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The article explores the direct health effects of gas stove emissions. Topics discussed include association of childhood asthma cases in the U.S. to gas stove use, association of natural gas connections in residential and commercial construction to carbon emissions and climate change, pollutants produced by gas burners such as volatile organic compounds and liquefied petroleum gas or propane, and concentration of nitrogen dioxide in kitchens with overhead range hood versus sealed off kitchens.

Background: Despite being disproportionately impacted by COVID-19 due to a lack of structural support, marginalized communities have been largely ignored in the politically polarized debate over school masking. In response to this, we sought to explore masking attitudes by centering the voices of parents and children at historically marginalized, predominantly Hispanic schools in southern California. Methods: We conducted a mixed-methods study with parents and children attending 26 low-income predominantly Hispanic-serving elementary schools. A random sample of parents was asked to provide a freelist of words they associate with masking. A subset of parents with children aged 4–6 was recruited from these surveys to participate in parent-child interviews (PCI). We calculated Smith's salience index for all unique items, stratifying by language (English/Spanish). Item salience guided PCI thematic analysis for additional context and meaning. Results: 648 participants provided 1118 unique freelist items in English and Spanish. 19 parent-child pairs were interviewed, 11 in Spanish and 8 in English. The most salient words were "safety"(0.37), "protection"(0.12), "prevention"(0.05), "health"(0.04), "good"(0.03), "can't breathe"(0.03), "necessary"(0.02), "care"(0.02), "precaution"(0.02), and "unnecessary"(0.02). Spanish speakers had a more favorable view of masking than English speakers, particularly regarding "protection" (0.20 vs 0.08) and "prevention" (0.10 vs 0.02). Discussion: Masking is an affordable individual-level risk mitigation that protects the communities that have inequitably shouldered the burdens of the COVID-19 pandemic. We recommend that policymakers prioritize the views of those most impacted when deciding on risk mitigation policies like school masking. [ABSTRACT FROM AUTHOR]

Problem: Children with chronic conditions often have difficulties with emotions, concentration, and behaviors (ECB) and are not recognized and treated adequately. In this paper, long‐term medication use (LTM) was adopted as a proxy for chronic illness due to the lack of consistent and standardized diagnostic criteria for chronic illnesses in children. Methods: Children (8–12 years) were selected from the California Health Interview Survey (2017) based on: (1) households with children (<12 years), (2) parent/adult caregivers report about child's health indicating "yes" to, (3) "does your child require prescription medicine for a health condition that has lasted or is expected to last at least 12 months or more," and (4) "difficulties with ECB in past 6 months." Findings: A total of 1600 children were included by the CHIS data set, and children whose parental report had met the selection criteria were children with LTM (n = 144; 7.4 ± 2.9 years), ECB (n = 233; 8.16 ± 2.14), and both LTM + ECB (n = 62; 8.61 ± 1.81). Children with LTM+ ECB were Caucasian (56.4%), Hispanic (19.3%), and males (64.5%). Children with both LTM + ECB had two to three (33.87%) or at least four (53.2%) physician visits, and/or receiving special therapy (45.1%). Children with LTM had prescription delays (n = 144; 5.6%) and were not able to get medical care due to lack of insurance (n = 144; 6.9%). The majority of the children with LTM (54.2%) and LTM + ECB (43.5%) had parental employment‐based insurance. More children that have both LTM and ECB (48.4%) than children with LTM, No ECB (32.9%) were on Medi‐Cal/Medicaid. Conclusion: Children with LTM need further evaluation for difficulties with ECB. Future studies are required to examine health status, healthcare use, and access for children with LTM and ECB. [ABSTRACT FROM AUTHOR]

Background: In this study, we describe a participatory design process to develop a technology-based intervention for sun protection for children and their parents. Our methodology embraces and leverages the expert knowledge of the target users, children and their parents, about their sun protection practices to directly influence the design of our mobile just-in-time adaptive intervention (JITAI). The objectives of this paper are to describe our research procedures and summarize primary findings incorporated into developing our JITAI modules. Methods: We conducted 3 rounds of iterative co-design workshops with design expert KidsTeam UW children (N: 11–12) and subject expert children and their parents from local communities in California (N: 22–48). Iteratively, we thematically coded the qualitative data generated by participants in the co-design sessions to directly inform design specifications. Results: Three themes emerged: (1) preference for non-linear educational format with less structure,; (2) situations not conducive for prioritizing sun protection; and (3) challenges, barriers, and ambiguity relating to sun protection to protect oneself and one's family. Based on the design ideas and iterative participant feedback, three categories of modules were developed: personalized and interactive data intake module, narrative-education module with augmented reality experiment, person/real-time tailored JITAI, and assessment modules. Conclusions: This is one of the first projects that maximally engage children and parents as co-designers to build a technology to improve sun protection with iterative and intentional design principles. Our scalable approach to design a mobile JITAI to improve sun protection will lay the foundation for future public health investigators with similar endeavors. [ABSTRACT FROM AUTHOR]

Background: Angiotensin II type-1 receptor antibody (AT1R-Ab) has been associated with vascular injury and kidney dysfunction in pediatric kidney transplant recipients. The role of AT1R-Ab in the development of chronic kidney disease in pediatric liver and intestinal transplant recipients has not been explored. Methods: Twenty-five pediatric intestinal transplant recipients and 79 pediatric liver transplant recipients had AT1R-Ab levels measured at varying time points in the post-transplant period. Estimated glomerular filtration rate (eGFR) was determined using creatinine based CKiD U25 equation and measured at time of AT1R-Ab measurement, at 1 year post-AT1R-Ab measurement, at 5 years post-AT1R-Ab measurement, and at the most recent routine clinic visit. The prevalence of hypertension and antihypertensive medication use were also evaluated. Results: Younger age at time of AT1R-Ab measurement was associated with AT1R-Ab positivity in liver transplant recipients. There was no association between AT1R-Ab status and change in eGFR, prevalence of hypertension, or use of antihypertensive medications at the described time points. Conclusions: AT1R-Ab positivity was not associated with a decline in eGFR or hypertension in pediatric liver and intestinal transplant recipients. Further studies are needed using other markers of kidney function, such as cystatin C, to validate this finding. [ABSTRACT FROM AUTHOR]

Epidemiologic studies of low-frequency exposures or outcomes using metabolomics analyses of neonatal dried blood spots (DBS) often require assembly of samples with substantial differences in duration of storage. Independent assessment of stability of metabolites in archived DBS will enable improved design and interpretation of epidemiologic research utilizing DBS. Neonatal DBS routinely collected and stored as part of the California Genetic Disease Screening Program between 1983 and 2011 were used. The study population included 899 children without cancer before age 6 years, born in California. High-resolution metabolomics with liquid-chromatography mass spectrometry was performed, and the relative ion intensities of common metabolites and selected xenobiotic metabolites of nicotine (cotinine and hydroxycotinine) were evaluated. In total, we detected 26,235 mass spectral features across 2 separate chromatography methods (C18 hydrophobic reversed-phase chromatography and hydrophilic-interaction liquid chromatography). For most of the 39 metabolites related to nutrition and health status, we found no statistically significant annual trends across the years of storage. Nicotine metabolites were captured in the DBS with relatively stable intensities. This study supports the usefulness of DBS stored long-term for epidemiologic studies of the metabolome. -Omics-based information gained from DBS may also provide a valuable tool for assessing prenatal environmental exposures in child health research. [ABSTRACT FROM AUTHOR]

Executive functions (EF) and sensorimotor skills play a critical role in children's goal-directed behavior and school readiness. The aim of the current study is to provide new insights into the relationship between executive functions and sensorimotor development by considering the risks associated with learning difficulties. Therefore, we investigate the predictive role of EF and sensorimotor skills in the development of learning difficulties during preschool years. Ninety-five preschool children (5–7 years old) were tested, comparing the performance of children that are at risk of learning difficulties (n = 55) to the performance of typically developing children (n = 40). Participants completed a battery for the assessment of sensorimotor skills (i.e., Southern California Sensory Integration Test: postural imitation, body midline crossing, bilateral motor coordination, and standing balance with eyes open) and executive functions (i.e., inhibition, cognitive flexibility, and verbal working memory). Our results show that children at risk for learning difficulties exhibited more impairments on sensorimotor and EF measures (inhibition and verbal working memory) when compared with TD children. We ran three separate binary logistic regression analyses to assess the relative influence of EF and sensorimotor functions on predicting risk for learning difficulties. Our findings demonstrated that verbal working memory as EF function (odd ratio OR = 0.91 , 95% CI 0.78-0.91, P = 0.05) and standing balance skills as a sensorimotor skill (odd ratio OR = 0.86 , 95% CI 0.81-0.98, P = 0.01) were the strongest predictors of risk for learning difficulties. The findings point to the importance of supporting children's executive function development and promoting sensorimotor development, as both fundamentally influence school readiness. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders are serious psychiatric conditions predominantly affecting children, adolescents, and young adults. While family‐based treatment (FBT) is the gold standard outpatient treatment approach for adolescents with restrictive eating disorders, there is not a universally recognized best practice within higher levels of care. There is a particular dearth of literature detailing recommended psychological and behavioral interventions in the inpatient medical setting. Method: The present article provides an account of how FBT principles have been incorporated in Children's Hospital of Orange County at Mission's inpatient medical stabilization program for children and adolescents with restrictive eating disorders. Practical examples illustrate how key FBT tenets are successfully translated into the inpatient multidisciplinary setting. Results: The use of FBT can encourage a unified approach among medical and psychosocial providers and serves to destigmatize patients with eating disorders and associated behaviors. The successes and challenges of FBT implementation are discussed. Discussion: Though anecdotal evidence and preliminary findings support positive outcomes from the implementation of FBT within a pediatric medical stabilization program for patients, families, and staff, research is needed to understand best practices within higher levels of care. Additional research efforts will also help elucidate whether adapted FBT can become a standard of care for patients with restrictive eating disorders in inpatient settings. Public Significance: This article describes how a children's hospital has adopted family‐based treatment (FBT) for youth who are hospitalized due to an eating disorder. FBT is the most efficacious treatment for youth with eating disorders. This article describes specific examples of how FBT can be implemented within a medical setting. This article will support a greater understanding of FBT principles and guide providers to translate FBT into higher level of care settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: We developed the Tobacco Prevention Toolkit (Toolkit) to enhance the impact of school‐based tobacco education. This study describes the process of developing the Toolkit, its contents, and reach. METHODS: Qualitative community‐based participatory research (CBPR), including focus group discussions (N = 152) and working groups with parents, educators, researchers, and youth (N = 87) were used to develop the Toolkit and design its implementation. Toolkit reach was assessed through number of trained educators using the Toolkit, estimated number of youth recipients of the Toolkit resources, and using Google Analytics for online engagement. RESULTS: The Toolkit is a free, online resource aimed at preventing tobacco use by middle and high school students. Toolkit content addresses varied forms of tobacco including electronic cigarettes, hookah, smokeless tobacco, and cigarettes; addiction; and positive youth development; and is available in multiple interactive formats such as real‐time quizzes, factsheets, activities, and presentations. The Toolkit is mainly delivered by trained educators, who adapt its content and duration to tailor their drug prevention teaching to student needs. As of April 2020, when data for this paper were collected, 4,750 educators have reached an estimated 1.3 million youth. The Toolkit website has 186,116 users and 802,602 page views, growing steadily since 2016. As of August 2021, additional students have been reached, for now a total of 1.85 million students reached. CONCLUSION: The Toolkit resources are evidence‐based, comprehensive, responsive, interactive, easily accessible, and flexible. Applying CBPR was instrumental in developing the Toolkit and expanding its reach. [ABSTRACT FROM AUTHOR]

Purpose: This paper describes the educational experiences of children and youth (aged 3–20) with disabilities during school closures resulting from the 2017 Northern California wildfires. Students with disabilities are particularly vulnerable to the adverse impacts of disaster, yet the effects of school closures on these children remains understudied. This study identifies considerations for students with disabilities and their families post-disaster. Design/methodology/approach: An inductive, qualitative approach was used for the study design, methodology and analysis. In-depth interviews were conducted with parents of 14 students with disabilities about their experiences during and following school closures. All of these children had missed between a week and over a month of school as a result of the wildfires. Thematic analysis was used to code data and identify four themes present across the data. Findings: Our findings indicate that children and youth with disabilities experienced disruptions in school-based services; lost previously acquired skills; exhibited negative health and behavioral issues; had difficulties adapting to new, unfamiliar routines and were saddened by lost social connections. Additionally, findings pinpoint the importance of social connections while schools were closed, the benefits of resuming school which included access to responsive school staff, as well as challenges faced by children with disabilities and their families once schools reopened. Originality/value: Families of children with disabilities, as illustrated in this study, often must transverse a different post-disaster landscape. Schools should assist them in navigating that landscape so students with disabilities can experience a more equitable return to education post-disaster. [ABSTRACT FROM AUTHOR]

Background: Parents play an important role in their children's oral health behaviors, provide oral health access, initiate prevention, and coping strategies for health care. Aim: This paper develops a short form (SF) to assist parents to evaluate their children's oral health status using Patient‐Reported Outcome Measurement Information System (PROMIS) framework that conceptualized health as physical, mental, and social components. Design: Surveys of parents were conducted at dental clinics in Los Angeles County, together with an on‐site clinical examination by dentists to determine clinical outcomes, Children's Oral Health Status Index (COHSI), and referral recommendations (RRs). Graded response models in item response theory were used to create the SF. A toolkit including SF, demographic information, and algorithms was developed to predict the COHSI and RRs. Results: The final SF questionnaire consists of eight items. The square root mean squared error for the prediction of COHSI is 7.6. The sensitivity and specificity of using SF to predict immediate treatment needs (binary RRs) are 85% and 31%. Conclusions: The parent SF is an additional component of the oral health evaluation toolkit that can be used for oral health screening, surveillance program, policy planning, and research of school‐aged children and adolescents from guardian perspectives. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of current study was to evaluate change in hours of Applied Behavior Analysis (ABA) therapy utilization for autistic children during the year prior to the COVID-19 pandemic, the first three months of the pandemic (crisis phase), and the following 9 months of the pandemic (mitigation phase). Additionally, this study aimed to evaluate if change in therapy utilization differed based on child race, ethnicity, and primary payer of services. Finally, we aimed to identify potential mechanisms of ABA therapy disruption by interpreting findings using an extended version of Donabedian's structure-process-outcome model. Methods: Retrospective clinical data on client demographics and therapy utilization (n = 283) were collected from ABA clinics in California and analyzed with four piecewise growth multi-level models. Results: We found that therapy utilization dropped during the first three months of the pandemic (-10.65 h/month; p <.001) and increased during the following 9 months (2.39 h/month; p <.001). Moderator analyses revelated that Asian, Non-Latinx and school-district funded children had significantly different trajectories of change in therapy utilization compared to white, non-Latinx participants and private insurance funded participants, respectively. Conclusion: Findings suggest that utilization of ABA therapy was disrupted for a full year following the onset of the COVID-19 pandemic and that child race/ethnicity and primary payer influenced the degree to which autistic children were impacted by service disruption. These findings have implications for autistic children who lost therapy access during key developmental periods and for the ABA care delivery system. [ABSTRACT FROM AUTHOR]

Carpooling has potential as an alternative mode of school transportation along with other viable options, especially at a time when technology continues to increase our reliance upon shared mobility. Unfortunately, our knowledge of carpooling as a school travel mode is very limited. The purpose of this paper is to fill this gap. Using a multinomial logit model, this study presents an analysis of data from the 2012 California Household Travel Survey to assess the effects of various factors, such as trip characteristics, child characteristics, parental or caregiver's characteristics, household characteristics, and spatial variables on choosing carpooling as a school travel mode. The findings of the study indicate that travel distance is one of the major determinants of carpooling, suggesting that children are more likely to carpool to school as travel distance from home to school increases. The analysis shows that a higher income two-parent two-earner family with a 5–15-year-old female schoolchild is more likely to use carpooling for school trips when compared to other modes of transportation. Parental/caregiver characteristics are also found to be important, as children from households with young, female, higher educated heads are more likely to carpool to school. Results of spatial variables suggest that families living in neighborhoods with higher numbers of schoolchildren are also more likely to carpool. The empirical evidence presented in this study provides useful insight to school districts, policymakers, and other transportation related entities in identifying potential target groups to whom this travel mode could be presented. [ABSTRACT FROM AUTHOR]

Dual language learners (DLLs) are sensitive to teachers' language influence in early childhood classrooms. In this mixed methods study incorporating 53 teachers from 28 preschools in Northern California, we investigated the characteristics of teachers' language use in preschools teaching Chinese–English and Spanish–English DLLs. We further examined the links of teachers' language use to the DLLs' expressive vocabulary in English and their heritage language (HL), controlling for home language exposure and other confounding variables. Finally, we conducted interviews with teachers to understand how they make meaning of their daily language practices. The sample of children consisted of 190 Chinese–English (N = 125) and Spanish–English (N = 65) DLLs (mean age = 48.3 months; 48% females). The teacher survey showed that most teachers spoke two or more languages and used a mix of English and their HL during their interactions with DLLs. The results of random-intercept models showed that teachers' language use did not uniquely predict children's vocabulary, controlling for family-level factors. However, the teachers with more years of teaching DLLs oversaw children with a higher HL vocabulary. The interview data revealed that teachers employ several strategies to communicate with DLLs and support HL maintenance. Our study reveals the multilingual backgrounds of preschool teachers and the rich language strategies they implement in multilingual classrooms. Future directions concerning the quality and development of teachers' language use are discussed. [ABSTRACT FROM AUTHOR]

Background As prenatal vaccinations continue to be given more frequently, it is important to assess long-term safety events. We investigated the association between prenatal influenza vaccination or infection and autism spectrum disorder (ASD) in offspring. Methods A retrospective cohort study of mother–child pairs with deliveries between 1 January 2011 and 31 December 2014 at Kaiser Permanente Southern California was performed. Children aged >1 year were followed through 31 December 2018. Maternal influenza vaccination or infection during pregnancy was obtained from electronic health records. ASD was defined by International Classification of Diseases, Ninth or Tenth Revisions, Clinical Modification , codes after age 1 year. Cox proportional hazard models estimated the crude and inverse probability of treatment weighted (IPTW) hazard ratios (HR) for the association between maternal influenza vaccination or infection and ASD. Results There were 84 739 mother–child pairs included in the final analytic sample. Of the 46 257 women vaccinated, 32.4% were vaccinated during the first trimester, 41.8% during the second trimester, and 25.8% during the third trimester. ASD was diagnosed in 1930 (2.3%) children. The IPTW analyses showed no association between prenatal influenza vaccination or infection and ASD in offspring (HR, 1.04; 95% confidence interval [CI],.95–1.13; HR, 1.12; 95% CI,.66–1.89, respectively). Conclusions Prenatal influenza vaccination or infection was not associated with ASD risk in offspring. The findings support recommendations to vaccinate pregnant women to protect themselves and their infants, both of whom are vulnerable to severe morbidity following infection. [ABSTRACT FROM AUTHOR]

This paper explores the way in which psychologists classified immigrant children as feebleminded through the use of intelligence testing and how state organisations consequently segregated them from public schools based on the scientific evidence. First, I show the way in which the psychologist Lewis Terman utilised intelligence testing to identify immigrant children deemed feebleminded. I focus closely on a survey and on his methodology and analysis. I then discuss the possibilities of education for the feebleminded and the segregation of immigrant children from regular classroom of public schools. Through his survey, Terman concluded that the exceptionally high ratio of feebleminded children in the tested region was caused by the large population of immigrant children, although the selection of the sample was often subjective, leading to “miscalculation” in his analysis. Terman’s survey was influential in terms of segregating feebleminded children by stating their incurability; possibilities of education for the feebleminded were thus denied. At his suggestion, special classes and schools, along with a home for the feebleminded, were established. Terman’s psychological survey was a cue for psychologists to enter the school system. The State Board of Education was not only attempting to discover the percentage of feebleminded children but also trying to apply psychology to school training. With the cooperation of the Board, the training of teachers for the feebleminded proceeded. [ABSTRACT FROM PUBLISHER]

Concern that synthetic food dyes may impact behavior in children prompted a review by the California Office of Environmental Health Hazard Assessment (OEHHA). OEHHA conducted a systematic review of the epidemiologic research on synthetic food dyes and neurobehavioral outcomes in children with or without identified behavioral disorders (particularly attention and activity). We also conducted a search of the animal toxicology literature to identify studies of neurobehavioral effects in laboratory animals exposed to synthetic food dyes. Finally, we conducted a hazard characterization of the potential neurobehavioral impacts of food dye consumption. We identified 27 clinical trials of children exposed to synthetic food dyes in this review, of which 25 were challenge studies. All studies used a cross-over design and most were double blinded and the cross-over design was randomized. Sixteen (64%) out of 25 challenge studies identified some evidence of a positive association, and in 13 (52%) the association was statistically significant. These studies support a relationship between food dye exposure and adverse behavioral outcomes in children. Animal toxicology literature provides additional support for effects on behavior. Together, the human clinical trials and animal toxicology literature support an association between synthetic food dyes and behavioral impacts in children. The current Food and Drug Administration (FDA) acceptable daily intakes are based on older studies that were not designed to assess the types of behavioral effects observed in children. For four dyes where adequate dose-response data from animal and human studies were available, comparisons of the effective doses in studies that measured behavioral or brain effects following exposure to synthetic food dyes indicate that the basis of the ADIs may not be adequate to protect neurobehavior in susceptible children. There is a need to re-evaluate exposure in children and for additional research to provide a more complete database for establishing ADIs protective of neurobehavioral effects. [ABSTRACT FROM AUTHOR]

Objective: In 2019, California and Wilmington, Delaware' implemented policies requiring healthier default beverages with restaurant kids' meals. The current study assessed restaurant beverage offerings and manager perceptions.Design: Pre-post menu observations were conducted in California and Wilmington. Observations of cashiers/servers during orders were conducted pre-post implementation in California and post-implementation in Wilmington. Changes in California were compared using multilevel logistic regression and paired t tests. Post-implementation, managers were interviewed.Setting: Inside and drive-through ordering venues in a sample of quick-service restaurants in low-income California communities and all restaurants in Wilmington subject to the policy, the month before and 7-12 months after policy implementation.Participants: Restaurant observations (California n 110; Wilmington n 14); managers (California n 75; Wilmington n 15).Results: Pre-implementation, the most common kids' meal beverages on California menus were unflavoured milk and water (78·8 %, 52·0 %); in Wilmington, juice, milk and sugar-sweetened beverages were most common (81·8 %, 66·7 % and 46·2 %). Post-implementation, menus including only policy-consistent beverages significantly increased in California (9·7 % to 66·1 %, P < 0·0001), but remained constant in Wilmington (30·8 %). During orders, cashiers/servers offering only policy-consistent beverages significantly decreased post-implementation in California (5·0 % to 1·0 %, P = 0·002). Few managers (California 29·3 %; Wilmington 0 %) reported policy knowledge, although most expressed support. Most managers wanted additional information for customers and staff.Conclusions: While the proportion of menus offering only policy-consistent kids' meal default beverages increased in California, offerings did not change in Wilmington. In both jurisdictions, managers lacked policy knowledge, and few cashiers/servers offered only policy-consistent beverages. Additional efforts are needed to strengthen implementation of kids' meal beverage policies. [ABSTRACT FROM AUTHOR]

BACKGROUND Low‐income and racial/ethnic minority students often face distinct challenges in attending school eading to lower academic performance, low graduation rates, and overall, an indicator of diminished long‐term social and financial stability. Chronic absenteeism is a national problem and to address this, a better understanding of risks and points of intervention for the students most at risk is needed. This cross‐sectional study sought to assess risks and protective factors associated with chronic absenteeism in a predominantly low‐income minority school district in Southern. METHODS: Conducted in southern California, students (N = 24,439) ages 9 to 21 years were recruited. A logistic regression was used to assess the role poor physical and mental health, safety, bullying, and family risk factors attributed to chronic absenteeism. RESULTS: Results revealed that asthma (odds ratio [OR] = 1.35, p <.001), being overweight/obese (OR = 1.38, p <.01), presence of family risk factors (OR = 1.49, p <.001), bullying (OR = 0.84, p <.05) and perceptions of safety at school (OR = 1.24, p <.05) increased the odds of chronic absenteeism, while protective factors such as support (OR = 1.30, p <.001), increased sleep (OR = 0.96, p <.001) and positive growth mindset (OR = 0.96, p <.001), mitigated it. CONCLUSION: This study not only identifies risk but protective factors worth adhering to, to promote school attendance. Future research should further examine the role of mental health in chronic absenteeism. [ABSTRACT FROM AUTHOR]

Mindfulness-based interventions (MBIs) may offer a means for Latinx families to ameliorate stress, enhance emotion regulation, and foster social support. We assessed pilot data from Latinx parents in Eastside Los Angeles (n = 27) matched with their children aged 10–16 (n = 32) to determine whether participation in a community-derived MBI was associated with greater improvements in dispositional mindfulness, perceived stress, emotion regulation, and family social support compared to a control condition. Compared to the control group, parents in the MBI group showed greater reductions in perceived stress scale (PSS) scores (B = − 2.94, 95% CI [− 5.58, − 0.39], p = 0.029), while their children reported greater increases in perceived social support from family (B = 2.32, 95% CI [0.26, 4.38], p = 0.027). Findings show a community-derived MBI may improve stress in Latinx parents and social support for their children. [ABSTRACT FROM AUTHOR]

Early life exposures have been associated with obesity later in life. We aim to assess the association between early life exposure to food insecurity and change in BMI throughout childhood and adolescents. Food security status and growth variables from 243 Mother–child dyads from the Center for the Health Assessment of Mothers and Children of Salinas study were assessed 7 times over a 12-year period. Generalized log linear models with Poisson distributions and linear regression models were implemented to assess the associations between early life food insecurity and obesity and growth. Early life food insecurity was associated with a 0.43 (0.01, 0.82) kg/m2 decrease in BMI from age 2 to 3.5, and a 0.92 kg/m2 (0.38, 1.46) increase in BMI among boys from ages 3.5 to 5, after adjusting for covariates. Sex and age modify the association between early life exposure to food insecurity and BMI. [ABSTRACT FROM AUTHOR]

Objective: The present paper examines the influence of age and gender on food patterns of Latino children.Design: Data are from baseline of a 5-year, quasi-experimental obesity prevention study: Niños Sanos, Familia Sana (NSFS; Healthy Children, Healthy Families). In 2012, the researchers interviewed Latino parents, using a thirty-item questionnaire to ask about their children's food consumption and feeding practices. Statistical tests included t tests and ANCOVA.Setting: Rural communities in California's Central Valley, USA.Subjects: Two hundred and seventeen parents (87-89% born in Mexico) and their children (aged 2-8 years).Results: Fifty-one per cent of the children were overweight or obese (≥85th percentile of BMI for age and gender). Mean BMI Z-scores were not significantly different in boys (1·10 (SD 1·07)) and girls (0·92 (SD 1·04); P=0·12). In bivariate analysis, children aged 2-4 years consumed fast and convenience foods less often (P=0·04) and WIC (Supplemental Nutrition Program for Women, Infants, and Children)-allowable foods more often than children aged 5-8 years (P=0·01). In ANCOVA, neither age nor gender was significantly related to food patterns. Mother's acculturation level was positively related to children's consumption of fast and convenience foods (P=0·0002) and negatively related to consumption of WIC foods (P=0·01). Providing role modelling and structure in scheduling meals and snacks had a positive effect on the vegetable pattern (P=0·0007), whereas meal skipping was associated with more frequent fast and convenience food consumption (P=0·04).Conclusions: Acculturation and child feeding practices jointly influence food patterns in Latino immigrant children and indicate a need for interventions that maintain diet quality as children transition to school. [ABSTRACT FROM AUTHOR]

Twenty-five years ago, one of the authors of this article (Pate) published in this journal a "point of view" that was aimed at making the case for large-scale physical fitness testing in American youth (17). While the author expressed caveats and conditions, the basic tenor of the article was positive. The article argued that carefully designed physical fitness testing protocols can have educational value for students, should be included in public health surveillance systems, and ought to be updated regularly in light of new knowledge. This article reflects on developments and advances that have played out over the intervening two and a half decades. Specifically, we will examine a) developments in the methodology for measuring physical fitness in youth, b) contemporary uses of fitness testing in educational settings, c) application of youth fitness testing in public health surveillance, and d) policy applications related to youth fitness. Fundamentally, we will address two questions: How has youth fitness testing evolved over the past 25 years? Is it playing a more productive role in education and public health today than it was in 1989? Because the original article limited its focus to fitness testing in the United States, this article will focus on changes that have occurred in the U.S. The authors recognize, however, that interesting developments have taken place in other countries and regions, including Canada (27), Australia (25), and Europe (26). [ABSTRACT FROM AUTHOR]

Trauma centers provide coordinated specialty care and have been demonstrated to save lives. Many states do not have a comprehensive statewide trauma system. Variable geography, resources, and population distributions present significant challenges to establishing an effective uniform system for pediatric trauma care. We aimed to identify patterns of primary (field) triage and transfer of serious pediatric trauma throughout California. We hypothesized that pediatric primary triage to trauma center care would be positively associated with younger age, increased injury severity, and local emergency medical service (EMS) regions with increased resources. We hypothesized that pediatric trauma transfer would be associated with younger age, increased injury severity, and rural regions with decreased resources. Methods: We conducted a retrospective cohort study of the California Office of Statewide Health Planning and Development emergency department and inpatient discharge data (2005–2015). All patients with serious injury, defined as Injury Severity Score (ISS) >9 were included. Demographic, injury, hospital, and regional characteristics such as distances between patient residence and destination hospitals were tabulated. Univariate and multinomial logit analyses were conducted to analyze individual, hospital, and regional characteristics associated with the outcomes of location of primary triage and transfer. Estimates were converted into predicted probabilities for ease of data interpretation. Results: Primary triage to was to either a pediatric trauma center (37.8%), adult level I/II trauma center (35.0%), adult level III/IV trauma center (1.9%), pediatric non-trauma hospital (3.4%), or an adult non-trauma hospital (21.9%).Younger age, private non-HMO insurance, motor vehicle mechanism, and rural areas were the major factors influencing primary triage to any trauma hospital. Younger age, private non-HMO insurance, higher ISS, fall mechanism, <200 bed hospital, and rural areas were the major factors influencing transfer from a non-trauma hospital to any trauma center. Conclusions: We demonstrate statewide primary triage and transfer patterns for pediatric trauma in a large and varied state. Specifically we identified previously unrecognized individual, hospital, and EMS system associations with pediatric trauma regionalization. Knowledge of these de facto trauma care access patterns has policy and process implications that could improve care for all injured children in need. [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]

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) to classify children with ASD, (2) examine psychometric properties of different ASD classification methods, including the SEED method that incorporates rules for resolving ADI-R and ADOS discordance, and (3) determine whether restricted interests and repetitive behaviors were noted for children who had instrument discordance resolved using ADI-R social and communication scores. Results support the utility of SEED criteria when well-defined groups of children are an important clinical or research outcome. [ABSTRACT FROM AUTHOR]

Recently, the state of California enacted a law requiring radiologists to record the radiation dose that each patient receives for a CT scan. Failure to do so is penalized by law. This law becomes effective in July 2012. By July 2013, every facility that performs CT scans must become accredited by one of three professional groups. This report discusses the role that legislation is playing in the practice of medicine in regard to CT practice. Inherent in this discussion is the assumption that pediatric radiologists know the right dose that a child should receive for a specific clinical indication. But do we really know the answer to this? Compared to the European radiology community, the United States radiology community lags in this regard. This paper defines diagnostic reference levels (DRL) and reviews the history of DRL in the United States compared to that in the European community and the progress by the American College of Radiology's National Radiology Data Registry (NRDR) to establish national registries. The establishment of the first pediatric Quality Improvement Registry in CT Scans in Children (QuIRCC) and its progress to date will be discussed. [ABSTRACT FROM AUTHOR]

In 1994, Stanford University's Exposure Research Group (ERG) conducted its first pilot study to collect micro-level activity time series (MLATS) data for young children. The pilot study involved videotaping four children of farm workers in the Salinas Valley of California and converting their videotaped activities to valuable text files of contact behavior using video-translation techniques. These MLATS are especially useful for describing intermittent dermal (i.e., second-by-second account of surfaces and objects contacted) and non-dietary ingestion (second-by-second account of objects or hands placed in the mouth) contact behavior. Second-by-second records of children contact behavior are amenable to quantitative and statistical analysis and allow for more accurate model estimates of human exposure and dose to environmental contaminants. Activity patterns data for modeling inhalation exposure (i.e., accounts of microenvironments visited) can also be extracted from the MLATS data. Since the pilot study, ERG has collected an immense MLATS data set for 92 children using more developed and refined videotaping and video-translation methodologies. This paper describes all aspects required for the collection of MLATS including: subject recruitment techniques, videotaping and video-translation processes, and potential data analysis. This paper also describes the quality assurance steps employed for these new MLATS projects, including: training, data management, and the application of interobserver and intraobserver agreement during video translation. The discussion of these issues and ERG's experiences in dealing with them can assist other groups in the conduct of research that employs these more quantitative techniques.Journal of Exposure Science and Environmental Epidemiology (2006) 16, 287–298. doi:10.1038/sj.jea.7500459; published online 12 October 2005 [ABSTRACT FROM AUTHOR]

The role of diuretic renography has become central in cases of upper tract dilatation, and in the first paper in this section the difficulties in interpreting results in asymptomatic congenital hydronephrosis are examined. These difficulties and controversies exist despite the presence of guidelines and consensus protocols, probably because renography procedures differ among centres. The authors found that there is a need for renography to be standardized for the optimum value to be obtained from the procedure.There are three papers from Los Angeles which attempt to standardize the measurement of bladder compliance, from both the theoretical and clinical perspective, and which assess the detrusor pressure rise of a normal bladder when filled to capacity.To discuss the main steps of renographic technique and underline some pitfalls related to the acquisition, processing and interpretation of diuretic renography, an important method for guiding the management of asymptomatic congenital hydronephrosis.Despite guidelines and consensus protocols, renographic procedures differ among centres, causing difficulties in comparison and controversy in the interpretation of results. Thus we comprehensively assessed published papers on the subject of diuretic renography.Differential renal function (DRF) is a robust measure provided there is adequate background subtraction. Pitfalls are related to the drawing of regions of interest, particularly in infants, to estimating the interval during which DRF is calculated, and to an adequate signal-to-noise ratio. There is no definition of a‘significant’ reduction in DRF. The classical variables of the diuretic renogram may not allow an estimate of the best drainage. Poor pelvic emptying may be apparent because the bladder is full and because the effect of gravity on drainage is incomplete. Estimating the drainage as residual activity rather than any parameter on the slope might be more adequate, especially if the time of frusemide administration is changed. Renal function and pelvic volume can influence the quality of drainage. Drainage may be better estimated using new tools.Provided the investigation is standardized and potential pitfalls accounted for, the diuretic renogram provides valuable and reproducible quantitative information on DRF and drainage. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic introduced challenges to families with young children with developmental delays. Beyond the widespread concerns surrounding illness, loss of employment and social isolation, caregivers are responsible for overseeing their children's educational and therapeutic programmes at home often without the much needed support of professionals. Method: The present study sought to examine the impact of COVID‐19 in 77 ethnically, linguistically and socioeconomically diverse families with young children with intellectual and developmental disabilities (IDDs) in California and Oregon, who were participating in larger intervention studies. Parents responded to five interview questions about the impact of the pandemic, services for their child, silver linings or positive aspects, coping and their concerns about the long‐term impact of the pandemic. Results: Parents reported that their biggest challenge was being at home caring for their children with the loss of many essential services. Parents reported some positive aspects of the pandemic, especially being together as a family. Although there were positive aspects of the situation, many parents expressed concern about long‐term impacts of the pandemic on their children's development, given the loss of services, education and social engagement opportunities. Conclusion: Results suggest that parents of young children with IDD report significant challenges at home during the pandemic. Professional support, especially during the reopening phases, will be critical to support family well‐being and child developmental outcomes. [ABSTRACT FROM AUTHOR]

Background: As a means to provide safety for a population at great risk of harm through abandonment, every state in the United States now has laws and practices for the safe relinquishment of newborns and infants. However, there is no national database tracking the population of infants surrendered through such programmes, and few states monitor these numbers. The primary aim of this study was therefore to examine the descriptive characteristics of infants who have been safely surrendered in a large, socio‐economically diverse urban area. The secondary aim was to compare them with local population norms to determine whether differences exist and to begin exploring what implications such differences may have for the treatment provided to these infants. Methods: A retrospective cross‐sectional study was conducted among safely surrendered infants. Results: Over half of the infants had medical issues, and the majority of the infants were surrendered in communities characterized by low median income. Conclusions: Preliminary information highlights potential economic, social, and medical risk factors, suggesting that these infants may require increased monitoring and/or specialized care. [ABSTRACT FROM AUTHOR]

Brighton Clark "Bugs" Cain was a naturalist who was professionally active in California (USA) during the 1920s to 1940s. Through the Boy Scouts of America, Cain helped popularize entomology with children, some of whom became famed entomologists. [ABSTRACT FROM AUTHOR]

Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use. Self-report survey data were collected using electronic handheld devices for a school-based randomised trial. The survey sample includes 911 young people (mean age = 12.4 years) representative of their schools. Logistic regressions explored associations between selected sexual behaviours and relationship characteristics. For all participants, having more boy/girlfriends, dating alone, ever touching and ever having had oral sex were associated with an increased likelihood of having vaginal sex. Among young people with current partners, having a partner three or more years older, length of relationship and ever having oral sex were associated with an increased likelihood of having vaginal sex. The study data confirm the importance of accounting for relationships in sexual risk reduction programmes, and provide avenues for enhancing the relevancy of typical school-based prevention programmes. [ABSTRACT FROM PUBLISHER]

Background: This paper outlines conclusions from a three-day workgroup hosting the eight authors as well as others with expertise in the evaluation and treatment of youth exposed to war and violence. Objective: The purpose of this meeting was to bring multiple perspectives together to identify components that comprise effective psychosocial interventions for child victims of war and community violence across cultures. The meeting also sought to identify gaps in the existing treatment approaches. Method: In the meeting, personal experiences and previous research were discussed to develop a wide-ranging intervention approach, determine a cohesive definition for 'indirect' exposure, and identify successful methods of intervention delivery for youth exposed to acts of war and violence. Results and Conclusions: Key components of intervention for youth exposed to war/violence, important outcome measures, and cultural differences that may influence effective intervention were identified. A clearer definition of 'indirect' exposure was also developed. Finally, a nine-phase model was developed to provide guidelines for establishing partnerships between trauma teams and other organizations or schools to implement and disseminate treatment for this population. [ABSTRACT FROM AUTHOR]

A collaborative approach to identify opportunities for interactions between mul- tiple systems is an important model for childhood obesity prevention. This paper describes a process aligning multiple partners in primary care, public health, university research, schools, and community organizations. Jointly implemented strategies in a Latino underserved community included: (1) building an effective and sustainable collaborative team; (2) disseminating a healthy weight message across sectors; (3) assessing weight status and healthy weight plans in primary care, school, and early childhood settings; and (4) implementing policy changes to support healthy eating and physical activity. The process and lessons learned were analyzed so other communities can utilize a systems approach to develop culturally appropriate interventions tailored to a specific community. [ABSTRACT FROM AUTHOR]

This paper is the third in a series of reports on preliminary empirical findings from replications of an integrated system of care for youth suffering from serious emotional disturbance. The development of the innovative .system of care was pioneered in Ventura County, California, and the replications in three other California counties were legislatively enabled through California legislation (Assembly Bill 377). This report presents results on the expenditure and utilization of foster homes, residential placements made through special education programs, and state hospitals. Evaluation results indicate that foster home and state hospital utilization and expenditures are lower for the counties replicating the innovative system of care than for the state of California as a whole. Expenditures for special education residential placements are either at the state rate or lower in one county. The cumulative evidence supports the conclusion that the replication counties are utilizing restrictive levels of care at lower rates than would be expected given state-wide patterns. The results, in conjunction with prior findings, are discussed in the context of questions about the possible fates of youth who no longer live in publicity funded residential facilities. [ABSTRACT FROM AUTHOR]

This paper explores the general nature of income redistribution effects of the financing of public higher education in California. The amount of available subsidy (full cost less student charges) varies dramatically among the three higher education systems—University, State College, and Junior College. Since eligibility for the higher-subsidy institutions is positively related to family income level, and since actual attendance among those eligible increases as family income rises, the result is that the distribution of subsidies actually favors upper income families. These subsidies are then compared with total state and local taxes paid. The results show that families with children enrolled in public higher education receive positive net transfers (subsidy less taxes paid) and that these net transfers are an increasing fraction of average family money income. [ABSTRACT FROM AUTHOR]

This paper describes Mexican American family members' descriptions of perceived discrimination by pediatric health care providers (HCPs) and the families' reactions to the HCPs' discriminatory conduct. A retrospective, grounded theory design guided the overall study. Content analysis of interviews with 13 participants from 11 families who were recruited from two children's hospitals in Northern California resulted in numerous codes and revealed that participants perceived discrimination when they were treated differently from other, usually white, families. They believed they were treated differently because they were Mexican, because they were poor, because of language barriers, or because of their physical appearance. Participants reported feeling hurt, saddened, and confused regarding the differential treatment they received from HCPs who parents perceived 'should care equally for all people.' They struggled to understand and searched for explanations. Few spoke up about unfair treatment or complained about poor quality of care. Most assumed a quiet, passive position, according to their cultural norms of respecting authority figures by being submissive and not questioning them. Participants did not perceive all HCPs as discriminatory; their stories of discrimination derived from encounters with individual nurses or physicians. However, participants were greatly affected by the encounters, which continue to be painful memories. Despite increasing efforts to provide culturally competent palliative care, there is still need for improvement. Providing opportunities for changing HCPs' beliefs and behaviors is essential to developing cultural competence. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a storytelling intervention targeting the oral health beliefs, knowledge, and behaviors of AIAN pregnant women and mothers.Methods: Fifty-three adult AIAN women from three tribal communities in Northern California participated. The intervention story delivered oral health messaging using a traditional storytelling format. The effect of the intervention on self-reported oral health behaviors, dental knowledge, and beliefs was assessed using a pretest-posttest design, with an additional six-month follow-up. Tests of repeated measures using Generalized Linear Models were conducted to assess changes in oral health knowledge, beliefs, and behaviors.Results: Knowledge and beliefs significantly increased as a result of the intervention and persisted after six months. A consistent, significant increase in positive oral health behaviors from baseline to six-months was also observed.Conclusions: The results of this intervention study suggest promise for traditional storytelling to increase oral health-related knowledge, beliefs, and behaviors among self-identified AIAN pregnant women and mothers. [ABSTRACT FROM AUTHOR]

Purpose: Residential mobility is considered as a potential source of confounding in studies assessing environmental exposures, including in studies of electromagnetic field (EMF) exposures and childhood leukemia.Methods: We present a hybrid simulation study where we simulate a synthetic dataset based on an existing study and use it to assess the sensitivity of EMF-leukemia associations to different scenarios of uncontrolled confounding by mobility under two major hypotheses of the infectious etiology of childhood leukemia. We then used the findings to conduct sensitivity analysis and empirically offset the potential bias due to unmeasured mobility in the California Power Line Study dataset.Results: As expected, the stronger the assumed relationship between mobility and exposure and outcome, the greater the potential bias. However, no scenario created a bias strong enough to completely explain away previously observed associations.Conclusions: We conclude that uncontrolled confounding by residential mobility had some impact on the estimated effect of EMF exposures on childhood leukemia, but that it was unlikely to be the primary explanation behind previously observed largely consistent, but unexplained associations. [ABSTRACT FROM AUTHOR]

This study explored the adjustment phase of the resiliency model of family adjustment and adaptation, particularly how stress and food insecurity interact with protective mechanisms to influence children's dietary adjustment. With increasing rates of Hispanic childhood obesity and disproportionate health disparities, this is an issue that must be better understood. Altogether, 137 Mexican immigrant mothers from Illinois and California completed questionnaires reporting their stressors, protective mechanisms, and family health behaviors. Multiple regression analyses revealed that higher perceived stress levels for mothers predicted non-nutritive snacking reasons. Furthermore, mother's dietary patterns predicted child's poor dietary quality. Taken together, maternal stressors play a role in family health behaviors, and future studies should consider household food environment factors when trying to understand protective mechanisms for families. [ABSTRACT FROM AUTHOR]

An enduring question in the cultural study of psychological experience concerns how emotion may play a role in shaping moral aspects of children's lives as they are mentored into socially preferred ways of understanding and responding to the world at hand. This article brings together approaches from psychological and linguistic anthropology to explore how cultural schemas of normativity are communicated, embodied, and enacted as children participate in day-to-day family activities and routines. Illustrative examples emanate from a videotaped corpus of naturalistic interactional data that document the daily lives of 32 ethnically diverse U.S. middle-class families who reside in the Los Angeles, California metropolitan region. The article employs discourse and narrative analysis to examine how children are apprenticed into perceiving, appraising, and reacting to the emotions of self and others as culturally shaped indicators for proper comportment. Data analysis emphasizes how implicit components of caregivers' interactions with children (i.e., gesture, gaze, facial expression) intertwine with explicit, verbal communication to constitute intricately layered affective messages that shape the evaluative frames through which children interpret, display, and respond to emotions. The article identifies two culturally salient childrearing practices, "pep talks" and "time outs," that apprentice children into moral accountable relationships with others by encouraging them to manage their emotions in culturally preferred ways. Study findings suggest that parental communications conveying praise and approval—or conversely indexing disapproval—toward children are emotionally resonant motivational practices in this cultural milieu as children are mentored into culturally meaningful emotional management techniques. The article highlights how children actively employ semiotic socio-communicative resources and it closely traces their sense-making processes in tandem with their discursive contributions to the moment-by-moment interaction. It argues that emotion, morality, and interpersonal relations are critical in shaping children's acquisition of consensually validated ways of perceiving, feeling, and responding to the phenomena they encounter in their day-to-day lives. This perspective aims toward contextualized understandings that render plausible connections between local contexts of everyday action and broader macro-level discourses and master narratives, such as those associated with a neo-liberal emphasis on cultivating citizens who learn to regulate their emotions on behalf of self and others. [ABSTRACT FROM AUTHOR]

Objectives: The objective was to determine whether children surviving to hospital discharge after firearm assault (FA) and nonfirearm assault (NFA) are at increased risk of mortality relative to survivors of unintentional trauma (UT). Secondarily, the objective was to elucidate the factors associated with long‐term mortality after pediatric trauma. Methods: This was a multicenter, retrospective cohort study of pediatric patients aged 0 to 16 years who presented to the three trauma centers in San Francisco and Alameda counties, California, between January 2000 and December 2009 after 1) FA, 2) NFA, and 3) UT. The Social Security Death Master File and the California Department of Public Health Vital Statistics (2000–2014) were queried through December 31, 2014, to identify those who died after surviving their initial hospitalization and to delineate cause of death. Multivariate Cox proportional hazards regression was performed to determine associations between exposure to assault and long‐term mortality. Results: We analyzed 413 FA, 405 NFA, and 7,062 UT patients who survived their index hospital visit. A total of 75 deaths occurred, including 3.9, 3.2, and 0.7% of each cohort, respectively. Two‐thirds of all long‐term deaths were due to homicide. After multivariate adjustment, adolescent age, male sex, black race/ethnicity, and public insurance were independent risk factors for long‐term mortality. FA (adjusted hazard ratio [AHR] = 1.8, 95% confidence interval [CI] = 0.82–4.0) and NFA (AHR = 1.9, 95% CI = 0.93–3.9) did not convey a statistically significant difference in risk of long‐term mortality compared to UT. Being assaulted by any means (with or without a firearm), however, was an independent risk factor for long‐term mortality in the full study population (AHR = 1.9, 95% CI = 1.01–3.4) and among adolescents (AHR = 1.9, 95% CI = 1.01–3.6). Conclusion: Children and adolescents who survive assault, including by firearm, have increased long‐term mortality compared to those who survive unintentional, nonviolent trauma. [ABSTRACT FROM AUTHOR]

Family, friend and neighbor (FFN) child caregivers represent a significant proportion of caregivers for young children. Yet, these caregivers receive little support for their services. In 2003, the First 5 California Children and Families Commission (First 5 California) began a study to determine the work-related needs of FFN caregivers in California. This paper reports on the results of all study activities, including focus groups and interviews with caregivers and parents. It details the specific needs related to licensing, materials and equipment, education and training, and support systems that were identified by FFN caregivers, parents, and other stakeholders as being important to improve the quality and working conditions of FFN care. It also discusses needs of agencies that provide services to FFN caregivers, including awareness of and knowledge about the population, funding and other resources, and professional development topics. [ABSTRACT FROM AUTHOR]

The LAUSD is the largest school district in the State and is charged with the responsibility of educating over one-fifth of the children in California. Taken individually, each of the LAUSD's eleven local districts would rank in the top twenty in the State in terms of student population. The District is LA County's second largest employer, and with an annual operating and capital budget of over nine billion dollars, it brings together a diverse range of active and dynamic stakeholders. In 2000 the LAUSD found itself at a crossroads. In response to growing criticism and the threat of a State-mandated break-up due to the poor performance of their schools, the District created eleven mini-districts to improve accountability and take instructional programs closer to the people who use them. This paper provides background on the LAUSD's decentralization effort and power sharing aspects of the District's self-imposed break-up, and recommendations for addressing these issues are postulated. [ABSTRACT FROM AUTHOR]

The California legislature enacted a law requiring the California Environmental Protection Agency (Cal/EPA) Office of Environmental Health Hazard Assessment (OEHHA) to evaluate whether our risk assessment methodologies are adequately protective of infants and children. In addition both OEHHA and the California Air Resources Board must examine whether the Ambient Air Quality Standards set for criteria air pollutants and the health values developed for air toxics are adequately protective of infants and children. We have initiated a program to look at potential differences in response to toxicants between children and adults. We are evaluating this issue from the perspective of exposure differences as well as toxicokinetic and toxicodynamic differences between children and adults. Data on specific chemicals are rather limited. As a result, we will be pooling information to determine whether there are generic differences between children and adults that may be applicable to risk assessment in general or to risk assessment of specific classes of compounds. This paper discusses the rationale for approaching the issue of determining whether our risk assessment methods are adequate for infants and children and includes a discussion of some of the available information on both qualitative and quantitative differences in response to toxicants between children and adults or immature and mature laboratory animals. We provide examples of differences between children and adults in absorption, metabolism, and excretion of toxicants as well as qualitative differences in toxic response. [ABSTRACT FROM AUTHOR]

The precise quantitation of smoking during pregnancy is difficult in retrospective studies. Routinely collected blood specimens from newborns, stored as dried blood spots, may provide a low-cost method to objectively measure maternal smoking close to the time of delivery. This article compares cotinine levels in dried blood spots to those in umbilical cord blood to assess cotinine in dried blood spots as a biomarker of maternal smoking close to the time of delivery. The California Genetic Disease Screening Program provided dried blood spots from 428 newborns delivered in 2001–2003 with known umbilical cord blood cotinine levels. Cotinine in dried blood spots was measured in 6.35­-mm punches by using liquid chromatography­–tandem mass spectrometry (quantitation limit, 3.1 ng/mL). Repeated measures of cotinine in dried blood spots were highly correlated (R2 = 0.99, P < 0.001) among 100 dried blood spots with cotinine quantitated in 2 separate punches. Linear regression revealed that cotinine levels in dried blood spots were slightly lower than those in umbilical cord blood and predicted umbilical cord blood cotinine levels well (β = 0.95, R2 = 0.80, and P < 0.001 for both cotinine levels in log10 scale). When defining active smoking as a cotinine level of 10 ng/mL or more and using umbilical cord blood cotinine as the criterion standard, we found that measurements of cotinine in dried blood spots had high sensitivity (92.3%) and specificity (99.7%) in the prediction of maternal active smoking. Cotinine levels in dried blood spots are an accurate biomarker of maternal smoking close to the time of delivery. [ABSTRACT FROM PUBLISHER]