Fire frequency and vulnerability in California

Wildfires pose a large and growing threat to communities across California, and understanding fire vulnerability and impacts can enable more effective risk management. Government hazard maps are often used to identify at-risk areas, but hazard zones and fire experience may have different implications for communities. This analysis of three decades of fire footprints, hazard maps, and census and real estate data shows that communities with high fire experience differ substantially from communities with high fire hazard. High-hazard communities average higher incomes than low- and no-hazard communities; conversely, communities with high fire experience average lower incomes than those with little to no experience. Home values have grown more slowly in communities with high fire experience, translating to differences in total appreciation of $165M-$630M per year relative to communities with no fire experience. Warming over the remainder of the century could add tens of thousands of homes to high-experience zones. This relationship between income and fire experience may be a reflection of the impacts of repeated fires relative to mapped hazards or single fires, or it could point to a relationship between income and the success of fire prevention or suppression. The discrepancies between dimensions indicates that considering fire frequency can support efforts to equitably target risk management resources

Emissions redistribution and environmental justice implications of California’s clean vehicle rebate project

Vehicle electrification is expected to reduce, in aggregate, emissions of greenhouse gases and criteria air pollutants. However, increased electricity generation to support new electric vehicles introduces possible redistribution of point-source emissions from mobile vehicles to electric generating units such that emissions may decrease in some locations and increase in others, with implications for equity. The potential for vehicle electrification to thereby shift the spatial distribution of air-pollution burdens has been previously noted, but analyses have yet to evaluate specific implemented climate policies. Here, we develop a model to analyze the implications of California’s Clean Vehicle Rebate Project (CVRP) for emissions of greenhouse gases and criteria air pollutants, both in aggregate and in their distribution. Analyzing rebates for 2010–2021, we find that the CVRP reduced aggregate statewide emissions of CO2, NOX, and SO2 and increased aggregate statewide emissions of primary PM2.5. Furthermore, changes in air pollution are not distributed equally: our results indicate that, as a result of the CVRP, net primary PM2.5, NOX, and SO2 emissions reductions disproportionately occur in Least Disadvantaged Communities, as compared to Disadvantaged Communities, with community disadvantage defined according to CalEnviroScreen 4.0 per California legislation. If the current spatial distribution of electric vehicle rebates remains unchanged, we project that these inequities will continue through the state’s legislative goal of 1.5 million zero-emission vehicles on California roadways by 2025, even with increased cleanliness of the electricity sources for new vehicles. Increased uptake of electric vehicles in communities facing the highest air pollution exposure, along with accelerated clean-energy generation, could ameliorate associated environmental inequities

DIP during perioperative chemotherapy

Purpose : Drug-induced interstitial pneumonia (DIP) that occurs during chemotherapy for breast cancer is a rare but a serious adverse event. Treatments of DIP requires interruption of breast cancer treatment, which may affect the patient’s prognosis. However, there are few reports which discuss DIP during breast cancer treatments. Purpose of this report is to make clear how DIP occurred and influenced breast cancer treatment in our hospital. Patients and Methods : A total of 74 patients who started perioperative chemotherapy in Tokushima Municipal Hospital for breast cancer from January 2019 to December 2020 were evaluated for DIP. Patients’ and tumors’ characteristics, and regimens which caused DIP were investigated. The clinical courses of the DIP patients were also followed up. Results : Twelve of the 74 patients developed DIP. All 12 patients had histories of cyclophosphamide administration ; however, the causative drug could not be determined. Ten of the 12 patients were treated with steroids, and all the patients recovered ultimately from the interstitial pneumonia. While chemotherapy was administered in six patients after mild DIP, no relapse of pneumonia was observed. Conclusion : DIP during perioperative chemotherapy for breast cancer was resolved with appropriate treatment. Patients were able to resume breast cancer treatment with minimal interruption

Recurrent giant longitudinal duodenal ulcer with massive hemorrhage in a Helicobacter pylori-negative patient

A 67-year-old man, in whom a linear ulcer running from the duodenal bulb to the descending part had been noted 3 years previously, was admitted to our hospital because of abdominal pain and melena. Duodenoscopy revealed a bleeding giant longitudinal ulcer, which was more extensive than before. Tests for Helicobacter pylori (Hp) were negative. The ulcer was cured by endoscopic hemostasis and repeated blood transfusions. Attention must be paid to Hp-negative post-bulbar duodenal ulcers because of the frequent complications including hemorrhage

新人看護師の看護基本技術習得に向けた統合型評価システムの有用性の検討

目的：看護基本技術習得に向けた統合型評価システムが，新人看護師の技術習得と課題の明確化につながっているかを明らかにし，システムの有用性を検討する． 方法：①システムを使用した新人看護師（以下システム使用後）14名とシステムを使用していない新人看護師20名のチェックリストの得点を統計学的に分析した．②システム使用後14名の課題を表す「整理シート」の記述を内容分析した．③システム使用後14名の知覚をインタビューし内容分析した． 結果：①入職1か月，6か月，1年でシステム使用後の得点が有意に高かった．②整理シートの課題は，自己学習や日常生活援助などが多く時期の経過とともに内容も変化した．③システム使用後14名の知覚は，【システムの使用で課題が明確になった】，【チェックリストが目標となり取り組めた】など，12カテゴリを形成した． 結論：システムの活用は，技術習得，課題の明確化，目標設定などを促進し有用性を示唆した．Objectives: To clarify whether an integrated evaluation system for novice nurses will contribute to the acquisition of skills and clarify nursing tasks [Does this reflect your intended meaning here and below?], and to evaluate the effectiveness of that system. Methods: We compared checklist scores of 14 novice nurses who used the system and 20 novice nurses who did not use the system by statistical analysis. “Summary sheets” that described problems with nursing tasks experienced by nurses who used the system were analyzed. In addition, we interviewed the nurses who used the system to obtain their impression of the system. Results: The scores of nurses who used the system were significantly higher at 1, 6, and 12 months after beginning their jobs. Most of the tasks observed on the summary sheets were related to self-learning and daily living care for patients; however, the tasks listed on the summary sheets changed over time as the nurses gained more experience [Is this addition ok?]. Nurses' impressions of system were classified into 12 categories, such as [use of the system helped to clarify tasks] and [ability to concentrate on completing the checklist as a goal]. Conclusions: The introduction of this system promoted the effective acquisition of skills, identification of problems, and setting of goals.報

Replication code for Metrics of wildfire risk in California

TEMPORARY - more to be added in future

Emissions redistribution and environmental justice implications of California’s clean vehicle rebate project

Vehicle electrification is expected to reduce, in aggregate, emissions of greenhouse gases and criteria air pollutants. However, increased electricity generation to support new electric vehicles introduces possible redistribution of point-source emissions from mobile vehicles to electric generating units such that emissions may decrease in some locations and increase in others, with implications for equity. The potential for vehicle electrification to thereby shift the spatial distribution of air-pollution burdens has been previously noted, but analyses have yet to evaluate specific implemented climate policies. Here, we develop a model to analyze the implications of California’s Clean Vehicle Rebate Project (CVRP) for emissions of greenhouse gases and criteria air pollutants, both in aggregate and in their distribution. Analyzing rebates for 2010–2021, we find that the CVRP reduced aggregate statewide emissions of CO 2 , NO X , and SO 2 and increased aggregate statewide emissions of primary PM 2.5 . Furthermore, changes in air pollution are not distributed equally: our results indicate that, as a result of the CVRP, net primary PM 2.5 , NO X , and SO 2 emissions reductions disproportionately occur in Least Disadvantaged Communities, as compared to Disadvantaged Communities, with community disadvantage defined according to CalEnviroScreen 4.0 per California legislation. If the current spatial distribution of electric vehicle rebates remains unchanged, we project that these inequities will continue through the state’s legislative goal of 1.5 million zero-emission vehicles on California roadways by 2025, even with increased cleanliness of the electricity sources for new vehicles. Increased uptake of electric vehicles in communities facing the highest air pollution exposure, along with accelerated clean-energy generation, could ameliorate associated environmental inequities

Risk screening methods for extreme heat: Implications for equity-oriented adaptation.

Morbidity and mortality impacts of extreme heat amplified by climate change will be unequally distributed among communities given pre-existing differences in socioeconomic, health, and environmental conditions. Many governments are interested in adaptation policies that target those especially vulnerable to the risks, but there are important questions about how to effectively identify and support communities most in need of heat adaptations. Here, we use an equity-oriented adaptation program from the state of California as a case study to evaluate the implications of the currently used environmental justice index (CalEnviroScreen 3.0) for the identification of socially vulnerable communities with climate change adaptation needs. As CalEnviroScreen is geared towards air and water pollution, we assess how community heat risks and adaptation needs would be evaluated differently under two more adaptation-relevant vulnerability indices: the Social Vulnerability Index and the Heat-Health Action Index. Our analysis considers communities at the census tract scale, as well as the patterns emerging at the regional scale. Using the current index, the state designates 25% of its census tracts as "disadvantaged" communities eligible for special adaptation funds. However, an additional 12.6% of the state's communities could be considered vulnerable if the two other indices were considered instead. Only 13.4% of communities are vulnerable across all three vulnerability indices studied. Choice of vulnerability index shapes statewide trends in extreme heat risk and is linked to a community's likelihood of receiving heat-related California Climate Investments (CCI) projects. Tracts that are vulnerable under the current pollution-focused index, but not under the heat-health specific index, received four times the number of heat-related interventions as tracts vulnerable under the reverse scenario. This study demonstrates important nuances relevant to implementing equity-oriented adaptation and explores the challenges, trade-offs, and opportunities in quantifying vulnerability