occur with continued climate change. [ABSTRACT FROM AUTHOR]

Objective: To use cognitive interviewing and pilot testing to develop a survey instrument feasible for administering in the food pantry setting to assess daily intake frequency from several major food groups and dietary correlates (e.g. fruit and vegetable barriers) - the FRESH Foods Survey.Design: New and existing survey items were adapted and refined following cognitive interviews. After piloting the survey with food pantry users in the USA, preliminary psychometric and construct validity analyses were performed.Setting: Three US food banks and accompanying food pantries in Atlanta, GA, San Diego, CA, and Buffalo, NY.Participants: Food pantry clients (n 246), mostly female (68 %), mean age 54·5 (sd 14·7) years.Results: Measures of dietary correlates performed well psychometrically: Cronbach's α range 0·71-0·90, slope (α) parameter range 1·26-6·36, and threshold parameters (β) indicated variability in the 'difficulty' of the items. Additionally, all scales had only one eigenvalue above 1·0 (range 2·07-4·71), indicating unidimensionality. Average (median, Q1-Q3) daily intakes (times/d) across six dietary groups were: fruits and vegetables (2·87, 1·87-4·58); junk foods (1·16, 0·58-2·16); fast foods and similar entrées (1·45, 0·58-2·03); whole-grain foods (0·87, 0·58-1·71); sugar-sweetened beverages (0·58, 0·29-1·29); milk and milk alternatives (0·71, 0·29-1·29). Significant correlations between dietary groups and dietary correlates were largely in the directions expected based on the literature, giving initial indication of convergent and discriminant validity.Conclusions: The FRESH Foods Survey is efficient, tailored to food pantry populations, can be used to monitor dietary behaviours and may be useful to measure intervention impact. [ABSTRACT FROM AUTHOR]

A medical information commons (MIC) is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust. [ABSTRACT FROM AUTHOR]

BACKGROUND: Congenital diaphragmatic hernia remains a complex disease with significant morbidity and mortality. Hypercarbia is a common derangement in this population, which often requires escalating ventilator support. By decreasing airway turbulence and enhancing CO2 removal, inhaled helium-oxygen mixture (heliox) has the potential to improve ventilation and thereby decrease ventilator support and its associated lung injury. METHODS: Retrospective cohort review of all neonates with congenital diaphragmatic hernia treated at Rady Children's Hospital San Diego during 2011-2015. Clinical characteristics were compared between the infants who were treated with heliox and those who did not receive this intervention. To analyze the effect of heliox in the subgroup that received this treatment, ventilator settings and arterial blood gas values were compared before and after starting heliox by using paired t tests. RESULTS: During the study period, 45 neonates with congenital diaphragmatic hernia were admitted to our neonatal ICU, 28 received heliox, and 27 were analyzed. During heliox treatment, ... levels decreased from 68 to 49 mm Hg (P < .001), amplitude decreased from 33 to 23 cm H2O (P < .001), ventilator frequency decreased from 28 to 23 breaths/min (P = .02), ... decreased from 0.52 to 0.40 (P < .01), and pH increased from 7.3 to 7.4 (P < .001). CONCLUSIONS: The addition of heliox to the standard practice of permissive hypercapnia facilitated improvement in gas exchange, which allowed a decrease in ventilator settings and oxygen exposure, both of which are known to contribute to lung injury in this population. A prospective trial is needed to more clearly define the acute and longterm impacts of this treatment. [ABSTRACT FROM AUTHOR]

Rising temperatures are amplifying drought-induced stress and mortality in forests globally. It remains uncertain, however, whether tree mortality across drought-stricken landscapes will be concentrated in particular climatic and competitive environments. We investigated the effects of long-term average climate [i.e. 35-year mean annual climatic water deficit (CWD)] and competition (i.e. tree basal area) on tree mortality patterns, using extensive aerial mortality surveys conducted throughout the forests of California during a 4-year statewide extreme drought lasting from 2012 to 2015. During this period, tree mortality increased by an order of magnitude, typically from tens to hundreds of dead trees per km2, rising dramatically during the fourth year of drought. Mortality rates increased independently with average CWD and with basal area, and they increased disproportionately in areas that were both dry and dense. These results can assist forest managers and policy-makers in identifying the most drought-vulnerable forests across broad geographic areas. [ABSTRACT FROM AUTHOR]

Background Neurobehavioral consequences of heavy prenatal alcohol exposure are well documented; however, the role of age or sex in these effects has not been studied. The current study examined the effects of prenatal alcohol exposure, sex, and age on neurobehavioral functioning in children. Methods Subjects were 407 youth with prenatal alcohol exposure ( n = 192) and controls ( n = 215). Two age groups (child [5 to 7 years] or adolescent [10 to 16 years]) and both sexes were included. All subjects completed standardized neuropsychological testing, and caregivers completed parent-report measures of psychopathology and adaptive behavior. Neuropsychological functioning, psychopathology, and adaptive behavior were analyzed with separate 2 (exposure history) × 2 (sex) × 2 (age) multivariate analyses of variance (MANOVAs). Significant effects were followed by univariate analyses. Results No 3-way or 2-way interactions were significant. The main effect of group was significant in all 3 MANOVAs, with the control group performing better than the alcohol-exposed group on all measures. The main effect of age was significant for neuropsychological performance and adaptive functioning across exposure groups with younger children performing better than older children on 3 measures (language, communication, socialization). Older children performed better than younger children on a different language measure. The main effect of sex was significant for neuropsychological performance and psychopathology; across exposure groups, males had stronger language and visual spatial scores and fewer somatic complaints than females. Conclusions Prenatal alcohol exposure resulted in impaired neuropsychological and behavioral functioning. Although adolescents with prenatal alcohol exposure may perform more poorly than younger exposed children, the same was true for nonexposed children. Thus, these cross-sectional data indicate that the developmental trajectory for neuropsychological and behavioral performance is not altered by prenatal alcohol exposure, but rather, deficits are consistent across the 2 age groups tested. Similarly, observed sex differences on specific measures were consistent across the groups and do not support sexually dimorphic effects in these domains. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers.Design: Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes.Setting: Data were collected in southern California, USA in 2013.Subjects: Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members.Results: Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members' food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers.Conclusions: Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices. [ABSTRACT FROM AUTHOR]

Objective. To determine Latino parents' beliefs regarding the effects of television viewing on infants and toddlers. Methods. We conducted interviews with 26 Latino parents of infants and toddlers. We evaluated parents' beliefs about the health effects of television viewing, sources of information on this topic and facilitators and barriers to following the American Academy of Pediatrics (AAP) screen-time guidelines. Results. Parents believed that television viewing was educational for children but were concerned that watching television could worsen childrens vision. Parents would be motivated to limit television viewing by children if it were recommended by a health care provider. Most parents were confident that they could limit their childrens television viewing, although some perceived logistical challenges to following guidelines. Conclusions. Parents in our study had limited knowledge of the effects of television. Counseling on television by health care providers for Latino parents may decrease Latino infants and toddlers' television exposure. [ABSTRACT FROM AUTHOR]

In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning,programming,and evaluation of this effort. [ABSTRACT FROM AUTHOR]

Global change is likely to affect invasive species distribution, especially at range margins. In the eastern Sierra Nevada, California, USA, the invasive annual grass, Bromus tectorum, is patchily distributed and its impacts have been minimal compared with other areas of the Intermountain West. We used a series of in situ field manipulations to determine how B. tectorum might respond to changing climatic conditions and increased nitrogen deposition at the high-elevation edge of its invaded range. Over 3 years, we used snow fences to simulate changes in snowpack, irrigation to simulate increased frequency and magnitude of springtime precipitation, and added nitrogen (N) at three levels (0, 5, and 10 g m−2) to natural patches of B. tectorum growing under the two dominant shrubs, Artemisia tridentata and Purshia tridentata, and in intershrub spaces ( INTR). We found that B. tectorum seedling density in April was lower following deeper snowpack possibly due to delayed emergence, yet there was no change in spikelet production or biomass accumulation at the time of harvest. Additional spring rain events increased B. tectorum biomass and spikelet production in INTR plots only. Plants were primarily limited by water in 2009, but colimited by N and water in 2011, possibly due to differences in antecedent moisture conditions at the time of treatments. The threshold at which N had an effect varied with magnitude of water additions. Frequency of rain events was more influential than magnitude in driving B. tectorum growth and fecundity responses. Our results suggest that predicted shifts from snow to rain could facilitate expansion of B. tectorum at high elevation depending on timing of rain events and level of N deposition. We found evidence for P-limitation at this site and an increase in P-availability with N additions, suggesting that stoichiometric relationships may also influence B. tectorum spread. [ABSTRACT FROM AUTHOR]

Every species occupies a restricted geographic distribution, but it is unclear why natural selection at the range margin fails to increase tolerance to limiting environmental variables and thereby allow continual range expansion. Models indicate that the interplay of demographic asymmetries, dispersal, divergent natural selection, and adaptive trade-offs across spatially varying environments can give rise to stable range limits. Here we examine sister species of the monkeyflowers Mimulus cardinalis and M. lewisii to identify traits that might contribute to the evolution of the species' ranges and to ask whether adaptive trade-offs between environments can limit their geographic distribution. In the Sierra Nevada Mountains of California, M. cardinalis is found from low to mid elevation and M. lewisii is found from mid to high elevation. We transplanted segregating populations of interspecific hybrids to low and high elevation and cross-pollinated those that survived to flowering to create selected populations that evolved at low or high elevation. When grown in a common environment, the progeny of hybrids selected at high elevation flowered earlier compared to a greenhouse control population, whereas hybrids selected at low elevation displayed increased warm-temperature photosynthetic capacity. If adaptation to one environment entails a cost to adaptation in other environments, then selected hybrid populations should display reduced fitness, relative to an unselected control population, when grown in an environment in which they were not selected. Two such trade-offs were observed in this study, where hybrids selected at high elevation displayed reduced biomass when grown in temperatures characteristic of low elevation and hybrids selected at low elevation showed reduced resistance to freezing. These results identify traits under selection for range expansion and suggest that adaptive trade-offs can contribute to limiting the geographic distribution of species. [ABSTRACT FROM AUTHOR]

In response to an Executive Order by California Governor Schwarzenegger, an evaluation of the implications to California of possible climate changes was undertaken using a scenario-based approach. The "Scenarios Project" investigated projected impacts of climate change on six sectors in the California region. The investigation considered the early, middle and later portions of the twenty-first century, guided by a set of IPCC Fourth Assessment global climate model runs forced by higher and lower greenhouse gas emission scenarios. Each of these climate simulations produce substantial impacts in California that would require adaptations from present practices or status. The most severe impacts could be avoided, however, if emissions can be held near the lower end of global greenhouse gas emissions scenarios. [ABSTRACT FROM AUTHOR]

Tests were conducted on wild Mediterranean fruit flies, Ceratitis capiata (Wiedemann), in Hawaii, Italy, and Kenya, and on sterile released flies in Florida and California with a new male attractant, (-)-ceralure B1. Compared on an equal dosage basis, Mediterranean fruit fly males were significantly more attracted to the (-)-ceralure B1 than to trimedlure in each of the sites tested except for California. Compared with the standard commercial 2 g trimedlure plug, 10 mg applied on cotton wicks (Kauai) was as attractive to wild males as trimedlure after the first 2 d of the test but not after 7 d. At a dose of 40 mg (50 times less than in the 2-g plug), the (-)-ceralure B1 was significantly more attractive to male flies than the 2-g trimedlure plug for the first week of service (Florida) but not after 2 wk. Studies using released sterile flies in Florida confirm our previous work on the improved attraction of (-)-ceralure B1 (40 mg) over trimedlure. However, this trend did not hold up in a single test conducted in a residential area in California that did not show a significant difference in attraction using 20 mg of compound. Future refinements in synthesis and costs of this compound and increased availability and testing will be needed before any final evaluation in the field can be carried out. [ABSTRACT FROM AUTHOR]

Describes the epidemiology of tuberculosis in San Diego County, California from 1989 to 1993. Identification of specific subgroups for whom the impact of the disease was most pronounced; Increase in tuberculosis cases in the country from 1989 to 1993; Sex differences in the distribution of the disease.

Studies the risk factors for and epidemiology of Stenotrophomonas maltophilia bacteremia (SMB) in a sample of case and control allogenic bone marrow transplant patients in a Los Angeles, California, hospital. Number of patients who had undergone transplantation during the same hospitalization that SMB was detected; Evidence that severe neutropenia and severe mucositis may promote infection with SM.

Approximately 1 in 3 women veterans endorse military sexual trauma (MST) during Veterans Health Administration (VHA) screening. Higher rates have been reported in anonymous surveys. We compared MST identified by VHA screening to survey-reported MST within the same sample and identified participant characteristics associated with discordant responses. Cross-sectional data were drawn from an observational study of women veterans aged 45–64 enrolled in VHA care in Northern California, with data from mail- and web-based surveys linked to VHA electronic health records (EHRs). Between March 2019 and May 2020, participants reported sociodemographic characteristics, current depressive (Patient Health Questionnaire-9) and posttraumatic stress (PTSD checklist for DSM-5) symptoms, and MST (using standard VHA screening questions) in a survey; depression and posttraumatic stress disorder diagnoses (ICD-10 codes) and documented MST were identified from EHRs. Associations between sociodemographic characteristics, mental health symptoms and diagnoses, and discordant MST reports (EHR-documented MST vs. MST reported on survey, not in EHR) were examined with multivariable logistic regression. In this sample of midlife women veterans (n = 202; mean age 56, SD = 5), 40% had EHR-documented MST, and 74% reported MST on the survey. Sociodemographic characteristics, mental health symptoms, and diagnosed depression were not associated with discordant MST responses. Women with an EHR-documented PTSD diagnosis had fivefold higher odds of having EHR-documented MST (vs. survey only; odds ratio 5.2; 95% confidence interval 2.3–11.9). VHA screening may not capture more than half of women who reported MST on the survey. VHA screening may underestimate true rates of MST, which could lead to a gap in recognition and care for women veterans. [ABSTRACT FROM AUTHOR]

Mosquitoes are major infectious disease-carrying vectors. Assessment of current and future risks associated with the mosquito population requires knowledge of the full repertoire of pathogens they carry, including novel viruses, as well as their blood meal sources. Unbiased metatranscriptomic sequencing of individual mosquitoes offers a straightforward, rapid, and quantitative means to acquire this information. Here, we profile 148 diverse wild-caught mosquitoes collected in California and detect sequences from eukaryotes, prokaryotes, 24 known and 46 novel viral species. Importantly, sequencing individuals greatly enhanced the value of the biological information obtained. It allowed us to (a) speciate host mosquito, (b) compute the prevalence of each microbe and recognize a high frequency of viral co-infections, (c) associate animal pathogens with specific blood meal sources, and (d) apply simple co-occurrence methods to recover previously undetected components of highly prevalent segmented viruses. In the context of emerging diseases, where knowledge about vectors, pathogens, and reservoirs is lacking, the approaches described here can provide actionable information for public health surveillance and intervention decisions. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence of occult uterine sarcoma and leiomyosarcoma in hysterectomies for leiomyomas and the risk associated with their morcellation.Methods: We conducted a population-based cohort study. All uterine sarcomas from 2006-2013 in an integrated health care system were identified. Age- and race-specific incidences of occult uterine sarcoma were calculated. Kaplan-Meier survival analysis was performed. Crude and adjusted risk ratios of recurrence and death associated with morcellation at 1, 2, and 3 years were estimated using Poisson regression with inverse probability weighting.Results: There were 125 hysterectomies with occult uterine sarcomas identified among 34,728 hysterectomies performed for leiomyomas. The incidence of occult uterine sarcoma and leiomyosarcoma was 1 of 278 or 3.60 (95% confidence interval [CI] 2.97-4.23) and 1 of 429 or 2.33 (95% CI 1.83-2.84) per 1,000 hysterectomies. For stage I leiomyosarcoma (n=111), eight (7.2%) were power and 27 (24.3%) nonpower-morcellated. The unadjusted 3-year probability of disease-free survival for no morcellation, power and nonpower morcellation was 0.54, 0.19, and 0.51, respectively (P=.15); overall survival was 0.64, 0.75, and 0.68, respectively (P=.97). None of the adjusted risk ratios for recurrence or death were significant except for death at 1 year for power and nonpower morcellation groups combined (6/33) compared with no morcellation (4/76) (5.12, 95% CI 1.33-19.76, P=.02). We had inadequate power to infer differences for all other comparisons including 3-year survival and power morcellation.Conclusion: Morcellation is associated with decreased early survival of women with occult leiomyosarcomas. We could not accurately assess associations between power morcellation and 3-year survival as a result of small numbers. [ABSTRACT FROM AUTHOR]

The article discusses the late Miocene to early Pleistocene sedimentary rocks in the Fish Creek-Vallecito basin in southern California that records late Cenozoic subsidence and basin filling due to deformation in the San Andreas fault system. Data reportedly show that the section ranges in age from circa 8.0-0.4 million years (Ma). The article states that the onset of sedimentation at circa 8.0-0.4 million years (Ma) preserves the earliest extension or transtension in the area.