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The Town Hall Meeting (THM) program at California State University, Fullerton has been annually incorporated into several Introduction to American Politics course sections since 2011, to improve academic performance and promote civic engagement among enrolled students. This article provides a detailed analysis of results from a 2017 quasi-experimental study of the program designed to overcome methodological challenges in earlier studies, using close-ended and open-ended surveys and institutional research data on student demographics and academic performance. The research finds that the THM program successfully increases students' political knowledge, political efficacy, and interest in political engagement and that it does so through the critically important and mediating variable of students' sense of a strong classroom community. This suggests that Introduction to American Government courses that build communal connections in the classroom can more successfully engage students politically.

Educators have sought to understand and address the disproportional representation of students from certain student subgroups in gifted education. Most gifted identification decisions are made with national comparisons where students must score above a certain percentage of test takers. However, this approach is not always consistent with the overall goal of gifted education. Scholars have long argued for the use of local normative criteria to increase the diversity of students identified for gifted services, and although some districts across the country have applied such recommendations, little research has been carried out. In this study, we use a large data set to assess the extent to which identifying gifted students with either school-level norms or a combination of national and school-level norms would improve gifted education representation rates for students who are from African American and Latinx families. A preprint of this registered report and this project's preregistration documentation are available at https://osf.io/z2egy/.

Few topics have garnered more attention in preservice teacher training and educational reform than student diversity and its influence on learning. However, the actual degree of cognitive diversity has yet to be considered regarding instructional implications for advanced learners. We used four data sets (three state-level and one national) from diverse contexts to evaluate how many students perform above grade level in English Language Arts and mathematics. Results revealed that among American elementary and middle school students, 20% to 49% in English Language Arts and 14% to 37% in mathematics scored 1 year or more above grade level. We address what these findings imply for K-12 schools, grouping decisions, and educational policies that strive to foster advanced abilities.

Determining the amount of heat units required to kill weed seeds is a crucial aspect for the success of weed control through soil solarization. Lab experiments were designed to determine the duration of exposure for weed seeds that is required to suppress germination at temperatures (40, 45, 50, 55, and 60 °C) in the range of those typically achieved during soil solarization in California. The species tested were annual sowthistle (Sonchus oleraceus L.), bristly oxtongue (Picris echioides L.), nettleleaf goosefoot (Chenopodium murale L.), redroot pigweed (Amaranthus retroflexus L.), common purslane (Portulaca oleracea L.), little mallow (Malva parviflora L.), and redstem filaree (Erodium cicutarium L.). Germination tests were performed to assess the germinability of the weed seeds. The germination suppression by the lab-simulated solarization temperatures differed among the species based on their seasonality. The cool-season annuals S. oleraceus and P. echioides were more susceptible to the heat treatments than the warm-season annuals P. oleracea, A. retroflexus, and C. murale. The hard-seeded weed species M. parviflora and E. cicutarium were the least susceptible to the heat treatments. The germination rates of S. oleraceus, P. echioides, and C. murale were reduced at all of the temperatures that were tested. The germination rates for A. retroflexus and M. parviflora were not affected by temperatures below 40 °C. The germination rates for P. oleracea were not affected by temperature below 45 °C and the germination of E. cicutarium was not affected by any of the temperatures that were tested. The duration (hours) of exposure and percent of germination suppression of the weed seeds were used to create thermal-time hazard models for weed seeds using logistic regression. [ABSTRACT FROM AUTHOR]

While community colleges serve as a postsecondary entry point for many "at-risk" students, not many who enroll will be ready or able to participate in college level courses on entry. Statistically, large numbers of community college students require college remediation, and only a handful are able to successfully emerge from the remediation pipeline. Many students find mathematics the most challenging course sequence and frequently report high levels of math anxiety and lower completion rates. Using population data from a large urban district in a western state, this study examined the impact of course grades on subsequent grades within math courses. (Contains 7 tables and 2 figures.)

Explores a service-learning program at a university attempting to develop a service-learning minor. This article examines the effect of the program on students and the university community. The qualitative data were gathered from 25 students over a period from December 2001 to December 2002. The results demonstrate that students in a comprehensive service-learning program became a strong community, developed leadership roles and skills, and increased their understanding of diversity. (SWM)

CRISPR technology has made questions about how best to regulate human genome editing immediately relevant. A sound and ethical governance structure for human genome editing is necessary, as the consequences of this new technology are far-reaching and profound. Because there are currently many risks associated with genome editing technology, the extent of which are unknown, regulatory prudence is ideal. When considering how best to create a prudent governance scheme, we can look to 2 guiding examples: the Asilomar conference of 1975 and the German Ethics Council guidelines for human germline intervention. Both models offer a path towards prudent regulation in the face of unknown and significant risks. [ABSTRACT FROM AUTHOR]

Objective. To characterize bedtime routines (BR) and associations between reading at bedtime and sleep behaviors in a sample of Latino preschoolers. Methods: A convenience sample of Latino parents of a 4-year-old child completed standardized questionnaires assessing BRs, bedtime reading frequency and other sleep variables. Family demographics and home environment were also assessed. Results. Parents of 62 children completed questionnaires. A consistent BR was reported by 48%. Frequent reading at bedtime was reported in 42%. After controlling for key confounders, reading at bedtime was significantly associated with longer total nighttime sleep (P < .01), but not with other sleep behaviors. Conclusion. Reading at bedtime was significantly associated with longer total nighttime sleep duration. This, together with the relatively low frequency of reading found in this sample, suggests that interventions aimed at increasing reading at bedtime among Latino preschoolers may improve overall sleep health. [ABSTRACT FROM AUTHOR]

The article focuses on the Alexander v. FedEx Ground Package System Inc. of Ninth Circuit Court of Appeals of the U.S. in which the court ruled that the FedEx should have designated the drivers as employees. Topics discussed include operating agreement of courier services firm FedEx with its drivers, filing a lawsuit at California Superior Court by a number of drivers of the firm in connection with misclassification of the drivers and the entrepreneurial-opportunity test by the circuit court.

Biodiversity conservation in an era of global change and scarce funding benefits from approaches that simultaneously solve multiple problems. Here, we discuss conservation management of the island scrub-jay (Aphelocoma insularis), the only island-endemic passerine species in the continental United States, which is currently restricted to 250-square-kilometer Santa Cruz Island, California. Although the species is not listed as threatened by state or federal agencies, its viability is nonetheless threatened on multiple fronts. We discuss management actions that could reduce extinction risk, including vaccination, captive propagation, biosecurity measures, and establishing a second free-living population on a neighboring island. Establishing a second population on Santa Rosa Island may have the added benefit of accelerating the restoration and enhancing the resilience of that island's currently highly degraded ecosystem. The proactive management framework for island scrub-jays presented here illustrates how strategies for species protection, ecosystem restoration, and adaptation to and mitigation of climate change can converge into an integrated solution. [ABSTRACT FROM AUTHOR]

The article discusses the findings of the study concerning the Red-shouldered Hawks involving the banding of nestlings and the analysis of the subsequent recovery from the Bird Banding Laboratory in California. The findings reveal that the Red-shouldered Hawks which were recovered consist of short-distance dispensers and long-term-dispensers. These long-term dispensers were identified as vagrants and were spotted at their banding locations in Great Basin, Mojave, and Vizcaino deserts.

The incidence and prevalence of older adults living with HIV infection is increasing. Recent reports of increased neuropathologic and metabolic alterations in older HIV+ samples, including increased cortical beta-amyloid, have led some researchers to suggest that aging with HIV may produce a neuropsychological profile akin to that which is observed in 'cortical' dementias (e.g., impairment in memory consolidation). To evaluate this possibility, we examined four groups classified by HIV serostatus and age (i.e., younger ≤40 years and older ≥50 years): (1) Younger HIV− ( n = 24); (2) Younger HIV+ ( n = 24); (3) Older HIV− ( n = 20); and (4) Older HIV+ ( n = 48). Main effects of aging were observed on episodic learning and memory, executive functions, and visuoconstruction, and main effects of HIV were observed on measures of verbal learning and memory. The interaction of age and HIV was observed on a measure of verbal recognition memory, which post hoc analyses showed to be exclusively attributed to the superior performance of the younger HIV seronegative group. Thus, in this sample of older HIV-infected individuals, the combined effects of HIV and aging do not appear to result in a 'cortical' pattern of cognitive deficits. [ABSTRACT FROM AUTHOR]

The article examines the court's analysis of California Penal Code Section 422 in cases which involve threatening hand gestures of deaf and hard of hearing people in the U.S. It notes the need to interpret the Penal Code Section 422 to reach threatening American Sign Language (ASL). It also notes the need of American jurisdictions to make sure that their criminal laws will be able to reach threats in sign language.

Background: The incidence of testicular germ cell tumors (TGCT) is increasing steadily in the United States, particularly among Latinos. TGCT is thought to be initiated in utero and exposure to endocrine-disrupting chemicals, suspected contributors to TGCT pathogenesis, during this critical developmental period may contribute to the rise.Objectives: To assess the relationship between fetal exposure to agricultural endocrine-disrupting pesticides (EDPs) and TGCT risk among adolescents in a diverse population in California.Methods: We conducted a registry-based case-control study of TGCT. Cases, diagnosed between 1997 and 2011, were 15-19 years of age (n = 381). Controls were matched on birth year and race/ethnicity (n = 762). Quantities (kilograms) of 33 pesticides applied within 3 km and 1 km radii of each individual's address before birth were estimated using the Pesticide Use Reporting database. Odds ratios (OR), 95% confidence intervals (CI), and population attributable risk (PAR) were calculated for each EDP (using log-2 transformed values). Risk models considered race/ethnicity, birth year, and neighborhood socioeconomic status.Results: A doubling of nearby acephate applications (3 km and 1 km radii) and malathion applications (1 km radius) was associated with increased risks of TGCT among Latinos only (OR = 1.09; 95% CI:1.01-1.17; 1.30; 95% CI:1.08-1.57, and 1.19; 95% CI:1.01-1.39, respectively), whereas application of carbaryl within a 3 km radius increased TGCT risk in non-Latinos only (OR = 1.14, 95% CI:1.01-1.28). We estimate that acephate was associated with approximately 10% of the TGCT PAR, malathion with 3% and carbaryl with 1%.Conclusions: TGCT among adolescents in California was associated with prenatal residential proximity to acephate and malathion among Latinos, and with carbaryl among non-Latinos. These results suggest that the rise in TGCT risk among Latinos may be associated with exposure to these pesticides. [ABSTRACT FROM AUTHOR]

Provides information on a California Supreme Court decision concerning the use of noncompete agreements which is well known to most employment law professionals. Hostility of California courts toward the use of contractual noncompete provisions; Way in which the noncompete provision in the state has been enforced; Scope of the California law on unfair competition.

Provides information on the Community-Based Education program (CBE) of a local school district in California for transition students with disabilities. Goals of the program; Roles of the Department of Kinesiology and Health Science at California State University in Sacramento and a local community college with regard to the program; Details on the efforts of the district to form partnerships in order to mobilize the program; Background on the formation of the CBE program.

A letter to the editor and a reply are presented in response to the article "California Told to 'Manage Drought With One Hand Behind Your Back!'" by David LaFrance in the September 2015 issue.

• Workplace charging is a major driver of the pattern of use of infrastructure. • Female and older PEV owners prefer home over non-home charging locations. • Non-home charging is important for PEV owners in multi-unit dwellings. • Owners of long- and short-range BEVs have different mixed use of infrastructure. • Commute distance is an important factor explaining charging behavior of PHEV owners. This paper examines the charging behavior of 7,979 plug-in electric vehicle (PEV) owners in California. The study investigates where people charge be it at home, at work, or at public location, and the level of charging they use including level 1, level 2, or DC fast charging. While plug-in behavior can differ among PEV owners based on their travel patterns, preferences, and access to infrastructure studies often make generalizations about charging behavior. In this study, we explore differences in charging behavior among different types of PEV owners based on their use of charging locations and levels, we then identify factors associated with PEV owner's choice of charging location and charging level. We identified socio-demographic (gender and age), vehicle characteristics, commute behavior, and workplace charging availability as significant factors related to the choice of charging location. [ABSTRACT FROM AUTHOR]

California has experienced enhanced extreme wildfire behaviour in recent years 1-3 , leading to substantial loss of life and property 4,5 . Some portion of the change in wildfire behaviour is attributable to anthropogenic climate warming, but formally quantifying this contribution is difficult because of numerous confounding factors 6,7 and because wildfires are below the grid scale of global climate models. Here we use machine learning to quantify empirical relationships between temperature (as well as the influence of temperature on aridity) and the risk of extreme daily wildfire growth (>10,000 acres) in California and find that the influence of temperature on the risk is primarily mediated through its influence on fuel moisture. We use the uncovered relationships to estimate the changes in extreme daily wildfire growth risk under anthropogenic warming by subjecting historical fires from 2003 to 2020 to differing background climatological temperatures and aridity conditions. We find that the influence of anthropogenic warming on the risk of extreme daily wildfire growth varies appreciably on a fire-by-fire and day-by-day basis, depending on whether or not climate warming pushes conditions over certain thresholds of aridity, such as 1.5 kPa of vapour-pressure deficit and 10% dead fuel moisture. So far, anthropogenic warming has enhanced the aggregate expected frequency of extreme daily wildfire growth by 25% (5-95 range of 14-36%), on average, relative to preindustrial conditions. But for some fires, there was approximately no change, and for other fires, the enhancement has been as much as 461%. When historical fires are subjected to a range of projected end-of-century conditions, the aggregate expected frequency of extreme daily wildfire growth events increases by 59% (5-95 range of 47-71%) under a low SSP1-2.6 emissions scenario compared with an increase of 172% (5-95 range of 156-188%) under a very high SSP5-8.5 emissions scenario, relative to preindustrial conditions., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Objectives: Our objective was to provide data contrasting commercial tobacco retailing in Tribal versus non-Tribal jurisdictions, in 3 states. These data may be relevant for US Food and Drug Administration regulation of Tribal retailing. Methods: With Tribal permission, observations were made on commercial tobacco advertising, product variety, pricing, and retail concept for stores within and just outside Tribal jurisdictions in areas of Arizona (AZ), California (CA), and Oklahoma (OK). Results: A total of 87 Tribal (20 AZ, 53 CA, 14 OK) and 67 (10, 43, 14) non-Tribal retailer visits were completed. There was substantial variation across tribes, with sales in AZ and most CA Tribal jurisdictions handled at convenience stores, whereas OK Tribal retailing was done mostly in specialized tobacco-specialty shops. Electronic cigarettes were ubiquitous across Tribal and non-Tribal outlets. Advertising and breadth of cigarette offerings was most extensive in the tobacco specialty retailers of Tribal OK. Surprisingly, Tribally manufactured cigarettes were found only at some CA Tribal retailers. Conclusions: Some Tribal commercial tobacco outlets actually price above their non-Tribal competitors and there is substantial variation in retailing strategy across Tribal jurisdictions. Tribal governments can continue to evaluate and reform commercial tobacco retailing so as to improve Tribal health.

Limited data are available on the clinical presentation and outcomes of coronavirus disease (COVID-19) patients in the United States hospitalized under normal-caseload or nonsurge conditions. We retrospectively studied 72 consecutive adult patients hospitalized with COVID-19 in 2 hospitals in the San Francisco Bay area, California, USA, during March 13-April 11, 2020. The death rate for all hospitalized COVID-19 patients was 8.3%, and median length of hospitalization was 7.5 days. Of the 21 (29% of total) intensive care unit patients, 3 (14.3% died); median length of intensive care unit stay was 12 days. Of the 72 patients, 43 (59.7%) had underlying cardiovascular disease and 19 (26.4%) had underlying pulmonary disease. In this study, death rates were lower than those reported from regions of the United States experiencing a high volume of COVID-19 patients.

The global spread of the fungal pathogen Batrachochytrium dendrobatidis (Bd) has led to widespread extirpation of amphibian populations. During an intervention aimed at stabilizing at-risk populations, we treated wild-caught Cascades frogs Rana cascadae with the antifungal drug itraconazole. In fall 2012, we collected 60 recently metamorphosed R. cascadae from 1 of the 11 remnant populations in the Cascades Mountains (CA, USA). Of these, 30 randomly selected frogs were treated with itraconazole and the other 30 frogs served as experimental controls; all were released at the capture site. Bd prevalence was low at the time of treatment and did not differ between treated frogs and controls immediately following treatment. Following release, Bd prevalence gradually increased in controls but not in treated frogs, with noticeable (but still non-significant) differences 3 wk after treatment (27% [4/15] vs. 0% [0/13]) and strong differences 5 wk after treatment (67% [8/12] vs. 13% [1/8]). We did not detect any differences in Bd prevalence and load between experimental controls and untreated wild frogs during this time period. In spring 2013, we recaptured 7 treated frogs but none of the experimental control frogs, suggesting that over-winter survival was higher for treated frogs. The itraconazole treatment did appear to reduce growth rates: treated frogs weighed 22% less than control frogs 3 wk after treatment (0.7 vs. 0.9 g) and were 9% shorter than control frogs 5 wk after treatment (18.4 vs. 20.2 mm). However, for critically small populations, increased survival of the most at-risk life stage could prevent or delay extinction. Our results show that itraconazole treatment can be effective against Bd infection in wild amphibians, and therefore the beneficial effects on survivorship may outweigh the detrimental effects on growth.

Vector and host abundance affect infection transmission rates, prevalence, and persistence in communities. Biological diversity in hosts and vectors may provide "rescue" hosts which buffer against pathogen extinction and "dilution" hosts which reduce the force of infection in communities. Anaplasma phagocytophilum is a tick-transmitted zoonotic pathogen that circulates in small mammal and tick communities characterized by varying levels of biological diversity. We examined the prevalence of A. phagocytophilum in Ixodes spp. ticks in 11 communities in northern and central California. A total of 1020 ticks of 8 species was evaluated. Five percent of ticks (5 species) were PCR-positive, with the highest prevalence (6-7%) in I. pacificus and I. ochotonae. In most species, adults had a higher prevalence than nymphs or larvae. PCR prevalence varied between 0% and 40% across sites; the infection probability in ticks increased with infestation load and prevalence in small mammals, but not tick species richness, diversity, evenness, or small mammal species richness. No particular tick species was likely to "rescue" infection in the community; rather the risk of A. phagocytophilum infection is related to exposure to particular tick species and life stages, and overall tick abundance., (Copyright © 2014 Elsevier GmbH. All rights reserved.)

Amphibians are experiencing global declines due in part to the infectious disease chytridiomycosis. Some symbiotic bacteria residents on frog skin have been shown to inhibit the growth of Batrachochytrium dendrobatitis (Bd) but few studies have attempted to fully describe the resident bacterial flora of frog skin. We cultured and sequenced 130 bacterial isolates from frogs collected from the California Klamath Range, recovering predominantly Gram-negative bacteria from 20 higher order taxa and 31 genera. There were also a large number of unclassifiable isolates. Forty-three isolates were assessed for their ability to inhibit the growth of Bd in vitro; of these, two had strong and three had slight anti-Bd activity. We suggest that many bacterial species may play a secondary role in Bd resistance, acting synergistically with inhibitory species. Future research is required in order to characterize these interactions. Understanding the relationships between bacterial strains may be important in predicting and managing the effects of future anti-Bd treatments such as antimicrobial compounds or probiotic bacteria., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The objective was to investigate the potential of using fatty acid and mineral compositions of sturgeon eggs to distinguish their source, either farm-raised or wild fish. Trafficking of illegally obtained wild white sturgeon eggs is a major concern to the California Department of Fish and Game, but there is no forensic method to separate wild and farm-raised white sturgeon eggs. The extension of these findings in future work will be to use the fatty acid and mineral compositions as forensic indicators of caviar produced legally from farm raised sturgeon compared with illegal caviar produced from sturgeon poached from the wild. Samples (10) of sturgeon eggs were collected from a commercial aquaculture facility in the Sacramento Valley. Eggs from wild sturgeon (9) were obtained primarily from confiscations of illegally caught sturgeon by fish and game law enforcement personnel. The total lipid content of sturgeon eggs was analyzed for fatty acid composition. The most notable difference was the higher concentration (P<0.001) of C18:2n6 in farm raised eggs (6.5 mg/100g total lipid) than wild eggs (0.6 mg/100g total lipid) while other differences between fatty acids were smaller. Eicosapentaenoic acid (C20:5n3) was higher (P<0.02) in farm-raised (5.56 mg/100g) than wild (4.49 mg/100g). Docosahexaenoic acid (C22:6n3), C18:1 cis 9&10, and C20:4n6 were not different for origin of the eggs. Concentration of selenium was markedly higher (P<0.001) in eggs from wild sturgeon (10.0 mg/kg dry weight) than farm-raised sturgeon (2.7 mg/kg dry weight). Concentrations of iron, zinc, copper, phosphorus, sulfur, calcium, and potassium did not differ between farm-raised and wild eggs. Arsenic concentration in wild eggs was 3.3mg/kg dry weight whereas arsenic was not detected in the farm-raised eggs. Fatty acid and mineral compositions of eggs differed significantly between farm-raised and wild sturgeon and these should be investigated further as biological markers for forensic identification of caviar origin., (Copyright © 2013. Published by Elsevier Ireland Ltd.)

Family based behavioral treatment for overweight and obese children includes parenting skills targeting the modification of child eating and activity change. The purpose of this study was to examine parenting skills and parent weight change as predictors of child weight change in a sample of 80 parent/child dyads who were enrolled in a family based behavioral weight loss program for childhood obesity. Eighty overweight and obese children and their parents who enrolled in treatment in two sites were included in the study. Variables included those related to parent modeling (parent BMI), home food environment, parenting (parent and child report), and demographics. Results suggested that parent BMI change was a significant predictor of child weight, in that a reduction of 1 BMI unit in the parent was associated with a 0.255 reduction in child BMI. None of the other variables were significant in the final model. This study is consistent with other research showing that parent weight change is a key contributor to child weight change in behavioral treatment for childhood obesity. Researchers and clinicians should focus on encouraging parents to lose weight to assist their overweight and obese child in weight management.

Background: Gowers' sign is a screening test for muscle weakness, typically seen in Duchenne muscular dystrophy but also seen in numerous other conditions. The mildest presentations and the variations of Gowers' sign are poorly described in the literature but are important to recognize to help with early diagnosis of a neuromuscular problem., Questions/purposes: We therefore (1) defined the characteristics of the mildest forms and the compensatory mechanism used, (2) categorized the spectrum of this sign as seen in various neuromuscular diseases, and (3) provide educational videos for clinicians., Methods: We videotaped 33 patients with Gowers' sign and three healthy children. Weakness was categorized as: mild = prolonged or rise using single-hand action; moderate = forming prone crawl position and using one or two hands on thigh; severe = more than two thigh maneuvers, rising with additional aid, or unable to rise., Results: The earliest changes were exaggerated torso flexion, wide base, and equinus posturing, which reduce hip extension moment, keep forces anterior to the knee, and improve balance. Patients with moderate weakness have wide hip abduction, shifts in pelvic tilt, and lordosis, which reduce knee extension moment, improve hamstrings moment arm, and aide truncal extension. The classic Gowers' sign (severe) exaggerates all mechanisms., Conclusions: The classically described Gowers' sign is usually a late finding. However more subtle forms of Gowers' sign including mild hand pressure against the thigh and prone crawl position should be recognized by clinicians to initiate additional diagnostic tests.

Objectives: To evaluate the impact of student pharmacists delivering medication therapy management (MTM) services during an elective advanced pharmacy practice experience (APPE)., Methods: Student pharmacists provided MTM services at community pharmacy APPE sites, documented their recommendations, and then made follow-up telephone calls to patients to determine the impact of the MTM provided. Students were surveyed about the MTM experience., Results: Forty-seven students provided MTM services to 509 patients over 2 years and identified 704 drug-related problems (average of 1.4 problems per patient). About 53% of patients relayed the recommendations to their physician and 205 (75%) physicians accepted the recommendations. Eighty-eight percent of patients reported feeling better about their medications after receiving MTM services. A majority of the students perceived their provision of MTM services as valuable to their patients., Conclusions: Providing MTM services to patients in a pharmacy practice setting allowed student pharmacists to apply skills learned in the doctor of pharmacy (PharmD) curriculum.

Objectives: We estimated the relative rate of highly credible gastrointestinal illness (HCGI) per year associated with active versus sham household water filtration devices among older adults in a community receiving tap water meeting current US standards., Methods: We conducted a randomized, triple-blinded, crossover trial in 714 households (988 individuals), which used active and sham water filtration devices for 6 months each. We estimated the annual incidence rate ratio of HCGI episodes and the longitudinal prevalence ratio of HCGI days at population and individual levels with a generalized estimating equation (GEE) and generalized linear mixed models (GLMMs), respectively, adjusted for covariates associated with outcome., Results: The incidence rate ratios (active versus sham) were 0.88 (95% confidence interval [CI] = 0.77, 1.00) and 0.85 (95% CI = 0.76, 0.94) HCGI episodes per year estimated by GEE and GLMM models, respectively. The corresponding longitudinal prevalence ratios were 0.88 (95% CI = 0.74, 1.05) and 0.84 (95% CI = 0.78, 0.90) HCGI days per person per year., Conclusions: We observed reductions in population- and individual-level measures of HCGI associated with use of the active filtration device. These findings suggest the need for further research on the impact of drinking water on the health of sensitive subpopulations.

Background: In May 2002, a Mycobacterium bovis outbreak occurred among cattle at a California dairy. We investigated to determine whether persons were infected after working with the cattle or drinking their raw milk., Methods: We identified persons with potential contact with infected cattle, including dairy workers, their family members, and slaughterhouse workers. Persons were given a tuberculin skin test (TST), and their occupational and milk-drinking habits were recorded., Results: Of 88 potential contacts, 78 (90%) were given a TST; 33 (43%) had positive TST results, of whom 32 were Mexican-born (RR 15.8, 95%CI 2.3-108.8). No persons had active tuberculosis. Eighteen (72%) dairy workers, 11 (27%) family members, and four (33%) slaughterhouse workers had positive TST results. After adjusting for Mexican-birth and age, dairy workers were no more likely to have positive TST results than others (adjusted RR 1.2, 95%CI 0.6-2.1). Forty-one (62%) dairy staff and their family members drank raw milk from the dairy; 21 (51%) had positive TST results and were Mexican-born. All 13 US-born raw milk drinkers had negative TST results., Conclusion: A high prevalence of positive TST results was documented among workers at the affected dairy, although results were not independently associated with contact with infected cattle or milk products. Further assessment of California dairy workers should be considered.

Objective: This study investigates whether binge eating disorder (BED) in obese individuals is associated with a greater degree of impairment in quality of life (QOL) than obesity alone., Method: Treatment-seeking obese individuals with and without BED were compared on QOL scores using the Impact of Weight on Quality of Life (IWQOL-Lite) questionnaire., Results: With the exception of the Physical Function subscale, obese individuals with BED scored significantly higher than non-BED participants on each of the subscales and on the total scale of the IWQOL-Lite. For all participants, body mass index (BMI) was related significantly to scores on the Physical Function and Public Distress subscales of the IWQOL-Lite., Discussion: Obese individuals with BED have impaired functioning on psychosocial aspects of QOL in addition to poorer physical functioning associated with obesity. These findings underscore the pervasive impact of BED in obese individuals, as BED is associated with more impairment than obesity alone., (2005 by Wiley Periodicals, Inc.)

The Centers for Disease Control and Prevention established the US National Tuberculosis Genotyping and Surveillance Network to study the utility of genotyping Mycobacterium tuberculosis isolates for prevention and control. From 1998 to 2000, four sites performed conventional contact investigations and epidemiologic investigations of cases with genotypically matched M. tuberculosis isolates, called cluster investigations. The authors compared cluster pairs (two cases with M. tuberculosis isolates having identical genotypes) whose epidemiologic linkages were discovered only during cluster investigation with those whose epidemiologic linkages were discovered during conventional contact investigation. Among the 2,141 reported culture-positive tuberculosis cases, 2,055 (96%) M. tuberculosis isolates were genotyped. By itself and at a minimum, cluster investigation added 43 (38%) of the 113 total epidemiologic linkages discovered. Of the epidemiologic linkages discovered during conventional contact investigation, 29% of tuberculosis case pairs were not supported by genotyping data. The linkages discovered only during cluster investigation were more likely discovered in nontraditional settings and relationships and among larger clusters (cluster size of >5: adjusted odds ratio = 57.6, 95% confidence interval: 31.8, 104.6). Information gained from genotyping M. tuberculosis isolates should initiate cluster investigations of tuberculosis cases not previously discovered as being epidemiologically linked during conventional contact investigation. Cluster investigations will play a crucial role in predicting recent tuberculosis transmission more accurately, as we move toward tuberculosis elimination in the United States.

Purpose: Antiretroviral therapy is being increasingly delayed until later stages of illness. Therefore, prior to prescribing HAART, providers are emphasizing the need for patients to be ready to adhere well to the treatment regimen. Unfortunately, providers are no better than chance at predicting a patient's adherence, and there are no established methods for accurately assessing a patient's adherence readiness. This pilot study assessed the utility of a series of up to five 1-week placebo practice trials accompanied by adherence counseling as a clinical tool to both assess and improve adherence readiness., Method: Participants were not prescribed treatment until they demonstrated readiness, which was defined as 90+% adherence during a single practice trial. Once HAART was initiated, adherence to one selected antiretroviral was monitored for 4 weeks. Electronic monitoring caps were used to measure adherence., Results: Twenty men enrolled in the study at two HIV outpatient clinics in Southern California. Mean age was 33, 50% were non-White, 35% were employed, 30% had not completed high school, 15% were Spanish monolingual, and 30% had unstable housing. Nine participants achieved 90+% adherence in the first practice trial, with an additional 8 participants demonstrating readiness after two to four practice trials; two participants withdrew from the study because of intolerance of the restrictions related to the use of the caps; and one participant was removed from the study after no effort was given during two practice trials. Of the 17 participants who completed the program and demonstrated adherence readiness, 15 started on an antiretroviral regimen and 2 decided to defer treatment indefinitely. Of the 15 who started therapy, 13 (87%) achieved 90+% adherence during the first month of antiretroviral therapy. The sample's mean adherence during the first 4 weeks of treatment was 93% (SD = 13)., Conclusion: These results suggest that once a patient is able to adhere well to a 1-week practice trial they are likely to adhere equally well to HAART. A larger controlled study is needed to further assess the effectiveness of practice trials as a clinical tool for both assessing and improving adherence readiness.

Chromium is a primary drinking water contaminant in the USA with hexavalent chromium, Cr(VI), being the most toxic form of the metal. As a required step in developing a revised state drinking water standard for chromium, the California Department of Health Services recently issued a new Public Health Goal (PHG) of 2.5 microg/l for total chromium and 0.2 microg/l for Cr(VI). Hexavalent chromium can be determined (as chromate) by ion chromatography, as described in US Evironmental Protection Agency Method 218.6; however, the method as originally published does not allow sufficient sensitivity for analysis at the California PHG level of 0.2 microg/l. Modification of the conditions described in Method 218.6, including the use of a lower eluent flow-rate, larger reaction coil, and larger injection volume, significantly increases the method sensitivity. The modified method, which uses IonPac NG1 and AS7 guard and analytical columns, an eluent of 250 mM ammonium sulfate-100 mM ammonium hydroxide operated at 1.0 ml/min, a 1000 microl injection volume, and postcolumn reaction with 2 mM diphenylcarbazide-10% methanol-0.5 M sulfuric acid (using a 750 microl reaction coil) followed by UV-Vis detection at 530 nm, permits a method detection limit for chromate of 0.02 microg/l. This results in a quantitation limit of 0.06 microg/l, which is more than sufficient for analysis at the California PHG level. Calibration is linear over the range of 0.1-10 microg/l and quantitative recoveries (>80%) are obtained for chromate spiked at 0.2 microg/l in drinking water. The modified method provides acceptable performance, in terms of chromate peak shape and recovery, in the presence of up to 1000 mg/l chloride or 2000 mg/l sulfate.

Objective: We have developed and analyzed a large surgical prophylaxis database and now report the factors significantly associated with early infection, readmission due to infection, and death within 28 days of surgery. This study is intended to be a stepping-stone for further studies using our clinical database., Design and Setting: A computerized database of 9,016 surgical patients from a 400-bed community hospital was examined. Multivariate logistic regression and tree-based modeling were used to identify factors associated with the outcomes. Factors considered included surgical procedure, prophylactic antibiotic, age, gender, serum creatinine, and albumin., Results: 12.6% had an early infection, 2.5% were readmitted due to infection, and 2.5% died within 28 days. Most combination prophylactic antibiotics were associated with an increased probability of an early infection. Decreased albumin and increased age were associated with an increased probability of an early infection. Tracheostomy and amputations were associated with an increased probability of an early infection, whereas gallbladder and orthopedic procedures involving the arm were associated with a decreased probability. Factors associated with readmission due to infection included dialysis shunt, vascular repair, and an early infection. Factors associated with increased probability of death within 28 days included age, albumin, serum creatinine, and an early infection. Gallbladder procedures and obstetric-gynecologic procedures were associated with a decreased probability of death within 28 days., Discussion: Older patients and those with a decreased albumin were most likely to have an early infection. To the extent that an early infection was a significant risk factor for readmission due to infection, the impact of age and albumin on the probability of readmission due to infection is demonstrated by their effects on early infections. Interestingly, albumin and age were significantly associated with death within 28 days, in addition to early infection, showing the predictive association between these factors and early death.

Under the auspices of the Resident Education Committee of the Society of American Gastrointestinal Endoscopic Surgeons, 158 of 298 (53%) of surgical training program directors responded to a survey on the current status of endoscopy in residency programs. Although 100 per cent claim that gastrointestinal endoscopy is provided by their program, only 76 per cent have formal endoscopy training, usually centered around the PGY 3 level, with only 23 per cent having didactic lectures in endoscopy. Directors claim to have trained nearly all of their residents by the completion of residency, averaging 44 esophagogastroscopies, 37 colonoscopies, and 46 flexible sigmoidoscopies per resident. However, they feel only 71 per cent of trainees are able to perform esophagogastroscopies and 67 per cent to perform colonoscopies in clinical practice. Ninety-seven per cent of directors feel endoscopy is important to surgical residency training, and 87 per cent have full-time faculty doing endoscopy. Only 44 per cent have a director of endoscopy; endoscopy is supervised by surgeons exclusively in only 48 per cent. Only 35 per cent have ongoing endoscopy research. When surgeons are not performing endoscopy, 66 per cent feel that the gastrointestinal (GI) service provides adequate service or training. Gastroenterology has a monopoly in endoscopy at 28 per cent of institutions, and 67 per cent of program directors feel there would be resistance to the formation of a separate surgical endoscopy service. Surgeons work in their own surgical endoscopy suite in only 15 per cent of institutions; in a GI suite in 13 per cent; and in a combined suite in the remainder.(ABSTRACT TRUNCATED AT 250 WORDS)

Meeting the needs of rural health care professionals for continuing education remains a challenge for health planners. An assessment of these needs is the focus of this survey of rural practitioners. A continuing education needs survey of five allied health professions in an agricultural region of California was conducted. Variables selected related to professional education and retention and included paramedics, physical therapists, pharmacists, clinical psychologists, and medical technologists. Results indicated a strong need for high quality, moderate cost, locally offered continuing education seminars. Access to professional literature searches was also regarded as important. Several of the selected health profession groups were concerned about maintaining licensure; most intended to remain in their professions for at least six to ten years. These survey findings clearly suggest a need for centrally coordinated continuing education opportunities for allied health personnel in rural service delivery areas.