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Introduction Collabo RATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate Collabo RATE scores and response rates across multiple clinical settings with varied patient populations. Method All adult patients at three United States primary care practices were eligible to complete Collabo RATE post-visit. To inform key learnings, we aggregated all mentions of unanticipated decisions, problems and administration errors from field notes and email communications. Mixed-effects logistic regression evaluated the impact of site, clinician, patient age and patient gender on the Collabo RATE score. Results While Collabo RATE score increased only slightly with increasing patient age ( OR 1.018, 95% CI 1.014-1.021), female patient gender was associated with significantly higher Collabo RATE scores ( OR 1.224, 95% CI 1.073-1.397). Clinician also predicts Collabo RATE score (random effect variance 0.146). Site-specific factors such as clinical workflow and checkout procedures play a key role in successful in-clinic implementation and are significantly related to Collabo RATE scores, with Site 3 scoring significantly higher than Site 1 ( OR 1.759, 95% CI 1.216 to 2.545) or Site 2 (z=−2.71, 95% CI −1.114 to −0.178). Discussion This study demonstrates that Collabo RATE can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation. Patient experience measurement risks becoming a burden to both patients and administrators. Episodic use of short measurement tools could reduce this burden. [ABSTRACT FROM AUTHOR]

In the research from which this paper is derived, we have observed and tape-recorded approximately 115 lawyer-client conferences. Our observations were made in two sites, one in California and one in Massachusetts. In this paper we take an in-depth look at the nature of lawyer-client discourse by focusing on one conference. We explore three of the most important themes in that discourse. First is the discussion and characterization of the legal system and its major actors. Next is the exploration of the advantages and disadvantages of disposing of disputed issues through negotiation or trial. Finally, the third theme involves the "legal construction of the client," where a lawyer and client discuss rules of relevance that govern the legal process as well as the aspects of the client's experience that are to be the subject of legal inquiry. The paper concludes by exploring the way each of these themes expresses or embodies prevailing legal ideologies and influences the way cases develop and are managed. [ABSTRACT FROM AUTHOR]

This phenomenological study explores the experiences of Chinese international undergraduate students in the United States as they work through the complications of COVID-19 that are potentially intertwined with Sinophobia. By drawing on insights from critical race theory, especially the lens of racial trauma and trauma-informed care, the current study interprets four primary themes: (a) Paradox: Confusions about Racism in Academic Life; (b) Racially-Traumatic Incidences and Risk Factors in Social and Cultural Life; (c) Exodus: Burnout, Homesick, and the Dilemma; and (d) Determined Traumatic Symptoms: Insomnia, Nightmare, and Negative Memories. Noticeably, social justice issues such as isolation, exclusion, threats, and discrimination were present during the 2020 academic year. Therefore, the implications are explored through sociopsychological perspectives. [ABSTRACT FROM AUTHOR]

In anticipation of extraterritorial application of antiabortion laws, many states have enacted laws that attempt to shield abortion providers, helpers, and patients from civil, professional, or criminal liability associated with legal abortion care. This essay analyzes and compares the statutory schemes of the seven early adopting shield states: California, Connecticut, Delaware, Illinois, Massachusetts, New Jersey, and New York. After describing what the laws do and how they operate, we offer reflections on coming disputes, areas of legal uncertainty, and ways to improve future shield laws. [ABSTRACT FROM AUTHOR]

Despite more than 30 years of public health programs to reduce tobacco use, smoking is still the leading preventable cause of death in the United States. In response to this continuing epidemic, voters in California (1988), Massachusetts (1992), Arizona (1994), and Oregon (19%) approved ballot initiatives that established state- wide tobacco control programs funded by cigarette excise tax revenues. Evaluating these innovative public health interventions is important, both to improve existing programs and to guide other states in developing and implementing similar interventions. In this paper we describe the methods being used to evaluate the statewide anti-tobacco campaigns in California and Massachusetts, and review the findings of process and outcome evaluations of both programs. Our review suggests that both programs have had a substantial impact on the public `s health by reducing cigarette consumption and stimulating the development of policies to reduce environmental tobacco smoke exposure. However, it does not appear that either program has reduced smoking initiation among adolescents. Our evaluation suggests three problems in pm gram implementation that future anti-tobacco campaigns must avoid in order to produce long-term, sustained effects: (1) the gradual erosion of program funding by the state legislatures and governors; (2) the lack of a consistent, supportive constituency within state government and (3) inconsistency in campaign themes, messages, and programs. We conclude by offering recommendations to correct these problems so that state- wide cigarette-tax -funded anti-tobacco campaigns can realize their potential to become one of the most effective public health interventions available. [ABSTRACT FROM AUTHOR]

The specific aim was to characterize retail purchases of red and processed meat and other major protein-rich foods in the U.S. and by state. Supermarket scanner data from grocery stores, supermarkets, and big box stores collected from 2017-2019 (NielsenIQ, New York, NY) was used to characterize retail purchases of red meat, processed meat, and other protein-rich foods in thirty-one states representative of US retail food sales. Red meat, processed meat, poultry, seafood, eggs, other meats, and non-meat foods (beans, nuts, seeds, meat alternatives) by weight accounted for 25.9%, 20.4%, 25.8%, 5.9%, 12.6%, 1.3%, and 10.1%, respectively of total sales in 2017-2019. Mean per capita purchases of red meat by weight was 30.1 g/d, ranging from 45.4 g/d in Mississippi to 21.9 g/d in New York. Mean per capita purchases of processed meat by weight was 23.8 g/d, ranging from 36.6 g/d in Mississippi to 15.2 g/d in California. We observed statistically significant correlations between red and processed meat purchases with cardiovascular mortality and colorectal cancer by state. Per capita retail purchases of red and processed meat appear to reflect a dietary pattern that is not consistent with current national and international dietary recommendations. [ABSTRACT FROM AUTHOR]

Parents make choices about their children's education within a neoliberal, racist system. Measurable metrics are used to evaluate school quality within a competitive, market-based system, yet those indicators often do not align with parents' definitions of a good school, and they obscure the role of race. This paper examines how white, privileged parents understand school quality and justify their educational decisions, illuminating how white parents subtly reinforce racial and socio-economic hierarchies.

Context: The authors examined the association between state-level policy protections and selfrated health disparities between transgender and cisgender adults. Methods: They used data on transgender (n =4,982) and cisgender (n=1.168,859) adults from the 2014-2019 Behavioral Risk Factor Surveillance System. The authors estimated state-specific health disparities between transgender and cisgender adults, and they used multivariable logistic regression models to compare adjusted odds ratios between transgender and cisgender adults by state-level policy environments. Findings: Transgender adults were significantly more likely to report poor/fair health, frequent mental distress, and frequent poor physical health days compared to cisgender adults. Disparities between transgender and cisgender adults were found in states with strengthened protections and in states with limited protections. Compared to transgender adults in states with limited protections. transgender adults in states with strengthened protections were marginally less likely to report frequent mental distress. Conclusions: Transgender adults in most states reported worse self-rated health than their cisgender peers. Much more research and robust data collection on gender identity are needed to study the associations between state policies and transgender health and to identify best practices for achieving health equity for transgender Americans. [ABSTRACT FROM AUTHOR]

We investigate the association between nativity status (U.S.- vs foreignborn) and viral suppression among women of color (WOC) with HIV (HIV +) and whether this association was modified by education and housing. Methods: Data were from 549 HIV + WOC, who participated in the Health Resources and Services Administration-funded WOC Initiative 2009–2013. We used generalized estimating equation models to quantify the association between the respondents' nativity status and viral suppression. Results: After adjusting for covariates, foreign-born WOC were 2.2 times (95% confidence interval: 1.25, 3.85) more likely to achieve viral suppression than U.S.-born WOC. This association was not modified by education or housing status. Conclusions: Despite facing barriers to care, foreign-born WOC were more likely to achieve viral suppression than U.S.-born WOC. Programs aiming to end the HIV epidemic and reduce HIV disparities in the U.S. should consider these findings as they provide a more nuanced understanding of HIV + WOC. [ABSTRACT FROM AUTHOR]

This section offers updates related to civic affairs in the U.S. as of June 1994. There has been a civic journalism boom in the country as evidenced by an increase in the number of papers and broadcasters that have adopted community debates. A formal organization is being established by Los Angeles County, California to support money-making ventures. A decision was made by the Massachusetts Department of Social Services (DSS) to privatize its revenue-generating operation to recover lost federal reimbursement dollars.

One of every two children in the world lives in poverty, with no access to safe water, health services or adequate shelter to the extent that 25,000 children die every day. Thirty-seven million Americans, thirteen million of whom are children, live below the poverty level. Of the developed world, despite our wealth and sophistication, the United States has the most children who live in poverty. Rather than race, ethnicity or gender, it is poverty, socio-economic class and deprivation that account for poor performances in school, to the extent that young people from poor families are three times more likely to drop out of school. Alone, neither schools nor communities can adapt to or realize the overlapping and contextually interacting needs presented by students and their families. Collaboratively, where schools are beginning to offer quality, equitable education at the same site in which access to requisite health, social and human services for children and families are provided, both educational and psycho-social outcomes are enhanced. Using a holistic position and an ecological model of resilience, this paper would suggest that these community schools, serving as hubs of social justice, are mitigating the academic and nonacademic needs of vulnerable children and families. (Contains 64 footnotes and 2 tables.)

Low-income women and women of color are disproportionately affected by unintended pregnancy. Lack of knowledge of abortion laws and services is one of several factors likely to hinder access to services, though little research has documented knowledge in this population. Survey with convenience sample of 1,262 women attending primary care or full-scope Ob/Gyn clinics serving low-income populations in three large cities and multivariable analyses with four knowledge outcomes. Among all participants, 53 % were first-generation immigrants, 25 % identified the correct gestational age limit, 41 % identified state parental consent laws, 67 % knew partner consent is not required, and 55 % knew where to obtain abortion services. In multivariable analysis, first-generation immigrants and primarily Spanish speakers were significantly less likely than higher-generation or primarily English speakers to display correct knowledge. Design and evaluation of strategies to improve knowledge about abortion, particularly among migrant women and non-primary English speakers, is needed. [ABSTRACT FROM AUTHOR]

The aims of this study were (1) to generate hypotheses to explain declines in HIV incidence in Massachusetts, North Carolina, San Francisco, and Seattle, and (2) based on lessons learned from these jurisdictions, to offer recommendations for implementation elsewhere. Through in-depth interviews, we identified policies and practices that stakeholders across jurisdictions believe are important to achieving successful outcomes. The most unifying observation was that leadership within health departments is critical to achieving success. With this consideration, we developed a list of tools for public health officials to assert leadership to address challenges posed by HIV: extending access to health insurance, using an array of approaches to increase knowledge of serostatus, investing in services to retain people in care, collecting and using better data, translating data into policy change and public health practice, developing targeted programming for vulnerable populations, minimizing administrative policies that attenuate program success, and diversifying funding sources. [ABSTRACT FROM AUTHOR]

The article offers information on the history, purpose and significant application of the U.S. trade secret law in the trial courts serving the high-technology industrial districts of Route 128 region of Massachusetts and Silicon Valley in California for protection of business secrets from departing employees. Topics include the difference between the trade secret law in California and Massachusetts, findings of Professor Ronald Gilson on effect of employee mobility and employment agreements.

This article outlines the history of women in American law enforcement. The author interviewed female police officers who worked with city and county agencies in the Texas Panhandle. Qualitative interviews were conducted with two high-ranking female officers in Massachusetts and California. Results determine women in the profession have overcome many obstacles but have not achieved complete equality. [ABSTRACT FROM AUTHOR]