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The coronavirus (COVID-19) global pandemic upended the academic trajectories and opportunities of many community college students in the United States. While four-year universities have seen an uptick in applications in the 2021-2022 academic year, community colleges have experienced a sharp decrease in enrollment, signifying significant challenges to students' life circumstances. In May 2020, we sampled 116 community college students (M[subscript age] 23.08; SD = 7.17) attending Hispanic Serving Institutions in California. The online survey gathered: (a) in-depth demographic information, including pandemic-related changes to students' academic and financial standing, and (b) qualitative data on pandemic-related stress. Given the novelty of the COVID-19 pandemic in May 2020, the overarching goal of this study was to conduct a broad needs assessment of community college students' experiences. Data highlighted significant socio-emotional challenges, financial hardship, and both current and projected academic delays. Community college students described severe challenges across financial, socio-emotional and academic areas. Data that capture first-hand qualitative descriptions of COVID-19 stress are necessary to inform the allocation of critical resources and policies to improve the well-being of community college students.

The number of students in higher education with psychiatric disabilities is rising; about one in three undergraduates identify as having some type of mental health condition (U.S. Dept. of Education, 2014). This qualitative study explores the experiences of 14 college students with one or more psychiatric disabilities (PD), who were receiving accommodations at a mid-sized four-year public university. Semi-structured interviews were transcribed, and four major themes were identified through inductive thematic analysis: (a) the effects of stigma on the university experience, (b) the impact and effect of the symptoms of PD for students in the university environment, (c) strategies for coping with the disability in the university environment, and (d) the role of social support from university faculty and staff. The findings of the research, their salience to the educational success of students with PD, and recommendations for improved outcomes are reported.

Block-based programming languages (BBLs) have been proposed as a way to prepare students for learning to program in more sophisticated, text-based languages, such as Java. Hybrid BBLs add the ability to view and edit the block commands in auto-generated, text-based code. We compared the use of a non-hybrid BBL (Scratch), a hybrid BBL (Pencil Code), and no BBL across three sections of an introductory CS course that taught Java programming, to determine whether either type of BBL offered cognitive or affective advantages for learning Java. Students in the BBL groups were surveyed about their perceptions of each BBL in terms of ease of use and helpfulness in learning Java, and all three groups were compared on their performance in Java programming. The results showed that, in this introductory CS course, neither type of BBL offered an advantage in preparing students for learning Java. These results held regardless of the students' level of Java knowledge prior to the course.

CADRE, an organization led by Maisie Chin, is a Human Right to Education Campaign. Between 2005 and 2013, CADRE played a lead role in using grassroots organizing and leadership development to create a seismic shift in public policy, debate, and narrative around school discipline, racial disparities, parents' roles, school climate, and closing the achievement gap for low-income students of color. Through parent organizing and coalition and movement building, CADRE ushered in major new educational policies locally, statewide, and nationally that have fundamentally changed the landscape and raised the expectations and standards by which responses to student behavior are assessed, their root causes, and the inherent biases that accompany them. By 2013, a Los Angeles Unified School District (LAUSD) high school in East Los Angeles achieved the unheard of standard of zero suspensions. A South Los Angeles high school that CADRE focused on brought suspensions down from 100 to 7 in one year. In 2013, in coalition with youth organizing groups and advocates, CADRE ushered in LAUSD's adoption of the School Climate Bill of Rights, making it the first district in California to ban suspensions for "willful defiance." This victory was just after the state of California passed six major pieces of legislation that Governor Brown then signed into law, changing the state's school discipline landscape fundamentally by, among other things, making suspensions the last resort. Here, Chin describes #MeetTheMoment, a movement designed to confront persistent racial disparities. It is grounded in the School Climate Bill of Rights and other previous CADRE campaigns that would go beyond compliance and numbers to create new experiences, new stories, and new possibilities for students.

Educators aim to equip students with learning strategies they can apply when approaching new problems on their own. Teaching design-thinking strategies may support this goal. A first test would show that the strategies are good for learning and that students spontaneously transfer them beyond classroom instruction. To examine this, we introduce choice-based assessments (CBAs). CBAs measure how people learn when there is minimal guidance and they must make decisions as independent learners. Here, sixth-grade students completed multiple design activities that emphasized either seeking constructive criticism or exploring a space of alternatives. Afterward, they completed the CBAs, which measured strategy transfer. Results showed that lower-achieving students benefitted most from instruction, exhibiting a relative increase in their use of design-thinking strategies. In addition, strategy choices correlated with prior achievement measures and appeared to mediate performance in and learning from the CBAs. The choices to use the two strategies themselves were not correlated, which indicates that they are not subsets of a larger construct, such as growth mindset. In sum, CBAs enabled a double demonstration: design-thinking strategies may improve learning and problem solving, and design-thinking instruction may improve the likelihood of lower-achieving students choosing to use effective strategies in novel settings that require new learning.

InnerSpark is a residential summer arts training program for high school students established by the California State Legislature (California Education Code sections 8950-8957) in order to make it possible for "artistically gifted and talented students, broadly representative of the socioeconomic and ethnic diversity of the state, to receive intensive training in the arts through a multidisciplinary program" (InnerSpark, 2008a, para. 3). Students who attend InnerSpark participate in a program focusing on one of the following arts: visual art, animation, creative writing, dance, film- and video-making, music, or theater. InnerSpark has taken place every summer since 1987, usually on the college campus of the California Institute of the Arts (CalArts) in Valencia, CA. InnerSpark is a highly selective program. Typically, each year more than 1,500 students apply, and approximately one third of the applicant pool is accepted. Admissions decisions are made without regard to the student's ability to pay. InnerSpark is supported by public and private funding, and scholarships are provided to those who need them. (Contains 6 resources and 3 endnotes.)

In partnership with community stakeholders, the present study aimed to gather descriptive data on pandemic-related stress and its association with mental health outcomes among a community sample of self-identified sexual minority women (SMW) in Los Angeles County (N = 84; Mage = 35.61). The sample was comprised solely of women (i.e. self-identified gender identity as woman, including cisgender and transgender women). Data were collected in April 2021, the 'third wave' of the COVID-19 global pandemic. Los Angeles experienced some of the highest COVID-19 incidence rates in the United States. Yet, there was a significant lack of COVID-19 data on SMW, thus making it difficult to address the specific needs of this community. Background data were collected on pre-existing health conditions and COVID-19 infection history. Data were specific to COVID-19 stressors in the areas of mental health, financial strain, social isolation and health and discrimination concerns. Findings revealed that mental health concern was strongly associated with financial strain (r =.63, p <.01), social isolation (r =.62, p <.01) and health and discrimination concerns (r =.63, p <.01), thus demonstrating the wide-ranging negative impact of pandemic stressors on the mental health of SMW in Los Angeles during the third wave of COVID-19. Recommendations for future research, practice and policy implications are discussed. [ABSTRACT FROM AUTHOR]

This exploratory study was designed to expand the field's understanding of talented adolescent visual artists and creative writers and their conscious motivations for engaging in these creative activities. Accordingly, 233 talented high school visual arts (n = 151) and creative writing (n = 82) students were asked to rate the degree to which they believed their creative activities were motivated by each of a wide range of possible motivations. The students in both fields reported being very strongly motivated by the opportunities their activities provided them to use their imaginations, feel free, sense that they were being their "true" selves, regulate their emotions, capture moments in time, deepen their self-understanding, express themselves, improve their skills, and enhance their self-esteem. Some of these motivations correspond closely to those highlighted by theories of intrinsic motivation, competence motivation, and self-actualization, several are similar to those which have been reported by professional artists and writers, and some suggest that the students may have derived important psychological benefits from their creative activities. Theoretically plausible differences between the motivational profiles of the visual and creative writing students were identified and discussed.

Object: This study examined the association between job stress and sleep disturbance among career firefighters. Methods: A cross-sectional survey study was conducted with 154 career firefighters working in Northern California, US job stress was measured using the short form of the Effort-Reward Imbalance questionnaire and sleep was measured with the Patient-Reported Outcomes Measurement Information System Sleep Disturbance. Results: Approximately 75% experienced sleep disturbance. For firefighters' job stress, high effort (odds ratio [OR] = 3.68; 95% confidence interval [CI]: 1.25-10.80), high effort-reward ratio (OR = 3.55; 95% CI: 1.23-10.23), and high overcommitment (OR = 9.09; 95% CI: 2.30-35.85) were significantly associated with increased likelihood of sleep disturbance, after adjustment for other factors. Conclusions: Job stress significantly affected firefighters' sleep health, suggesting the need to design effective health promotion interventions to reduce job stress and improve sleep quality for these public service workers. [ABSTRACT FROM AUTHOR]

The preschool years are a critical time to identify and treat early emotional or behavioral problems. Universal screening can be used to identify emotional and behavioral risk in preschoolers and fits well within current service delivery frameworks. This criterion-related validity study examined the use of a brief teacher-rated screener, the Behavioral and Emotional Screening System (BESS Preschool) in a sample of 65 preschool-age students from a predominately Latino/a background. Findings suggest that screening results from the BESS Preschool are highly correlated with important outcomes, including kindergarten readiness, receptive vocabulary, and social emotional development.

The Marin Environmental Stewardship pilot project demonstrates the potential for a partnership model that brings together external and internal collaborators to recruit and train episodic 4-H volunteers to meet environmental education needs within a community. The clientele served by the volunteers trained through the project was at-risk, urban youth. In this model, the University of California Cooperative Extension provided project design and leadership, youth development professionals, and natural resources expertise. The community partner provided volunteers, training facility, transportation for field trips, community sites for service, and support material for program delivery. The resulting framework provided a strategy for other professionals.

Universal screening is a promising approach for identifying students at risk for behavioral and emotional problems. Due to the frequent adolescent onset of behavioral and emotional problems, middle school is an important time for early identification. This study explored the ability of the Behavioral and Emotional Screening System (BESS) to predict behavioral outcomes (i.e., behavioral grades, suspensions, and office disciplinary referrals) in a sample of 694 middle-school students. Both the teacher and student rated BESS forms were able to significantly predict behavioral outcomes. Findings suggest that the BESS can be an effective tool for identifying students at risk of experiencing behavior problems. (Contains 2 tables.)

Tests of working memory capacity (WMC) and fluid intelligence (gF) are thought to capture variability in a crucial cognitive capacity that is broadly predictive of success, yet pinpointing the exact nature of this capacity is an area of ongoing controversy. We propose that mind-wandering is associated with performance on tests of WMC and gF, thereby partially explaining both the reliable correlations between these tests and their broad predictive utility. Existing evidence indicates that both WMC and gF are correlated with performance on tasks of attention, yet more decisive evidence requires an assessment of the role of attention and, in particular, mind-wandering during performance of these tests. Four studies employing complementary methodological designs embedded thought sampling into tests of general aptitude and determined that mind-wandering was consistently associated with worse performance on these measures. Collectively, these studies implicate the capacity to avoid mind-wandering during demanding tasks as a potentially important source of success on measures of general aptitude, while also raising important questions about whether the previously documented relationship between WMC and mind-wandering can be exclusively attributed to executive failures preceding mind-wandering (McVay & Kane, 2010b). (Contains 4 figures, 3 tables and 5 footnotes.)

The Women-Centered Program for Women of Color, a culturally congruent sexual health intervention, was implemented in 2018 in Los Angeles County, California, according to the principles of community-based participatory research: enhancing community capacity, establishing sustainable programs, and translating research findings to community settings. Participants exhibited significantly increased knowledge of and interest in preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) over time, but no significant change in condom use was evident. Booster sessions are needed to maintain interest in PrEP and PEP given concerns about reproductive and sexual health. (Am J Public Health. 2023;113(S2):S110–S114. https://doi.org/10.2105/AJPH.2023.307296) [ABSTRACT FROM AUTHOR]

In response to budgetary constraints, a new staffing structure, the Pilot Leadership Plan, was proposed for California's 4-H Youth Development Program. County clusters were formed, each led by a coordinator. The plan was piloted for 2 years to provide insight into how county clustering could support Extension staff to increase and enhance program consistency and administrative efficiency. This article highlights key activities and innovations, impacts for staff and programming, and lessons learned in piloting a new staffing structure.

Students with limited English proficiency (LEP) make up one of the fastest growing segments of the student population; however, LEP status is often related to poor academic and behavioral outcomes. Teacher-reported behavioral rating scales can be informative measurements to screen and identify students at risk for behavioral and emotional problems. Given the focus on early identification and the changing demographics in schools, it is important to research the validity of screening instruments, as well as more comprehensive assessments, among LEP students. Items on a teacher-rated screener and a comprehensive behavioral rating scale were evaluated for invariance across two language groups. Results showed that the majority of items could be considered invariant across groups. This study also examined how behavioral ratings on invariant measures differed at the mean level between LEP and non-LEP students. LEP students were rated as having more learning problems and fewer adaptive skills; no significant differences were found for internalizing and externalizing problems. Results highlight the need for further research on this topic. (Contains 3 tables.)

4-H volunteers and staff are often faced with providing educational programs and opportunities for youth with wide ranges of age and ability. To address this challenge, researchers from the University of California Cooperative Extension developed and tested a Best Practices Matrix that outlines domain-specific, age-appropriate characteristics of youth and their applications to 4-H programming. Post-implementation surveys that included six forced-response and five open-ended questions were collected from 48 adult volunteers who attended volunteer development workshops. Outcomes indicated that participants improved their understanding of youths' developmental characteristics and how to use the matrix to help improve their project and activities. (Contains 1 figure.)

The low achievement of students from non-English-speaking households living in low socioeconomic contexts is associated with academic skill gaps evident at kindergarten entry. Yet, few cost-effective, valid instruments are available to assess these students' school readiness. To examine this topic, this longitudinal study followed 1,069 primarily Latino students (536 males, 553 females) in a midsized school district. Teachers used the Kindergarten Student Entrance Profile (KSEP) to rate students' school readiness at entry into kindergarten and measures of reading skills and of performance on state standardized assessments were collected through the end of Grade 2. Latent-variable path analysis examined whether students' school readiness ratings predicted midkindergraten phonological awareness and reading fluency at the end of Grades 1 and 2. KSEP scores significantly predicted midkindergarten phonological awareness (standardized path coefficient of 0.40) and end of Grade 1 reading fluency (standardized path coefficient of 0.17), beyond what was explained by midkindergarten phonological awareness skills. Additional analyses examined the practical implications of these findings. Students were placed into 5 categories on the basis of their total scores on the California Standards Test (CST) score (far below basic, below basic, basic, proficient, and advanced). Students who performed better on the CST assessment (English/language arts and mathematics) at the end of Grade 2 had significantly higher KSEP ratings at kindergarten entry than did students with lower CST scores. This collaborative research project provides an example of how a district-community-university partnership can lead to research that contributes to ongoing systems change. (Contains 3 tables and 4 figures.)

The prevalence of chronic hepatitis B (HBV) among college-age US-born Asian and Pacific Islanders (A/PI) is not well known. Objectives: To compare the prevalence of hepatitis B surface antigen (HBsAg) seropositivity in US-born to A/PI-born students at a public university. Participants: Undergraduate who self-identified themselves as A/PI. Results: Of 145 US-born A/PI, 1.4% (confidence interval [CI] = 0.0%, 3.3%) tested positive for HBsAg compared to 3.3% (CI = 0.5%, 6.1%) of the 152 A/PI-born students. Approximately 1/3 of all students were unaware of their HBV vaccination status. Conclusions: HBsAg prevalence among A/PI undergraduates, including US-born, is considerably higher (3 to 11 times) than the mainstream US population (0.3% to 0.5%) and supports the Centers for Disease Control and Prevention (CDC) recommendations for testing all persons of A/PI ancestry, including US-born persons whose parents were born in regions with HBsAg prevalence of greater than or equal to 8%. Awareness of HBV vaccination status was relatively low and vaccination did not assure that individuals were HBsAg negative. (Contains 3 tables and 1 figure.)

In this article, the authors argue for the use of ecological models of development in studies of teachers prepared through alternative certification (AC) programs. Previous studies of candidates in AC programs have focused on variables that describe their demographic characteristics. An ecological approach focuses on persons and situates their desires and attitudes toward teaching as shaped by their particular life circumstances and personal histories. This approach was applied to a large-scale study of individuals enrolled in California's teacher internship program. The results are the development of six typological profiles that capture some of the complexities behind why individuals choose to enter teaching through AC routes. (Contains 3 tables and 1 note.)

A survey of 1,433 northern California high school seniors examined career awareness and effects of part-time work. Most students agreed that career awareness is important, but only half understood their interests or had sufficient knowledge about occupations. Minority groups expressed greater career exploration needs than Whites. Working students perceived benefits from working, but stress increased with hours worked. (TD)

Background: Increasing evidence connects the gut microbiome to Parkinson's disease (PD) etiology, but little is known about microbial contributions to PD progression and its clinical features. Objective: We aim to explore the association between the gut microbiome with PD, and the microbial association with PD-specific clinical features. Methods: In a community-based case-control study of 96 PD patients and 74 controls, microbiome data were obtained from 16S rRNA gene sequencing of fecal samples, and analyzed for microbial diversity, taxa abundance, and predicted functional pathways that differed in PD patients and controls, and their association with PD-specific features (disease duration, motor subtypes, L-DOPA daily dose, and motor function). Results: PD patients' gut microbiome showed lower species diversity (p = 0.04) and were compositionally different (p = 0.002) compared to controls but had a higher abundance of three phyla (Proteobacteria, Verrucomicrobiota, Actinobacteria) and five genera (Akkermansia, Enterococcus, Hungatella, and two Ruminococcaceae) controlling for sex, race, age, and sequencing platform. Also, 35 Metacyc pathways were predicted to be differentially expressed in PD patients including biosynthesis, compound degradation/utilization/assimilation, generation of metabolites and energy, and glycan pathways. Additionally, the postural instability gait dysfunction subtype was associated with three phyla and the NAD biosynthesis pathway. PD duration was associated with the Synergistota phylum, six genera, and the aromatic compound degradation pathways. Two genera were associated with motor function. Conclusion: PD patients differed from controls in gut microbiome composition and its predicted metagenome. Clinical features were also associated with bacterial taxa and altered metabolic pathways of interest for PD progression. [ABSTRACT FROM AUTHOR]

Background Prisons and jails are high-risk settings for coronavirus disease 2019 (COVID-19). Vaccines may substantially reduce these risks, but evidence is needed on COVID-19 vaccine effectiveness for incarcerated people, who are confined in large, risky congregate settings. Methods We conducted a retrospective cohort study to estimate effectiveness of messenger RNA (mRNA) vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), against confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among incarcerated people in California prisons from 22 December 2020 through 1 March 2021. The California Department of Corrections and Rehabilitation provided daily data for all prison residents including demographic, clinical, and carceral characteristics, as well as COVID-19 testing, vaccination, and outcomes. We estimated vaccine effectiveness using multivariable Cox models with time-varying covariates, adjusted for resident characteristics and infection rates across prisons. Results Among 60 707 cohort members, 49% received at least 1 BNT162b2 or mRNA-1273 dose during the study period. Estimated vaccine effectiveness was 74% (95% confidence interval [CI], 64%–82%) from day 14 after first dose until receipt of second dose and 97% (95% CI, 88%–99%) from day 14 after second dose. Effectiveness was similar among the subset of residents who were medically vulnerable: 74% (95% CI, 62%–82%) and 92% (95% CI, 74%–98%) from 14 days after first and second doses, respectively. Conclusions Consistent with results from randomized trials and observational studies in other populations, mRNA vaccines were highly effective in preventing SARS-CoV-2 infections among incarcerated people. Prioritizing incarcerated people for vaccination, redoubling efforts to boost vaccination, and continuing other ongoing mitigation practices are essential in preventing COVID-19 in this disproportionately affected population. [ABSTRACT FROM AUTHOR]

Sunday Streets is an Open Streets initiative where local communities temporarily close streets to traffic, creating car-free space for recreation. This study used a survey of open- and close-ended questions to examine the reciprocal relationship between Sunday Streets and the communities and neighborhoods it serves. Findings suggest Sunday Streets provides participants with a safe (97.2%), vibrant environment (79.4%) where residents can decrease their stress (84.8%). Participants "feel more connected" to their neighborhood environment and recommend expansion of the route and more amenities. Sunday Streets offers ways for communities to support neighborhood social characteristics and social interactions and influence population health. [ABSTRACT FROM AUTHOR]

For nearly a century, California law embodied a rabid anti-Asian policy, which included school segregation, discriminatory law enforcement, a prohibition on marriage with Whites, denial of voting rights, and imposition of many other hardships. The Alien Land Law was a California innovation, copied in over a dozen other states. The Alien Land Law, targeting Japanese but applying to Chinese, Koreans, South Asians, and others, denied the right to own land to noncitizens who were racially ineligible to naturalize, that is, who were not White or Black. After World War II, California's policy abruptly reversed. Years before Brown v. Board of Education, California courts became leaders in ending Jim Crow. In 1951, the California legislature voluntarily voted to pay reparations to people whose land had been escheated under the Alien Land Law. This article describes the enactment and effect of the reparations laws. It also describes the surprisingly benevolent treatment by courts of lawsuits undoing the secret trusts and other arrangements for land ownership intended to evade the Alien Land Law. But ultimately, the Alien Land Law precedent may be melancholy. California has not paid reparations to other groups who also have conclusive claims of mistreatment. Reparations in part were driven by geopolitical concerns arising from the Cold War and the hot war in Korea. In addition, anti-Asian immigration policy had succeeded in halting Japanese and other Asian immigration to the United States. Accordingly, one explanation for this remarkable act was that there was room for generosity to a handful of landowners with no concern that the overall racial arrangement might be compromised. [ABSTRACT FROM AUTHOR]

Background: Correctional institutions nationwide are seeking to mitigate COVID-19-related risks.Objective: To quantify changes to California's prison population since the pandemic began and identify risk factors for COVID-19 infection.Design: For California state prisons (March 1-October 10, 2020), we described residents' demographic characteristics, health status, COVID-19 risk scores, room occupancy, and labor participation. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively.Participants: Residents of California state prisons.Main Measures: Changes in the incarcerated population's size, composition, housing, and activities. For the risk factor analysis, the exposure variables were room type (cells vs. dormitories) and labor participation (any room occupant participating in the prior 2 weeks) and the outcome variable was incident COVID-19 case rates.Key Results: The incarcerated population decreased 19.1% (119,401 to 96,623) during the study period. On October 10, 2020, 11.5% of residents were aged ≥60, 18.3% had high COVID-19 risk scores, 31.0% participated in out-of-room labor, and 14.8% lived in rooms with ≥10 occupants. Nearly 40% of residents with high COVID-19 risk scores lived in dormitories. In 9 prisons with major outbreaks (6,928 rooms; 21,750 residents), dormitory residents had higher infection rates than cell residents (adjusted hazard ratio [AHR], 2.51 95% CI, 2.25-2.80) and residents of rooms with labor participation had higher rates than residents of other rooms (AHR, 1.56; 95% CI, 1.39-1.74).Conclusion: Despite reductions in room occupancy and mixing, California prisons still house many medically vulnerable residents in risky settings. Reducing risks further requires a combination of strategies, including rehousing, decarceration, and vaccination. [ABSTRACT FROM AUTHOR]

We conducted a phone-based field experiment to investigate the callback rate of psychologists. Providers (N = 903) in Los Angeles, California who were selected from a health maintenance organization insurance panel list were left voicemails by actors simulating patients of various backgrounds (i.e., race, gender, clinical diagnosis, and ethnic distinctiveness of name). Findings indicated that 71.5% of providers did not return calls to prospective patients. There were no main effects of race and ethnicity on callback. However, ethnic distinctiveness of name moderated the effects of diagnosis. Providers were more responsive to depressed patients with ethnic names, but less responsive to patients with ethnic names and personality or substance abuse disorders. These findings are important because unresponsive providers and insurance companies that do not provide up-to-date panel listings can act as barriers to care, which can have deleterious consequences for help-seekers. Advocacy recommendations and the importance of cultural competency are highlighted. [ABSTRACT FROM AUTHOR]

Background Early virologic suppression (VS) after human immunodeficiency virus (HIV) infection improves individual health outcomes and decreases onward transmission. In San Francisco, immediate antiretroviral therapy (ART) at HIV diagnosis was piloted in 2013–2014 and expanded citywide in 2015 in a rapid start initiative to link all new diagnoses to care within 5 days and start ART at the first care visit. Methods HIV providers and linkage navigators were trained on a rapid start protocol with sites caring for vulnerable populations prioritized. Dates of HIV diagnosis, first care visit, ART initiation, and VS were abstracted from the San Francisco Department of Public Health HIV surveillance registry. Results During 2013–2017, among 1354 new HIV diagnoses in San Francisco, median days from diagnosis to first VS decreased from 145 to 76 (48%; P  < .0001) and from first care visit to ART initiation decreased from 28 to 1 (96%; P  < .0001). By 2017, 28% of new diagnoses had a rapid start, which was independently associated with Latinx ethnicity (AOR, 1.73; 95% CI, 1.15–2.60) and recent year of diagnosis (2017; AOR, 16.84; 95% CI, 8.03–35.33). Persons with a rapid ART start were more likely to be virologically suppressed within 12 months of diagnosis than those with a non-rapid start (RR, 1.17; 95% CI, 1.10–1.24). Conclusions During a multisector initiative to optimize ART initiation, median time from diagnosis to VS decreased by nearly half. Immediate ART at care initiation was achieved across many, but not all, populations, and was associated with improved suppression rates. [ABSTRACT FROM AUTHOR]

Data from the Wildlife Liquefaction Array, which is located at southern California's Imperial Valley in the USA, are analyzed. Variations in shear wave (Vs) and compression wave (Vp) velocities are identified during strong motions. Shear strains (γ) are computed from recorded acceleration time series between the sensors. All these variables are compared with the ground-surface accelerations and excess pore water pressure ratio (Ru) at different depths. Results show that Ru starts to accumulate when γ exceeds the threshold strain of 0.01–0.015%. Vs is negatively correlated to Ru and γ. Further investigation shows that Vs degradation depends on maximum horizontal shear strain with the different azimuthal angles at the same time window. By contrast, Vs reduction with Ru is caused by the decrease in effective stress; hence Ru reduces Vs regardless of the azimuthal angles. Vp degradation is limited compared with that of Vs under strong shaking, indicating that the constrain modulus is determined by the combination of soil skeleton and pore fluid. [ABSTRACT FROM AUTHOR]

The most destructive wildfires recently in Northern California have been linked to the occurrences of Diablo Winds (DWs). This study investigates the climatology of DWs during September–December 1979–2018, and their relationships with various climate modes using observations and two high-resolution reanalysis datasets. Our finding shows that DWs do not have a long-term trend in terms of the annual total number, total duration, and associated maximum wind speeds of DWs over the past 4 decades. However, their associated minimum relative humidity (RH) has decreased significantly, especially in October, which suggests that the dryness during DWs has become more severe with time, possibly leading to an increased chance of fires, and their destructive potential. We also find that the annual total number and duration of DWs have exhibited an quasi-periodic variation, with intervals ranging from 2 to 4 years. The periodic variability of DWs might be attributed to the teleconnections between DWs and climate oscillations, specifically the El Niño–Southern Oscillation (ENSO) and the quasi-biennial oscillation (QBO), through their modulation of pressure systems near California and the location of the Pacific jet stream. It is suggested that when La Niña and the QBO westerly phases co-occur in the spring, DWs in the following fall and winter tend to occur more frequently, and are associated with more intense high winds and dryness as compared to other springtime QBO and ENSO phases. This relationship may be used to predict the seasonal outlook of DWs. [ABSTRACT FROM AUTHOR]

We describe activity patterns of North American River Otters (Lontra canadensis) in relation to social group size and the presence of young. Over the course of 15 y, we collected observations of 8 River Otter behaviors from a network of citizen scientists in northern California, retaining 1692 records following a rigorous data-cleaning process. Observers were asked to indicate 1 or more of the following 8 behaviors: "diving", "swimming", "walking", "running", "digging", "turning rocks", "pursued birds", and "retreating from observer." We treated "digging", "turning rocks", and "pursued birds" as alternative foraging strategies in some comparisons. Assessment of these reports showed that families were seen diving, running, and retreating from the observers more frequently than adult groups. Likewise, adult social groups behaved differently than solitary adult otters. Propensity to retreat from humans increased with increasing group size in social otters, whereas diving behavior also increased with group size. Solitary adults employed alternative foraging strategies more than adults in social groups. Citizen observers also reported that diving and styles of foraging behavior varied among months for adult otters. Taken together, these results provide evidence that citizen-science questionnaires can be used to provide insight into the natural behaviors of species that are difficult to observe. [ABSTRACT FROM AUTHOR]

Chronic hepatitis B (CHB) disproportionately affects non-US born Asians. The Hmong have been shown to have the highest rates of CHB and mortality from liver cancer compared to other Asian groups. From September 2014 to September 2017, testing for CHB within Sacramento County was conducted through community-based testing events and an electronic health record alert that identified Asian patients by surname. Demographic and laboratory data were collected for analysis and patients were followed through the study period to assess linkage to care and treatment to compare differences between Asian origin groups. Of 4350 patients tested for CHB, 318 (7.3%) were HBsAg positive, including 90 Chinese, 47 Hmong, and 101 Vietnamese. Hmong were more likely to have Medicaid insurance compared to other Asian origin groups (15%, p < 0.001). Hmong had significantly lower rates of hepatitis B DNA testing (p < 0.001), referral to hepatology (p < 0.001), attendance of first (p < 0.001) and second medical visit (p = 0.0003), and lower rates of antiviral treatment compared to other Asian origin groups. Hmong also had the highest proportion of non-English speakers (p < 0.001). Hmong patients in the Sacramento CHB testing and linkage to care program experience socioeconomic disadvantages compared to Vietnamese and Chinese patients. These factors may contribute to decreased linkage of care and decreased anti-viral treatment rates for CHB. [ABSTRACT FROM AUTHOR]

BACKGROUND: We sought to describe adverse events associated with unplanned extubation (UE) and to explore risk factors for serious adverse events post-UE among infants who experienced UE. METHODS: Data were prospectively collected on all infants who had a UE event at a single institution over a 4-y period. Demographic information and information on outcomes were obtained retrospectively. We described the frequency of post-UE adverse events: success or failure of extu- bation trial if offered, rate of re-intubation, post-UE changes in ventilator settings, and serious adverse events post-UE (eg, need for cardiopulmonary resuscitation, clinical sepsis, and death or tracheostomy prior to discharge). We used a multivariate logistic regression model to identify the risk factors associated with serious adverse events. RESULTS: There were 134 documented UE events. Agitation was the most common known cause. After UE, 49% of the subjects were given a trial of extubation, and 65% of the trials were successful at 48 h. Cardiopulmonary resuscitation (CPR) was performed in 13% of cases. In subjects requiring immediate re-intubation, mean airway pressure (...) and oxygen requirement increased in 33% and 55% of the subjects, respectively. Post-UE clinical sepsis occurred in 17% of subjects. Higher pre-UE ... and difficult re-intubation were associated with a need for CPR. Subjects who received CPR had increased odds (3.7 X) of developing clinical sepsis. CONCLUSION: UE can result in serious adverse events, including hemodynamic instability and possibly an increased risk for clinical sepsis. Difficult re-intubation was associated with a higher risk of needing CPR and, later, tracheostomy and death. [ABSTRACT FROM AUTHOR]

Currently, influenza vaccine manufacturers need to produce 1–5 x 107 PFU of each vaccine strain to fill one dose of the current live-attenuated-influenza-vaccine (LAIV). To make a single dose of inactivated vaccine (15 ug of each hemagglutinin), the equivalent of 1010 PFU of each vaccine strains need to be grown. This high dose requirement is a major drawback for manufacturing as well as rapidly sourcing sufficient doses during a pandemic. Using our computer-aided vaccine platform Synthetic Attenuated Virus Engineering (SAVE), we created a vaccine candidate against pandemic H1N1 A/CA/07/2009 (CodaVax-H1N1) with robust efficacy in mice and ferrets, and is protective at a much lower dose than the current LAIV. CodaVax-H1N1 is currently in Phase I/II clinical trials. The hemagglutinin (HA) and neuraminidase (NA) gene segments of A/California/07/2009 (H1N1) (CA07) were "de-optimized" and a LAIV was generated ex silico using DNA synthesis. In DBA/2 mice, vaccination at a very low dose (100 or approximately 1 PFU) with CodaVax-H1N1 prevented disease after lethal challenge with wild-type H1N1. In BALB/c mice, as little as 103 PFU was protective against lethal challenge with mouse-adapted H1N1. In ferrets, CodaVax-H1N1 was more potent compared to currently licensed LAIV and still effective at a low dose of 103 PFU at preventing replication of challenge virus. [ABSTRACT FROM AUTHOR]

This study investigates critical thinking (CT) studies in e-learning settings to provide a comprehensive analysis of CT studies. Research indexed in the Web of Science database which includes major peer-reviewed social sciences citation index journals in the e-learning field from January 2006 to November 2017 was searched for a systematic review and analysis. A total of 42 studies were selected and synthesized. The distribution of publishing years, geographical areas, education sectors, publications, disciplines, research methods, activities, CT measurement instruments, teaching instruction, the CT roles applied in the studies, and the experiment durations were reviewed. The results showed that most CT studies were conducted in nontraditional teaching environments using strategies such as online discussion or concept mapping; the most used quantitative method was the California critical thinking skills test (CCTST), whereas the most frequently adopted qualitative method was the practical inquiry model of cognitive presence (PIMCP). The common method to enhance students' CT was online synchronous or asynchronous discussion, and the role that CT played in these studies was as a dependent variable for evaluating whether the designed e-learning instruction(s) can cultivate CT. This study concludes that with active learning instruction and experienced tutor facilitation, students' CT could be enhanced in a variety of e-learning environments. [ABSTRACT FROM AUTHOR]

After severe neurocognitive decline developed in an otherwise healthy 63-year-old man, brain magnetic resonance imaging showed eosinophilic meningoencephalitis and enhancing lesions. The patient tested positive for antibodies to Baylisascaris spp. roundworms, was treated with albendazole and dexamethasone, and showed improvement after 3 months. Baylisascariasis should be considered for all patients with eosinophilic meningitis. [ABSTRACT FROM AUTHOR]

Background: Limited intimal tears (LITs) of the aorta (Class 3 dissection variant) are the least common form of aortic pathology in patients presenting with acute aortic syndrome (AAS). LITs are difficult to detect on imaging and may be underappreciated.Objectives: This study sought to describe the frequency, pathology, treatment, and outcome of LITs compared with other AAS, and to demonstrate that LITs can be detected pre-operatively by contemporary imaging.Methods: The authors retrospectively reviewed 497 patients admitted for 513 AAS events at a single academic aortic center between 2003 and 2012. AAS were classified into classic dissection (AD), intramural hematoma, LIT, penetrating atherosclerotic ulcer, and rupturing thoracic aortic aneurysm. The prevalence, pertinent risk factors, and detailed imaging findings with surgical and pathological correlation of LITs are described. Management, early outcomes, and late mortality are reported.Results: Among 497 patients with AAS, the authors identified 24 LITs (4.8% of AAS) in 16 men and 8 women (17 type A, 7 type B). Patients with LITs were older than those with AD, and type A LITs had similarly dilated ascending aortas as type A AD. Three patients presented with rupture. Eleven patients underwent urgent surgical aortic replacement, and 2 patients underwent endovascular repair. Medial degeneration was present in all surgical specimens. In-hospital mortality was 4% (1 of 24), and in total, 5 patients with LIT died subsequently at 1.5 years (interquartile range [IQR]: 0.3 to 2.5 years). Computed tomography imaging detected all but 1 LIT, best visualized on volume-rendered images.Conclusions: LITs are rare acute aortic lesions within the dissection spectrum, with similar presentation, complications, and outcomes compared with AD and intramural hematoma. Awareness of this lesion allows pre-operative diagnosis using high-quality computed tomography angiography. [ABSTRACT FROM AUTHOR]

To better understand the change in California's climate over the past century, the long-term variability and extreme events of precipitation as well as minimum, mean, and maximum temperatures during the rainy season (from November to March) are investigated using observations. Their relationships to 28 rainy season average climate indices with and without time lags are also studied. The precipitation variability is found to be highly correlated with the tropical/Northern Hemisphere pattern (TNH) index at zero time lag with the highest correlation in Northern California and the Sierra and the correlation decreasing southward. This is an important finding because there have been no conclusive studies on the dominant climate modes that modulate precipitation variability in Northern California. It is found that the TNH modulates California precipitation variability through the development of a positive (negative) height anomaly and its associated low-level moisture fluxes over the northeast Pacific Ocean during the positive (negative) TNH phase. Temperature fields, especially minimum temperature, are found to be primarily modulated by the east Pacific/North Pacific pattern, Pacific decadal oscillation, North Pacific pattern, and Pacific-North American pattern at zero time lag via changes in the lower-tropospheric temperature advections. Regression analysis suggests a combination of important climate indices would improve predictability for precipitation and minimum temperature statewide and subregionally compared to the use of a single climate index. While California's precipitation currently is primarily projected by ENSO, this study suggests that using the combination of the TNH and ENSO indices results in better predictability than using ENSO indices only. [ABSTRACT FROM AUTHOR]

The objective was to examine gender differences in causes of death using the San Francisco HIV/AIDS and death registries. Data from San Francisco residents diagnosed with HIV/AIDS who died from 1996 to 2013 were analyzed. Age, race/ethnicity, year, and gender-adjusted standardized mortality ratios and Poisson 95% confidence intervals were calculated for underlying causes of death. Among the 6268 deaths, deaths attributed to drug use, mental disorders due to substance use, cerebrovascular disease, chronic obstructive pulmonary disease, renal disease, and septicemia were more likely among women than among men. Compared to the California population, women had elevated standardized mortality ratios for drug overdose (25.37), mental disorders due to substance abuse (27.21), cerebrovascular disease (2.83), chronic obstructive pulmonary disease (7.37), heart disease (2.37), and liver disease (5.54), and these were higher than the standardized mortality ratios for the men in our study. Men, but not women, had elevated standardized mortality ratios for suicide (2.70), undetermined intent (3.88), renal disease (2.29), and non-AIDS cancer (1.68) compared to population rates. Continued efforts to reduce HIV-related illnesses and an increased emphasis on diagnosing and treating preventable causes of death, including substance use, heart disease, and mental health disorders, are needed as part of comprehensive HIV care. [ABSTRACT FROM AUTHOR]

Background: While there is substantial evidence that syringe exchange programs (SEPs) are effective in preventing HIV among people who inject drugs (PWID), nearly all the evidence comes from PWID who obtain syringes from an SEP directly. Much less is known about the benefits of secondary exchange to PWID who get syringes indirectly from friends or acquaintances who visit an SEP for them.Objectives: We evaluated the effectiveness of direct versus indirect syringe exchange in reducing HIV-related high-risk injecting behavior among PWID in two separate studies conducted in Sacramento and San Jose, California, cities with quite different syringe exchange models.Methods: In both studies associations between direct and indirect syringe exchange and self-reported risk behavior were examined with multivariable logistic regression models. Study 1 assessed effects of a “satellite” home-delivery syringe exchange in Sacramento, while Study 2 evaluated a conventional fixed-site exchange in San Jose.Results: Multivariable analyses revealed 95% and 69% reductions, respectively, in high-risk injection associated with direct use of the SEPs in Sacramento and San Jose, and a 46% reduction associated with indirect use of the SEP in Sacramento.Conclusions/Importance: The very large effect of direct SEP use in Sacramento was likely due in part to home delivery of sterile syringes. While more modest effects were associated with indirect use, such use nevertheless is valuable in reducing the risk of HIV transmission of PWID who are unable or unwilling to visit a syringe exchange. [ABSTRACT FROM PUBLISHER]

In the spring of 2015, a local health department (LHD) in county A notified the California Department of Public Health (CDPH) about three adults with close ties to one another and a congregate community site who had received diagnoses of tuberculosis (TB) disease within a 3-month period. Subsequent review revealed matching TB genotypes indicating that the cases were likely part of a chain of TB transmission. Only three TB cases in California in the preceding 2 years shared this same genotype. One of those three previous cases occurred in a lung-transplant recipient who had no identified epidemiologic links to the outbreak. CDPH, multiple LHDs, and CDC conducted an investigation and determined that the lung-transplant donor (patient 1) was epidemiologically linked to the three outbreak cases and had a tuberculin skin test (TST) conversion detected in 2012 upon reentry at a local jail. Three other solid organ recipients from this donor were identified; none had developed TB disease. This investigation suggests that review of organ donors' medical records from high-risk environments, such as jails, might reveal additional information about TB risk. The evaluation of TB in organ recipients could include genotyping analysis (1) and coordination among local, state, and national partners to evaluate the potential for donor-derived TB. [ABSTRACT FROM AUTHOR]

The primary study objective was to identify determinants of short-term recovery from a 161-km ultramarathon. Participants completed 400 m runs at maximum speed before the race and on days 3 and 5 post-race, provided a post-race blood sample for plasma creatine kinase (CK) concentration, and provided lower body muscle pain and soreness ratings (soreness, 10-point scale) and overall muscular fatigue scores (fatigue, 100-point scale) pre-race and for 7 days post-race. Among 72 race finishers, soreness and fatigue had statistically returned to pre-race levels by 5 days post-race; and 400 m times at days 3 and 5 remained 26% (P = 0.001) and 12% (P = 0.01) slower compared with pre-race, respectively. CK best modelled soreness, fatigue and per cent change in post-race 400 m time. Runners with the highest CKs had 1.5 points higher (P < 0.001) soreness and 11.2 points higher (P = 0.006) fatigue than runners with the lowest CKs. For the model of 400 m time, a significant interaction of time with CK (P < 0.001) indicates that higher CKs were linked with a slower rate of return to pre-race 400 m time. Since post-race CK was the main modifiable determinant of recovery following the ultramarathon, appropriate training appears to be the optimal approach to enhance ultramarathon recovery. [ABSTRACT FROM PUBLISHER]

Background: Ulnar collateral ligament (UCL) reconstruction (UCLR) has been studied and shown to be a successful procedure for returning overhead athletes to sport. Many studies of Major League Baseball (MLB) players have shown high levels of return to play with successful statistical performance. No study has followed professional advancement of drafted pitchers who underwent UCLR as amateurs when compared with drafted pitchers who did not undergo the procedure before selection in the MLB draft. Hypothesis: There would be no difference in professional advancement, statistical performance, or injury rate between the UCLR and control groups. Study Design: Cohort study; Level of evidence, 3. Methods: Thirty-eight pitchers with a UCLR as an amateur and 114 controls were identified in the MLB draft between 2006 and 2010. Highest level of professional baseball achieved was collected from all players, as well as statistical performance metrics including velocity, wins, earned run average (ERA), and walks and hits per inning pitched (WHIP). Additional data on future injuries were analyzed for days on the disabled list (DL), risk of being placed on the DL, and DL assignment for elbow injury. Results: Thirteen of 38 UCLR pitchers reached the major league level (34.2%) compared with 29 of 114 (25.4%) control pitchers, which was not statically significant (P = .295). The UCLR and control groups were similar for average velocity, peak velocity, innings pitched, games, games started, innings per game, ERA, WHIP, wins, losses, saves, batters faced, and innings pitched per year, as well as hits, runs, home runs allowed, strikeouts, batters walked, and batters struck per inning. The UCLR group had a significantly increased rate of DL assignment when compared with controls (86.8% vs 64.0%; P = .008); however, days on DL (152.8 vs 135.6; P = .723) and DL assignment for elbow injury (45.5% vs 43.8%; P = .877) were similar. Conclusion: There was no difference in the rate of professional advancement among pitchers drafted by the MLB who had undergone UCLR as amateurs compared with controls. Both groups had similar statistical performance. Pitchers in the UCLR group had an increased risk of DL assignment but no increase in the number of days on DL or risk of DL placement for elbow injury. [ABSTRACT FROM AUTHOR]