Nitrogen dioxide (NO2) is responsible for aggravating respiratory diseases, particularly asthma. The aim of this study is to investigate the association between NO2 exposure and asthma emergency ...department (ED) visits during the cold season (November–February) in five populated locations (Sacramento, San Francisco, Fresno, Los Angeles, and San Diego) of California from 2005 to 2015 (1320 Days). Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with a 5 ppb increase in NO2 concentration for the 19,735 ED visits identified. An increase in NO2 exposure increased the odds of having asthma ED visits for the studied population. The potential effect modification by sex (female and male), race (White, Black, Hispanic, and Asian), and age (2–5, 6–18, 19–40, 41–64, and ≥65) was explored. A 5 ppb increase in the concentration of NO2 during lag 0–30 was associated with a 56% increase in the odds of having an asthma ED visit (OR = 1.560, CI: 1.428–1.703). Sex was not found to be a modifier. Asthma ED visits among all the races/ethnicities (except Asians) were associated with NO2 exposure. Whites had the highest OR 75% (OR = 1.750, CI: 1.417–2.160) at lag 0–30 in response to NO2 exposure. The association between NO2 exposure and asthma ED visits was positive among all age groups except for 19 to 40 years old; the OR was higher among 2 to 18 year old (at lag 0–30: age group 2–5 (OR = 1.699, CI: 1.399–2.062), and age group 6–18 (OR = 1.568, CI 1.348–1.825)). For stratification by location, San Diego and Fresno were found to have the highest OR, compared to the other studied locations.
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•Effect of NO2 exposure on asthma emergency department (ED) visits was evaluated.•A time-stratified case-crossover method was used to address NO2 exposure.•Increase in NO2 concentration increases the odds of having asthma attack.•Among all races, Whites showed a greater association with NO2 exposure.•2 to 18 years old had the greater and faster response to NO2 exposure.
Health misinformation, which was particularly prevalent during the COVID-19 pandemic, hampers public health initiatives. Spanish-speaking communities in the San Francisco Bay Area may be especially ...affected due to low digital health literacy and skepticism towards science and healthcare experts. Our study aims to develop a checklist to counter misinformation, grounded in community insights.
We adopted a multistage approach to understanding barriers to COVID-19 vaccine uptake in Spanish-speaking populations in Alameda and San Francisco counties. Initial work included key informant and community interviews. Partnering with a community-based organization (CBO), we organized co-design workshops in July 2022 to develop a practical tool for identifying misinformation. Template analysis identified key themes for actionable steps, such as source evaluation and content assessment. From this, we developed a Spanish-language checklist.
During formative interviews, misinformation was identified as a major obstacle to vaccine uptake. Three co-design workshops with 15 Spanish-speaking women resulted in a 10-step checklist for tackling health misinformation. Participants highlighted the need for scrutinizing sources and assessing messenger credibility, and cues in visual content that could instill fear. The checklist offers a pragmatic approach to source verification and information assessment, supplemented by resources from local CBOs.
We have co-created a targeted checklist for Spanish-speaking communities to identify and counter health misinformation. Such specialized tools are essential for populations that are more susceptible to misinformation, enabling them to differentiate between credible and non-credible information.
Trans women experience high rates of gender-based violence (GBV)-a risk factor for adverse health outcomes. Transphobic hate crimes are one such form of GBV that affect trans women. However, little ...is understood about factors that shape transphobic hate crimes and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area.
From 2016 to 2018, trans women participated in a longitudinal cohort study of HIV. Secondary data analyses (N = 629) examined self-reported experiences of transphobic hate crimes (i.e., robbery, physical assault, sexual assault, and battery with weapon) by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined demographic, sociocultural, and gender identity factors associated with transphobic violence experiences and police reporting.
About half (45.8%) of participants reported ever experiencing a transphobic hate crime; only 51.1% of these were reported to the police. Among those who reported a hate crime experience, Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of "other" race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p = 0.001). Having one's gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing a transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned.
A high proportion of trans women experienced a transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors, especially among trans women of color, can yield violence prevention benefits.
En 1727 el obispo fray Juan Muñoz y Salcedo decidió establecer en la ciudad de Mondoñedo el primer y único convento de la Reforma de San Pedro de Alcántara en Galicia. Desde entonces y hasta 1731 se ...construyó bajo la dirección del lego y maestro de obras fray Lorenzo de Santa Teresa. Actualmente solo se conserva la iglesia, la capilla de la Venerable Orden Tercera y uno de sus claustros. Nuestro objetivo en el presente trabajo es explicar los motivos por los que se erigió, dar a conocer a los maestros y canteros que lo edificaron, las distintas fases de la construcción, describir su morfología original, y reseñar asimismo sus primitivos altares. Para ello nos valdremos de varios fondos documentales y de antiguas fotografías.
gl En 1727 o bispo frei Juan Muñoz y Salcedo decidiu establecer na cidade de Mondoñedo o primeiro e único convento da Reforma de San Pedro de Alcántara en Galicia. Dende entón e ata 1731 construíuse baixo a dirección do freire e mestre de obras frei Lorenzo de Santa Teresa. Actualmente só se conserva a igrexa, a capela da Venerable Orde Terceira e un dos seus claustros. O noso obxectivo no presente traballo é explicar os motivos polos que se erixiu, dar a coñecer os mestres e canteiros que o edificaron, as distintas fases da construción, describir a súa morfoloxía orixinal, e reseñar tamén os seus primitivos altares. Pra isto servirémonos de varios fondos documentais e de antigas fotografías.
To address gaps in U.S. health care outcomes, medical education is evolving to incorporate new competencies, as well as to align with care delivery transformation and prepare systems-ready providers. ...These new health systems science (HSS) competencies—including value-based care, quality improvement, social determinants of health, population health, informatics, and systems thinking—require formal education and role modeling in both classroom and clinical settings. This is challenging because few faculty had formal training in how to practice or teach these concepts. Thus, these new competencies require both expanding current educators’ skills and a new cohort of educators, especially interprofessional clinicians. Additionally, because interprofessional teams are the foundation of many clinical learning environments, medical schools are developing innovative experiential activities that include interprofessional clinicians as teachers. This combination of a relative “expertise vacuum” within the current cohort of medical educators and expanding need for workplace learning opportunities requires a reimagining of medical school teachers. Based on experiences implementing HSS curricula at two U.S. medical schools (Penn State College of Medicine and University of California, San Francisco, School of Medicine, starting in 2013), this Perspective explores the need for new educator competencies and the implications for medical education, including the need to identify and integrate “new” educators into the education mission, develop faculty educators’ knowledge and skills in HSS, and acknowledge and reward new and emerging educators. These efforts have the potential to better align the clinical and education missions of academic health centers and cultivate the next generation of physician leaders.
This essay examines an understudied Jewish American autobiographical text, Harriet Lane Levy's memoir 920 O'Farrell Street (1947). Completed when she was eighty years old, the memoir uses modernist ...aesthetics to describe Levy's Jewish upbringing in late nineteenth-century San Francisco. Arguing that 920 O'Farrell Street fills a significant gap in Jewish American literary history, I consider Levy's modernist memoir as an alternative to the established Jewish American autobiographical tradition, which has privileged the stories of working-class immigrants making their way from the ghetto into mainstream America. As I demonstrate through close analysis of the memoir, and in particular Levy's use of the Victorian house as a structuring device, 920 O'Farrell Street expands the parameters of Jewish American literary history by mapping Jewishness to the geographic and architectural sites of turn-of-thetwentieth-century San Francisco, and displacing the ghetto as the sole locus of Jewish life and literature in the United States. Further, Jewish American literary scholarship's New York-centrism and its privileging of the ghetto tale have obscured the pivotal role played by California Jewish women in the early stages of the modernist movement. As a corrective, I preface my close reading of the memoir with background on Levy, placing her in the context of a group of remarkable women-including Gertrude Stein, an Oakland resident in her youth, and Alice B. Toklas, Levy's O'Farrell Street neighbor-who moved between the middle-class Jewish communities of northern California and the expatriate salons of Paris in the first decades of the twentieth century.
Landslides are a major natural hazard, threatening communities and infrastructure worldwide. The mitigation of these hazards relies on the understanding of their causes and triggering processes, ...which depends directly on soil properties, land use, and their changes over time. In this study, we propose a novel framework to estimate the probability of failure in highly developed urban areas. The framework combines remote sensing and geophysical data to estimate soil properties and land covers. Such estimate properties are then integrated into a hydro-geomechanical model to provide a robust estimate of the probability of failure. To assess the importance and sensitivity of the input parameters to the probability of failure assessment, a sensitivity analysis was performed on the seven main parameters (density, friction angle, cohesion, soil thickness, slope, water recharge and saturated hydraulic conductivity) of the hydro-geomechanical model. Slope angle, soil thickness and cohesion are shown to be the most important parameters. While the slope angle can be derived from high-resolution digital elevation models, soil thickness and cohesion cannot be assessed. To incorporate the variability of these two parameters into the model, seismic noise measurements were performed to estimate soil thickness. Supervised classification of remote sensing data was used to map vegetation type and related root cohesion, which can impact the cohesion significantly. The results show that slopes with relatively thick soil layers (above 2 m) have up to four times higher probability of failure. Slopes with tall vegetation cover, and hence comparably high root cohesion, reduce the probability of failure, particularly when the soil layer is relatively thin (< 3 m). The developed approach makes use of rapid to acquire geophysical and easily to obtain remote sensing data, and hence is transferable to other study sites. This approach may be of particular importance to areas of active vegetation management that may cause considerable changes in landslide hazard maps.
•The probability of failure is evaluated using Monte-Carlo approach.•A sensitivity analysis permitted to extract the most impactful parameters•Combining of geophysical measurements and remote sensing allowed to refine the model
El presente artículo profundiza en la construcción del primer espacio público haussmaniano del sur de España, la plaza Nueva de Sevilla, así como en las razones que llevan al desmantelamiento de su ...unidad arquitectónica y, por lo tanto, de parte de sus valores patrimoniales. La pérdida de la unidad proyectual original deriva de la introducción de modelos historicistas y del Movimiento Moderno, en los cuales se prima la singularidad de la arquitectura en detrimento de la homogeneidad del proyecto urbano. La especulación inmobiliaria y la celebración de la Exposición Iberoamericana de 1929 construyen un escenario funcional y estéticamente capitalista que limita las actividades sociales de una plaza ideada originalmente como punto de encuentro colectivo. A través de la secuencia de planimetrías elaboradas se observa el cambio de paradigma desde los valores Ilustrados a la pujanza desarrollista.
The Tenderloin Center (TLC), a multi-service center where people could receive or be connected to basic needs, behavioral health care, housing, and medical services, was open in San Francisco for 46 ...weeks in 2022. Within a week of operation, services expanded to include an overdose prevention site (OPS), also known as safe consumption site. OPSs have operated internationally for over three decades, but government-sanctioned OPSs have only recently been implemented in the United States. We used ethnographic methods to understand the ways in which a sanctioned OPS, situated in a multi-service center, impacts the lives of people who use drugs (PWUD).
We conducted participant observation and in-depth interviews June–December 2022. Extensive field notes and 39 in-depth interviews with 24 TLC guests and 15 TLC staff were analyzed using an inductive analysis approach. Interviewees were asked detailed questions about their experiences using and working at the TLC.
TLC guests and staff described an atmosphere where radical hospitality—welcoming guests with extraordinary warmth, generosity, and unconditional acceptance—was central to the culture. We found that the co-location of an OPS within a multi-service agency (1) allowed for the culture of radical hospitality to flourish, (2) yielded a convenient one-stop shop model, (3) created a space for community building, and (4) offered safety and respite to guests.
The co-location of an OPS within a multi-service drop-in center is an important example of how such an organization can build positive sociality among PWUD while protecting autonomy and reducing overdose mortality. Overdose response and reversal is an act of relational accountability in which friends, peers, and even strangers intervene to protect and revive one another. This powerful intervention was operationalized as an anti-oppressive, horizontal activity through radical hospitality with a built environment that allowed PWUD to be both social and safe.
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