California

Traditionally, the American child welfare system intervenes in cases of evident and severe maltreatment. Families in need of help, but who have not reached a crisis, are excluded from typical services. Some suggest that if these families were served, few would be rereferred to the child welfare system. California’s Differential Response (DR) has three tracks, of which ‘‘Track 1’’ targets families screened out of child protective services (CPS) and refers them to agencies that provide voluntary, home-based services and referrals. This study examined child-welfare trajectories for families receiving Track 1 DR services in one California county. Using survival analysis, treatment group children (N = 134) were compared to children eligible for services but denied due to program capacity (comparison group N = 511). Findings suggest no statistically significant differences between groups on the likelihood of a re-report following program participation, timing of maltreatment reports, or r...

This article reflects on how the diversity discourse in an undergraduate classroom can be enhanced by paying
attention to particularities such as the location and mission of the educational institution, the identity of the teacher,
and the demographic profile of students. In particular, the author develops two distinctive points about teaching
diversity in higher education: (a) diversity discourse in classrooms can be enhanced by deep reflections on
geographical location, institutional contexts, student demographics, and the professor’s situated identities; and b)
diversity conversations need to move beyond celebrating common ground. Although the article employs examples from
one specific course in religious studies, the pedagogical insights and strategies offered here can be employed
universally in the fields of humanities and social sciences.

To evaluate and characterize the racial/ethnic differences in obstetric outcomes of early and late teenagers in California. A data-set linking birth and death certificates with maternal and neonatal hospital discharge records in California was utilized to identify nulliparous women (11 to 29 years of age) who delivered between January 1,1992 and December 31,1997. Pregnancy outcomes of early (11-15 year) and late (16-19 year) teenagers were compared to those of a control group of women aged 20-29. Early (n = 31 232) and late teens (n = 271 470) demonstrated greater neonatal and infant mortality and major neonatal morbidities (delivery < 37 weeks of gestation and birthweight < 2500 g) when compared to pregnancies in the older control women (n = 662 752). Ethnicity adversely affected outcome with African-Americans of all ages having worse outcomes than whites. The higher rate of adverse obstetric outcomes among the teenage pregnancies occurred despite a lower cesarean section rate and was consistent across all ethnic groups. When compared to women aged 20-29, all teen pregnancies were associated with higher rates of poor obstetric outcomes. Other factors besides teen pregnancy appear to be responsible for poor outcomes in certain ethnic groups.

This ethnographic study of interpretations of stress among hospital social workers reveals concrete ways in which institutional systems take form in the mundane actions and interpretations of individuals embedded in these systems. It also reveals how organizational cultures reflect and reinforce institutional conditions that have been negotiated in the interactions of individuals. Here, the institutional systems of medicine and social work come together in the everyday work of the social workers and result in two patterns of cultural dominance. Within these distinct types of culture emerge two forms of stress experience, including a dominant form, consistent with medical ideology, and a marginalized form, consistent with social work ideology. Some surprising patterns of interpretation emerge, including interpretations of ambiguity and burnout as normal, social, and desirable when the social work ideology is dominant. This institutional analysis of stress has theoretical, practical, and epistemological implications.

Osteonecrosis of the jaw (ONJ) is a serious complication associated with bisphosphonate therapy, but its epidemiology in the setting of oral bisphosphonate therapy is poorly understood. The present study examined the prevalence of ONJ in patients receiving chronic oral bisphosphonate therapy.We mailed a survey to 13,946 members who had received chronic oral bisphosphonate therapy as of 2006 within a large integrated health care delivery system in Northern California. Respondents who reported ONJ, exposed bone or gingival sores, moderate periodontal disease, persistent symptoms, or complications after dental procedures were invited for examination or to have their dental records reviewed. ONJ was defined as exposed bone (of >8 weeks' duration) in the maxillofacial region in the absence of previous radiotherapy.Of the 8,572 survey respondents (71 ± 9 years, 93% women), 2,159 (25%) reported pertinent dental symptoms. Of these 2,159 patients, 1,005 were examined and an additional 536 provided dental records. Nine ONJ cases were identified, representing a prevalence of 0.10% (95% confidence interval 0.05% to 0.20%) among the survey respondents. Of the 9 cases, 5 had occurred spontaneously (3 in palatal tori) and 4 occurred in previous extraction sites. An additional 3 patients had mandibular osteomyelitis (2 after extraction and 1 with implant failure) but without exposed bone. Finally, 7 other patients had bone exposure that did not fulfill the criteria for ONJ.ONJ occurred in 1 of 952 survey respondents with oral bisphosphonate exposure (minimum prevalence of 1 in 1,537 of the entire mailed cohort). A similar number had select features concerning for ONJ that did not meet the criteria. The results of the present study provide important data on the spectrum of jaw complications among patients with oral bisphosphonate exposure.

To examine patient preferences for age-,gender-, and racial/ethnic-concordant primary care physicians. Focus group interviews. Forty-nine adults (African Americans, Caucasians, and Latinos) receiving their outpatient medical care in university-based primary care clinics in Northern California. Guiding questions were designed to elicit information about what patients look for in establishing and maintaining a therapeutic relationship with a primary care physician. Patients were prompted to provide examples and to discuss demographic-concordance factors. Many participants felt that their continuity of care was poor and that they could not choose their own primary care physicians in the academic system. Most reported tolerating these inconveniences for what they perceived to be a higher quality of care linked to medical innovations at academic medical centers. Patients' views regarding age concordance were varied and unrelated to gender or racial/ethnic group. Women in all English-...

Key Words: dental caries, preschool, racdethnicity, Head Start, socioeconomic status, feeding practices. ... California is among the most popu-lated and ethnically diverse states in the country. It is also among the states with the lowest proportion of the population with ...

To better understand the extent that empirically supported and promising substance abuse treatment approaches are implemented in community settings, treatment providers were surveyed regarding their perceptions and use of several psychosocial and pharmacological treatment interventions. Program directors (n=30) and staff members (n=331) from diverse community settings rated the effectiveness and extent of use of various treatment interventions, and provided information

The subspecies composition of migratory sandhill cranes (Grus canadensis) which stage and winter along the Lower Columbia River in northwest Oregon and southwest Washington is uncertain, but may include all 3 using the Pacific Flyway: lesser (G. c. canadensis), Canadian (G. c. rowani), and greater (G. c. tabida). However, the status of rowani has been debated. During 2001-02, we captured and marked 8 cranes using a noose line trapping technique, and attached Platform Transmitter Terminals (PTTs) to 6 to ascertain locations of their breeding areas, migration corridors and winter sites. Morphometric data were collected for subspecies determination. From measurements and their summer distribution, we conclude that they are likely the intermediate rowani form. Because of their limited numbers, distinct coastal migration path, and habitat issues at breeding, staging, and wintering areas, we recommend that conservation efforts be increased and that they be managed as a unique population. ...