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Attention is correlated with reading, but the extent to which behavioral ratings and sustained attention relate to reading skills is unclear. We assessed 245 fourth and fifth grade struggling readers (mean age = 10.3 years) on behavioral ratings of attention, sustained attention, and reading over a school year. Contributions of behavioral ratings and sustained attention were considered cross-sectionally and longitudinally in the context of other important predictors of reading. Results suggest that sustained measures and behavioral ratings assess distinct, yet overlapping, aspects of attention. Both types of attention accounted for unique variance in comprehension, but not word reading accuracy or fluency, when evaluated cross-sectionally. Results also support the role of behavioral ratings of attention in fluency and in comprehension growth. Findings suggest that multidimensional assessment of attention is useful when considering its relation to reading, and highlight the need to integrate conceptualizations of attention that arise from different theoretical approaches.

BackgroundEmerging interest in precision health and the increasing availability of patient- and population-level data sets present considerable potential to enable analytical approaches to identify and mitigate the negative effects of social factors on health. These issues are not satisfactorily addressed in typical medical care encounters, and thus, opportunities to improve health outcomes, reduce costs, and improve coordination of care are not realized. Furthermore, methodological expertise on the use of varied patient- and population-level data sets and machine learning to predict need for supplemental services is limited. ObjectiveThe objective of this study was to leverage a comprehensive range of clinical, behavioral, social risk, and social determinants of health factors in order to develop decision models capable of identifying patients in need of various wraparound social services. MethodsWe used comprehensive patient- and population-level data sets to build decision models capable of predicting need for behavioral health, dietitian, social work, or other social service referrals within a safety-net health system using area under the receiver operating characteristic curve (AUROC), sensitivity, precision, F1 score, and specificity. We also evaluated the value of population-level social determinants of health data sets in improving machine learning performance of the models. ResultsDecision models for each wraparound service demonstrated performance measures ranging between 59.2%% and 99.3%. These results were statistically superior to the performance measures demonstrated by our previous models which used a limited data set and whose performance measures ranged from 38.2% to 88.3% (behavioural health: F1 score P

Background: Hospitals are increasingly engaging in partnerships to address population health in response to national policies, such as value-based payment models. However, little is known about how institutional factors influence hospital partnerships for population health. Purpose: Guided by institutional theory, we examine the association between institutional pressures (coercive, normative, and mimetic isomorphism) and hospital partnerships for population health. Methodology: A pooled cross-sectional analysis used an unbalanced panel of 10,777 hospital-year observations representing respondents to a supplemental question of the American Hospital Association's annual survey (2015–2017). The analysis included descriptive and bivariate statistics, and regression models that adjusted for repeated observations to examine the relationship between key independent variables and partnerships over time. Findings: In regression analyses, we found the most support for measures of coercive (e.g., regulatory factors) isomorphism, with nonprofit status, participation in accountable care organizations, and acceptance of bundled payments, all being consistently and significantly associated with partnerships across all organization types. Modest increases were observed from 2015 to 2017 for hospital partnerships with public health organizations (+2.8% points, p <.001), governmental organizations (+2.0% points, p =.009), schools (+4.1% points, p <.001), and businesses (+2.2% points, p =.007). Practice Implications: Our results suggest that institutional factors, particularly those related to regulatory policies and programs, may influence hospital partnerships to support population health. Findings from this study can assist hospital leaders in assessing the factors that can support or impede the creation of partnerships to support their population health efforts. [ABSTRACT FROM AUTHOR]

Childhood socioeconomic status (SES) strongly predicts disparities in reading development, yet it is unknown whether early environments also moderate the cognitive and neurobiological bases of reading disorders (RD) such as dyslexia, the most prevalent learning disability. SES-diverse 6–9-year-old children (n = 155, half with RD) completed behavioral and functional magnetic resonance imaging (fMRI) tasks engaging phonological and orthographic processing, which revealed corresponding double-dissociations in neurocognitive deficits. At the higher end of the SES spectrum, RD was most strongly explained by differences in phonological skill and corresponding activation in left inferior frontal and temporoparietal regions during phonological processing—widely considered the "core deficit" of RD. However, at the lower end of the SES spectrum, RD was most strongly explained by differences in rapid naming skills and corresponding activation in left temporoparietal and fusiform regions during orthographic processing. Findings indicate that children's early environments systematically moderate the neurocognitive systems underlying RD, which has implications for assessment and treatment approaches to reduce SES disparities in RD outcomes. Further, results suggest that reliance on high-SES convenience samples may mask critical heterogeneity in the foundations of both typical and disordered reading development. • Socioeconomic status (SES) moderates which deficits explain reading disorders (RDs). • RD in higher-SES children is best explained by reduced phonological skills. • These children exhibit reduced activation in phonological processing brain regions. • Instead, RD in lower-SES children is best explained by reduced rapid naming skills. • These children exhibit reduced activation in orthographic processing brain regions. [ABSTRACT FROM AUTHOR]

The article examines the role of the Centers for Disease Control and Prevention's National Public Health Performance Standards Program (NPHPSP) in building a public health standards in the U.S. It is concluded that NPHPSP helps a state or a local jurisdiction to move towards a national accreditation program. It is also stated that NPHPSP represents one of the most comprehensive outlines of public health system activities, addressing a mix of capabilities, processes and outputs.

Describes the use of a week-long internship program as part of a course on newspaper management. Notes that students were given a checklist for gathering specific information during their visit with a newspaper. Reports enthusiastic response on the part of students and professional journalists. (TJ)

Since the beginning of the 1990s, public health has struggled to measure its performance and capacity to carry out the core functions of public health practice, while facing increasing challenges within the ever-changing landscape of healthcare delivery, bioterrorism response, emerging infections, and other threats to the public's health. The article describes the development of a set of national performance standards for measuring how effectively public health systems deliver the 10 Essential Public Health Services, The standards were developed through a practice-driven approach that incorporated comprehensive field testing and iterative revisions. The standards represent a national consensus framework for measuring important aspects of public health practice. [ABSTRACT FROM AUTHOR]

In an attempt to stimulate development of public health finance as a field of practice, policy, and scholarship, this article proposes a working definition of the term "public health finance," embeds it in the context of the maturing literature on the public health system and its infrastructure, and proposes a four-part typology that spans both public-sector and private-sector contributions to the financing of prevention and health promotion. A developmental strategy for the field-in applied research, training and education, and performance standards-is outlined as well. [ABSTRACT FROM AUTHOR]

Governmental spending in public health varies widely across communities, raising questions about how these differences may affect the availability of essential services and infrastructure. This study used data from local public health systems that participated in the National Public Health Performance Standards Program pilot tests between 1999 and 2001 to examine the association between public health spending and the performance of essential public health services. Results indicated that performance varies significantly with both local and federal spending levels, even after controlling for other system and community characteristics. Some public health services appear more sensitive to these expenditures than others, and all services appear more sensitive to local spending than to state or federal spending. These findings can assist public health decision makers in identifying public health financing priorities during periods of change in the resources available to support local public health infrastructure. [ABSTRACT FROM AUTHOR]

This article uses data from the National Public Health Performance Standards Program to explore how the performance of essential public health services varies across communities and to identify underlying domains of activity that appear to drive variation in performance. Cross-sectional data were used from 315 local public health jurisdictions located within seven states that participated in the Performance Standards Program pilot tests between 1999 and 2001. Results demonstrate that local public health systems vary considerably in the extent to which they perform essential services and meet established performance standards. Factor analysis results indicate that four underlying domains of activity explain much of the variation observed in the individual performance measures, and that achieving performance standards for a single essential public health service often involves more than one underlying domain of activity. The findings suggest that composite measures constructed from the Performance Standards Program can assist public health decision makers in monitoring the performance of public health systems and identifying promising pathways for improving performance. [ABSTRACT FROM AUTHOR]

Discusses the need to improve the public health system in the U.S. Prevention of bioterrorism; Gaps in public health resources and services within communities; Public health systems research.

As part of the developmental process for the National Public Health Performance Standards Program, the CDC convened a group of experts in the fields of public health practice and research to evaluate key conceptual and methodological issues involved in measuring the performance of public health organizations. Participants engaged in a nominal group process and an electronic polling exercise designed to elicit expert opinions about these issues, Results revealed broad consensus around the need for measurement systems that support quality improvement and accountability applications, with scientific investigation viewed as an important but secondary objective of measurements. Substantial variation was observed in perceptions about the importance of specific measurement concepts and methods. Results highlight the need for performance measurement systems to reflect multiple organizational perspectives in their design and implementation. [ABSTRACT FROM AUTHOR]

Efforts are under way to develop a performance measurement monitoring system for state and local public health systems and to develop a strategic planning tool for local public health systems. The development of these measures is being based on the Essential Public Health Services. This article provides the rationale for why the Essential Services offer a good framework for identifying, analyzing, and evaluating public health activities. The article also reviews the history of local public health and the development and application of the Essential Public Health Services and their predecessor frameworks such as the core functions, the organizational practices, and the essential elements. [ABSTRACT FROM AUTHOR]

Focuses on the uprising public debate over concerns about the nation's health and health systems in the U.S. Escalation of health care costs and persistent gaps in the quality, safety, and accessibility of health services; Rise of preventable diseases and disabilities; Decrease of life expectancies.

The article highlights economics as a topic for journalists. Economics has been called the dismal science-and it is just that to many students. The media themselves frequently be have weakly in dealing with economic matters. In fact, thinking about this course, "Economics for Journalists," began because a wire service failed to differentiate between gross and net profits. Economic journalism need not be obscure and "Economics for Journalists," does help students move toward the ability to write clearly and knowledgeably on the "dismal science."

This article focuses on the importance of "mini-internships" in journalism courses. Opinions differ on the role internships in general should play in a journalism student's education, but few teachers decry the value of practical experience during college training. The mini-internships were set for the ninth week of a 10-week term. For their part, publishers were urged to send the students through every department and to allow them to work, if time and the situation permitted. Not only did students absorb the flavor and style of community and daily journalism, but they were furnished by most publishers with a variety and depth of statistics so as to open the economic workings of newspapers very wide indeed.

Objective: The objective of this paper is to provide empirical guidance by comparing the performance of six different area-level SDoH measurement approaches in predicting patient referral to a social worker and hospital admission after a primary care visit., Methods: We compared the performance of six area-level SDoH measurement approaches in predicting patient referral to a social worker and hospital admission after a primary care visit using random forest classification algorithm. Data came from 209,605 patient encounters at a federally qualified health center. Models with each area-based measurement approach were compared against the patient-level data only model using area under the curve, sensitivity, specificity, and precision., Results: Addition of area-level features to patient-level data improved the overall performance of models predicting need for a social worker referral. Entering area-level measures as individual features resulted in highest model performance., Conclusion: Researchers seeking to include area-level SDoH measures in risk prediction may be able to forego more complex measurement approaches.

Objectives: This study examines organizational characteristics and market conditions likely to influence collaborative relationships between public health agencies and community medical care providers., Methods: Public health directors in 60 US counties were surveyed by telephone concerning their relationships with area community hospitals (n = 263) and community health centers (n = 85). Multivariate models were used to estimate the effects of organizational and market characteristics on collaboration., Results: Collaboration was reported among 55% of the hospitals and 64% of the health centers. Certain forms of collaboration were more likely in markets characterized by higher HMO penetration and lower HMO competition., Conclusions: Targeted efforts to facilitate collaboration may be required in settings where institutional and market incentives are lacking.

Growth in managed care enrollment potentially creates incentives for health plans to become involved in public health activities, such as health promotion and disease prevention interventions, and care for vulnerable populations. Using cross-sectional data from 60 diverse markets, this study explores the extent to which health maintenance organizations (HMOs) form cooperative alliances with local public health agencies to perform such activities. Results from multivariate models suggest that the incentives for cooperation vary substantially with health plan ownership and market structure. In view of recent HMO industry trends, these findings raise questions about the ability of alliances to integrate the practice of public health and medicine on a broad national scale, as some proponents suggest they do.

Background: Many health care organizations have begun to pursue collaborative approaches for addressing community-level health issues. To understand how these community health alliances develop and operate, a descriptive study was conducted within a nationally selected group of 60 local communities and supplemented by detailed case studies in 8 communities., Alliance Models: A broad array of organizations were found to participate in community health alliances. Moreover, alliances were found to vary considerably. Strategically, alliances focused on one of three primary objectives: acquiring needed organizational knowledge and skills; addressing common resource needs; and pursuing a shared organizational mission. Functionally, alliances were observed in the areas of service delivery, planning and policy development, surveillance and assessment, and education and outreach. Structurally, alliances were found to operate through one of four interorganizational arrangements; informal collaboration, contractual agreements, shared governance, and shared ownership., Alliance Development: Organizational characteristics such as ownership type, organizational proximity, and market share appear to be important in the development of community health alliances. Community and market characteristics--including health resource availability, HMO penetration, and market consolidation--also appear to be influential in alliance development. Longitudinal observations suggest that alliances evolve over time in response to changing community health needs and organizational objectives., Alliance Management: Several managerial tasks appear to be important to successful alliance operations, including developing a shared vision of collaboration; devising explicit strategies for addressing participation constraints; ensuring the compatibility of organizational incentives; managing communication and information flows across organizations; and developing appropriate processes for performance monitoring., Conclusions: The observed variation in alliance structures and functions appears healthy rather than problematic, as organizations develop arrangements to fit community needs, organizational capacities, and market conditions.

Throughout the past decade, growing attention has focused on ways to monitor the performance of local public health organizations and ensure the adequacy of their services. We surveyed representatives of the nation's state health agencies during 1997 to examine their processes for local public health performance assessment. Eighty-eight percent of agencies reported some involvement in assessment activities. Of these agencies, 50 percent reported having an assessment process that was currently operative. States reported using a diversity of assessment methods. Results suggest that states are developing performance assessment processes that are tailored to local resources, needs, and priorities.

Concerns about the cost, quality, and efficiency of services provided within public sector health care systems are leading policy makers and health care administrators to reinvent government and develop alternative methods for the delivery of services traditionally offered in the public sector. Privatization structures that incorporate strong quality management principles, both through formal accountability systems and through financial risk-sharing arrangements, appear to hold the greatest promise for achieving quality and efficiency goals.

Strategic alliances are proving to be effective strategies for responding and adapting to changing environments, and as such they offer the U.S. Department of Veterans Affairs (VA) healthcare system valuable opportunities for accomplishing the goals of its major reorganization effort. This article begins with an examination of basic strategic-alliance structures that are employed across many different types of industries. Next, consideration is given to the ways in which these basic alliance structures may be adapted to the unique organizations and individuals that serve as providers, purchasers, and consumers of health services. Finally, this article explores how models of strategic alliance in healthcare can be tailored to the specific needs and constraints of the VA healthcare system through an examination of existing and potential alliance opportunities.

This article provides a framework for analyzing how downsizing and reengineering have affected healthcare organizations. These approaches are reviewed, and key tools that have been used, such as across-the-board cuts, reorganizing, and redesigning, are described. Examples are drawn from healthcare as well as other business sectors. The consequences of cost reduction strategies for an organizations's performance in terms of costs, quality of services, and satisfaction of consumers and employees are explored. The case is made that an organization's context--that is, its culture, level of trust, and leadership--is an important factor that influences the effect of cost-cutting strategies. Characteristics of organizations where downsizing has a better chance of succeeding also are described.

The growing complexity of the nation's health care system is creating new challenges and opportunities for public health officials, and a renewed concern for leadership training among these officials. A focus group conducted with public health officials at local, state, and national levels reveals perceptions about the predominant trends effecting public health practice, the leadership skills required for effective public health practice, and the strategies that are needed for providing appropriate leadership training to public health executives. Officials indicate that public health practice is undergoing substantial changes in response to the growth of managed care and integrated delivery systems, changes in public health funding sources and levels, and efforts to privatize the delivery of public health services. The skills identified as critical for effective leadership in this environment include the ability to guide organizational behavior and cultivate interorganizational relationships; apply scientific knowledge to public health problems, and build and sustain community coalitions. In light of these skills, public health officials identify four essential components of an optimally effective executive training program in public health leadership: exposure to the core scientific disciplines within public health; exposure to organization theory and management science; training in community development and empowerment; and training in ethics and social justice. All of the officials agree with the need for distance learning programs for executives in public health leadership, and most officials also support the need for doctoral-level training in public health practice.

Managed care is fast becoming the dominant form of medical care delivery and financing in the United States, yet its effects on public health practice remain largely unknown. Tuberculosis (TB) is a classic example of a disease with both public health and medical care implications, and as such it provides an opportunity for examining the impact on public health of the shift towards managed care in the medical marketplace. The authors approach the role of managed care in TB control by first considering the need for interorganizational coordination at the community level. The authors identify four basic models of how managed care organizations may fit into TB control efforts in local communities, using observations from 12 local public health jurisdictions to illustrate these models. These TB control models provide insight into the general mechanisms through which managed care organizations may affect other areas of public health practice.