Guidance or Gatekeeping: An Audit Examination of Racial Discrimination in Leading STEM High Schools: Systems that Marginalize BIPOC Youth Special Issue: Dismantling Oppression Series: Systems that Marginalize BIPOC Youth Special Issue: Dismantling Oppression Series.

Racial discrimination remains a mechanism by which ethnic-racial minorities are restricted from power. We examined whether racial discrimination restricts ethnic-racial minority access to high-achieving STEM schools. We conducted an audit correspondence experiment to investigate racial discrimination in guidance counselor responsiveness to 976 emails from fictitious Asian, Black, Latina, and White mothers inquiring about school enrollment. Moderation analyses revealed that guidance counselors restricted access from Asian mothers at schools characterized as rural, lower socioeconomic status, and higher STEM prestige-evidence of gatekeeping points to the restriction of Asian students from advanced STEM opportunities. Results are situated within educational audit experiments to objectively document how racism from multiple facets of the education system intersect to inhibit ethnic-racial minority youth.

Quantifying gender norm resistance.

INTRODUCTION: Qualitative and mixed-methods researchers have described the experience of gender norm resistance in adolescence and identified potential types of resistance including indirect resistance (motivated by a preference for gender-atypicality) and direct resistance (motivated by dislike of gender norms and a desire to change them). Building on this work, we developed the Gender Norm Resistance measure to operationalize indirect and direct gender norm resistance. We explored how gender norm resistance aligns with and differs from other gender self-concepts (e.g., felt pressure to conform to gender norms) and peer relations (e.g., contact with peers) and tested for gender differences. METHODS: Participants included 484 early adolescents (girls = 234; Mage = 11.44 years, SD = 0.56). Analyses included factor analyses (EFA, CFA) and bivariate correlations to gather validity evidence, and ANOVAs to determine mean level differences. RESULTS: Evidence that validated using the proposed measure as intended was found including confirmation of the two types of gender norm resistance (indirect and direct). Mean differences were found across participant gender as well as across types of gender norm resistance. CONCLUSIONS: The findings highlight the strengths and weaknesses of the Gender Norm Resistance measure, the different ways adolescents experience indirect and direct gender norm resistance, and the limited role of felt pressure in gender norm resistance.

Understanding the role of mother guilt and self-compassion in health behaviors in mothers with young children.

We explored whether the guilt mothers of young children feel about engaging in health behaviors mediates the relationship between self-compassion and self-reported engagement in health-promoting behaviors such as physical activity, eating a healthy diet and getting enough sleep. In this online, cross-sectional study, 143 mothers of young children completed measures of self-compassion, guilt about taking time to engage in health-promoting behaviors, trait guilt, health-promoting behaviors, self-esteem, and demographics. Mediation analysis, using Hayes' PROCESS macro showed that mother guilt mediated the relationship between self-compassion and health-promoting behaviors, ß = .05, Bca CI (.0014, .1133) with a bootstrapped standard error of .03 and a 95% confidence interval. Self-compassion may offer mothers a positive way to deal with guilty feelings about looking after their health.

Peer Influence on Academic Performance: A Social Network Analysis of Social-Emotional Intervention Effects.

Longitudinal social network analysis (SNA) was used to examine how a social-emotional learning (SEL) intervention may be associated with peer socialization on academic performance. Fifth graders (N = 631; 48 % girls; 9 to 12 years) were recruited from six elementary schools. Intervention classrooms (14) received a relationship building intervention (RBI) and control classrooms (8) received elementary school as usual. At pre- and post-test, students nominated their friends, and teachers completed assessments of students' writing and math performance. The results of longitudinal SNA suggested that the RBI was associated with friend selection and peer influence within the classroom peer network. Friendship choices were significantly more diverse (i.e., less evidence of social segregation as a function of ethnicity and academic ability) in intervention compared to control classrooms, and peer influence on improved writing and math performance was observed in RBI but not control classrooms. The current findings provide initial evidence that SEL interventions may change social processes in a classroom peer network and may break down barriers of social segregation and improve academic performance.

Acceptability and feasibility of using established geosocial and sexual networking mobile applications to promote HIV and STD testing among men who have sex with men.

This study is the first published multi-app study, of which we are aware, to evaluate both the acceptability and feasibility of providing sexual health information and HIV/STD testing referrals via established geosocial and sexual networking apps for MSM. Data were collected using an online survey and through four apps (A4A Radar, Grindr, Jack'd, and Scruff). Two-thirds (64 %) found apps to be an acceptable source for sexual health information. MSM who found apps as acceptable were more likely non-white, not sure of their current HIV status, and have low HIV testing self-efficacy. One-quarter (26 %) of informational chats with the health educator resulted in users requesting and being referred to local HIV/STD testing sites. There were significant differences in the number and types of interactions across apps. Established apps designed for MSM may be both an acceptable and feasible platform to promote HIV/STD testing. Future research should evaluate interventions that leverage this technology.

A systematic community-based participatory approach to refining an evidence-based community-level intervention: the HOLA intervention for Latino men who have sex with men.

Our community-based participatory research partnership engaged in a multistep process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were the following: (1) increase Latino MSM participation in the existing partnership, (2) establish an Intervention Team, (3) review the existing sexual health literature, (4) explore needs and priorities of Latino MSM, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latino MSM's lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors known as Navegantes. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion.

Brain damage in preterm newborns and maternal medication: the ELGAN Study.

OBJECTIVE: We sought to evaluate the association between maternal medication use during pregnancy and cerebral white matter damage and cerebral palsy (CP) among very preterm infants. STUDY DESIGN: This analysis of data from the Extremely Low Gestational Age Newborns (ELGAN) Study included 877 infants born <28 weeks' gestation. Mothers were interviewed, charts were reviewed, placentas were cultured and assessed histologically, and children were evaluated at 24 months corrected age. A diagnostic algorithm classified neurologic findings as quadriparetic CP, diparetic CP, hemiparetic CP, or no CP. RESULTS: After adjustment for the potential confounding of disorders for which medications might have been indicated, the risk of quadriparetic CP remained elevated among the infants of mothers who consumed aspirin (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.3-6.9) and nonsteroidal antiinflammatory drugs (NSAIDs) (OR, 2.4; 95% CI, 1.04-5.8). The risk of diparetic CP was also associated with maternal consumption of an NSAID, but only if the consumption was not approved by a physician (OR, 3.5; 95% CI 1.1-11.0). CONCLUSION: The possibility that aspirin and NSAID use in pregnancy could lead to perinatal brain damage cannot be excluded.

Pulmonary veno-occlusive disease: a misnomer?

Pulmonary veno-occlusive disease (PVOD) is a rare entity with non-specific signs and symptoms and is nearly always associated with a dismal prognosis. This review will first consider pulmonary hypertension in general and then will focus on PVOD specifically with particular attention to the pathophysiology of the disease. Classically PVOD is described as a disease primarily involving obstructed venules, with the arterial side of the circulation involved to a lesser degree. This article discusses the demographics of affected individuals; the ways in which an accurate diagnosis can be made, including imaging features; predisposing diseases and associated disorders; and potential treatment.

Associations between fifth graders' gender atypical problem behavior and peer relationships: a short-term longitudinal study.

An accruing body of evidence supports associations between self-perceived gender typicality and peer relationship difficulties; however, researchers have yet to evaluate peers' perceptions of problem behaviors to gain insight into the social correlates of gender typicality. A short-term longitudinal study was conducted to evaluate associations between gender atypical problem behavior and subsequent peer relational difficulties for 2,076 fifth graders (M age= 10.27; 53% female). Peer nomination methodology was used to assess participants' classroom peer relationships, problem behaviors, and social-emotional characteristics. Findings showed that youth characterized by gender atypical, compared to gender typical, problem behavior (withdrawn boys/aggressive girls vs. withdrawn girls/aggressive boys, respectively) evidenced higher levels of subsequent peer difficulties; moreover, participation in a mutual friendship was associated with decreased risk for peer relationship maladjustment, particularly among youth characterized by gender atypical problem behavior. Results further revealed that, compared to friendless youth, friended youth earned higher prosocial and peer liking scores and, for withdrawn youth, lower emotional sensitivity scores. The present research contributes to our understanding of the potential short-term consequences of youth's gender atypical problem behavior. Findings underscore the need for supplemental conceptualizations of gender typicality as well as multifaceted interventions designed to promote the acceptance of gender nonnormativity, support the development of adaptive peer relationships, and reduce the occurrence of problem behaviors.

Text Message Intervention for Latino Adults to Improve Diabetes Outcomes.

Introduction: Determine the effectiveness of a diabetes text message intervention to improve diabetes outcomes in Latino adults at a free clinic in the southeastern United States. Methods: A pre-post, one-group design was used with a convenience sample (n = 24) of Latino adults with type 2 diabetes and A1C ≥ 7 who consented to participate. Over 8 weeks, participants were sent 23 educational and motivational text messages that were based on the American Association of Diabetes Educators (AADE) 7 self-care tasks and the American Diabetes Association (ADA) Standards of Medical Care in Diabetes Mellitus (DM). Diabetes knowledge, self-efficacy, self-care, and A1C were measured. Results: Diabetes knowledge, self-efficacy, self-care, and A1C improved after 8 weeks. Statistically significant results (p < .05) were seen in two of the four evaluation instruments administered (Spoken Knowledge in Low Literacy in Diabetes Scale [SKILLD], p = .001, Diabetes Self-Efficacy Scale [DSES], p = .000). A1C improvements were significant (0.86 or 10 mmol/mol) from the pre-intervention (M = 9.06 [76 mmol/mol], SD = 1.49) to the post-intervention (M = 8.20 [66 mmol/mol], SD = 1.27, t [23] = 3.02, p = .006). Conclusion: Personalized communication, education, and follow-up via text messages improved diabetes knowledge, self-efficacy, self-care, and A1C among pilot project participants. Text messages are a useful tool for diabetes management.

'It's not that we hate you': understanding children's gender attitudes and expectancies about peer relationships.

Widespread gender segregation, evident throughout elementary school, seems to imply that girls and boys have negative feelings and thoughts about one another, and classic theories of inter-group processes support this idea. However, research has generally overlooked children's feelings and perceptions about gender-related interpersonal interactions. This paper investigates the nature of children's attitudes about same- and other-gender peers, and explores how those attitudes relate to the expectancies and beliefs children hold about same- and other-gender peer interactions. Children (N= 98 fifth graders) completed questionnaires assessing their global liking of own- and other-gender peers (Yee & Brown, 1994), positive and negative attitudes about own- and other-gender peers, and outcome expectancies related to interacting with own- and other-gender peers. Results indicated that rather than being characterized by out-group negativity, children's inter-group gender attitudes are best characterized by an in-group positivity bias. Children's positive and negative affective attitudes were also significantly associated with outcome expectancies. In contrast, global liking of own- and other-gender peers was less predictive of outcome expectancies. Thus, the greater specificity of the affective attitude measures appeared to be a more predictive and potentially fruitful gauge of children's feelings about own- and other-gender peers. Results are discussed in terms of the need for finer grained and more extensive studies of children's gender-related feelings and cognitions about own- and other-gender peers.

Self-compassion and responses to health information in middle-aged and older women: An observational cohort study.

The aim of this study was to determine whether self-compassion-orientation to care for oneself during challenges-helps people at risk of cardiovascular disease deal with emotional reactions and assist with self-regulating health behaviors. This observational study recruited women (N = 102) who attended three research visits over 3 weeks to gather information on emotions, intentions, and engagement in health behaviors after women received news they were at risk of cardiovascular disease. Self-compassion negatively associated with emotional responses and associated with intentions and engagement in health behaviors after receiving news of their cardiovascular disease risk. Self-compassion was associated with adaptive lifestyle behaviors.

A pilot intervention utilizing Internet chat rooms to prevent HIV risk behaviors among men who have sex with men.

OBJECTIVES: Chat room-based prevention interventions for human immunodeficiency virus (HIV) are being implemented to reduce the risk of HIV exposure, infection, and re-infection among men who have sex with men (MSM). METHODS: Our community-based participatory research partnership implemented a chat room-based intervention known as Cyber-Based Education and Referral/Men for Men (CyBER/M4M). We collected both quantitative and qualitative data to describe the characteristics of chat-room participants ("chatters") and their HIV risks and prevention needs, and to document intervention delivery. RESULTS: Of the 1,851 chatters who participated in the 18-month intervention, 210 completed the online assessment. The mean age was 30 years. Although the majority self-identified as gay, 25.8% self-identified as bisexual. More than half self-identified as white and one-third as black or African American. A total of 8.6% reported being HIV-positive and 14.8% reported never having been tested for HIV. Grounded theory analysis of transcripts from chat-room instant-message discussions identified 13 thematic categories related to chatter characteristics, prevention needs, and intervention delivery. Chatters were looking for sexual partners, were not open about their orientation, lacked basic information about HIV, had questions about how to be tested, and perceived a lack of general community resources to meet their needs. Furthermore, CyBER educators had to understand and respect the online culture, build trust, and deliver well-crafted and focused messages. CONCLUSIONS: Chat room-based interventions hold promise to systematically reach Internet communities of MSM, a group that is particularly at risk for infection with HIV and other sexually transmitted diseases.

Mechanisms of injury to white matter adjacent to a large intraventricular hemorrhage in the preterm brain.

The purpose of this article is to investigate the hyperechoic lesion seen adjacent to a lateral ventricle that contains blood but is not distended. The literature on ependymal barrier dysfunction was reviewed in search of mechanisms of injury to the white matter adjacent to an intraventricular hemorrhage. The clinical literature on the clinical diagnosis of periventricular hemorrhagic infarction was also reviewed to find out how frequently this diagnosis was made. Support was found for the possibility that the ventricular wall does not always function as an efficient barrier, allowing ventricular contents to gain access to the white matter where they cause damage. Hemorrhagic infarction may not be the only or the most frequent mechanism of white matter damage adjacent to a large intraventricular hemorrhage.

Reader variability in the use of diagnostic terms to describe white matter lesions seen on cranial scans of severely premature infants: the ELGAN study.

PURPOSE: To evaluate reader variability of white matter lesions seen on cranial sonographic scans of extreme low gestational age neonates (ELGANs). METHODS: In 1,452 ELGANs, cranial sonographic scans were obtained in the first and second postnatal weeks, and between the third postnatal week and term. All sets of scans were read independently by two sonologists. We reviewed the use of four diagnostic labels: early periventricular leucomalacia, cystic periventricular leucomalacia, periventricular hemorrhagic infarction (PVHI), and other white matter diagnosis, by 16 sonologists at 14 institutions. We evaluated the association of these labels with location and laterality of hyperechoic and hypoechoic lesions, location of intraventricular hemorrhage, and characteristics of ventricular enlargement. RESULTS: Experienced sonologists differed substantially in their application of the diagnostic labels. Three readers applied early periventricular leucomalacia to more than one fourth of all the scans they read, whereas eight applied this label to ≤5% of scans. Five applied PVHI to ≥10% of scans, while three applied this label to ≤5% of scans. More than one third of scans labeled cystic periventricular leucomalacia had unilateral hypoechoic lesions. White matter abnormalities in PVHI were more extensive than in periventricular leucomalacia and were more anteriorly located. Hypoechoic lesions on late scans tended to be in the same locations, regardless of the diagnostic label applied. CONCLUSIONS: Experienced sonologists differ considerably in their tendency to apply diagnostic labels for white matter lesions. This is due to lack of universally agreed-upon definitions. We recommend reducing this variability to improve the validity of large multicenter studies.

Developmental correlates of head circumference at birth and two years in a cohort of extremely low gestational age newborns.

OBJECTIVES: To evaluate the developmental correlates of microcephaly evident at birth and at 2 years in a cohort born at extremely low gestational age. METHODS: We assessed development and motor function at 2 years of 958 children born before the 28th week of gestation, comparing those who had microcephaly at birth or 2 years with children with normal head circumference while considering the contribution of neonatal cranial ultrasound lesions. RESULTS: A total of 11% of infants in our sample had microcephaly at 2 years. Microcephaly at 2 years, but not at birth, predicts severe motor and cognitive impairments at 2 years. A total of 71% of children with congenital microcephaly had a normal head circumference at 2 years and had neurodevelopmental outcomes comparable with those with normal head circumference at birth and 2 years. Among children with microcephaly at 2 years, more than half had a Mental Developmental Index <70, and nearly a third had cerebral palsy. The risks were increased if the child also had cerebral white matter damage on a cranial ultrasound scan obtained 2 years previously. CONCLUSION: Among extremely low gestational age newborns, microcephaly at 2 years, but not at birth, is associated with motor and cognitive impairment at age 2.

Are abusive fractures in young children becoming less common? Changes over 24 years.

OBJECTIVE: To determine whether the proportion of fractures rated as abusive in children <36 months of age evaluated at a regional pediatric hospital increased over a 24-year period from 1979 to 2002. Fractures were chosen as an example of serious injuries in young children. METHODS: Medical records were abstracted for all children <36 months of age who were seen at a single pediatric hospital with a fracture during three time periods: 1979-1983, 1991-1994, and 1999-2002. After reviewing the abstracted and radiographic information, two clinicians (one an expert on child abuse) and two pediatric radiologists each rated the likelihood of abuse using explicit criteria and a seven-point scale from definite abuse to definite unintentional injury. Ratings were done independently; when disagreements occurred, the case was discussed, and a joint rating was agreed upon, if possible. The proportions of cases rated as abuse were compared over the three time periods, and logistic regression was used to calculate adjusted odds ratios (OR). RESULTS: In the early, middle, and late samples, there were 200, 240, and 232 children, respectively, with fractures. The proportion of cases rated as abuse decreased from 22.5% in the early period to 10.0% in the middle period and was 10.8% in the late period (p<.001). When comparing the odds of abuse in the middle and late groups to the odds of abuse in the early group (controlling for age, gender, ethnicity, type of medical insurance, and site of pediatric care), the adjusted ORs were .31 (95% CI=.15, .62) for the middle group and .45 (95% CI=.23, .86) for the late group. Thus, the odds of a given case being rated as abuse decreased by over 50% from the early period to the middle and late time periods. No statistically significant difference was found when comparing the odds of abuse for the middle group to those of the late group, OR: 1.46 (95% CI=.69, 3.08). CONCLUSIONS: The proportion of abusive fractures in young children decreased substantially from 1979-1983 to 1991-1994 and 1999-2002 at a major pediatric hospital. We speculate that this decrease may reflect early recognition of less serious forms of maltreatment and the availability of services to high-risk families.

Evaluating patients' perceptions of end-stage renal disease.

Patients not adhering to hemodialysis treatment is a pervasive problem in the renal community. We need to identify renal patients' unique needs and incorporate these needs into the delivery of dialysis care. The social workers at the USF Dialysis Center created and implemented a questionnaire to ascertain patients' confidence in and perception of success levels of specific aspects of treatment. Nephrology social work interventions to address the issue of non-compliance are suggested.