Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.

Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., "black people's skin is thicker than white people's skin"). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient's pain as lower and made less accurate treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient's pain as higher, but showed no bias in treatment recommendations. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.

Estimating rates of change to interpret quantitative wastewater surveillance of disease trends.

BACKGROUND: Wastewater monitoring data can be used to estimate disease trends to inform public health responses. One commonly estimated metric is the rate of change in pathogen quantity, which typically correlates with clinical surveillance in retrospective analyses. However, the accuracy of rate of change estimation approaches has not previously been evaluated. OBJECTIVES: We assessed the performance of approaches for estimating rates of change in wastewater pathogen loads by generating synthetic wastewater time series data for which rates of change were known. Each approach was also evaluated on real-world data. METHODS: Smooth trends and their first derivatives were jointly sampled from Gaussian processes (GP) and independent errors were added to generate synthetic viral load measurements; the range hyperparameter and error variance were varied to produce nine simulation scenarios representing different potential disease patterns. The directions and magnitudes of the rate of change estimates from four estimation approaches (two established and two developed in this work) were compared to the GP first derivative to evaluate classification and quantitative accuracy. Each approach was also implemented for public SARS-CoV-2 wastewater monitoring data collected January 2021-May 2023 at 25 sites in North Carolina, USA. RESULTS: All four approaches inconsistently identified the correct direction of the trend given by the sign of the GP first derivative. Across all nine simulated disease patterns, between a quarter and a half of all estimates indicated the wrong trend direction, regardless of estimation approach. The proportion of trends classified as plateaus (statistically indistinguishable from zero) for the North Carolina SARS-CoV-2 data varied considerably by estimation method but not by site. DISCUSSION: Our results suggest that wastewater measurements alone might not provide sufficient data to reliably track disease trends in real-time. Instead, wastewater viral loads could be combined with additional public health surveillance data to improve predictions of other outcomes.

Out of place: Socioeconomic status, use of public space, and belonging in higher education.

Those from low socioeconomic status (SES) often lack access to public space and, when they have access, they are often discouraged from using public space. Scholars from human geography and related fields have argued that this limits engagement in civic life and undermines sense of belonging in one's community. In the present work, we consider whether lower-SES students face this predicament in higher education, particularly at elite public institutions. Across four studies, we find that, compared with higher-SES students, lower-SES students use public space on campus less-iconic public space in particular-and this can mediate the relationship between SES and sense of belonging at the University. We also find that experimentally increasing students' use of public space can reduce and even close SES gaps in felt belonging. Taken together, the present studies suggest that use of public space matters for belonging and for understanding gaps in belonging. This work contributes to our understanding of SES disparities in higher education. More generally, it illustrates the importance of public space. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A socioecological psychology of racism: making structures and history more visible.

Psychology has been accused of 'psychologizing' racism. Here, we summarize the argument that Psychology routinely neglects structural racism and historical legacies of racism. We then discuss two cases-healthcare and police use of force-in which studying individual bias could benefit from incorporating a focus on structures and history. We close by echoing others who have advocated that Psychology move forward with a better integrated view of racism; in particular, we suggest a socioecological view that contextualizes individual bias within the relevant realities of historical and structural racism.

Children's racial bias in perceptions of others' pain.

Previous research indicates that American adults, both Black and White, assume a priori that Black people feel less pain than do White people (Trawalter, Hoffman, & Waytz, 2012, PLoS One, 7[11], 1-8). The present work investigates when in development this bias emerges. Five-, 7-, and 10-year-olds first rated the amount of pain they themselves would feel in 10 situations such as biting their tongue or hitting their head. They then rated the amount of pain they believed two other children - a Black child and a White child, matched to the child's gender - would feel in response to the same events. We found that by age 7, children show a weak racial bias and that by age 10, they show a strong and reliable racial bias. Consistent with research on adults, this bias was not moderated by race-related attitudes or interracial contact. This finding is important because knowing the age of emergence can inform the timing of interventions to prevent this bias.

The invisible man: interpersonal goals moderate inattentional blindness to African Americans.

Research on inattentional blindness demonstrates that when attending to 1 set of stimuli, people often fail to consciously perceive a task-irrelevant object. In this experiment, we tested for selective inattentional blindness to racial outgroup members. We reasoned that some racial groups would be perceived as more relevant than others, depending on the interpersonal goal that was active. White participants were primed with interpersonal goals that ranged from psychologically distant (searching for a coworker) to psychologically close (searching for a romantic partner). In the control condition, no goal was explicitly activated. Then, participants watched a video of 2 teams passing a ball and were asked to count the ball passes of one of the teams. In the middle of the video, a Caucasian or an African American man walked through the scene. Participants were then asked to report whether they had seen the interloper. Results revealed that as interpersonal goals became closer to the self, participants were less likely to see the African American man. This research demonstrates a new form of social exclusion based on early attention processes that may perpetuate racial bias.

Racial bias in perceptions of others' pain.

The present work provides evidence that people assume a priori that Blacks feel less pain than do Whites. It also demonstrates that this bias is rooted in perceptions of status and the privilege (or hardship) status confers, not race per se. Archival data from the National Football League injury reports reveal that, relative to injured White players, injured Black players are deemed more likely to play in a subsequent game, possibly because people assume they feel less pain. Experiments 1-4 show that White and Black Americans-including registered nurses and nursing students-assume that Black people feel less pain than do White people. Finally, Experiments 5 and 6 provide evidence that this bias is rooted in perceptions of status, not race per se. Taken together, these data have important implications for understanding race-related biases and healthcare disparities.

Randomized, double-blind, placebo-controlled study of zeaxanthin and visual function in patients with atrophic age-related macular degeneration: the Zeaxanthin and Visual Function Study (ZVF) FDA IND #78, 973.

BACKGROUND: The purpose of this study is to evaluate whether dietary supplementation with the carotenoid zeaxanthin (Zx) raises macula pigment optical density (MPOD) and has unique visual benefits for patients with early atrophic macular degeneration having visual symptoms but lower-risk National Institute of Health/National Eye Institute/Age-Related Eye Disease Study characteristics. METHODS: This was a 1-year, n = 60 (57 men, 3 women), 4-visit, intention-to-treat, prospective, randomized controlled clinical trial of patients (74.9 years, standard deviation [SD] 10) with mild-to-moderate age-related macular degeneration (AMD) randomly assigned to 1 of 2 dietary supplement carotenoid pigment intervention groups: 8 mg Zx (n = 25) and 8 mg Zx plus 9 mg lutein (L) (n = 25) or 9 mg L ("Faux Placebo," control group, n = 10). Analysis was by Bartlett's test for equal variance, 3-way repeated factors analysis of variance, independent t test (P < 0.05) for variance and between/within group differences, and post-hoc Scheffé's tests. Estimated foveal heterochromic flicker photometry, 1° macular pigment optical density (MPOD QuantifEye(®)), low- and high-contrast visual acuity, foveal shape discrimination (Retina Foundation of the Southwest), 10° yellow kinetic visual fields (KVF), glare recovery, contrast sensitivity function (CSF), and 6° blue cone ChromaTest(®) color thresholds were obtained serially at 4, 8, and 12 months. RESULTS: Ninety percent of subjects completed ≥ 2 visits with an initial Age-Related Eye Disease Study report #18 retinopathy score of 1.4 (1.0 SD)/4.0 and pill intake compliance of 96% with no adverse effects. There were no intergroup differences in 3 major AMD risk factors: age, smoking, and body mass index as well as disease duration and Visual Function Questionnaire 25 composite score differences. Randomization resulted in equal MPOD variance and MPOD increasing in each of the 3 groups from 0.33 density units (du) (0.17 SD) baseline to 0.51 du (0.18 SD) at 12 m, (P = 0.03), but no between-group differences (Analysis of Variance; P = 0.47). In the Zx group, detailed high-contrast visual acuity improved by 1.5 lines, Retina Foundation of the Southwest shape discrimination sharpened from 0.97 to 0.57 (P = 0.06, 1-tail), and a larger percentage of Zx patients experienced clearing of their KVF central scotomas (P = 0.057). The "Faux Placebo" L group was superior in terms of low-contrast visual acuity, CSF, and glare recovery, whereas Zx showed a trend toward significance. CONCLUSION: In older male patients with AMD, Zx-induced foveal MPOD elevation mirrored that of L and provided complementary distinct visual benefits by improving foveal cone-based visual parameters, whereas L enhanced those parameters associated with gross detailed rod-based vision, with considerable overlap between the 2 carotenoids. The equally dosed (atypical dietary ratio) Zx plus L group fared worse in terms of raising MPOD, presumably because of duodenal, hepatic-lipoprotein or retinal carotenoid competition. These results make biological sense based on retinal distribution and Zx foveal predominance.