To provide a baseline of various driving behaviors and to identify opportunities for prevention of distracted driving during the infancy of state laws that prohibited cellphone use while operating a ...motor vehicle, the 2010-2011 Distracted Driving Survey collected information on multiple distracted driving behaviors from lower-income clients of three designated, multi-purpose public health centers in Los Angeles County.
Descriptive and multivariable negative binomial regression analyses were performed to examine patterns of driving distractions using the Distracted Driving Survey dataset (
= 1,051).
The most common distractions included talking to other passengers (
= 912, 86.8%); adjusting the radio, MP3, or cassette player (
= 873, 83.1%); and adjusting other car controls (
= 838, 79.7%). The median number of distinct distractions per survey participant was 11 (range: 0-32). Factors predicting the number of distinct distractions included being male incidence rate ratio (IRR): 1.14; 95% confidence interval (CI): 1.06, 1.23, having a lower education (IRR: 0.73; 95% CI: 0.62, 0.84), and having more years of driving experience (IRR: 1.67; 95% CI: 1.33, 2.11). A variety of distractions, including cellphone use and texting, were predictive of increased motor vehicle crashes in the prior 12 months (
< 0.05).
Distracted driving beyond cellphone use and texting were common in the survey sample, suggesting a need for additional public education and more inclusive distracted driving laws that cover these other activity types.
It is well established that pregnant persons with SARS-CoV-2 are at an increased risk for preterm birth, however, less is known about perinatal outcomes for neonates with intrauterine exposure to ...SARS-CoV-2.
Characteristics of 50 SARS-CoV-2 positive neonates born to SARS-CoV-2 pregnant persons positive between May 22, 2020, and February 22, 2021, in Los Angeles County, CA, were assessed. Pattern of neonate SARS-CoV-2 test results and time to positive test was analyzed. Objective clinical severity criteria were applied to assess neonatal disease severity.
Median gestational age was 39 weeks with 8 (16%) neonates born preterm. Most (74%) were asymptomatic, while 13 (26%) were symptomatic from any cause. Four (8%) symptomatic neonates met criteria for severe disease, of which 2 (4%) were likely secondary to COVID-19. The other 2 with severe disease had more likely alternate diagnoses, and 1 of these neonates subsequently died at 7 months of life. Among 12 (24%) that were positive within 24 hours after birth, one was persistently positive and represented likely intrauterine transmission. Sixteen (32%) were admitted to the neonatal intensive care unit.
In this case series of 50 SARS-CoV-2 positive mother-neonate pairs, we found that most neonates were asymptomatic regardless of when they tested positive during the 14 days after birth, that there was relatively low risk of COVID-19 associated severe disease, and that intrauterine transmission can occur in rare cases. Although short-term outcomes are mostly promising, more research is needed to study long-term consequences of SARS-CoV-2 infection in neonates born to positive pregnant persons.
Objectives:
The objective of this study was to analyze all animal-to-human bite reports during a 3-year period from a regional surveillance database. Results helped to inform local efforts to reduce ...and prevent animal-to-human bites.
Methods:
We reviewed all cases of animal-to-human bites occurring from 2009 through 2011 that were reported to the Los Angeles County Department of Public Health’s Animal Bites Database. We collected data on the bite victim’s date of birth, age, and address; bite circumstances (ie, date, time, location, how bite occurred); anatomic site and treatment of bite; type of reporting facility; and breed and management of biting animal.
Results:
From 2009 through 2011, 26 169 animal-to-human bites were reported, of which 23 103 (88%) were dog bites. Most animal-to-human bites (n = 7673, 29%) occurred between 4 pm and 8 pm and peaked during the month of July (n = 2663, 10%). Most animal-to-human bites occurred outdoors (n = 8772, 34%) and while victims engaged in recreational activities (n = 4353, 17%). The hands were the most common injury site (n = 9130, 35%), and only 1% of animal bites (n = 267) resulted in hospitalization. A total of 4115 bite victims (16%) received tetanus vaccinations. Of all animal-to-human bite cases, medical organizations reported 13 451 (51%), and animal control agencies reported 10 682 (41%).
Conclusions:
Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.
Background: With the aging of the Baby Boomer population, sexually transmitted diseases (STD) are becoming an important issue among older people. Better physical health at older ages and changing ...psychosocial norms have led to sexual activity later in life. Despite engaging in high-risk sexual behavior, testing and treatment is still infrequent. With the paucity of information on STDs in older people, this study was undertaken to examine the risk in this demographic, challenge existing assumptions on the topic, inform surveillance and prevention strategies, and provide a basis for future research in the area. Methods: Routine surveillance data that captures all cases of syphilis, gonorrhea, and chlamydia reported to the Los Angeles County Department of Public Health between January 1, 2000 and December 31, 2011 was utilized for analyses. The rate per 100,000 of STDs over time among older people (50 and over) was examined and compared to younger populations. Predictors of repeat infection were assessed to identify the high-risk groups among older people. Appropriate treatment documentation among older people was investigated to ascertain areas of need in STD case follow-up and treatment. Results: During the study period, rates of early syphilis, gonorrhea, and chlamydia significantly increased for older people and at a rate similar to younger populations. Older men who have sex with men (MSM) and who have sex with both men and women (MSM/W) as well as those co-infected with other STDs were at highest risk for repeat infections. Documented, appropriate treatment of older gonorrhea and chlamydia cases increased over the study period but remained lower compared to younger populations. Neurosyphilis was significantly associated with older age and delayed treatment. Conclusions: There is a need to improve STD screening among older people by educating both providers and the demographic of interest. Programmatic improvements such as quality improvement and implementation of electronic reporting mechanisms are necessary to ensure better treatment information of older cases, who tend to be low priority for health department investigations. Future studies on high-risk behaviors of older people and providers’ knowledge and attitudes are necessary to inform additional STD prevention strategies for this demographic.
This paper “opens a black box” in examining how and under what conditions do firms achieve productivity gains by exporting, conventionally known as the learning-by-exporting (LBE) effect. We extend ...the current theoretical paradigm by proposing that exporters utilize strategic decisions pertinent to innovativeness, production capability, and human capital so as to leverage knowledge and resources obtained from exporting in order to achieve productivity gains. We test and validate our hypotheses with panelized data of roughly 250,000 Chinese firms over a 7-year period (2001-2007). We also show that the salience of these mediation mechanisms is contingent upon ownership structure and industry characteristics: Non-state-owned enterprises and firms in industries with medium export intensity or medium and high new product development intensity effectuate more learning through these conduits than their counterparts. The multimediation mechanism LBE model offers useful implications for academia, practitioners, and policy makers.
To characterize and compare glucose-lowering medication use in type 2 diabetes in the U.S., Sweden, and Israel, including adoption of newer medications and prescribing patterns.
We used data from the ...National Health and Nutrition Examination Survey (NHANES) from the U.S., the Stockholm CREAtinine Measurements (SCREAM) project from Sweden, and Maccabi Healthcare Services (Maccabi) from Israel. Specific pharmacotherapy for type 2 diabetes between 2007 and 2018 was examined.
Use of glucose-lowering medications among patients with type 2 diabetes was substantially lower in NHANES and SCREAM than in Maccabi (66.0% in NHANES, 68.4% in SCREAM, and 88.1% in Maccabi in 2017-2018). Among patients who took at least one glucose-lowering medication in 2017-2018, metformin use was also lower in NHANES and SCREAM (74.1% in NHANES, 75.9% in SCREAM, and 92.6% in Maccabi) whereas sulfonylureas use was greater in NHANES (31.5% in NHANES, 16.0% in SCREAM, and 14.9% in Maccabi). Adoption of dipeptidyl peptidase 4 inhibitors and sodium-glucose cotransporter 2 inhibitors (SGLT2i) was slower in NHANES and SCREAM than in Maccabi. History of atherosclerotic cardiovascular disease, heart failure, reduced kidney function, or albuminuria was not consistently associated with greater use of SGLT2i or glucagon-like peptide 1 receptor agonists (GLP1RA) across the three countries.
There were substantial differences in real-world use of glucose-lowering medications across the U.S., Sweden, and Israel, with more optimal pharmacologic management in Israel. Variation in access to care and medication cost across countries may have contributed to these differences. SGLT2i and GLP1RA use in patients at high risk was limited in all three countries during this time period.
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