Crime and Inequality in Academic Achievement Across School Districts in the United States.

This study investigates the effect of violent crime on school district-level achievement in English language arts (ELA) and mathematics. The research design exploits variation in achievement and violent crime across 813 school districts in the United States and seven birth cohorts of children born between 1996 and 2002. The identification strategy leverages exogenous shocks to crime rates arising from the availability of federal funds to hire police officers in the local police departments where the school districts operate. Results show that children who entered the school system when the violent crime rate in their school districts was lower score higher in ELA by the end of eighth grade, relative to children attending schools in the same district but who entered the school system when the violent crime rate was higher. A 10% decline in the violent crime rate experienced at ages 0-6 raises eighth-grade ELA achievement in the district by 0.03 standard deviations. Models that estimate effects by race and gender show larger impacts among Black children and boys. The district-wide effect on mathematics achievement is smaller and statistically nonsignificant. These findings extend our understanding of the geography of educational opportunity in the United States and reinforce the idea that understanding inequalities in academic achievement requires evidence on what happens inside as well as outside schools.

Association of Primary Language and Hospitalization for Ambulatory Care Sensitive Conditions.

BACKGROUND: Limited English proficiency is associated with decreased access to ambulatory care, however, it is unclear if this disparity leads to increased use of emergency departments (EDs) for low severity ambulatory care sensitive conditions (ACSCs). OBJECTIVE: We sought to determine the association between the patient's preferred language and hospital utilization for ACSCs. RESEARCH DESIGN: We conducted a retrospective cohort study of all ED visits in New Jersey in 2013 and 2014. The primary outcome was hospital admission for acute ACSCs, chronic ACSCs, and fractures (a nonambulatory care sensitive control condition). Secondary outcomes included intensive care unit (ICU) utilization and length of stay. Mixed-effect regression models estimated the association between preferred language (English vs. non-English) and study outcomes, controlling for demographics, comorbidities, and hospital characteristics. RESULTS: We examined 201,351 ED visits for acute ACSCs, 251,193 visits for chronic ACSCs, and 148,428 visits for fractures, of which 13.5%, 11.1%, and 9.9%, respectively, were by non-English speakers. In adjusted analyses, non-English speakers were less likely to be admitted for acute ACSCs [-3.1%; 95% confidence interval (CI), -3.6% to -2.5%] and chronic ACSCs (-2.3%; 95% CI, -2.8% to -1.7%) but not fractures (0.4%; 95% CI, -0.2% to 1.0%). Among hospitalized patients, non-English speakers were less likely to receive ICU services but had no difference in length of stay. CONCLUSIONS: These findings suggest non-English-speaking patients may seek ED care for lower acuity ACSCs than English-speaking patients. Efforts to decrease preventable ED and increase access to ambulatory care use should consider the needs of non-English-speaking patients.

Predicting international students' clinical and academic grades using two language tests (IELTS and C-test): A correlational research study.

Academic English tests are used to ascertain if international English as a Second Language nursing students have sufficient language skills to commence their nursing degrees, and later, if they have sufficient English for nursing registration. However, an academic English test may not be appropriate for clinical contexts. This study examines the relationship between two types of English test and the performance of forty-nine undergraduate international nursing students in both their first year of theory-centred academic topics and practice-centred clinical topics. An academic English test, called the International English Language Testing System (IELTS), and a general English proficiency/processing speed test using a variation of the cloze-test (C-test) format were administered at the commencement of the students' course of study. At the end of one year, grade percentages were collected. It was found that both the IELTS test and the C-test were significantly correlated to both types of topic, albeit with different patterns. The two English tests were also tested for similarities in the constructs they measured, with a significant overlap found. The implications are to rethink the way English tests are applied to entry in university degrees involving a clinical component and, by extension, to direct universities to rethink how nursing students are supported during their degree. The question is also raised about the practice of using academic English tests for professional nursing registration purposes. The benefits of the two testing approaches are also considered, particularly the large differences in monetary outlay and time found between the two tests, given their performance in explaining the variance in grade outcomes.

Household language use and health care access, unmet need, and family impact among CSHCN.

OBJECTIVES: We examined the association of household language use and access to care among children with special health care needs (CSHCN). From this study we describe the demographics of children and the prevalence of selected access characteristics according to their primary household language and examine the independent effects of household language on health care access, unmet needs, and family impact while controlling for confounding variables. METHODS: Data from the 2005-2006 National Survey of Children With Special Health Care Needs, a nationally representative telephone survey of 40,723 CSHCN, were analyzed. Bivariate and multivariable analyses were used to examine disparities and estimate adjusted odds ratios of health care access, satisfaction, and family-impact measures for CSHCN from non-English-primary-language (NEPL) versus English-primary-language (EPL) households. RESULTS: Nearly 14% of all US children live in NEPL households. NEPL CSHCN were significantly more likely to be Hispanic or other race, be poor, have less educated parents, and reside in metropolitan areas and larger households and yet were less likely to be on cash assistance from welfare. Logistic regression showed that NEPL CSHCN were twice as likely to lack access to a medical home, a usual source of care, and family-centered care. They were 4 times as likely to lack health insurance, and their family members were also more likely to lack adequate insurance. Family members of NEPL children were almost twice as likely to have to stop employment as a result of their child's condition. CONCLUSIONS: Although limited by program eligibility contingent on immigrant status and state policies, increased referrals to programs such as the State Children's Health Insurance Program and Medicaid can improve access while utilization can be improved by the availability of interpreters, community health workers, linguistically concordant providers, and outreach education efforts of NEPL parents.

Analysis of compositional data in communication disorders research.

UNLABELLED: The study of communication and its disorders often involves coding several behaviors and examining the proportions with which individual behaviors are produced within data sets. Problems are encountered when studying multiple behaviors between data sets, because of the interdependence of the proportions: as one coded behavior increases, at least one other must decrease. The interdependence of data means that traditional statistical techniques can be used to analyse differences in the proportion of only one behavior over time or between clinical groups. We describe a statistical technique, previously used in geological and biomedical research, which can be used to analyse all behaviors in compositional data sets, and give examples of its use with interaction data. The technique allows, for the first time, full comparison of entire patterns of multiple communication behaviors, both over time and between clinical groups. The technique will aid both basic and applied communication research. LEARNING OUTCOMES: Readers will understand the advantages and limitations of frequency counts and proportions for the analysis of multiple behaviors. Readers will be able to analyze change in proportions of multiple behaviors within a data set between groups and across time.

Scientist-friendly policies for non-native English-speaking authors: timely and welcome.

That English is the lingua franca of today's science is an indisputable fact. Publication in English in international journals is a pre-requisite for a research paper to gain visibility in academia. However, English proficiency appears to be taken for granted in the scientific community, though this language can be a hurdle for a number of authors, particularly from non-native English-speaking countries. The influence of English proficiency on the publication output of Brazilian authors has never been assessed. We report our preliminary data on the relationship between the English proficiency of 51,223 researchers registered in the CNPq database and their publication output in international journals. We have found that publication rates are higher for those authors with good command of English, particularly written English. Although our research is still underway and our results are preliminary, they suggest that the correlation between written English proficiency and research productivity should not be underestimated. We also present the comments of some Brazilian scientists with high publication records on the relevance of communication skills to the scientific enterprise.

Scientist-friendly policies for non-native English-speaking authors: timely and welcome

That English is the lingua franca of today's science is an indisputable fact. Publication in English in international journals is a pre-requisite for a research paper to gain visibility in academia. However, English proficiency appears to be taken for granted in the scientific community, though this language can be a hurdle for a number of authors, particularly from non-native English-speaking countries. The influence of English proficiency on the publication output of Brazilian authors has never been assessed. We report our preliminary data on the relationship between the English proficiency of 51,223 researchers registered in the CNPq database and their publication output in international journals. We have found that publication rates are higher for those authors with good command of English, particularly written English. Although our research is still underway and our results are preliminary, they suggest that the correlation between written English proficiency and research productivity should not be underestimated. We also present the comments of some Brazilian scientists with high publication records on the relevance of communication skills to the scientific enterprise.

A comparison of physician examiners', standardized patients', and communication experts' ratings of international medical graduates' English proficiency.

PURPOSE: To assess the quality of ratings of interviewing skills and oral English proficiency provided on a clinical skills OSCE by physician examiners, standardized patients (SPs), and communication skills experts. METHOD: In 1998, 73 candidates to the Ontario International Medical Graduate (OIMG) Program completed a 29-station OSCE-type clinical skills selection examination. Physician examiners, SPs, and communication skills experts assessed components of oral English proficiency and interview performance. Based on these results, the frequency and generalizability of English-language flags, physician examiners' indications that spoken English skills were bad enough to significantly impede communication with patients; the reliability of the OIMG's Interview and Oral Performance Scales and generalizability of overall interview and oral performance ratings; and comparisons of repeated assessments by experts were calculated. Principal-components analysis was applied to the panels' ratings to determine a more economical expression of the language proficiency and interview communication skills results. RESULTS: The mean number of English-language flags per candidate was 2.1, the median was 1.0, and Cronbach's alpha of the ratings was 0.63. Means, SDs, and alphas of the physician examiners' and SPs' ratings of the interview performance scale were 9.15/10, 0.43, 0.36, and 9.30/10, 0. 56, 0.50, respectively. Corresponding values for overall interview performance ratings were 3.08/4, 0.30, 0.33, and 3.34/4, 0.32, 0.47. Means, SDs, and alphas of the physician examiners' and SPs' ratings of the oral performance scale were 8.54/10, 0.74, 0.78, and 8.74/10, 1.00, 0.76. Corresponding values for overall ratings of oral performance were 3.85/5, 0.51, 0.68, and 4.08/5, 0.60, 0.68. For the two experts' ratings of two contiguous five-minute interview stations, internal consistencies were 0.88 and 0.78. For the two experts' ratings of standardized ten-minute interviews, internal consistencies were 0.81 and 0.92. Correlations between the mean values of the experts' ratings of the ten- and five-minute stations were 0.45 and 0.51. Three factors emerged from the PCA, language proficiency, physician examiners' ratings of interview proficiency, and SPs' ratings of interview proficiency. CONCLUSIONS: Consistency between the physician examiners' and SPs' ratings of English proficiency was observed; less agreement was observed in their ratings of interviewing skills, and little agreement was observed between the experts' ratings. Communication skills results may be validly expressed by three measures: one overall global rating of language proficiency provided by physician examiners or SPs, and overall global ratings of interview proficiency provided separately by physician examiners and SPs.