In this study, we extend research on the allocation of educational resources to an underdeveloped domain—the distribution of counselors, psychologists, and social workers (i.e., support personnel) to schools. Using administrative data for all North Carolina public schools in the 2007–2008 through 2015–2016 school years, we measure the allocation of support personnel to schools, track secular changes in support personnel ratios during a period in which state budgetary provisions contracted and expanded, and assess the distribution of support personnel to high-poverty and high-minority schools. We calculate more accurate support personnel ratios and show that trends in support personnel ratios differ across school levels. We find that districts concentrate support personnel in high-need schools, however, this compensatory pattern is narrowing over time. Our findings call for further research on the allocation of support personnel and charge states/districts to calculate more accurate and granular support personnel ratios to inform decision making.
Splenic injuries are mostly treated with nonoperative management (NOM) with observation to monitor for continued hemorrhage and holding early chemical DVT prophylaxis to reduce the risk of NOM failure. Eberle et al demonstrated chemoprophylaxis prior to 72 hours didn’t increase failure rate of NOM. We chose to extrapolate this finding and compare outcomes in high-grade splenic injuries (HGSI) with chemoprophylaxis before and after 48 hours. From January 2013 to December 2017, 104 patients with HGSI received chemoprophylaxis with unfractionated heparin (UH) or low molecular weight heparin (LMWH) within 72 hours of diagnosis. Of these, 8 patients received chemoprophylaxis within 24 hours, 46 between 24 and 48 hours, and 50 patients between 48 and 72 hours. This population consisted of 70 males and 34 females, with an average age of 40.1 years. The average ISS was 23 and the majority (77%) were grade 3 injuries. We observed 6 failures of NOM: 1 in the <24 hour group, 3 in the 24-48 hour group, and 2 in the 48-72 hour group. There was no statistically significant difference between the <24 hour and >24 groups or between the <48 hour and 48-72 hour groups. A linear regression analysis created a model describing the time to initiation of DVT prophylaxis using age, sex, splenic injury grade, and ISS; the failure rate decreased by 0.00002% for each hour prior to giving DVT prophylaxis, with a P value of .111. We conclude a noninferiority statement that DVT prophylaxis prior to 48 hours does not increase the risk of NOM failure.
The present study explored the ways school professionals adapted school‐based mental health supports and services for remote delivery during the coronavirus disease 2019 (COVID‐19) pandemic. We surveyed 81 school professionals (e.g., counselors, psychologists, and social workers) and conducted in‐depth interviews with a subsample of professionals (n = 14) to explore their perceptions and experiences of supporting youth with mental health concerns and suicide‐related risk during the fall and winter of the 2020–2021 school year. Commonly endorsed school‐based mental health interventions (e.g., counseling services and checking in), ways of communicating (phone and email), and individuals delivering support and services to students with suicide‐related risk (e.g., counselors and teachers) were identified based on school professional survey responses. Qualitative findings point to facilitators (e.g., specific platforms for connecting with students and families) and barriers (e.g., limited communication) to successful service delivery during COVID‐19. Findings highlight the creative ways school support professionals adapted to provide school‐based mental health supports. Implications for remote school‐based mental health services during and following the pandemic are discussed.
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