Search

This study compared two versions of the same elementary science professional development (PD) and curriculum program that were offered face-to-face and completely online, while keeping all content consistent between the two. Using quantitative analyses of pre- and posttests of content knowledge (CK), we evaluated the extent to which the online version of the PD compared to the face-to-face PD for increasing the earth science and art CK of upper elementary teachers required to teach an earth science and art integrated curriculum. Additionally, we explored how the impact of PD modality (online vs. face-to-face) on teachers' CK learning outcomes differed for novice and experienced teachers. Findings revealed significantly higher CK learning gains for teachers who participated in online PD compared with face-to-face PD, but with a small effect size. Subgroup analysis revealed that compared with experienced teachers, the novice teachers had significantly higher CK gains from participating in the online PD compared to the face-to-face version with a large effect size. We also discuss the implications for the design of large-scale online teacher PD.

Despite the push to increase inclusive early childhood (EC) care and education programs to support the learning and development of all children, such programs remain rare in California where most preschoolers with disabilities receive special education services in special day classrooms. Developing inclusive programs requires EC educators who are committed to supporting inclusion. Using a survey of EC teachers in public and private programs, this study sought to identify factors that influenced the teachers' attitudes toward and self-efficacy for providing inclusive programs for young children with disabilities. While most of the teachers reported positive views of inclusion, they reported less comfort with the idea of supporting children with disabilities in their programs. Examinations of the teachers' education and experience levels suggest that experience with children with disabilities influences teacher comfort while education may influence understanding of law.

This study leverages national data and a quasi-experimental design to examine the influence of enrolling in an exclusively online degree program on students' likelihood of completing their degree. We find that enrolling in an exclusively online degree program had a negative influence on students' likelihood of completing their bachelor's degree or any degree when compared to their otherwise-similar peers who enrolled in at least some face-to-face courses. The negative relationship between exclusively online enrollment and students' likelihood of bachelor's degree completion was relatively consistent among White, Black, Hispanic, Asian, low-income, and military students. Findings focused solely on those students enrolled in exclusively online degree programs revealed that the negative influence of exclusively online enrollment was exacerbated when the student attended a for-profit 4-year institution.

Highly proficient expert engineers begin the iterative process of design by thoroughly investigating the design problem. Engineering students are often distracted by surface details, leading to a faulty conception of the problem and inappropriate solution strategies. Adequate problem-scoping is arguably the most important step in the design process. To address this issue, the researchers developed an instructional framework to help teachers scaffold students' cognitive and metacognitive processes during the problem-scoping phase of a design challenge. The purpose of this quasi-experimental study was to investigate the impact that scaffolded instruction related to the SCOPE process had on students' solution success during a design challenge. The SCOPE process is used to help teachers scaffold students' design experiences during a tower design challenge and increase the overall effectiveness of their design efforts. Students in this study (N = 802) were separated into treatment and control groups. Using hierarchical multiple regression, the SCOPE process accounted for 40.4% ([delta]R[superscript 2] = 0.404) of the variability of the design score, which was statistically significant (p < 0.001). The results indicate that students who received scaffolded instruction from their teachers related to the SCOPE process during the design experience performed better on the design challenge.

Traditional teacher professional development (PD) programs frequently lack sufficient face-to-face preparation time to adequately support the implementation of evidence-based pedagogical strategies in classrooms, with teachers citing insufficient preparedness and training time for new methods. To investigate potentials for online PD methods to effectively address these issues, while increasing sustainability, this study examined teachers in Title-I elementary schools spanning multiple school districts participating in a large-scale online PD certificate program preparing teachers over 10 instructional weeks to implement Next Generation Science Standards (NGSS) (S)cience, (T)echnology, (E)ngineering, (A)rts, (M)ath (STEAM) curricular instruction with goals of increasing teachers' science content knowledge, self-efficacy to implement STEAM instruction, and STEAM teaching perceptions. Paired sample t-tests indicate teachers' life science content knowledge, self-efficacy, and STEAM perceptions increased significantly after completing the online PD. Multiple regression analyses identified teachers' science content knowledge and STEAM perceptions as statistically significant predictors of teachers' self-efficacy to implement STEAM instructional strategies. Teachers' posttest course evaluations were gleaned, highlighting three emergent themes: learning experience design, modality, and online teacher collaboration. Utilizing a mixed method approach, these qualitative insights corroborated the quantitative trends, describing how specific aspects of the pedagogical learning experience design (LXD) framework operationalized in the online course fostered a practitioner development learning environment, focused on supporting teachers' learning needs. Results suggest practical design implications for sustainably increasing the efficacy of PD through online teacher training developed in conjunction with LXD models for iterative improvement and design of high-quality online instructional PD programs.

The article provides an analytical overview of core-subject teachers' endorsement of career and technical education (CTE). The article discusses phenomena that have likely influenced core-subject teachers' perceptions of CTE and, in turn, their endorsement of CTE to students. California is taking steps towards successfully preparing students for college and career readiness, but more needs to be done (Bae & Darling-Hammond, 2014). Additionally, some educators still believe that "CTE programs maintain diminished value in helping to raise school achievement scores or encourage student success" (Shanklin, 2014, p. 3). Since the 20th century, CTE educators have been fighting negative perceptions of CTE, particularly that the only students who enroll in CTE are disengaged or underperforming. The study had a sample size of 16 participants (N = 16), and data were collected using focus groups, one-on-one interviews, and surveys. Findings show that participants were generally unaware of but were still biased against CTE. Participants' biases were influenced by multiple phenomena, including perfectionism, educational reforms, and societal expectations.

This quantitative portion of a convergent complementarity, mixed-methods, exploratory study describes the design and implementation of a 5-week preservice teacher professional development (PD) experience and the associated Metacognitive Awareness Inventory (MAI) measures before and after the experience. The PD experience was designed to explicitly address participants' domain-general and domain-specific knowledge and regulation of cognition through a highly integrated academic and clinical preparation regimen centered on a cognitive coaching model. The study participants comprised preservice STEM education teachers (N=11) enrolled in a dual teaching certification and Master's in Education program. The findings showed an increase in participants' regulation of cognition based on all utilized factor structures of metacognitive awareness, but not all factor structures indicated a change in participants' knowledge of cognition over the study period.

Faculty-in-residence programs have recently returned to the forefront in higher education. This paper investigates how residential students experienced a recently established faculty-in-residence (FIR) program at a mid-sized public university in Southern California. Drawing on existing research on faculty-student interaction, the paper explores the kinds of interactions students had with faculty in the context of the FIR program and how different types of interactions impacted outcomes for students. The study draws on data from interviews with one graduate student and six undergraduate students who participated in the FIR program. The paper concludes that (1) residential students who had frequent interactions with FIRs tended to share similar experiences of social and academic challenges, and (2) the FIR experience helped students to address these challenges. The study also highlights relationships among students and FIRs that helped students to address the big questions of life and understand that lifelong learning extends beyond the classroom. [Discussion questions developed by Denise Davidson, Brianna Fulp, and Nick Paseano.]

The aim of this descriptive study was to examine the perspectives of first generation Asian American parents of children with disabilities regarding causes, meaning of disabilities, level of educational involvement and self-advocacy in their children's special education school programs. Using convenience sampling, 18 Asian American parents from the San Francisco Bay area participated in this study. The major findings in this study were interesting ones in that some were similar and others different from those previously reported in the past for Asian American families. First, the majority of the parents did not believe their past wrong doings caused their child's disability. Secondly, the majority of parents reported that they relied on the help and guidance of family members, friends, and family resource agencies over their religious or spiritual community. In addition, academic achievement was still held in high regard in their families and was the responsibility and obligation of the children with disabilities to achieve it and even pursue higher education degrees. Lastly, the levels of parent's involvement and self-advocacy were higher compared to previous studies. Implications for professionals working with Asian-American families and their children with disabilities are discussed.

This study examined the perspectives of professionals and parents on part-time inclusive preschool Head Start programs that included both children with and without disabilities. The purpose of this study was twofold: (a) to examine parent and teacher perspectives of inclusion on the developmental outcomes of all children and (b) to investigate their perspectives on what constitutes a high quality inclusive program. Thirty Head Start and Early Childhood Special Education preschool teachers, as well as 30 parents of children with and without disabilities participated in this study. The major findings indicated that both parents and teachers strongly agreed that all children with disabilities should learn in the same environment with their classmates without disabilities. The majority of parents and teachers had positive attitudes toward inclusion and perceived there were social, emotional and academic benefits for all children in inclusive settings. However, some of the teacher and parent participants were concerned about possible isolation for children with disabilities. In addition, findings also indicated that inclusive programs were still lacking some essential elements of a high quality inclusion program. Implications for practitioners and future research are discussed.

Teacher educators need to remain current regarding the challenges that prospective teachers are going to face in their classrooms. One way to maintain this currency is for teacher educators periodically to spend some time in the K-12 classroom testing the theories they teach. This paper will discuss the benefits both teacher educators and prospective teachers will derive from engaging in such an activity. (Contains 1 footnote.)

The hyper-regulation of education (and most recently the teacher preparation component of education) thrives on the premise that any perceived deficiencies in the educational system can be alleviated by reducing differences among the ways in which people are educated and by demanding adherence to standards. In its impact, however, this simplification has an opposite effect. Rather than raising expectations, a reliance on standards as the solution to perceived ineffectiveness has disconnected education from the more complex set of needs that should be addressed. To meet standards, teachers must often ignore issues which may also need to be addressed, but for which they are not being evaluated. Additionally, teachers must allow someone else to determine what is of value--even if that means ignoring the cognitive, cultural, and societal developmental needs of learners. As a direct result, K-12 schools now focus on a narrow band of certain content areas to the exclusion or diminution of others. This article presents an analysis of the technology standards which focuses on what the demands for standardization in teacher education misses. While presuming neutrality, the technology standards eliminate some skills and require others in ways that are inconsistent with the developmental needs of beginning teachers. In pursuing the gaps between what is required versus what exists, this analysis seeks to identify the impact that these gaps will have on teachers in programs like the one in which the author works.

Policy responses to the challenges associated with environmental change, including more frequent and severe climatic events, have interlinked environmental and social impacts. Less attention has been afforded to the latter, and specifically to the question of not just whether but how such responses create or entrench inequality. This paper examines policy responses to drought events in California, United States, and the Western Cape Province, South Africa, in terms of their effects on inequality, revealed in relationships to water access networks. We use concepts of water justice and hydraulic citizenship to evaluate how and why these policy responses reproduced water injustices in the two settings. We focus particularly on two mechanisms linking responses to widened inequalities: values‐reinforcement and strategic communication. Using interviews, policy documents, and media reports, we employ process tracing methods to illustrate these mechanisms through which drought policy impacts hydraulic citizenship experiences, manifesting water injustice. We contribute to emerging examinations of environmental policy responses and maladaptation by demonstrating how concepts of hydraulic citizenship and an emphasis on mechanisms can help us better understand and identify experiences of water injustice. We note policy implications and areas for future research, highlighting droughts as consequential policy sites for advancing social and environmental justice. [ABSTRACT FROM AUTHOR]

Objectives: Given the high rates of recurrent instability following the initial arthroscopic Bankart repair (ABR), it is crucial to provide recommendations for appropriate surgical interventions for patients at a higher risk of experiencing recurring instability. In Part 1 of the study, it was discovered that on-track Hill-Sachs lesions (HSL) with specific prognostic factors (i.e., younger age, increased shoulder laxity, lower DTD, and 2+ preoperative instability events) were associated with a greater risk of failure. Therefore, the objective of Part 2 was to develop a risk assessment tool that takes into account significant prognostic factors for recurrent shoulder instability following primary ABR and evaluate the role of remplissage augmentation given a patient's risk profile. Methods: We retrospectively reviewed prospectively collected data of consecutive patients aged 14-40 who underwent either ABR (arthroscopic Bankart repair) or ABR+R (ABR with remplissage) procedures between 2013 and 2021 for anterior glenohumeral instability. Preoperative magnetic resonance imaging was used to determine the values of glenoid bone loss, Hills-Sachs Interval (HSI), glenoid track (GT), and distance-to-dislocation (DTD). On-track lesions have a distance-to-dislocation (DTD) value greater than zero. In addition, within the category of on-track lesions, there is a subset known as "near-track" lesions, with a DTD ranging from 0 to 10 mm. Capsuloligamentous laxity scores were categorized according to hyperlaxity status, defined as external rotation greater than 85 degrees and/or grade 2+ posterior and inferior load-and-shift on examination under anesthesia. Recurrent shoulder instability was defined as recurrent dislocation and/or subjective subluxation postoperatively. Patients were excluded if the indexed surgery was a revision procedure, < 2-year follow-up, or glenoid bone loss (GBL) >20%. A final multivariate survival analysis was constructed using categorical prognostic factors (i.e., patient age, "near-track" status, hyperlaxity, and 2+ preoperative instability episodes) identified in Part 1, while adjusting for GBL. Although contact athlete status was not identified as a significant predictor of recurrent shoulder instability in Part 1, the final model stratified by contact athlete status given its established importance in prior literature. Multivariate hazard ratio estimates were utilized to create a risk assessment tool and correlated with patient-specific risk estimates via post-estimation analysis. Results: One-hundred-and-fifty-five patients were included for analysis (ABR: 116 | ABR+R: 39) with an average age of 21.6 ± 6.2 years and an average follow-up of 5.1 ± 2.0 years (range: 2.0 – 8.7 yrs). Patients with near-track lesions had a three-fold higher risk of recurrent instability (Hazard Ratio [HR]: 2.5, p = 0.03) compared to on-track HSL with DTD > 10mm. Individuals with evidence of hyperlaxity exhibited a five-fold increased risk (HR: 5.4, p=0.03) relative to patients without hyperlaxity. Younger patient groups had twice the risk of recurrent shoulder instability (HR: 2.2, p=0.003) compared to older adjacent groups. Patients with two or more preoperative recurrent instability episodes faced a four-times greater risk (HR: 4.2, p=0.004) for recurrent shoulder instability compared to patients who experienced a single instability event preoperatively. Lastly, patients who underwent primary ABR only had almost 10-times greater risk of recurrent shoulder instability (HR: 9.5, p=0.002) than those who underwent primary ABR+R. The Recurrent Instability after Primary Shoulder Stabilization (RIPSS) risk assessment score considers patient age, near-track status, hyperlaxity, preoperative instability episodes, and surgical technique (ABR vs. ABR+R) as important prognostic indicators, Table 2. The RIPSS score was created with risk stratifying subgroups: Low-risk (0 – 2), Moderate-risk (3 – 6), High-risk (7 – 9), and Extreme-risk (10+). Figure 1 illustrates a strong correlation between patient RIPSS scores with patient-specific hazard ratio estimates derived from the multivariate Cox regression modeling computed in "To Remplissage or not to Remplissage Part 1". According to RIPSS score subgroups, recurrent shoulder instability rates range from 4.3% among low-risk groups to 54.6% among extreme-risk groups, Figure 1. Conclusions: Patients with a low-risk RIPSS score without ABR+R may not benefit from remplissage augmentation. Their risk for recurrent instability would remain low despite the addition of remplissage. However, patients with a high- or extreme-risk RIPSS score prior to considering ARB+R would likely benefit from remplissage supplementation. The RIPSS score may be an effective risk assessment tool that may help identify patients who may benefit from a primary Bankart repair with remplissage augmentation. The risk assessment tool developed may optimize surgical treatment and allow physicians to determine patient risk scores with and without remplissage augmentation. [ABSTRACT FROM AUTHOR]

Justice Goodwin Liu reexamined seminal affirmative action in higher education legal cases beginning with the landmark 1978 case, "Regents of the University of California v. Bakke" and leading up to the U.S. Supreme Court's 2003 decision in "Gratz v. Bollinger." Liu argued that the "Bakke and Gratz" lawsuits were grounded in an underlying causation fallacy, largely because neither case involved enough applicants of color to change the likelihood of Bakke's and Gratz's admittance. Recent lawsuits from self-identified White and Asian, rejected applicants have emerged against top-ranked universities. This article revisits Liu's assertions by applying his critical approach to those cases. Data indicate too few applicants of color to change the likelihood of recent plaintiffs' admittance. Concluding arguments name Causation Fallacy 2.0 as a useful tool for explaining the cultural politics of race surrounding affirmative action admissions cases.

Differential response (DR), also referred to as alternative response (AR), family assessment response (FAR), or multiple track response, was developed to incorporate family-centered, strengths-based practices into child protective services (CPS), primarily by diverting lower risk families into an assessment track rather than requiring the traditional CPS investigation. Since the program's inception, researchers have conducted several large evaluation studies of DR programs, and a large body of research and program literature has been published touting the success and benefits of DR. In response to significant concerns about the clarity and consistency of DR program models and the validity and generalizability of its associated research, the authors undertook a comprehensive, three-pronged evaluation to provide guidance in shaping the ongoing development of DR programs. This report summarizes the methodology, findings, conclusions, and recommendations from the review.

In this retrospective study, we measured enterovirus D68 (EV-D68) genomic RNA in wastewater solids longitudinally at 2 California, USA, wastewater treatment plants twice per week for 26 months. EV-D68 RNA was undetectable except when concentrations increased from mid-July to mid-December 2022, which coincided with a peak in confirmed EV-D68 cases. [ABSTRACT FROM AUTHOR]

College students' perceptions of parental notification (PN) were examined. Anonymous surveys were received from 72 students who had received a notification and 73 students who had not. Students reported that PN increased parent-student communication. While noting interference with their autonomy, students also reported more positive than negative outcomes in response to a notification. Students who received a notification still reported poorer communication with their parents than did students who did not receive a notification. Implications for working with parents and students are discussed.

The Common Core State Standards (CCSS) lays out "a vision of what it means to be a literate person in the twenty-first century." Among educators, conversations about reading and writing have shifted to reflect the CCSS emphasis on informational, technical, opinion, and other non-narrative forms. Yet, these standards also demand that students at the elementary school level write increasingly sophisticated narratives. Many teachers meet the writing standards by having their elementary students produce personal narratives or fictional stories, such as fairy tales, but historical fiction writing projects also satisfy the narrative writing standards. Crafting historical fiction narratives also provides an opportunity for students to think rigorously about the past. Through the process of writing historical fiction, students can develop and refine their historical thinking capabilities in many dimensions. Namely, writing historical fiction allows students to: (1) Engage their imaginations; (2) Humanize history; (3) Think empathetically; (4) Demonstrate historical causation; (5) Consider multiple viewpoints; and (6) Engage in historical inquiry. In order for students to produce high-quality historical fiction, they must be immersed in learning about a specific time period, event, or era. Ryan Hughes teaches second and third grades, and he knew that he needed to select a historical topic that had a wide array of print, photo, and film resources that third graders could read and analyze for the lesson described in this article. The civil rights movement met this initial requirement, and there were also dozens of relevant historical fiction picture books available for reference. Furthermore, much of the history the class covered would fulfill the third grade History-Social Studies Content Standards for California.

We measured concentrations of SARS-CoV-2, influenza A and B virus, respiratory syncytial virus (RSV), mpox virus, human metapneumovirus, norovirus GII, and pepper mild mottle virus nucleic acids in wastewater solids at twelve wastewater treatment plants in Central California, USA. Measurements were made daily for up to two years, depending on the wastewater treatment plant. Measurements were made using digital droplet (reverse-transcription–) polymerase chain reaction (RT-PCR) following best practices for making environmental molecular biology measurements. These data can be used to better understand disease occurrence in communities contributing to the wastewater. [ABSTRACT FROM AUTHOR]

Concentrations of SARS-CoV-2 RNA in wastewater settled solids from publicly owned treatment works (POTWs) historically correlated strongly with laboratory confirmed incident COVID-19 case data. With the increased availability of at-home antigen tests since late 2021 and early 2022, laboratory test availability and test seeking behavior has decreased. In the United States, the results from at-home antigen tests are not typically reportable to public health agencies and thus are not counted in case reports. As a result, the number of reported laboratory-confirmed incident COVID-19 cases has decreased dramatically, even during times of increased test positivity rates and wastewater concentrations of SARS-CoV-2 RNA. Herein, we tested whether the correlative relationship between wastewater concentrations of SARS-CoV-2 RNA and reported laboratory-confirmed COVID-19 incidence rate has changed since 1 May 2022, a point in time immediately before the onset of the BA.2/BA.5 surge, the first surge to begin after at-home antigen test availability was high in the region. We used daily data from three POTWs in the Greater San Francisco Bay Area of California, USA for the analysis. We found that although there is a significant positive association between wastewater measurements and incident rate data collected after 1 May 2022, the parameters describing the relationship are different than those describing the relationship between the data collected prior to 1 May 2022. If laboratory test seeking or availability continues to change, the relationship between wastewater and reported case data will continue to change. Our results suggest, assuming SARS-CoV-2 RNA shedding remains relatively stable among those infected with the virus as different variants emerge, that wastewater concentrations of SARS-CoV-2 RNA can be used to estimate COVID-19 cases as they would have been during the time when laboratory testing availability and test seeking behavior were at a high (here, before 1 May 2022) using the historical relationship between SARS-CoV-2 RNA and COVID-19 case data. [ABSTRACT FROM AUTHOR]

Despite the push to increase inclusive early childhood (EC) care and education programs to support the learning and development of all children, such programs remain rare in California where most preschoolers with disabilities receive special education services in special day classrooms. Developing inclusive programs requires EC educators who are committed to supporting inclusion. Using a survey of EC teachers in public and private programs, this study sought to identify factors that influenced the teachers’ attitudes toward and self-efficacy for providing inclusive programs for young children with disabilities. While most of the teachers reported positive views of inclusion, they reported less comfort with the idea of supporting children with disabilities in their programs. Examinations of the teachers’ education and experience levels suggest that experience with children with disabilities influences teacher comfort while education may influence understanding of law. [ABSTRACT FROM AUTHOR]

Although many colleges and universities use "parental notification" to inform parents of students' alcohol use, the impact of this intervention on student and parent behavior is unclear. Surveys were obtained from 326 parents of university undergraduates, 56 of whom had received a notification. Parent responses to the notification were largely positive, and the association of notification to parent and student drinking and to the quality of parent-student communication on alcohol and other topics was also investigated. This impact of parental notification on parents and students and the importance of parental involvement with college students are discussed. (Contains 2 tables and 1 figure.)

Dual enrollment is viewed by many as part of a promising college preparation strategy for a broad range of students. But as participation in dual enrollment has expanded across the country, there has been increasing attention paid to the rigor and authenticity of dual enrollment courses, particularly for those courses held on high school campuses and taught by high school teachers. Because dual enrollment courses are actual college courses that appear on a transcript the same way as other college courses, as opposed to college-level courses or curriculum such as Advanced Placement and International Baccalaureate programs, instructors are expected to maintain the standards, texts, and assessments of the sponsoring college or university. The potential tension between broader access to dual enrollment courses and rigorous standards leads to interesting possibilities for innovative pedagogical practices. How can dual enrollment instructors uphold rigor "and" provide instruction and supports so that a broad range of students can be successful? Pedagogy in the dual enrollment classroom has been studied little, but answers to this question have implications for pedagogy in general at open-access postsecondary institutions such as community colleges, where some have argued that the quality of instruction has long been neglected as an area of study. In this article, the authors draw on data from the Concurrent Courses Initiative, a multisite project that provided dual enrollment opportunities to disadvantaged California high school students within career-focused education pathways. As part of the project, a small number of dual enrollment instructors participated in an action research project in which they identified the particular ways their students were struggling and then devised classroom strategies to address them. A number of insights and practices emerged that are relevant not only to dual enrollment instruction but to instruction at postsecondary institutions that provide broad access to students of varied academic abilities.

Context: Pregnant women in rural areas may give birth in either rural or urban hospitals. Differences in outcomes between rural and urban hospitals may influence patient decision making. Purpose: Trends in rural and urban obstetric deliveries and neonatal and maternal mortality in California were compared to inform policy development and patient and provider decision making in rural health care settings. Methods: Deliveries in California hospitals identified by the California Department of Health Services, Birth Statistical Master Files for years 1998 through 2002 were analyzed. Three groups of interest were created: rural hospital births to all mothers, urban hospital births to rural mothers, and urban hospital births to urban mothers. Findings: Of 2,620,096 births analyzed, less than 4% were at rural hospitals. Neonatal death rates were significantly higher in babies born to rural mothers with no pregnancy complications who delivered a normal weight baby vaginally at an urban hospital compared to urban mothers delivering at an urban hospital (0.2 [CI 0.2-0.4] deaths per 1,000 births versus 0.1 [CI 0.1-0.1]). Logistic regression analysis showed that delivery in a rural hospital was a protective factor compared to urban mothers delivering in an urban hospital, with an odds ratio of 0.8 (CI 0.6-0.9). Maternal death rates were not different. Conclusions: Rural obstetric services in this period showed favorable neonatal and maternal safety profiles. This information should reassure patients considering a rural hospital delivery, and aid policy makers and health care providers striving to ensure access to obstetric services for rural populations.

In 1997 the California State University Monterey Bay Master of Arts in Education program began accepting students with the explicit intent of offering an academically challenging curriculum that grounds teacher-leaders in multicultural social justice education. By 2003, the program had successfully attracted and graduated a student population that is as racially and ethnically diverse as the state of California. As eight faculty members who designed and implemented this program, writing from a position of "insider knowledge" regarding how it functioned on a day-to-day basis, we show how culturally and linguistically diverse students, many of whom have been underprepared for rigorous academic work, can attain high levels of academic excellence in a challenging and supportive context. In addition, we explore the tensions and realities of doing this work, especially in a state university context that is experiencing decreased funding that jeopardizes programs such as this one. We write so that our work is not forgotten but rather narrates what is possible. (Contains 2 tables.)

Purpose: Identify census-derived characteristics of residency graduates' high school communities that predict practice in rural, medically underserved, and high minority-population settings. Methods: Cohort study of 214 graduates of the University of California, San Francisco-Fresno Family Practice Residency Program (UCSF-Fresno) from its establishment in 1970 through 2000. Rural-urban commuting area code; education, racial, and ethnic distribution; median income; population; and federal designation as a medically underserved area were collected for census tracts of each graduate's (1) high school address and (2) practice location. Findings: Twenty-one percent of graduates practice in rural areas, 28% practice in areas with high proportions of minority population (high minority areas), and 35% practice in federally designated medically underserved areas. Graduation from high school in a rural census tract was associated with rural practice (P less than 0.01). Of those practicing in a rural site, 32% graduated from a rural high school, as compared with 11% of nonrural practitioners. Graduation from high school in a census tract with a higher proportion of minorities was associated with practice in a proportionally high minority community (P = 0.01). For those practicing in a high-minority setting, the median minority percentage of the high school census tract was 31%, compared with 16% for people not practicing in a high minority area. No characteristics of the high school census tract were predictive of practice in a medically underserved area. Conclusion: Census data from the residency graduate's high school predicted rural practice and practice in a proportionally high minority community, but not in a federally designated medically underserved area.

Among 137 rural Hispanic Americans surveyed in central California--over half having limited English proficiency and less than a 7th-grade education--almost all knew that smoking causes lung cancer and osteoporosis, but less than half knew of smoking's other health risks. Current smokers were most likely to underestimate smoking risks. (Contains 26 references.) (SV)

Background California has experienced an increase in reported cases of disseminated gonococcal infection (DGI). Given significant morbidity associated with DGI and the ability of Neisseria gonorrhoeae to rapidly develop antibiotic resistance, characterization of these cases can inform diagnosis, management, and prevention of DGI. Methods As part of the public health response to increased reports of DGI, we used gonorrhea surveillance data reported to the California Department of Public Health to identify all DGI cases in a geographically-bound region. Standardized case report forms were used to collect epidemiologic risk factors and clinical information obtained from provider/laboratory reports, medical records, and patient interviews. Results From 1 July 2020 to 31 July 2021, we identified 149 DGI patients among 63 338 total gonorrhea infections, representing 0.24% of gonorrhea cases. Estimated incidence was 0.47 DGI cases per 100 000 person-years. Mean age of DGI patients was 40 years, and 75 (50%) were cisgender men, of whom only 13 were known to have male partners. Where reported, more than one-third (36%) used methamphetamine and nearly one-quarter (23%) experienced homelessness. Clinically, 61% lacked urogenital, pharyngeal, or rectal symptoms; 2 patients died in the hospital. Among 47 isolates from patients with antimicrobial susceptibility testing (AST) results available, all were susceptible to ceftriaxone and cefixime. Conclusions Most DGI patients lacked urogenital symptoms and were not among populations for which routine gonorrhea screening is currently recommended. Expanding gonorrhea screening might prevent DGI. Cefixime is likely the best option if transitioning from parenteral to oral therapy when AST results are unavailable. [ABSTRACT FROM AUTHOR]

365 Background: HNC survivors often experience post-treatment pain. Given known disparities in pain management and opioid use in the non-cancer population, we explored sociodemographic predictors of opioid use in HNC survivors enrolled in the HN-STAR trial (NCT04208490, funding: American Cancer Society and UG1CA189824). Methods: Survivors of HNC (stages I-III) who completed therapy 6-24 months prior and had no evidence of disease were enrolled throughout the NCI Community Oncology Research Program (NCORP). Survivors were randomized to a clinical informatics intervention or usual care. Baseline surveys elicited recent prescription opioid use in the prior week (yes/no). Blinded to arm assignment, we conducted bivariate analyses of recent opioid use and the following sociodemographic predictors: age, gender, marital status, race and ethnicity (non-white/Latinx vs all others), highest level of education, and being able to meet daily financial needs in the prior 4 weeks. We conducted stepwise multivariable logistic regression to evaluate the association of these factors on opioid use. Results: Among 254 survivors (mean age 63, 74% male, 25% non-white/non-Latinx, 13% reporting financial need) at 25 oncology practices, 14% (n=35) reported recent opioid use. In bivariate analyses, survivors who reported financial needs were more likely to have used opioids (odds ratio [OR] 4.35, 95% confidence interval [CI] 1.85-10.20, p<.001). In stepwise multivariable analyses, only having financial needs remained in the final model (Table). Conclusions: In a national sample of post-treatment HNC survivors during a subacute survivorship period (6-24 months after treatment completion), 1 in 7 survivors reported using opioids in the past week – more than twice the annual rate of opioid receipt in the general adult population. Several demographic factors related to opioid use were examined and not associated with recent opioid use among HNC survivors. Findings suggest that financial concerns may be a barrier to non-narcotic pain management (e.g., cognitive behavioral approaches, physical therapy) – or simply that unmet financial needs are associated with lower quality of pain management. Attention should focus on equitable pain management in this population. Clinical trial information: NCT04208490. Predictors of opioid use in past week. Bivariate Models Estimate (standard error) p-value Age (years) -.01 (.02).52 OR (95% CI) p-value Female.98 (.41, 2.16).97 Latinx/non-white.71 (.27, 1.63).45 Married.56 (.27, 1.18).13 Some college or more.62 (.30, 1.30).20 Had financial needs 4.35 (1.85,10.20) <.001 Final model OR (95% CI) p-value Had financial needs 4.35 (1.85,10.20) <.001 [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 pandemic has differentially impacted populations across race and ethnicity. A multi-omic approach represents a powerful tool to examine risk across multi-ancestry genomes. We leverage a pandemic tracking strategy in which we sequence viral and host genomes and transcriptomes from nasopharyngeal swabs of 1049 individuals (736 SARS-CoV-2 positive and 313 SARS-CoV-2 negative) and integrate them with digital phenotypes from electronic health records from a diverse catchment area in Northern California. Genome-wide association disaggregated by admixture mapping reveals novel COVID-19-severity-associated regions containing previously reported markers of neurologic, pulmonary and viral disease susceptibility. Phylodynamic tracking of consensus viral genomes reveals no association with disease severity or inferred ancestry. Summary data from multiomic investigation reveals metagenomic and HLA associations with severe COVID-19. The wealth of data available from residual nasopharyngeal swabs in combination with clinical data abstracted automatically at scale highlights a powerful strategy for pandemic tracking, and reveals distinct epidemiologic, genetic, and biological associations for those at the highest risk. There is a genetic component to the risk of severe COVID-19, but the genetic effects are difficult to separate from social constructs that covary with genetic ancestry. To address this, the authors identify determinants of COVID-19 severity using admixture mapping, viral phylodynamics, and host immune and metagenomic sequencing. [ABSTRACT FROM AUTHOR]