Promoting proactive bystander responses to racism and racial discrimination in primary schools: a mixed methods evaluation of the 'Speak Out Against Racism' program pilot.

BACKGROUND: Racism and racial discrimination are fundamental causes and determinants of health and health inequalities globally, with children and adolescents particularly vulnerable. Racial discrimination is a common stressor in the lives of many children and adolescents, with growing evidence of negative associations between racial discrimination and multiple domains of child and adolescent health. Addressing racism and racial discrimination must be core public health priorities, even more so among children and young people. Schools are key settings in the lives of children and adolescents and become increasingly more important to identity formation. School communities, teachers and peers greatly influence children and adolescents' beliefs about race and difference. Schools are therefore key sites for the delivery of population-based programs to reduce racism and promote proactive bystander behaviour and healthy resistance to racism among all children and adolescents as well as among the adults. METHODS: This study examines the feasibility and acceptability of the 'Speak Out Against Racism (SOAR)' program, a whole of school, multi-level, multi-strategy program that aimed to promote effective bystander responses to racism and racial discrimination in primary schools. A mixed-methods, quasi-experimental design was used. Students in Years 5 and 6 (10-12 years) across six schools completed surveys pre- and post- intervention (N = 645; 52% female; 6% Indigenous, 10% Middle Eastern, African, Latinx or Pacific Islander, 21% Asian, 52% Anglo/European). Focus groups with students and interviews with staff collected qualitative data about their experiences of the program and their views about the program's perceived need, implementation, impacts and suggested improvements. RESULTS: Quantitative data showed student prosocial skills and teacher inter-racial climate improved in intervention schools compared to comparison schools. Qualitative data highlighted teacher attitudinal and behaviour change regarding racism, and student reduced interpersonal racial discrimination, improved peer prosocial norms, commitment to anti-racism, knowledge of proactive bystander responses and confidence and self-efficacy to intervene to address racism. CONCLUSIONS: This study provides quantitative evidence of the potential of the SOAR program to improve the prosocial skills of students and their perceptions of the inter-racial school climate provided by their teachers. This program also provided qualitative evidence of the potential to promote teacher and student attitudinal and behavioural change. Further refinement and testing of the program in a large scale implementation trial is recommended.

Improving the Patient Experience: Call Light Intervention Bundle.

PURPOSE: Delays in call light response are a significant patient quality and safety concern. Research on call light interventions and patient outcomes has focused exclusively on adult inpatients. This project examined the impact of increasing staff awareness and workflow redesign to improve the pediatric patient experience and outcomes based on timely response. DESIGN AND METHODS: A quality improvement project was conducted on two pediatric medical surgical units' (31 and 35 beds respectively) at a large Midwest academic medical center with patients' ages from to young adults. Data on staff knowledge, patient satisfaction, and fall rates was examined pre- and post-intervention of an evidence-based call light intervention bundle which included: 1) unit-based patient experience committees, 2) purposeful rounding, 3) pod buddy assignments, and 4) staff education. RESULTS: Post-intervention both units demonstrated improvement in staff knowledge on call light interventions and exhibited sustained improvement in patient satisfaction scores for promptness to call. Likelihood to recommend the hospital and satisfaction with pain control improved for one of the two units. No impact on fall rates was noted over time for either unit. CONCLUSIONS: A call light intervention bundle can positively impact patient satisfaction with promptness to call lights in pediatric medical surgical hospitalized patients and their families. Unlike adult patients, a call light intervention bundle did not impact fall rates in children and further study in pediatric fall reduction strategies is needed.

Efficacy of ultrasound in the evaluation of iliac vein stenting.

Objectives: The current study evaluated the efficacy of iliac and IVC ultrasound alone for follow-up evaluation of iliac vein stents in patients with pelvic venous disorders or iliac occlusion from chronic deep vein thrombosis. Methods: A retrospective single site cohort study was conducted by evaluating the most recent 100 iliac vein and inferior vena cava ultrasounds in patients who had undergone iliac vein stenting. Inclusion criteria included a history of iliac vein stent placement. Exclusion criteria included patients under 18-years-old, duplicates of the same patient, and pregnancy at the time of ultrasound. The degree of visualization for color flow, gray scale, and phasicity were determined and classified into the following categories: complete, partial, or none. In addition, each chart was assessed for external compression, in-stent narrowing, and requirements for further imaging. Results: Of the 100 iliac vein and IVC ultrasounds assessed in this review, 99 of the ultrasounds were sufficient for evaluation during follow-up visits without requiring further investigation. Within this study cohort, the average follow-up time was 22 months. The average participant body mass index was 27.6. One iliac vein and IVC ultrasound was considered inadequate for follow-up evaluation and required further imaging. Conclusion: The use of iliac and IVC venous doppler ultrasound alone in the follow-up evaluation of iliac stent patency is effective and noninvasive and avoids unnecessary radiation exposure and cost.

A highly efficient transgene knock-in technology in clinically relevant cell types.

Inefficient knock-in of transgene cargos limits the potential of cell-based medicines. In this study, we used a CRISPR nuclease that targets a site within an exon of an essential gene and designed a cargo template so that correct knock-in would retain essential gene function while also integrating the transgene(s) of interest. Cells with non-productive insertions and deletions would undergo negative selection. This technology, called SLEEK (SeLection by Essential-gene Exon Knock-in), achieved knock-in efficiencies of more than 90% in clinically relevant cell types without impacting long-term viability or expansion. SLEEK knock-in rates in T cells are more efficient than state-of-the-art TRAC knock-in with AAV6 and surpass more than 90% efficiency even with non-viral DNA cargos. As a clinical application, natural killer cells generated from induced pluripotent stem cells containing SLEEK knock-in of CD16 and mbIL-15 show substantially improved tumor killing and persistence in vivo.

The association between experiences of religious discrimination, social-emotional and sleep outcomes among youth in Australia.

BACKGROUND: Religious-based hate crimes are on the rise worldwide. However, the relationship of religious discrimination on health and well-being, especially earlier on the lifecourse, is largely understudied. This study examines the prevalence of religious discrimination and the relationship it has on social-emotional adjustment and sleep outcomes among a diverse sample of students in Australia. METHODS: Data came from Speak Out Against Racism, a population-representative cross-sectional study of 4664 public school students in grades 5-9 in Australia in 2017. An adaption of the Adolescent Discrimination Distress Index (ADDI), was used to derive four measures of religious discrimination (peer, school, societal and the sum of those as a "total" score). The Strengths and Difficulties Questionnaire measured the total difficulties, conduct, emotional, and prosocial behavior subscales. Measures of sleep outcomes included duration, latency, and disruption. RESULTS: 27 % (95 % CI 22.82, 31.12) of students reported experiences of direct total religious discrimination with higher levels being reported by students identifying as a religious minority. There was strong evidence that experiences of religious discrimination (across all four sources) was related to all measures of socioemotional adjustment and sleep outcomes. DISCUSSION: Religious discrimination is an understudied form of social disadvantage that has implications for adolescents' development, health and well-being. Conclusion: More programs, particularly in the school-context, address religious-based discrimination may reduce inequities in health.

Evaluation of Threaded External Skeletal Fixation Pin Insertion with and without Predrilling in Avian Bone.

OBJECTIVE: The aim of this study was to document the effects of positive-profile threaded external skeletal fixation (ESF) pin insertion without predrilling on heat generation, structural damage and pullout strength in avian bone than that with predrilling. STUDY DESIGN: This study was an ex vivo study. MATERIALS AND METHODS: Twenty paired tibiotarsi and 40 paired humeri from 20 Mallard duck cadavers were used. Specimens were randomized to have positive-profile threaded ESF pins placed with or without predrilling insertion sites. Heat generation (maximum-baseline temperature) was measured during drilling and pin insertion with infrared thermography. Structural damage (gross trans-cortical damage and thread quality) was evaluated and scored using a visual analog scale (VAS). Mechanical testing was performed to evaluate pullout strength of inserted pins. RESULTS: VAS scores for trans-cortical surfaces were significantly higher than for cis-cortical surfaces; however, no difference was noted between predrilled and non-predrilled specimens. No significant difference in heat generation or pullout strength was noted between pins placed with and without predrilling. CONCLUSION: Pin insertion without predrilling in avian humeri and tibiotarsi does not cause significantly more structural damage or heat generation, or reduced pullout strength, compared with predrilling. Overall, our results indicate that predrilling prior to ESF pin placement provides no obvious advantage in avian bone.

The role of persuasive arguments in changing affirmative action attitudes and expressed behavior in higher education.

The research reported in this article examined the conditions under which persuasive arguments are most effective in changing university students' attitudes and expressed behavior with respect to affirmative action (AA). The conceptual framework was a model that integrated the theory of reasoned action and the elaboration likelihood model of persuasion. Studies 1 and 2 established effective manipulations of positive?negative AA information, and peripheral?central routes of processing. Study 3 implemented these techniques, and a path analysis was carried out testing the differential effects of valence of information processed via different routes on AA evaluative beliefs, attitudes, intention, and expressed behavior. Results indicated that positive AA messages processed centrally (i.e., for meaning) resulted in significantly more positive evaluative beliefs. Modifications to the original model resulted in a final model with excellent fit to the data that supported the mediating role of intention in the AA attitude?behavior relationship, as predicted by the theory of reasoned action. The findings highlight potential benefits of interventions for improving support for AA policies, provided that positive information is processed at a central, evaluative level.