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Telemedicine implementation and use in community health centers during COVID-19: Clinic personnel and patient perspectives.


In March 2020, federal and state telehealth policy changes catalyzed telemedicine adoption and use in community health centers. There is a dearth of evidence on telemedicine implementation and use in these safety net settings and a lack of information reflecting the perspectives of patients with limited English proficiency. We conducted in-depth interviews with clinic personnel and patients during the pandemic in two federally qualified health centers that primarily serve Chinese and Latino immigrants. Twenty-four interviews (clinic personnel ​= ​15; patients who primarily speak a language other than English ​= ​9) were completed remotely between December 2020 and April 2021. Interview scripts included questions about their telemedicine experiences, technology, resources and needs, barriers, facilitators, language access, and continued use, with a brief socio-demographic survey. Data analyses involved a primarily deductive approach and thematic analysis of transcript content. Both FQHCs adopted telemedicine in a few weeks and transitioned primarily to video and audio-only visits within two months. Findings reveal third-party language interpretation services were challenging to integrate into telemedicine video visits. Bilingual personnel who provided language concordant care were seen as essential for efficient and high-quality patient telemedicine experiences. Audio-only visits were of particular benefit to reach patients of older age, with limited English proficiency, and with limited digital literacy. Continued use of telemedicine is contingent on reimbursement policy decisions and interventions to increase patient digital literacy and technological resources. Results highlight the importance of reimbursing audio-only visits post-pandemic and investing in efforts to improve the quality of language services in telemedicine encounters.

Cover page of How Customer Demand Reactions Impact Technology Innovation and Security

How Customer Demand Reactions Impact Technology Innovation and Security


Innovation is a very important concern for both managers and governmental policy makers. There is an important interplay between security and technology innovation that is largely unrecognized in the literature. This research considers the case where technology innovation in the form of additional product features increases demand through greater functionality. However, the likelihood of a security breach increases with the number of product features as the features interact in unintended ways, thereby increasing the attack surface. Using a two-stage game, we demonstrate how potential demand changes (from direct risk or externalities) impact firm technology innovation strategy. The analysis shows that the type and extent of customer demand reaction has a significant impact on innovative feature development. This research identifies two potential impacts on the level of innovation that can be strategically managed - the impact of externalities on demand and industry risk - explaining how these forces alter the level of innovation in the product ecosystem. Additionally, high-security development is disincentivized, and leads to a type of competitive behavior where the opportunity window for high-security development for all firms is small.

Cover page of Foundations for California's Water Security in a Changing Climate

Foundations for California's Water Security in a Changing Climate


California’s water supplies are facing unprecedented stresses, and the state’s water-management systems are struggling to meet both environmental and human needs (agricultural, municipal, industrial). Supplies are highly vulnerable to climate variability and extreme events, limiting options to respond to the combined stresses of a changing climate, population, and land cover. Strategic, coordinated investments in California’s water infrastructure, institutions, and information will provide the foundation for a secure, equitable, and efficient water future. The cornerstone of water security, and priority need for California, is a modern, robust water-information system that enables accurate, timely, and transparent accounting through the water-supply and use cycle. This system must extend from mountain headwaters through valley groundwater. Investments are also needed in capacity building for use of water information among institutions and stakeholders across the state. Priority infrastructure improvements are needed for central elements of the state’s “green” infrastructure: restoration of Sierra Nevada and other forests in source-water areas, and additional groundwater recharge on farmland and expanded floodplains. With better-informed management, California’s existing water supplies could go further to meeting the state’s urban, agricultural, ecological, and industrial needs.

Cover page of Effect of Ion Pair on Contact Angle for Phosphonium Ionic Liquids.

Effect of Ion Pair on Contact Angle for Phosphonium Ionic Liquids.


The wettability of ionic liquids (ILs) is relevant to their use in various applications. However, a mechanistic understanding of how the cation-anion pair affects wettability is still evolving. Here, focusing on phosphonium ILs, wettability was characterized in terms of contact angle using experiments and classical molecular dynamics simulations. Both experiments and simulations showed that the contact angle was affected by the anion and increased as benzoate < salicylate < saccharinate. Further, the simulations showed that the contact angle decreased with increasing cation alkyl chain length for these anions paired with five different tetra-alkyl-phosphonium cations. The trends were explained in terms of adhesive and cohesive energies in the simulations and then correlated to the atomic scale differences between the anions and the cations.

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