Search

Background: Little is known regarding utilization of school-based health centers (SBHCs) during prolonged school closures, such as those that occurred during the COVID-19 pandemic. We sought to compare SBHC utilization before and after pandemic-related school closures across a network of SBHCs affiliated with a large Southern Californian urban school district. Methods: We conducted a secondary analysis of encounter data extracted from electronic health records from 12 SBHCs that remained open despite school closures, including patient demographics and diagnostic and billing codes. We used the Clinical Classifications Software Refined to group encounters for common primary care conditions. Utilization before and during pandemic-related school closures was compared using logistic regression with cluster-robust standard errors to account for clustering within clinics, after adjusting for month of encounter. Results: During the pandemic, study SBHCs conducted 52,530 encounters and maintained [approximately]4040 encounters/month. The frequency of encounters for annual preventative health exams increased for school-aged patients but decreased for other age groups while the frequency of encounters for mental health problems increased for all age groups. Implications for School Health Policy, Practice, and Equity: Despite pandemic-related school closures, SBHCs appeared play a critical role in providing primary care to vulnerable communities. Conclusions: SBHCs may hold value beyond their co-location with academic instruction.

The current pilot study examines the impact of the "Ten Education Commandments for Parents" program on (1) new immigrant Latino parents' knowledge of the U.S. public education system, (2) parent engagement, and (3) their children's academic achievement. Utilizing a pre-experimental, pre- and post-test research design, four schools with similar demographic compositions were chosen for the study. Parents in the experimental group (n = 68) participated in the "Ten Education Commandments for Parents" workshop sessions and completed pre- and post-tests to assess differences in their perceptions and knowledge of parent engagement before and after attending the program. Additionally, two consecutive years of student data from these parents' children (n = 164) were compared with students attending similar schools (n = 1,628) whose parents did not participate in the workshop sessions. Results from both parent survey questionnaires and student report cards strongly suggest positive outcomes in three areas: increase in parents' understanding and knowledge of the U.S. education system, greater parent engagement in their children's education, and improvement in student achievement. Findings also support the implementation of the "Ten Education Commandments for Parents" program in other schools, suggesting it has the potential to positively influence both parent engagement and the academic achievement of Latino students.

Background: In the United States, a long-standing debate has existed over advantages/disadvantages of general versus specialty hospitals. A recent stream of research has investigated whether general hospitals accrue performance benefits from a focus strategy; a strategy of specializing in certain clinical conditions while remaining a multiproduct firm. In contrast, a substantial and long-standing body of research on hospitals has been concerned with the absolute volume of cases in a service area as an indication of experience based largely on the idea that absolute volume confers learning opportunities. Purpose: We investigated whether hospital focus and experience in a service area have complementary effects or are largely substitutive for hospital performance. Methodology/Approach: Key data sources were patient discharge records and hospital discharge profiles from California's Office of Statewide Health Policy and Development for years 2010--2014. We specified hospital focus as the proportion of total cardiology-related discharges and hospital experience as the cumulative volume of cardiology-related discharges for each hospital. Performance was specified using quality (inpatient mortality and 30-day readmission) and efficiency (length of stay and cost) patient-level performance metrics. We analyzed the data using logistic and log-linear ordinary least squares regression models. Results: Study results generally supported our hypotheses that focus and experience are related to better quality and efficiency performance and that the effects are largely substitutive for hospitals. Conclusion: Our study extends the literature by finding that hospitals exhibit distinct and stable patterns regarding their positioning on focus and experience and that these patterns have important implications for hospitals' performance in terms of quality and efficiency. Practice Implications: Many general hospitals in the United States may be stretched too thin across service areas for which they lack necessary patient volumes for clinical proficiency. A viable alternative is to select a limited set of service areas on whichtofocus. [ABSTRACT FROM AUTHOR]

A dramatic change in the hospital industry is the increasing emphasis on linking provider payment to quality performance metrics. This is one of several considerations leading hospitals to employ physicians. Yet, there is little evidence regarding whether physician employment as a form of hospital‐physician integration leads to better operational performance. Using data from 201 California hospitals that experienced a total of 405,766 eligible opportunities to conform to external performance metrics (conformance quality) for treating patients in the cardiovascular service area, we empirically evaluated the relationship between physician employment and conformance quality. We also evaluated whether the presence of core capabilities in the hospital's cardiovascular service area complements or substitutes for physician employment. Findings suggest that physician employment is not only positively associated with conformance quality, but also associated with more consistent conformance quality. Moreover, the presence of core capabilities in the service area substitutes for physician employment. Theoretical, managerial, and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Efficiency in supply chain operations is increasingly a key strategic goal as organizations focus on containing cost. This is especially the case for hospitals where supply chain costs account for a substantial portion of operating budgets. In this study, we examine the impact of incentive mechanisms for internal stakeholders and negotiating leverage with external partners on supply chain efficiency in the hospital industry. We premise the study on agency, stewardship, and power theories. We use data from over 200 California hospitals in a five-year period (pooled data) to estimate regression models using generalized estimating equation. We find that physician employment and contract management enhance supply chain efficiency. Surprisingly, we did not find that better supply chain efficiency was associated with either hospital affiliation with systems or high-volume purchases through large national group purchasing organizations. The results have important theoretical and managerial implications for supply chain management. [ABSTRACT FROM AUTHOR]

Examines the long distance exchange between the Kumeyaay Indians and other southern California Indian groups after Spanish colonization. Mortuary analysis of the distribution of beads and other grave associations; Preservation of socioeconomic interactions; Complexity in the sociopolitical organization of the Kumejaay.

Presents a study which investigated the active tectonic geomorphology of Wheeler Ridge, southern San Joaquin Valley, California. Information on the hypothesis which indicated that climatic perturbations are responsible for producing geomorphic surfaces such as alluvial fan segments and river terraces; Methodology used to conduct study; Results of study; Conclusion reached.

• Most child-initiated linguistic interactions were with peers, not with the adults in the classroom. • Children language interactions with teachers were of basic quality rather than complex quality (e.g., decontextualized talk, reading aloud). • Associations were found between complex language interactions in English and children's bilingual receptive vocabulary outcomes. • The Language Interaction Snapshot (LISn) holds promise as a measure of language interactions in early childhood classrooms with DLLs. The Language Interaction Snapshot (LISn) is an observational measure developed to document the quantity and quality of language use in early childhood classrooms with dual language learners (DLLs). This study detailed the ways in which LISn data describes the linguistic interactions of Spanish–English DLLs with their teachers and peers. Participants were 104 teachers and assistant teachers from 52 classrooms in preschool programs in California, Florida and North Carolina and 341 DLLs. During the fall and spring classrooms were observed with the LISn and children were assessed in English and Spanish using receptive and expressive vocabulary measures. The association between linguistic interactions, as measured by the LISn, and DLLs' language outcomes was examined in about half the sample (in 26 classrooms). Results revealed that children had fewer language interactions with adults in Spanish than in English, even though there was at least one adult who spoke Spanish in every classroom, and they had few language interactions with any adult in either language. The language interactions children did have with teachers were generally of basic quality (i.e., giving directions and providing information) rather than complex quality (i.e., requesting language, using decontextualized talk, and reading aloud). Although children had somewhat more verbal interactions with peers, very few were sustained more than two turns. Associations were found between complex language interactions in English and children's bilingual receptive vocabulary outcomes. This demonstrates that the LISn holds promise as a measure of language interactions in early childhood classrooms with DLLs. [ABSTRACT FROM AUTHOR]