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CDPH in the News January 2018

CDPH in the News

Kern hospital employees least vaccinated in California

from Bakersfield Now

As we enter the peak of flu season, dozens of local residents will end up in hospitals for treatment. What they may not know is that many of the people treating them have not received a flu shot. Last year, Kern County had the lowest immunization rate among hospital employees in the state, with only 70 percent getting the flu shot.
According to the California Department of Public Health, last year at Bakersfield Memorial Hospital only 62 percent of employees got vaccinated, 65 percent at Kern Medical, 54 percent at Mercy Hospital, 52 percent at Mercy Southwest, and 78 percent at Adventist Health. In fact, the study shows only four hospitals in Kern County are meeting the state’s expectations of 81 percent immunized staff.

California flu deaths spike to 74 this season, 32 in 1 week

from ABC&.com

Thirty-two people died of the flu last week, and 74 have died since October, the California Department of Public Health said. The California Department of Public Health said the reported deaths reflected those who were younger than 65 years old. Currently, there are 60,000 confirmed cases of the flu nationwide. Videos included in story.

Syringe exchangers more likely to get treatment

from Eureka Times Standard

After 18 years as Humboldt County Public Health Officer, I worked in the Bay Area for six years. Returning to Humboldt in 2107, I visited Humboldt Area Center for Harm Reduction (HACHR) in Eureka and was thrilled with this well-run program that started in my absence.
The issue with used syringes on the street pre-dates syringe exchange programs here. Syringe exchange programs have operated in California since the 1980s. A study comparing cities with and without syringe exchange programs found that people who inject drugs were 34 more likely to safely dispose of used syringes if they had access to needle exchange. HACHR follows the model of “needs-based” distribution recommended by the California Department of Public Health as the model most likely to reduce needle sharing with transmission of HIV and Hepatitis B and C without increasing unsafe syringe disposal.

Sheriff’s stations collect 6,813 pounds of old and unneeded medications

from VC Star

The Ventura County Sheriff’s Office announced the annual results of its collection of unused and expired prescription medications for 2017. The agency collected 6,813 pounds over the course of the year, the highest annual total since it began collecting prescription drugs in 2013. It has collected 29,143 pounds in total over the past five years. Also presented in the article are some numbers on the state’s opioid problem from the California Department of Public Health and its Opioid Overdose Surveillance Dashboard.

Marijuana use among pregnant teens has spiked in California

from Vice

California already has the world’s largest pot economy and the state is preparing to legalize recreational sales on Jan. 1. But a new study about marijuana use by pregnant women suggests the pot boom is having an overlooked impact on public health. The California Department of Public Health has already started to warn pregnant women about the dangers of getting stoned. The department maintains a webpage called “Let’s Talk Cannabis,” which includes a section that says “if you use cannabis while you are pregnant or breastfeeding the growth and development of your baby’s brain can be harmed, and your baby is more likely to be born with a lower birth weight and to have health problems.”

New California law aims to reduce pool and spa drownings

from Orange County Register

A law that will go into effect Monday, Jan. 1 requiring an additional safety feature for newly constructed or remodeled pools and spas aims to reduce drownings – the leading cause of death among California toddlers. It further strengthens a 20-year-old regulation requiring new or remodeled pools to have at least one safety device, such as a fence, a cover or an alarm. Under the new law, new pools and spas must have at least two safety mechanisms.
Drowning is the leading cause of death among children ages one to four, claiming the lives of more than 160 such boys and girls in California from 2010 to 2014, according to the California Department of Public Health.

Wondering how, where, and what to publish? Our symposium (Jan. 31) has you covered.

How, Where, and What to Publish: UC Berkeley Scholarly Publishing Symposium
January 31, 8:30 a.m.-12:30 p.m.

309 Sproul Hall (Graduate Professional Development Center)

Register online: bit.ly/013018pubsymposium

Are you an early career researcher looking to make a mark? Come hear from leading scholarly journal and book publishers (such as Elsevier, Springer-Nature, and UC Press) and open publishing framework and platform creators (such as Collaborative Knowledge Foundation and California Digital Library) during a half-day symposium in which experts cover all aspects of how, where, and what to publish.

More details here:

Wondering how, where, and what to publish? Our symposium has you covered.

CDPH In The News, December 2017

CDPH in the News

Bears exposed to plague found in Paradise

from ChicoER

Two black bears exposed to the plague were found in Paradise, according to the California Department of Public Health. The department collected blood in September from two bears killed under depredation permits, and the samples tested positive for antibodies to Yersinia pestis, the bacterium that causes plague.

California Plant Transforms Medical Waste to Green Energy

from Future Structure

Aemerge RedPak officials said Christmas came early as they unveiled their “technological wonder” to the High Desert in the form of the first medical waste treatment facility permitted in California. “Besides being the only facility in the state permitted to treat all types of medical waste as regulated by the California Department of Public Health, RedPak will have also created 30 new jobs within the community at full ramp-up.”

Why big business will love California’s new marijuana rules, and why you should worry

from Sacramento Bee

McWeeds may be coming soon to your community. The state of California last week proposed emergency rules to regulate marijuana when recreational use becomes legal in January. Some parts of the emergency regulations are urgently needed. But their overall breadth and lack of caution will fulfill big business’s wildest dreams. They will promote the unfettered growth of a new harmful California industry dominated by special interests and wealthy investors, not the health and well-being of our communities.
The California Department of Public Health’s subset of the proposed new regulations do make some significant progress: not allowing human or animal-shaped edibles, nixing cartoons from packaging and generally saying products shouldn’t be attractive to youth or look like M&M’s. But that’s not enough.

SLO Food Bank cited for ‘food adulteration’ in addition to permit issue

from KSBY

The Food Bank Coalition of San Luis Obispo County is facing a citation related to unsanitary conditions in addition to an issue over apparently expired paperwork. According to the California Department of Public Health (CDPH), a state investigator inspected the Food Bank’s facility on Kendall Road in San Luis Obispo on Monday, Nov. 27 and observed unsanitary conditions. It also found that the Food Bank was operating without a valid Processed Food Registration permit.

Public Health Office teams up with spiritual leader to talk safe sex

from The Renegade Rip

A 2016 California Department of Public Health report found that one out of every four sexually active teen girls in Kern County has an STD. Kern County ranked fourth highest in cases of Gonorrhea and Primary and Secondary Syphilis, while ranking second highest in Chlamydia. The county also exceeds state averages for Congenital Syphilis, a form of Syphilis that is passed from mother to child during pregnancy, by 344 percent.
“We asked our community for help, including parents, educators, medical providers, media, non-profits, and the faith-based community.” The first to accept the invitation was Pastor Eric Simpson of the Bridge Bible Church. KCDPH staff joined Simpson at his church in giving a presentation on ways in which parents should discuss sexual health issues with their children.

Avoiding EMF radiation not as easy as quitting smoking

from San Francisco Chronicle

How much more proof do we need that being online isn’t healthy for us? The latest terrible tech research is from Kaiser Permanente, published last week in the journal Scientific Reports. In a study of hundreds of pregnant women in the Bay Area, the authors found that those who were more exposed to the kind of radiation produced by cell phones, wireless networks and power lines were nearly three times as likely to suffer miscarriages.
San Francisco’s radiation-warning law, championed by then-Mayor Gavin Newsom, passed in 2010. But after a lawsuit from the cell phone industry, the city backed off on implementing it. Around the same time, the California Department of Public Health drew up its set of guidelines to inform the public about the risks associated with cell phone use. The health department then sat on these guidelines — for seven years — until The Chronicle told the state it was going to publish a news story about the case, and a judge signaled that she would order them to be released.

CDPH In The News, November 2017

CDPH in the News

INTERACTIVE MAP: What does the opioid epidemic look like in California?
from Bakersfield.com

Just days before President Donald J. Trump declared the opioid epidemic a National Public Health Emergency, California’s Department of Public Health released a slew of data related to opioid overdose death, prescriptions and incidence. Roughly 1,925 people died in California of opioid overdose, including 51 in Kern County, which had a death rate of 5.7 per 100,000 people, topping the state average of 4.6.
So where are opioid deaths occurring? We’ve used the data to narrow it down by zip code. Take a look at what your neighborhood looks like.

State water board scraps restrictions on toxic metal
from San Diego Union Tribune

California must go back to the drawing board and reassess limits for how much hexavalent chromium — a toxic compound made famous in the film “Erin Brokovich” — can be present in drinking water. The state water board last month eliminated a rule restricting how much of the heavy metal is permitted in drinking water supplies after Sacramento Superior Court Judge Christopher Krueger ruled that state regulators didn’t consider whether the restrictions were economically feasible.
Krueger agreed with arguments by the California Manufacturers and Technology Association and the Solano County Taxpayers Association that the California Department of Public Health didn’t properly analyze the economic impacts of the rule, which the plaintiffs argued would be “massively expensive.” The State Water Resources Control Board must now develop a new standard for the chemical, with more rigorous analysis of its costs.

Mendocino County’s climate change-related health impacts
from Ukiah Daily Journal

Mendocino County is a large rural county, stretching along the Pacific Coast, across fault lines and spanning miles inland to valleys full of vineyards and marijuana cultivation. It’s home to less than 90,000 people, redwood forests, wild boars and salmon. Despite its unique landscape, climate change projections show it’s set to experience changes just like any other county. Putting together public data from local and state agencies, the California Department of Public Health published a report that’s designed to help counties develop plans for the unique health impacts expected as a result of climate change.
Expecting to see increases of average January temperatures by 2 degrees Fahrenheit by 2050, and five degrees by 2100 in Mendocino County, among other changes, public health officials have compiled projected risks and health impacts. Their goal is to give counties the most up-to-date information so that they may make more informed public health decisions.

California’s got the fever—Valley Fever, that is
from Safety.BLR.com

What’s native to dry southwest US soils, causes a flu-like illness that can turn deadly, and can get you cited by Cal/OSHA for letting workers be exposed? It’s Valley Fever—a disease caused by inhaling fungal spores—and California is reporting an uptick in both cases of Valley Fever, and Cal/OSHA citations arising from it. The California Department of Public Health (CDPH) has taken the unusual step of releasing provisional data—data showing suspect, probable, and confirmed cases of Valley Fever infection—because they are seeing a striking increase in the number of new Valley Fever cases reported in California through October 31, 2017.

Hospital will stop seeing patients amid dispute, forcing them to travel for care
from Fresno Bee

Tulare Regional Medical Center and clinics will not be open for patients beginning midnight Sunday, leaving the city without a hospital and health workers potentially without jobs. The district issued a notice Thursday afternoon stating it is voluntarily suspending its license with the state of California to operate the 112-bed hospital, clinics and other outpatient facilities. Niki Cunningham, a Fresno lawyer retained by the district board, said Thursday that she had been told by the California Department of Public Health that no new patients were being admitted.

Hepatitis A reaches beyond homeless; vaccine dwindling
from Food Safety News

An ongoing hepatitis A outbreak among more than 1,200 people in at least five states, with more than 800 hospitalizations and 40 deaths, has local and state officials struggling to meet vaccination needs. Many of the victims of the outbreak — described by the California Department of Public Health as the largest person-to-person hepatitis A outbreak in America since a vaccine for the virus became available in the mid-1990s — are homeless people or substance abusers, or both. However, a third of the 644 confirmed ill people in California and a fourth of the 495 confirmed ill people in Southeast Michigan are neither homeless nor substance abusers. Other states reporting confirmed outbreak cases are Utah, Arizona and Colorado.

bioRxiv: a free open access archive for unpublished preprints in the life sciences

bioRxiv (pronounced “bio-archive”) is a free online archive and distribution service for unpublished preprints in the life sciences. It is operated by Cold Spring Harbor Laboratory, a not-for-profit research and educational institution. By posting preprints on bioRxiv, authors are able to make their findings immediately available to the scientific community and receive feedback on draft manuscripts before they are submitted to journals.
bioRxiv accepts preprints of articles covering all aspects of research in the life sciences. Categories include:
  • Bioengineering
  • Cancer biology
  • Cell biology
  • Ecology
  • Epidemiology
  • bioRxiv logoGenomics
  • Molecular biology
  • Neuroscience
  • Pharmacology and toxicology
  • Scientific Communication and Education
and more.
Readers may add public comments to articles on bioRxiv. Comments are moderated to ensure they conform to the standards of normal professional discourse.
Once an article is published in a journal, bioRxiv will automatically update the preprint with a link to the published version.

Free online does not equal open access

Lots of articles are freely available online. Does that mean they are open access? Nope.

Here’s a nice post on the difference between public access  and open access:


Basically, the difference is in copyright ownership:

“In public access, funding agencies make research results freely available, while still retaining traditional copyright restrictions. As with a published journal article, anyone can read the findings, but no one may redistribute the content without permission. In OA, the content is freely available and may be reused or even republished by others without having to gain permission. Many OA authors choose to protect their content by applying a Creative Commons or similar license to their work.”

For more information, read the original post.

If you only use PubMed to find public health articles, you may be missing lots!

PubMed is a great source of journal article citations on most public health topics. It’s where I usually start. But there are many other article databases you should use, depending on your topic. Here are a few examples:

Embase is an international index including over 2,000 journals not in Medline/PubMed, as well as conference abstracts. Broad biomedical scope with strong coverage in drug, pharmaceutical, and toxicological research, including economic evaluations and healthcare policy & management. Includes a PICO search tool, as well as drug, device, and disease searches.

Global Health is a public health database particularly strong for finding articles from or about countries in the “Global South.” Topics such as environmental health, nutrition, infectious diseases, and more are covered.

Sociological Abstracts offers access to the international literature in sociology, demography, social psychology, and related disciplines in the social and behavioral sciences. If your research is on families, social relationships, peer groups, etc., you should try this database.

This is but a small sample of the databases offered by the UC Berkeley Library. For more public health databases, please visit our Databases in Public Health guide.


CDPH in the News, October 2017

CDPH in the News

State Health Officer Urges Caution During Wildfire Cleanup

from YubaNet

California Department of Public Health (CDPH) Director and State Health Officer Dr. Karen Smith today advised residents of recently burned areas to use caution in cleaning up ash from recent wildfires. Ash from trees burned in wildfires is relatively nontoxic and similar to ash that might be found in your fireplace. However, ash from burned homes and other items will likely contain metals, chemicals, and potentially asbestos, items that may be considered toxic if breathed in or touched with wet skin.

Understanding California’s Hepatitis A outbreak

from PBS

On March 18, the California Department of Public Health first announced an outbreak of the Hepatitis A virus. Seven months later on Oct. 13, California Governor Jerry Brown declared a state of emergency. Reported cases of Hepatitis A had more than tripled in the state, and 19 people have died. Nearly 600 hepatitis A cases, mostly concentrated in downtown San Diego, have been reported since the beginning of the outbreak, likely caused by person-to-person transmission. This is up from an average 160 cases per year in California, said Dr. Gil Chavez, state epidemiologist at California Department of Public Health. More than 500 of the cases were reported in San Diego County.

An ‘open door’: Gay and Lesbian Center celebrates new facility

from Bakersfield.com

The Gay and Lesbian Center of Bakersfield celebrated the opening of its new home with an open house and ribbon-cutting ceremony on Thursday. The Annex, as it’s called, located at 841 Mohawk St., provides private counseling, workshops and other services. Vice Mayor Bob Smith and Councilman Andrae Gonzales, as well as representatives from the offices of Congressmen Kevin McCarthy and David Valadao, were among those attending the event.
“We’re very excited about what today represents. This is such an achievement for the center,” Center Executive Director Jan Hefner said. “Before the center was born in 2011, there was no specific place available year-round where LGBTQ people could gather in comfort and create a community. This new facility gives us the ability to expand our services.”
The Annex was developed after the center received a five-year $1.18 million grant in September 2016 from the California Reducing Disparities Project, a program of the California Department of Public Health.

Policy changes at Alameda Co. hospital after high-profile murder: 2 Investigates

from KTVU

The California Department of Public Health has agreed with part of an Oakland mother’s complaint that Alameda Health System (AHS) could have done more to treat her mentally ill son, who later followed through on threats to kill his own brother. Days after Demetrius Sells was discharged from Highland Hospital — an AHS-run facility — in May 2015, he stabbed and killed his brother Kevin McGhee.
Before being discharged, medical records obtained by 2 Investigates show Sells had attempted suicide, overdosing on the prescription drug Abilify. He also threatened to kill McGhee for calling 911. Documents show staff knew Sells made threats and had a history of bipolar disorder, drugs and violence. Sells spent less than nine hours in treatment before his mandatory hold was canceled by a John George mental hospital psychiatrist working in the hospital’s Emergency Department.

Why I’m Suing California for Lead Data

from Capitol and Main

Digging through documents for hidden truths and revelations is a huge part of what investigative journalists like myself do. Requests for documents made under California’s Public Records Act typically take 10 days to a month to be fulfilled. Sometimes the wait can be excruciatingly longer. Earlier this year I spent four months waiting and pleading with the California Department of Public Health (CDPH) to hand over 56 pages of documents related to lead contamination at a Sacramento gun range.
Ultimately, the records showed that in 2003, California public health officials were aware of life-threatening levels of lead at Sacramento’s city-owned, indoor Mangan Park Rifle and Pistol Range. Yet the range continued to operate for another dozen years, raising questions about official negligence in allowing such a hazardous operation to continue.
Because the delay in providing the documents seemed unreasonable and one not allowed under California law, I considered suing CDPH. However, public records lawsuits are time consuming, requiring an attorney who believes the case is one for which it is worth going to the mat. But occasionally lines are crossed that simply have to be challenged. That’s why I filed a lawsuit last week in Sacramento County Superior Court objecting to the secrecy surrounding the protracted cleanup of lead at the range.

STD Rates In California Reach ‘All-Time High’

from laist

According to a new report from the California Department of Public Health, California ranked first among all states in 2016 for the total number of cases of chlamydia, gonorrhea, syphilis, and congenital syphilis. Bacterial STD rates (chlamydia, gonorrhea, and syphilis) in California “significantly increased” in 2016, with over a quarter million cases reported during the course of the year. This marks a 40% increase compared to five years ago, according to the CDPH, which characterized the 2016 data as marking an “all-time high” for the state.

CDPH in the News, September 2017

CDPH in the News

Orange County’s wealthiest cities have biggest opioid problem

from 89.3 KPCC

Opioid abuse and overdoses have caused emergency room visits in Orange County to more than double over the last decade, according to a recent report from the county health care agency. The cities with the highest rates of opioid-related emergency room visits are in generally wealthy south Orange County and along the coast, with Dana Point at the top of the list. Orange County’s opioid-related death rate is much higher than the state average — and nearly three times higher than neighboring Los Angeles County, according to the California Department of Public Health’s Opioid Overdose Surveillance Dashboard.

Hepatitis C Virus outbreak among millennials

from Capitol Weekly

Millennials haven’t inherited the best batch of goods from baby boomers. They got a housing crisis, a shaky job market, and some enormous student loans. But until recently, viral hepatitis was the burden of boomers alone to bear. Now, millennials are also facing an outbreak of Hepatitis C Virus (HCV). California’s Department of Public Health says newly reported HCV infections increased 55 percent among men aged 20-to-29, from 2007 to 2015. Among women in the same age group the increase was 37 percent.
Viral hepatitis is often thought of as a disease of baby boomers. Since Hepatitis C wasn’t screened out of the blood supply until 1992, it’s been mostly older populations who are affected. But California is now seeing a spike in new HCV infections in millennials. With existing money tight and future funding uncertain to test and treat hepatitis, the observed increase could be just the tip of the iceberg.

California is ‘hiring extensively’ as recreational marijuana approaches

from Desert Sun

California is staffing up for the regulation of recreational marijuana. The state is seeking at least 175 employees in the Bureau of Cannabis Control, the CalCannabis Cultivation Licensing office and the California Department of Public Health. Those three agencies split the responsibilities of regulating recreational marijuana, which California voters approved in November 2016. A spokesperson for the Department of Public Health said the 2017-2018 budget created 50 new positions in cannabis regulation, which they aim to fill by January.

Protecting Oil/Gas Extraction Workers from Hazards

from Sun News

The National Institute for Occupational Safety and Health (NIOSH) and the California Department of Public Health, Occupational Health Branch (CDPH-OHB), recently released a video to help protect oil and gas extraction workers from the hazards they face when measuring oil storage tanks. The video, Protecting Oil and Gas Workers from Hydrocarbon Gases and Vapors, weaves together a narrative of the health and safety risks involved with this activity, and how employers and workers can reduce injuries and fatalities from exposure to toxic gases and oxygen-deficient atmospheres.
Over 500,000 workers are employed in the oil & gas industry, a workforce that is critical to the energy infrastructure of the nation. In the video, the experiences of oil and gas workers who are responsible for measuring tank levels, or tank gauging, and the sampling of crude oil are told from the heart by a truck owner/operator, a company operations superintendent, and the widow of a man who died of sudden cardiac death while gauging.

California will now track suicide among veterans

from San Diego Union Tribune

A new law will require California officials to compile statistics on how many military veterans are committing suicide in the state. Gov. Jerry Brown signed the legislation Monday. One of the law’s proponents said the new requirement makes California one of 22 states to accurately report veteran suicide. Assembly Bill 242 was introduced by two Fresno assemblymen, Republican Jim Patterson and Democrat Joaquin Arambula. Specifically, the legislation requires the California Department of Public Health to report the number of veteran suicides every year to the state Legislature and the U.S. Department of Veteran Affairs.
The data would come from county coroners.

CDPH in the News August, 2017

CDPH in the News

California health officials battle state’s largest hepatitis A outbreak in 2 decades

from Healio Infectious Disease News

The California Department of Public Health is working with local health officials in San Diego and Santa Cruz counties to contain the state’s largest hepatitis A outbreak in 2 decades. As of July 18, officials identified 251 cases and five deaths in San Diego, and 27 cases in Santa Cruz since the outbreak began in November, according to the California Department of Public Health (CDPH). San Diego’s Health and Human Services Agency reported that 69% of cases in the county required hospitalization.

California Valley Fever Cases Highest On Record

from Kaiser Health News

The number of Valley Fever cases in California rose to a record level in 2016, with 5,372 reported – a jump of 71 percent from the previous year. Historically, about three-quarters of cases have been in the state’s heavily agricultural San Joaquin Valley. The fungal infection, known as coccidioidomycosis, or “cocci,” is most common in the southern portion of the Valley and along the Central Coast of California. State health officials say they’re not sure what caused the recent increase, the largest since 2011, but “climatic and environmental factors” could have increased the risk of exposure to the airborne spores that cause the disease, according to the California Department of Public Health.

Study: Insurance Status Affects Cancer Outcomes

from Los Angeles Sentinal

Results from a recent study by the Cancer Prevention Institute of California, revealed that health insurance type at diagnosis greatly impacts cancer outcomes especially in adolescent and young adult patients. Published in the July 10, 2017 issue of Cancer Causes Control, researchers examined joint associations between sociodemographic factors – race/ethnicity, neighborhood socioeconomic status (nSES), and health insurance – and cancer survival for the most frequent cancers among AYAs. The research was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885 and the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute at the National Institutes of Health

Record number of students vaccinated under stricter state law

from Santa Clarita Valley Signal

A record number of students in seventh grade and kindergarten were vaccinated during the 2016-17 school year, according to two executive summary reports from the California Department of Public Health. According to the reports, immunizations increased to 98.4 percent for seventh grade students and increased to 95.6 percent for kindergarten students in 2016-17. The increase in immunizations could be attributed to the state’s stricter vaccination law that went into effect July 1, 2016. Senate Bill 277 ended the exemption of vaccinations based on personal beliefs. Under the law, only students enrolled in independent study programs or homeschooled programs are not required to be vaccinated. Students can also still receive exemptions due to medical reasons.

Want To Know Your Hospital’s C-Section Rate? Yelp Is On The Way.

from California Healthline

You might check Yelp reviews before deciding where to go to dinner, or which plumber to hire. Now you can use the website to decide where to have a baby. San Francisco-based Yelp is now adding clinical data on cesarean sections, episiotomies and breastfeeding rates to consumer reviews of California hospitals, so women can make better-informed decisions about where they deliver. Yelp’s maternity data is drawn from self-reported information from California hospitals, the California Department of Public Health and the state’s Office of Statewide Health Planning and Development.

How you can blast your ashes into space for just £9,500 or book yourself a cemetery plot on the MOON

from The Sun (UK)

A FUNERAL director has come up with an out-of-this-world plan for a final send off – blasting your ashes into space for nearly £10,000. People who choose a space funeral can either have a gram of cremated remains launched to the moon, or a small amount sent into a low-Earth orbit. The ashes will then eventually make their way back into the atmosphere, where they burn up completely. Celestis became the first to get permission from the California Department of Public Health to send cremated remains to space on the first privately funded lunar mission led by Moon Express.

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