The Physician Fee Index and Other Economic Indicators—Recent Changes and Outlook

Figures compiled by the Bureau of Research and Planning show that the California Physician Fee Index increased 3.0 percent in the last six months of 1969, compared with 2.5 percent in the first six months. Nationally, physicians'' fees increased at a slightly slower rate—2.9 percent during the last half of the year, according to the U. S. Bureau of Labor Statistics. This was the first time since 1965 that physicians'' fees increased faster in California than nationally. In the seven and a half years since the California Physician Fee Index was started, fees have shown an increase of 36.3 percent in the state and 42.9 percent for the whole country.The “all items” component of the Consumer Price Index published by the Bureau of Labor Statistics increased 6.1 percent in 1969, while the medical care component increased 6.0 percent. This, too marks the end of a trend which had showed more rapid increases in medical care costs than in the cost of all goods and services.     

Physician Fee Indices in California and the U.S. Through June 1971 Socio-Economic Report of the Bureau of Research and Planning

California physicians'' fees increased 2.2 percent in the first half of 1971, according to figures compiled by the Bureau of Research and Planning. Nationally, physicians'' fees increased at a faster rate of 3.4 percent during the same period.This was the slowest semi-annual increase in the California Index since the final six months of 1968 when fees increased only 2.0 percent. A decline was also recorded in the rate of price increase for other goods and services in the first half of 1971. Nationally, the “all items” increase amounted to 2.0 percent, and the service component rose 2.1 percent.Also included in this Report is special information on the charging patterns of physicians for office and hospital visits and data on physicians'' fees in the Los Angeles and San Francisco Metropolitan Areas.The California Physician Fee Index is a continuing survey conducted by the CMA Bureau of Research and Planning since 1962. The survey questionnaire which lists 26 medical, surgical, radiological, and laboratory procedures, elicits fee information from approximately 1,000 randomly selected physicians. Since June 1970, the procedures on the questionnaire have been listed according to the coding nomenclature used in the 1969 edition of the Relative Value Studies, published by the California Medical Association. Prior to that, the 1964 edition was used to delineate the procedure being surveyed.     

The Need for Routine Rubella Antibody Testing of Women

Results of rubella antibody tests performed by the California State Viral and Rickettsial Disease Laboratory on blood specimens collected in 1968 and 1969 from school children and women of childbearing age showed a slightly lower prevalence of rubella antibody in California than reported from most other areas of the United States. Among women of childbearing age, rubella hemagglutination-inhibition (hi) antibody was found in 72 percent of those tested in California compared with 80 percent to 90 percent in other areas of the country.Rubella antibody testing services offered by the State Virus Laboratory included situations in which a pregnant woman was exposed to a suspected case of rubella. It was shown that very few of these exposures constitute a significant risk to the fetus as most of the women already possessed antibody to rubella from past infection and in many instances the exposures were not to actual cases of rubella.The results of this study emphasized the urgency of obtaining blood specimens from pregnant women as soon as possible after exposure to rubella or development of symptoms of rubella. The urgency and anxiety attending these situations can largely be obviated if routine rubella antibody testing of women is carried out prior to pregnancy or at the first prenatal visit.     

Deaths From Bites and Stings of Venomous Animals

Data abstracted from 34 death certificates indicate that the three venomous animal groups most often responsible for human deaths in California from 1960 through 1976 were Hymenoptera (bees, wasps, ants and the like) (56 percent), snakes (35 percent) and spiders (6 percent). An average incidence of 2.0 deaths per year occurred during these 17 years, or an average death rate of 0.01 per 100,000 population per year. Nearly three times more males than females died of venomous animal bites and stings. Half of the deaths from venomous snake bites occurred in children younger than 5 years of age. Susceptible persons 40 years or older appeared to be particularly vulnerable to hymenopterous insect stings and often quickly died of anaphylaxis. Fatal encounters with venomous animals occurred more often around the home than at places of employment or during recreational activities. Deaths resulting from spider bites are rare in California but many bites are reported. Medical practitioners are urged to seek professional assistance in identifying offending animals causing human discomfort and to use these animals'' scientific names on death certificates and in journal articles.     

Importation of Shiga Bacillus Dysentery into California—Clinical and Public Health Significance

Concurrent with the regional epidemic of classic Shiga dysentery in Central America during 1969 and 1970, a pronounced increase in the isolation of Shigella dysenteriae type 1 was noted in California. A retrospective study of 20 cases diagnosed in California in 1969 and 1970 revealed that 18 of the patients had traveled to Central America or Mexico during or immediately before the onset of symptoms. Sixteen were known to have been admitted to hospital; there was one death. Despite the concern that such importations might result in epidemics in this country among groups living in crowded, unsanitary settings, no definite secondary transmission was identified in this study. The problems of differential diagnosis, laboratory isolation of the agent, chemotherapy, and epidemic control are discussed.     

Vitamin B12 Production and Depletion in a Naturally Occurring Eutrophic Lake

The distribution of vitamin B(12) within Upper Klamath Lake was surveyed at approximately monthly intervals during a period from September 1968 to November 1969. High concentrations (up to 1.8 mug/g of dry sediment) characteristically occurred at the water-sediment interface, with a sharp decline below this area. A heavy bloom of Aphanizomenon flos-aquae occurred from the latter part of May through October 1969. B(12) concentrations of the uppermost sediments, from all but one sampling site, increased gradually through the bloom, followed by a drastic increase during the die-off period. B(12) is probably not a limiting factor for primary productivity, since sufficient levels of this vitamin were found to occur throughout the year. Of 42 cultures isolated from Upper Klamath Lake water and sediments, 20 were found capable of producing 50 pg or more of B(12)/ml of medium. Phytoplankton samples were found to contain up to 5 mug of B(12)/g of dry material. Degradation of B(12) occurred in sterilized as well as fresh sediment samples.     

Cardiopulmonary Resuscitation in a University Hospital: An Analysis of Survival and Cost

A cost analysis and study were done of patient survival after inhospital cardiopulmonary resuscitation during one year at a university hospital. The immediate survival rate in 128 patients was 52 percent. Survival to discharge and six-month survival rates were 19 percent and 15.6 percent, respectively. In all, 23 patients (18 percent) had multiple arrests (two to four per patient) during the same hospital stay. Immediate and six-month survival rates in this group were 52 percent (12 patients) and 9 percent (two patients), respectively. Gender or location where cardiopulmonary arrests occurred in the hospital did not influence survival. The cost of a Code Blue (direct expenses only) was $366. We conclude that the outcome following resuscitation at this university hospital compares favorably with the experience of others, and that the direct cost is modest in relation to the results obtained.     

Studies on Stabilization Ponds for Domestic Sewage in India

For one year a single cell stabilization pond, T. T. Nagar, Bhopal (August, 1968 to July, 1969) and series stabilization ponds, Shahpur, Bhopal (January, 1969 to December, 1969) were studied. Climatological conditions in Bhopal were favourable for the treatment of sewage in stabilization ponds. There was a considerable reduction in BOD, total nitrogen, phosphate, coliforms and enterococci during the process of treatment. The reductions were highest in series ponds. Studies on diurnal variations showed that highest pH, dissolved oxygen, algal cell number and lowest alkalinity values occurred around 4.00 p.m. Algal flora present in the single cell pond consisted of 31 species representing 27 genera. In the series ponds 33 species belonging to 30 genera and 37 species belonging to 33 genera were recorded for the primary and secondary ponds, respectively.     

Epidemiological studies on Japanese encephalitis in Kyoto City area, Japan. II. Annual patterns of virus dissemination on virus recoveries from unfed Culex tritaeniorhynchus summorosus.

Annual patterns of dissemination of Japanese encephalitis virus in vector mosquitoes have been investigated at the main collection station from 1965 through 1973 at some other stations from 1969 through 1971. The virus was recovered usually from Culex tritaeniorhynchus summorosus during a period of about a month from July to August every year till 1969, and from August to September after 1970, although at some of the stations the virus was recovered intermittently for longer or shorter terms. Higher infection rates were recorded with the mosquitoes caught at the stations near to pig sheds than at the stations far from pig sheds. The infection rates at the peak of virus recovery in high epidemic year (1965 to 1967) were higher, being over 2%, than those in lower or latent epidemic years (1968 to 1973). Human patients of Japanese encephalitis were found in 17 to 20 days after the appearance of the highest peak of the infection rate in mosquitoes.     

Egg oiling to reduce hatch-year ring-billed gull numbers on Chicago's beaches during swim season and water quality test results

A burgeoning ring-billed gull population along Chicago's Lake Michigan beaches contributes to degraded water quality through fecal contamination. Egg oiling was conducted at Chicago's gull colonies to reduce production and the influx of hatch-year (HY) gulls using Chicago's beaches, with a second, long-term objective of eventually reducing adult gull numbers through attrition. We also investigated swim season water quality trends through the course of this work. From 2007 to 2009, 52, 80, and 81%, of nests at the two primary nest colonies had their eggs rendered inviable by corn oil application. Counts of HY and after hatch-year (AHY) gulls were analyzed during treatment years for 10 beaches. Water quality data were available from the Chicago Park District during our three treatment years and the prior year (baseline) for 19 beaches. HY counts declined at all 10 surveyed beaches from the initial year (52% nests with oiled eggs) to subsequent years with ~80% of nests oiled. Overall, HY gulls numbers on beaches decreased 86% from 2007 to 2009. Decreases in beach usage by AHY gulls were not detected. Compared to pretreatment, the number of beaches with improved water quality test rates increased each year through the course of the study. The frequency of water quality tests showing bacterial exceedances compared to 2006 declined at 18 of 19 beaches by 2009. Egg oiling resulted in fewer HY gulls using Chicago's beaches and was likely a beneficial factor for reduced frequencies of swim advisories and swim bans.     

Response of ants and spiders to prescribed fire in oak woodlands of California

Conservation managers of oak woodlands have been reintroducing fire both as an ecological process per se and to assist in restoring native plant communities. To increase our understanding of the impacts of reintroduced fire on ground-dwelling invertebrates we examined the response of ants and spiders to a late season (autumn) prescribed fire conducted in a blue oak (Quercus douglasii) woodland ecosystem in northern California. Twelve 100 m × 100 m plots were established, six plots received a burn treatment and the remaining six plots were unburned controls. Ants and spiders were sampled using pitfall traps left open continuously and collected approximately every 32 days. Sampling was conducted over a year, consisting of four pre-burn and nine post-burn collections. Abundance was analyzed using a repeated measures ANOVA, which showed seed-harvester ants decreased significantly in the two months following the fire. Total spider abundance also showed a significant decrease in two months, although this did not occur immediately after the burn. One spider hunting guild, the ‘diurnal ambush’ group (Thomisidae) remained suppressed for up to nine months. Correspondence analysis measures of ant species abundance with environmental and vegetation variables (percent rock, bare ground, plant species richness and height of herbaceous vegetation) were higher than expected by chance, which assists in explaining some of the responses. Findings from this study revealed that the reintroduction of autumn burns has modest and short-term effect on the invertebrates sampled, suggesting that late season fires are compatible with other conservation goals for oak woodland ecosystems.     

Density-dependent effects on productivity in the Griffon Vulture Gyps fulvus: the role of interference and habitat heterogeneity

Griffon Vultures Gyps fulvus in northern Spain were studied between 1969 and 1994. The number of breeding pairs increased from 221 in 1969–1975 to 1395 in 1994. The annual population growth rate decreased in the last 5 years, and this may reflect population regulation through density-dependent phenomena. Breeding success was monitored in 1994 and examined in relation to colony size, density of breeding pairs within a radius of 25 km (regional density), climate, human disturbance and food availability. We also recorded whether the year of first occupation of each nest site was before 1989 or after 1989 and whether or not the nest had a rocky shelter. The probability of successfully raising young declined as the regional density increased, which suggests that resource limitation would take place at foraging sites because the Griffon Vulture scavenges socially and no permanent feeding hierarchies are established. The other significant variable was the year of occupation of the nest; nests occupied after 1989 had a lower probability of raising a chick. The increase in the regional density of Griffon Vultures produced a decrease in the productivity at both optimal and suboptimal nest sites. This suggests that density-dependent regulation of breeding success operates through interference and that all the individuals in a colony are similarly affected. In birds of prey, prevalence of interference or habitat heterogeneity may be dependent on the social strategy of each species in space exploitation.     

Sewage and community shower drains are environmental reservoirs of Fusarium solani species complex group 1, a human and plant pathogen

In two recent studies, clinical isolates in the Fusarium solani species complex (FSSC) were sequenced; one of the most common lineages was FSSC Group 1 (FSSC 1), a phylogenetic species that is synonymous with F. solani f. sp. cucurbitae race 2, a pathogen of cucurbit fruits. FSSC 1 was also identified in sink and shower drains in two hospitals. The environmental sources of FSSC 1 are important for understanding the epidemiology of both human and plant diseases caused by this organism. FSSC 1 was detected in sewage influent at all six tested urban wastewater treatment plants (WWTPs) in California with a concentration ranging from 75 to 413 colony-forming units (cfu) l⁻¹, a mean of 246 ± 52 cfu l⁻¹ and a median of 254 cfu l⁻¹. During the treatment process, the concentration of FSSC 1 in the solid and liquid fractions diminished. FSSC 1 was detected in five and six of 14 community shower drains by culturing and polymerase chain reaction, respectively, whereas FSSC DNA was detected in all drains. FSSC accounted for 17 ± 6% ( n  = 14) of the total fungal DNA in the drains. FSSC 1 was rarely isolated from post-harvest cucurbit fruits and was not found in cucurbit fields in California.     

Fitness components of Aphytis melinus (Hymenoptera: Aphelinidae) reared in five California insectaries

Shipments of 50,000 commercially reared Aphytis melinus DeBach were obtained from each of the five insectaries that produce and sell this parasitoid to citrus growers in California for control of California red scale, Aonidiella aurantii (Maskell). Shipments were received from each insectary every 2 mo over a period of a year to assess variability in quality through time and between insectaries. As indices of quality, we assessed the percentage of live parasitoids (both sexes) 1, 3, 7, 14, and 28 d after receipt of the shipment, shipment sex ratio, and the size of female wasps. We found a fair amount of variation in the percentage of A. melinus that were alive on different sampling days. Despite the fact that all insectaries rear A. melinus in temperature controlled rooms and all of our studies were done at 22°C, wasp mortality occurred more quickly in the colder months of November, January through February, and March. Similar trends were observed with sex ratios; many of the insectaries had male-biased sex ratios in the colder months, especially January through February. Wasp size varied significantly for each of the insectaries throughout the year, with the summer months of July through August yielding significantly smaller females than other months. Collectively our results have important implications for biological control on citrus in California.     

Culture and Progress. DISTINGUISHED LECTURE-1975

This paper is the text of the sixth Distinguished Lecture, delivered in San Francisco at the 74th annual meeting of the American Anthropological Association, December 1975. The Lectureship was established in 1969 to honor outstanding scholars in the profession. Colson, a social anthropologist and ethnographer of wide experience, has worked in both the New and the Old Worlds, with American Indian and central African cultures. She is currently Fairchild Fellow, California Institute of Technology, on leave from her professorship at the University of California, Berkeley. Her interest in both the history and the future of our profession is reflected in her talk. The first five Distinguished Lectures—by Joseph H. Greenberg, Robert J. Braidwood, Georges Condominas, John W. M. Whiting, and Miguel León-Portilla—were published in the Association's Annual Reports (1970–74). The Lecture will now appear each year in the American Anthropologist.     

Medical School Graduates Who Leave California: A Study at the University of California,San Francisco

A follow-up survey of 1,087 physicians who had graduated from the University of California, San Francisco, School of Medicine from 1951 through 1971 was completed in 1977. A total of 307 (28.2 percent) of these persons were found to have left California. Comparison of the 307 who left with the 780 who remained showed only slight and statistically insignificant differences on most variables, such as sex, academic performance in premedical and medical education, educational level and social class of parents, age at entry into medical school, ratings by admissions interviewers, choice of specialty and a wide variety of personality inventory measures. Among the variables that did differentiate were place of birth, location and prestige of premedical college, preferences for subjects in the sciences and the humanities, and the Medical College Admission Test (MCAT) scores for quantitative ability and general information. However, attempts to combine these individual differentiators into clusters or equations from which to forecast emigration from California were unsuccessful.     

Impact of management treatments on waterfowl use of dense nesting cover in the Canadian parklands

Periodic treatment of established stands of dense nesting cover (DNC) is a recommended practice to maintain cover quality, but little information exists on the magnitude and duration of treatment effects on nesting waterfowl. During 1998–2001, we examined the effect of management treatments on vegetative characteristics and waterfowl nest success and density in fields of DNC seeded to introduced and native grass and forb mixes in the parklands of Saskatchewan and Manitoba. We measured vegetation height–density and litter depth within fields and located and monitored 1,927 duck nests within 33–42 fields/yr ranging in size from 6 ha to 62 ha. We considered a series of models examining the influence of grass type and management treatment (GTMT) and years post-management (YPM) on vegetative characteristics, nest success, and nest density while including covariates potentially affecting these response variables. Visual obstruction and litter depth were lowest in native-burned fields and greatest in introduced-hayed fields. Visual obstruction was low the year following management, peaked 2–3 YPM, and remained at intermediate levels through ≥6 YPM. Litter depth remained low for the first 3 YPM and increased thereafter. Nest success and nest density varied little among GTMT. Nest success was high (14.3%) the year following a management treatment, low (6.5%) at 2 YPM, and moderate thereafter. Nest success decreased with percent cropland in the surrounding landscape. Nest density was 0.7 nests/ha the first year following management, increased to approximately 1.3 nests/ha in years 2–3, and declined back to approximately 0.7 nests/ha for ≥6 YPM. Nest density decreased with field size and increased with the area of small wetlands, percent cropland, and percent wetland within surrounding landscapes. Nest density tracked vegetation density as expected and our results indicate a possible trade-off between nest density and nest success. Given ancillary data on small mammal and insect prey in our study fields, and evidence from other studies, we speculate that DNC fields may act as prey reservoirs during years of peak vegetative density with a consequent reduction in nest survival. Therefore, management to increase waterfowl production based on our results needs to consider the interaction of treatment effects, competing habitats, and surrounding landscape composition. © 2011 The Wildlife Society.     

Root production and demography in a california annual grassland under elevated atmospheric carbon dioxide

This study examined root production and turnover in a California grassland during the third year of a long‐term experiment with ambient (LO) and twice‐ambient atmospheric CO₂ (HI), using harvests, ingrowth cores, and minirhizotrons. Based on one‐time harvest data, root biomass was 32% greater in the HI treatment, comparable to the stimulation of aboveground production during the study year. However, the 30–70% increase in photosynthesis under elevated CO₂ for the dominant species in our system is considerably larger than the combined increase in above and belowground biomass. One possible explanation is, increased root turnover, which could be a sink for the additional fixed carbon. Cumulative root production in ingrowth cores from both treatments harvested at four dates was 2–3 times that in the single harvested cores, suggesting substantial root turnover within the growing season. Minirhizotron data confirmed this result, demonstrating that production and mortality occurred simultaneously through much of the season. As a result, cumulative root production was 54%, 47% and 44% greater than peak standing root length for the no chamber (X), LO, and HI plots, respectively. Elevated CO₂, however, had little effect on rates of turnover (i.e. rates of turnover were equal in the LO and HI plots throughout most of the year) and cumulative root production was unaffected by treatment. Elevated CO₂ increased monthly production of new root length (59%) only at the end of the season (April–June) when root growth had largely ceased in the LO plots but continued in the HI plots. This end‐of‐season increase in production coincided with an 18% greater soil moisture content in the HI plots previously described. Total standing root length was not affected by CO₂ treatment. Root mortality was unaffected by elevated CO₂ in all months except April, in which plants grown in the HI plots had higher mortality rates. Together, these results demonstrate that root turnover is considerable in the grassland community and easily missed by destructive soil coring. However, increased fine root turnover under elevated CO₂ is apparently not a major sink for extra photosynthate in this system.     

Long-term follow-up of the effectiveness and safety of inferior turbinectomy.

The long-term effectiveness and safety of inferior turbinectomy were assessed in 186 patients who were interviewed and examined 10 to 15 years after surgery (mean 12.3 years). Relief of nasal obstruction was reported by 82 percent of the patients; rhinoscopy showed wide, clean nasal airways in 88 percent. Rhinorrhea was still a problem for 34 percent of patients, and 19 percent were receiving medical treatment for this symptom. Smell acuity had improved in 52 percent of the patients. Before turbinectomy, 32 patients had suffered from bronchial asthma; postoperatively, there was an improvement in 16, and no change in 13; 3 patients reported exacerbation of asthmatic attacks. Atrophic changes of the nasal mucosa and chronic purulent infection were not observed in any of the patients.