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At least 19 recordsLinked to original sources
PubMed1996

The effect of race and ethnicity on the use of selected health care procedures: a comparison of south central Los Angeles and the remainder of Los Angeles county.

The purpose of this study was to compare the use of eight hospital-based procedures (appendectomy, cesarean section, coronary artery angioplasty (PTCA), coronary artery bypass grafting (CABG), carotid endarterectomy, hysterectomy, mastectomy, and transurethral prostate resection) in South Central Los Angeles (SCLA) to the remainder of Los Angeles County. The authors used age- and gender-adjusted procedure rates and population-weighted multivariate regression techniques, adjusting for illness proxies, physician distribution, hospital distance, income, and ethnicity variation to quantitate the effect of SCLA residence. Four procedures were performed at significantly lower rates among residents of SCLA: PTCA, CABG, carotid endarterectomy, and cesarean section. In multivariate regression models, SCLA was also a significant predictor for appendectomy, mastectomy, and transurethral prostatectomy (TURP). The SCLA effect was diminished but not eliminated when ethnicity variables were incorporated into regression models. The use of selected procedures by residents of SCLA frequently differs from that of residents of the remainder of Los Angeles Country. Some differences are not attributable to level of health, income, ethnicity, or the availability of medical resources.

Adult↗
PubMed1983

Baseline chronic disease risk factors in a racially heterogeneous elementary school population: The "Know Your Body" program, Los Angeles.

The Los Angeles "Know Your Body" (KYB) program is an organized health education activity for children designed to encourage positive health behavior and discourage or interrupt behavioral patterns that are linked to illness, injury, disability, or death. Components of KYB include a 20-week curriculum; a survey of health knowledge, attitudes, and behaviors; in-service training for elementary school teachers; and a clinical screening that provides feedback to students on selected indices. As part of a KYB field demonstration in Los Angeles conducted by the UCLA Division of Cancer Control, Jonsson Comprehensive Cancer Center, 1,503 Los Angeles and Santa Monica-Malibu children ages 9-11 in grades 4 and 5 underwent baseline health screening evaluations in March 1981, measuring height, weight, triceps skinfold thickness, serum cholesterol, pulse rate recovery following exercise, and blood pressure. The population mean for serum cholesterol was 182.6 mg/dl, with no significant racial/ethnic, sex, or age differences. Significant racial/ethnic differences were found in obesity, with Hispanics having the highest prevalence, Asians the lowest. Black students scored significantly higher in pulse rate recovery following exercise, suggesting better relative cardiovascular fitness, and Asians scored lowest. Blacks were more likely to exceed the 95th percentile in diastolic and systolic blood pressure. Overall, 48% of the children had one or more chronic disease risk factors.

Age Factors↗
PubMed1996

Los Angeles Free-Net: an experiment in interactive telecommunication between lay members of the Los Angeles community and health care experts.

The Los Angeles Free-Net, an interactive community information resource, was established in part to help community members become more effective consumers of health care services. By providing timely, expert answers to anonymously asked medical questions at no charge, we hope to decrease unnecessary physician-patient encounters, encourage effective preventive-health measures, and improve the overall results of health care in our community. Although it is too early to assess health care benefits from this system, the following observations may help guide the development of similar systems around the nation: (1) A small annual registration fee generates both moral and financial public support. (2) Demographic information from registered users can help direct attempts at enfranchising all members of the community. (3) Toll-free access, free public-instruction sessions, moderated forums, extensive volunteer help, and encryption security are encouraged, while Internet censorship is difficult and counterproductive. (4) Access to Internet resources is important, but the strength of a community system lies primarily in the sharing of expertise and resources among members of the community. (5) A critical mass of available physicians to answer questions must be matched with a critical level of question input for this type of interactive medical information resource to function in a time-sensitive fashion.

Community Networks↗
PubMed1994

Progression of human immunodeficiency virus disease among infants and children infected perinatally with human immunodeficiency virus or through neonatal blood transfusion. Los Angeles County Pediatric AIDS Consortium and the Los Angeles County-University of Southern California Medical Center and the University of Southern California School of Medicine.

Using community-based surveillance data for pediatric human immunodeficiency virus (HIV) infection, we examined disease progression using survival analysis among perinatally HIV-infected children and children HIV-infected through a neonatal blood transfusion. As of December 31, 1991, 238 HIV-infected children (classified P-1 or P-2 according to the Centers for Disease Control and Prevention classification system) were identified. Median symptom-free survival time from birth to symptomatic infection (P-2) was different for perinatally acquired (n = 166) and neonatal transfusion-acquired (n = 72) infection (6.4 months vs. 17.8 months, respectively; P < 0.001). Survival after development of symptomatic infection (P-2) did not differ by transmission mode. Survival differences from birth to death were significant at P < 0.05 (75% of perinatally HIV-infected children survived 44 months vs. 71 months for transfusion-associated children). Although survival estimates improved for those receiving antiretroviral treatment, differences by mode were still observed. For perinatally HIV-infected children, mortality was highest in the first year of life (12%). Those remaining symptom-free beyond their first year demonstrated survival experiences similar to those for children with transfusion-associated infection.

AIDS Serodiagnosis↗
PubMed2007

Inter- and intra-observer variability of the Los Angeles classification: a reassessment.

BACKGROUND: Los Angeles classification is widely adopted for reporting endoscopic gastroesophageal reflux disease. We assessed the inter- and intra-observer variability of the Los Angeles classification. METHODS: Still images (n = 254) of the lower esophagus were presented to 9 gastroenterologists (6 experts and 3 trainees) and they were asked to report the images according to the Los Angeles classification. After 2 weeks the images were reordered and they were asked to report them again. Kappa statistic was calculated for intra- and inter-observer variability. RESULTS: The kappa for intra-observer agreement was 0.54 (attendings: 0.54; trainees; 0.55; P = not significant) and the inter-observer agreement was 0.22 (attendings: 0.20; trainees: 0.31; P = 0.027). The inter- and intra-observer kappa values in differentiating nonerosive from erosive cases were 0.22 (attendings: 0.21; trainees: 0.31, P = not significant) and 0.57 (attendings: 0.58; trainees: 0.55, P = not significant), respectively. CONCLUSION: According to our data, the Los Angeles classification has acceptable intra-observer variability, both for detecting presence or absence of erosions and for differentiating between different degrees of esophagitis, while its inter-observer performance seems to be less acceptable. It may be reasonable and timely to have another look at the Los Angeles classification to see whether its performance can be improved even further.

Diagnosis, Differential↗
PubMedDate not supplied

Public health impact of the 1992 Los Angeles civil unrest.

The Los Angeles civil unrest in April 1992 stunned the nation. The days of violence resulted in 53 deaths, 2,325 reported injuries, more than 600 buildings completely destroyed by fire, and approximately $735 million in total damages. The purpose of this paper is to give an overview of the activities of the Public Health Programs and Services Branch of the Los Angeles County Department of Health Services during and after the civil unrest and to illustrate the types of public health issues and problems that may result from large-scale civil disturbance. Public health agencies and jurisdictions should consider these issues in their disaster planning. Public Health Programs and Services Branch activities were directly affected by the violence and destruction. Women, Infants and Children Program vouchering sites and 20 drug program and alcohol recovery sites were damaged or burned and 15 county health centers closed during the unrest. At least 38 private medical and dental offices and 45 pharmacies were destroyed or damaged. County health authorities offered facilities to house relocated private care providers and filled prescriptions for medications where needed. The environmental health impact required the inspection of 2,827 burned and damaged sites for hazardous waste including asbestos; at 9 percent of the inspected sites, waste required special disposal. More than 1,000 food facilities suffered damage and required inspection before reopening. In the 3 months following the unrest, a 20-percent increase in disposal capacity was authorized at four county landfills to accommodate the disposal of debris. Violence was a public health issue of particular concern. The Centers for Disease Control and Prevention sent a team to study the violence from an epidemiologic perspective. The Federal agency also provided funding for televised children's talk shows dealing with reactions to the violence.

Crime↗
PubMed1984

Life-threatening complications in a child with hemoglobin SD-Los Angeles disease.

Hemoglobin SD-Los Angeles is an uncommon sickle hemoglobinopathy. We describe a boy with documented Hb SD-Los Angeles who had experienced acute splenic sequestration, pneumococcal sepsis, aplastic crisis and functional asplenia during his first two years of life. We suggest that children with Hb SD-Los Angeles are at similar risks for the life-threatening complications which characterize sickle cell anemia and should receive the same comprehensive medical care currently recommended for children with Hb SS disease.

Anemia, Sickle Cell↗
PubMedDate not supplied

Monitoring health in Los Angeles County.

The University of California at Los Angeles School of Public Health, in collaboration with the Los Angeles County Department of Health Services, compiled data and developed a standardized format that displayed a comparison of mortality and morbidity data between Los Angeles County, the State of California, and the United States in 1960, 1970, and 1980 for 16 health topic areas. Findings noted both favorable and unfavorable health trends, as well as substantial data collection problems. In 1980, compared with the United States, the Los Angeles County rates for tuberculosis, gonorrhea, syphilis, and hepatitis B were as much as 45 to 128 percent higher, the homicide rate was more than double, and, for the population aged 65 years and over, the cirrhosis of the liver rate was more than 56 percent higher. The myocardial infarction rate was 58 percent lower in the population aged 18 to 64. Problems of inadequate data for many health indicators, lack of comparability in data, and conflicting information from different data sources were noted. These limitations with the data underscore the need to standardize data collection procedures and to extend the parameters on which information is collected. The approach represents a tool that could be used by many health departments to monitor their activities and set future goals.

Accidents↗
PubMed1993

Los Angeles organ sharing: twenty-six-year report.

1. The Los Angeles Transplant Society and the Regional Organ Procurement Agency of Southern California (ROPA) was established in November 1967. ROPA was the first such organization in the United States. 2. The use of simple cold storage and shipment of kidneys by commercial airline resulted from pioneering concepts developed in the Los Angeles area from 1968-1969. 3. In the 26-year period of ROPA's operation, it has coordinated 8,446 kidney transplants. 4. All kidneys transplanted in 1993 were allocated according to the UNOS point system. 5. Allocating all kidneys under the point system has not significantly disadvantaged either large or small transplant centers in the greater Los Angeles area. 6. Racial distribution of recipients: 13% Black (compared with Los Angeles population of 12% and 6% donor population). Blacks represent 20% of the recipient waiting list. Hispanic recipients were 31% (compared to Los Angeles population of 40% and donor population of 30%). Hispanics comprised 28% of the waiting list. 7. The average waiting times for centers in the Los Angeles area ranged from 14-19.4 months. Transplanted patients waited an average of 16.3-22.1 months. 8. "Required request" had a significant effect on the number of referrals but did not produce a meaningful increase in the number of kidneys transplanted.

Cryopreservation↗
PubMed1987

The Visiting Nurse Association of Los Angeles.

In short, the VNA of Los Angeles has a proud tradition. For almost 50 years, it has been providing needed health care and supportive services to the chronically ill and disabled in their own homes. Thanks to the efforts of all who made these traditions, the VNA also has a bright future. The VNA is a source of pride in California not only because of what it has accomplished but also because of what the good people of the VNA will be able to accomplish in the future. The VNA of Los Angeles is a valuable community resource whose services will be needed now more than ever before. The combination of demographics, consequences of the greying of America, the effects of the expected AIDS epidemic, and the evolution of new technology all point in the direction of home care. The VNA is already in the vanguard of what surely will become a national trend. Because of these contributions--past, present, and future--CARING is proud to salute the Visiting Nurse Association of Los Angeles.

California↗