Place-Based Developmental Research: Conceptual and Methodological Advances in Studying Youth Development in Context.

Scientists have, for some time, recognized that development unfolds in numerous settings, including families, schools, neighborhoods, and organized and unorganized activity settings. Since the turn of the 20th century, the body of mainstream neighborhood effects scholarship draws heavily from the early 20th century Chicago School of Sociology frameworks and have been situating development in neighborhood contexts and working to identify the structures and processes via which neighborhoods matter for a range of developmental outcomes, especially achievement, behavioral and emotional problems, and sexual activity. From this body of work, two new areas of developmental scholarship are emerging. Both areas are promising for advancing an understanding of child development in context. First, cultural-developmental neighborhood researchers are advancing neighborhood effects research that explicitly recognizes the ways that racial, ethnic, cultural, and immigrant social positions matter for neighborhood environments and for youths' developmental demands, affordances, experiences, and competencies. This body of work substantially expands the range of developmental outcomes examined in neighborhood effects scholarship to recognize normative physical, emotional, cognitive, behavioral, social, and cultural competencies that have largely been overlooked in neighborhood effects scholarship that espoused a more color-blind developmental approach. Second, activity space neighborhood researchers are recognizing that residential neighborhoods have important implications for broader activity spaces-or the set of locations and settings to which youth are regularly exposed, including, for example, schools, work, organized activities, and hang-outs. They are using newer technologies and geographic frameworks to assess exposure to residential neighborhood and extra-neighborhood environments. These perspectives recognize that time (i.e., from microtime to mesotime) and place are critically bound and that exposures can be operationalized at numerous levels of the ecological system (i.e., from microsystems to macrosystems). These frameworks address important limitations of prior development in context scholarship by addressing selection and exposure. Addressing selection involves recognizing that families have some degree of choice when selecting into settings and variables that predict families' choices (e.g., income) also predict development. Considering exposure involves recognizing that different participants or residents experience different amounts of shared and nonshared exposures, resulting in both under-and over-estimation of contextual effects. Activity space scholars incorporate exposure to the residential neighborhood environments, but also to other locations and settings to which youth are regularly exposed, like schools, after-school settings, work, and hang-outs. Unfortunately, the cultural-development and activity space streams, which have both emerged from early 20th century work on neighborhood effects on development, have been advancing largely independently. Thus, the overarching aim of this monograph is to integrate scholarship on residential neighborhoods, cultural development, and activity spaces to advance a framework that can support a better understanding of development in context for diverse groups. In Chapters I and II we present the historical context of the three streams of theoretical, conceptual, and methodological research. We also advance a comprehensive cultural-developmental activity space framework for studying development in context among children, youth, and families that are ethnically, racially, and culturally heterogeneous. This framework actively recognized diversity in ethnic, racial, immigrant, and socioeconomic social positions. In Chapters III-V we advance specific features of the framework, focusing on: (1) the different levels of nested and nonnested ecological systems that can be captured and operationalized with activity space methods, (2) the different dimensions of time and exposures or experiences that can be captured and operationalized by activity space methods, and (3) the importance of settings structures and social processes for identifying underlying mechanisms of contextual effects on development. Structures are setting features related to the composition and spatial arrangement of people and institutions (e.g., socioeconomic disadvantage, ethnic/racial compositions). Social processes represent the collective social dynamics that take place in settings, like social interactions, group activities, experiences with local institutions, mechanisms of social control, or shared beliefs. In Chapter VI, we highlight a range of methodological and empirical exemplars from the United States that are informed by our comprehensive cultural-developmental activity space framework. These exemplars feature both quantitative and qualitative methods, including method mixing. These exemplars feature both quantitative and qualitative methods, including method mixing. The exemplars also highlight the application of the framework across four different samples from populations that vary in terms of race, ethnicity, gender, age, socioeconomic status (SES), geographic region, and urbanicity. They capture activity space characteristics and features in a variety of ways, in addition to incorporating family shared and nonshared activity space exposures. Finally, in Chapter VII we summarize the contributions of the framework for advancing a more comprehensive science of development in context, one that better realizes major developmental theories emphasizing persons, processes, contexts, and time. Additionally, we offer a place-based, culturally informed developmental research agenda to meet the needs of an increasingly diverse population.

Impact of Being a Peer Recovery Specialist on Work and Personal Life: Implications for Training and Supervision.

Peer recovery specialists are an important resource in community mental health settings. This study, which was part of a larger statewide assessment, evaluates how the role impacts work and personal lives of peers, with implications for improving the training and supervision of this service. The importance of peer work has been investigated through client outcomes, however less work has investigated outcomes on peers themselves, which impacts the work force and service delivery. Nine focus groups were conducted with peer recovery specialists. A two-stage qualitative analysis led to two overarching themes, work and personal, and six subthemes. Findings suggest being a peer presents unique benefits and challenges in work and personal life. Peers benefit from more training and supervision, consistency within the role, and maintaining boundaries. Additionally, work environment roles may be improved by attention to needs of supervisors in terms of skills for effective supervision and clarification of supervisory roles.

Redefining Exposure: Using Mobile Technology and Geospatial Analysis to Explore When and Where Chicago Adolescents are Exposed to Neighborhood Characteristics.

Differences in how individuals navigate and interact with physical space have clear implications for when and where they are exposed to environmental characteristics. To address this reality, we propose and test a novel method with a sample of Chicago adolescents that links individual GPS coordinates with locations of environmental characteristics as a strategy to increase precision in the measurement of environmental exposures. We use exposure to violent crime as an example and link the GPS coordinates of 51 youth collected over a one-week period during the summer of 2016 to locations and times of violent crime. We explore different spatial and temporal parameters to determine whether an exposure occurred. Using the 660-foot (201 m), 24-hour operationalization, we found that youth were exposed to a total of 126 violent crimes, with an average of 3.82 (SD = 3.24) per respondent. This was higher than the 12 that were identified when exposure was calculated as the number of violent crimes occurring within 660 feet (201 m) of youths' residential addresses during the week-long assessment period. Examining correlations between the different exposure variables and measures of youths' psychological functioning, we found the largest relationships when using the GPS-based indices. We present a strategy for measuring exposure to environmental characteristics using GPS data. Higher rates of crime exposure are found based on GPS coordinates than with residential address. GPS-based exposure measures are related to youths' psychological functioning.

What Drives You? Black and Latinx Youth's Critical Consciousness, Motivations, and Academic and Career Activities.

More research is needed that elucidates the mechanisms by which critical consciousness impacts marginalized youth's academic and career development. To address this gap, this short-term longitudinal study (i.e., two waves) examined motivations for post-high school plans (i.e., career/personal motivation; humanitarian motivation; encouragement received from important individuals; pressure from parents/family to succeed) as mediators in the relationship between dimension of critical consciousness and academic and career activities. The sample consisted of low-income, Black and Latinx youth (N = 191; Mage = 16, SD = 0.80; 59% female) living in Chicago. The results from structural equation path models show that youth's beliefs about their ability to engage politically (i.e., sociopolitical efficacy) predict motivations for post-secondary plans (e.g., encouragement; pressure from parents/family), which is subsequently related to engagement in academic and career activities, albeit in different directions. To continue fostering positive youth development, critical consciousness programming will need to integrate how youth understand their role in changing social inequality in relation to their perception of and interactions with parents and mentors.

Chicago Youths' Exposure to Community Violence: Contextualizing Spatial Dynamics of Violence and the Relationship With Psychological Functioning.

This study explores where and when community violence exposure (CVE) matters for psychological functioning in a sample of low-income, racial/ethnic minority youth (M) age = 16.17, 55% female, 69% Black, and 31% Non-Black/Latinx) living in Chicago. CVE was measured with violent crime data that were geocoded in terms of distance from youths' home and school addresses, and then calculated in terms of three distinct spatial dynamics: chronicity, pervasiveness, and spatial proximity. These measures reflect indirect/objective CVE across different conceptualizations of time, space, and neighborhood context. We tested the relationship between each CVE measure and trait anxiety and behavioral and cognitive dysregulation while controlling for youth-reported, direct violent victimization (e.g., being attacked) to examine how indirect/objective CVE occurring within youths' neighborhood contexts matters beyond direct/subjective violence exposure. Results revealed that long-term chronic, pervasive, and spatially proximal CVE was related to higher levels of behavioral dysfunction. In contrast, CVE within home- and school-based neighborhoods interacted to predict trait anxiety; youth living in low-crime neighborhoods and attending schools in high-crime neighborhoods had the highest rates of trait anxiety. Measuring CVE within both home and school neighborhoods at specific spatial measurements and time frames is critical to understand and prevent the consequences of CVE.

Safe Spaces Embedded in Dangerous Contexts: How Chicago Youth Navigate Daily Life and Demonstrate Resilience in High-Crime Neighborhoods.

Much is known about how experiences of community violence negatively affect youth, but far less research has explored how youth remain resilient while living in dangerous neighborhoods. This study addresses this need by analyzing in-depth, geo-narrative interviews conducted with 15 youth (60% Black, 27% Latinx, 53% female, 14 to 17 years old) residing in low-income, high-crime Chicago neighborhoods to explore youths' perceptions of safety and strategies for navigating neighborhood space. After carrying geographical positioning system (GPS) trackers for an eight-day period, youths' travel patterns were mapped, and these maps were used as part of an interview with youth that explored daily routines, with special consideration paid to where and when youth felt safe. Drawing on activity settings theory and exploring youth voice, we find that experiences of community violence are commonplace, but youth describe how they have safe spaces that are embedded within these dangerous contexts. Perceptions of safety and danger were related to environmental, social, and temporal cues. Youth reported four overarching safety strategies, including avoidance, hypervigilance, self-defense, and emotional management, but these strategies considerably varied by gender. We discuss implications for practice and future directions of research. HIGHLIGHTS: This study explored Chicago youths' safety strategies and resilience in high-crime neighborhoods. Safe and dangerous spaces are embedded or overlapping settings. All youth practiced safety strategies but they considerably varied by gender. Perceptions are intersubjectively created due to the codes, rules, and norms of community life. Violence is common and extreme in everyday life of this sample of Chicago adolescents.

Safety and efficacy of a urine alkalinization protocol developed for high-dose methotrexate patients during intravenous bicarbonate shortage.

PURPOSE: Urinary alkalinization with intravenous sodium bicarbonate is standard during high-dose methotrexate administration. Due to a national intravenous sodium bicarbonate shortage, a urinary alkalinization protocol involving hyperhydration with intravenous fluids, oral bicarbonate, and intravenous or oral acetazolamide was utilized from 10 April to 30 May 2017 ("shortage protocol"). This study compared outcomes between protocols. METHODS: A single-center, retrospective chart review was conducted for adults who received methotrexate ≥500 mg/m2 on ≥ two occasions, at least once during each protocol, between 19 February and 19 July 2017. RESULTS: Eighteen patients (50% male), median age 65 years, received 76 total high-dose methotrexate cycles. Shortage protocol was used in 37 cycles (48.7%). Mean time to methotrexate clearance did not differ between groups (p = ns). Mean time to urinary alkalinization and duration of hospitalization were not statistically different (p = 0.49 and 0.23, respectively). Average total bicarbonate administered per 24 hours was higher in standard protocol (p < 0.05), but hydration rates were similar (p = 0.73). Creatinine clearance and urine output on days 1 and 2 post-high-dose methotrexate did not significantly differ (creatinine clearance day 1, p = 0.27; creatinine clearance day 2, p = 0.55; urine output day 1, p = 0.62; urine output day 2, p = 0.60). Interruptions in alkalinization were significantly higher during shortage (0.41 ± 0.75 instances of urine pH < 7 during standard vs. 1.3 ± 1.7 under shortage, p < 0.05).

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University.

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (Mage = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.

The Latent Threat of Community Violence: Indirect Exposure to Local Homicides and Adolescents' Mental Health in Colombia.

This study examines the relation between adolescents' indirect exposure to local homicides and mental health disorders and post-traumatic stress disorder (PTSD) symptoms. We employ a sample of 300 adolescents ( Mage=14.52,range=12-17) representative for Bogotá, Colombia, and geocoded data on violent crimes recorded by the national police. Findings show that one SD increment in local homicides is associated with increments by 0.17 SD in the mental health disorder index and a 0.14 SD increase in the PTSD score index, even after accounting for adolescents' direct exposure to violence. The estimated effect for PTSD was larger for adolescents' who were directly exposed to violence and for those living in multidimensionally poor households, whereas no detectable effects were found for adolescents who perceived their residential neighborhood as relatively safe.

Intersectional Ecologies: Positioning Intersectionality in Settings-Level Research.

Developmental science has recognized the import of ecological theory and research in furthering understanding of development in context. However, despite the fact that ecological and intersectional theory share points of commonality, few researchers to date have attempted to integrate these perspectives. This manuscript addresses this gap and highlights three ways that an intersectional lens can advance settings-level research. With a focus on neighborhoods as settings of development, we (1) describe how intersectionality may manifest itself within neighborhoods, (2) discuss how intersectionality can inform our understanding of how individuals experience neighborhoods, and (3) detail strategies for conceptualizing and measuring intersectionality in neighborhood research. As such, the goal of this manuscript is to push thinking on the ways that intersectionality may inform and advance settings-level research in developmental science.

Innovation or Violation? Leveraging Mobile Technology to Conduct Socially Responsible Community Research.

Mobile technology is increasingly being used to measure individuals' moods, thoughts, and behaviors in real time. Current examples include the use of smartphones to collect ecological momentary assessments (EMAs; assessments delivered "in the moment"); wearable technology to passively collect objective measures of participants' movement, physical activity, sleep, and physiological response; and smartphones and wearable devices with global positioning system (GPS) capabilities to collect precise information about where participants spend their time. Although advances in mobile technology offer exciting opportunities for measuring and modeling individuals' experiences in their natural environments, they also introduce new ethical issues. Drawing on lessons learned while collecting GPS coordinates and EMAs measuring mood, companionship, and health-risk behavior with a sample of low-income, predominantly racial/ethnic minority youth living in Chicago, this manuscript discusses ethical challenges specific to the methodology (e.g., unanticipated access to personal information) and broader concerns related to data conceptualization and interpretation (e.g., the ethics of "monitoring" low-income youth of color). While encouraging researchers to embrace innovations offered by mobile technology, this discussion highlights some of the many ethical issues that also need to be considered.

Neighborhood crime as a predictor of individual differences in emotional processing and regulation.

Emerging research suggests that early exposure to environmental adversity has important implications for the development of brain regions associated with emotion regulation, yet little is known about how such adversity translates into observable differences in children's emotion-related behavior. The present study examines the relationship between geocoded neighborhood crime and urban pre-adolescents' emotional attention, appraisal, and response. Results indicate that living in a high-crime neighborhood is associated with greater selective attention toward negatively valenced emotional stimuli on a dot probe task, less biased appraisal of fear on a facial identification task, and lower rates of teacher-reported internalizing behaviors in the classroom. These findings suggest that children facing particularly high levels of environmental threat may develop different regulatory processes (e.g. greater use of emotional suppression) than their peers from low-crime neighborhoods in order to manage the unique stressors and social demands of their communities.

Do We Know Where We Stand? Neighborhood Relative Income, Subjective Social Status, and Health.

Bridging research on relative income and subjective social status (SSS), this study examines how neighborhood relative income is related to ones' SSS, and in turn, physical and mental health. Using a survey sample of 1807 U.S. adults, we find that neighborhood median income significantly moderates the relationship between household income and self-reported physical and mental health. Low-income individuals living in high-income neighborhoods (i.e., relative disadvantage) report better physical and mental health than low-income individuals living in low-income neighborhoods. In addition, high-income individuals living in low-income neighborhoods (i.e., relative advantage) report higher SSS (relative to neighbors), whereas low-income individuals living in high-income neighborhoods (i.e., relative disadvantage) also report higher SSS. We draw from social comparison theory to interpret these results positing that downward comparisons may serve an evaluative function while upward comparisons may result in affiliation with better-off others. Finally, we demonstrate that SSS explains the relationship between neighborhood relative income and health outcomes, providing empirical support for the underlying influence of perceived social position.

Evaluating the Iowa Gambling Task as a Direct Assessment of Impulsivity with Low-Income Children.

This study examined performance on the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) as a measure of low-income school-aged children's affective decision-making and considered its utility as a direct indicator of impulsivity. One hundred and ninety-three 8-11 year olds performed a computerized version of the Iowa Gambling Task, a validated measure of decision-making. Multi-level modeling was used to examine children's performance over the course of the task, with age, gender, and teachers' ratings of child impulsivity (BIS-11; Patton, Stanford, & Barratt, 1995) used to predict children's Iowa Gambling performance. Higher impulsivity scores predicted a decrease in slope of Iowa Gambling performance, indicating students rated higher on impulsivity chose more disadvantageously across the task blocks. Results support evidence of the validity of the Iowa Gambling Task as a measure of impulsivity in low-income minority children.

Intersections between nativity, ethnic density, and neighborhood SES: using an ethnic enclave framework to explore variation in Puerto Ricans' physical health.

Although past research has demonstrated a "health disadvantage" for Puerto Rican adults, very little is known about correlates of health among this group. Given Puerto Ricans' unique experiences of migration and settlement, an ethnic enclave framework that integrates nativity, ethnic density, and neighborhood SES may offer insight into factors influencing Puerto Ricans' health. This study uses a sample of 449 adult mainland- and island-born Puerto Ricans living in New York City and Chicago. The data, collected as a part of the MIDUS Survey of Minority Groups, are stratified by neighborhood ethnic density and neighborhood SES, allowing for the examination of the individual and joint influences of neighborhood characteristics on physical health. Results revealed that ethnic density and neighborhood SES were not independently or interactively related to physical health for mainland-born Puerto Ricans. However, the interaction between ethnic density and neighborhood SES was related to self-reported health, functional limitations, and health symptoms for island-born Puerto Ricans. Island-born Puerto Ricans living in ethnically dense, low SES neighborhoods reported worse health than island-born Puerto Ricans living in other types of neighborhoods. This may be a result of isolation from resources both within and outside the neighborhood.

Neighborhood crime and school climate as predictors of elementary school academic quality: a cross-lagged panel analysis.

Past research has found negative relationships between neighborhood structural disadvantage and students' academic outcomes. Comparatively little work has evaluated the associations between characteristics of neighborhoods and schools themselves. This study explored the longitudinal, reciprocal relationships between neighborhood crime and school-level academic achievement within 500 urban schools. Results revealed that higher neighborhood crime (and particularly violent crime) predicted decreases in school academic achievement across time. School climate emerged as one possible mechanism within this relationship, with higher neighborhood crime predicting decreases in socioemotional learning and safety, but not academic rigor. All three dimensions of school climate were predictive of changes in academic achievement. Although this research supports a primarily unidirectional hypothesis of neighborhoods' impacts on embedded settings, additional work is needed to understand these relationships using additional conceptualizations of neighborhood climate.

Association of census-tract level gentrification and income inequality with 6-year incidence of metabolic syndrome in the Hispanic Community Health Study/Study of Latinos, an epidemiologic cohort study.

BACKGROUND: Metabolic syndrome varies by socio-demographic characteristics, with younger (18-29 years) and older (50-69 years) Hispanic/Latino having higher prevalence compared to other groups. While there is substantial research on neighborhood influences on cardiometabolic health, there are mixed findings regarding the effects of gentrification and few studies have included Hispanic/Latinos. The role of neighborhood income inequality on metabolic health remains poorly understood. OBJECTIVES: Examined associations of neighborhood gentrification and income inequality with metabolic syndrome (MetSyn) using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). DESIGN, SETTING AND PARTICIPANTS: The HCHS/SOL is a community-based cohort of adults of Hispanic/Latinos (aged 18-74). Analyses included 6710 adults who did not meet criteria for MetsS at baseline (2008-2011) and completed the visit 2 examination (2014-2017). Poisson regressions estimated odds ratios (IRR) and 95% confidence intervals (CI) for neighborhood gentrification and change in income inequality with MetSyn incidence. MAIN OUTCOME AND EXPOSURE MEASURES: Gentrification was measured with an index that included changes (2000 to 2006-2010) in education, poverty, and income. Change in neighborhood income inequality (2005-2009 to 2012-2016) was measured using the Gini coefficient of income distribution. MetSyn was defined using National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: Among 6647 Hispanic/Latino adults, 23% (N = 1530) had incident MetSyn. In models adjusted for socio-demographic, health insurance status, and neighborhood characteristics, gentrification (IRR, 1.00, 95%CI, 0.96-1.03) and income inequality change (IRR, 1.00, 95%CI, 0.99-1.00) were not associated with MetSyn at visit 2. There was no association between cross-sectional income inequality (2005-2009) and MetSyn at visit 2 (IRR, 0.97, 95%CI, 0.82-1.15). CONCLUSION: Neighborhood gentrification and income inequality change were not associated with incidence of MetSyn over 6 years among Hispanic/Latino adults. This study demonstrated that income-based residential changes alone may not be sufficient to explain neighborhood influences on health outcomes among this population.

Association of neighborhood segregation with 6-year incidence of metabolic syndrome in the Hispanic community health study/study of Latinos.

PURPOSE: Examine the association between neighborhood segregation and 6-year incident metabolic syndrome (MetSyn) in the Hispanic Community Health Study/Study of Latinos. METHODS: Prospective cohort of adults residing in Miami, Chicago, the Bronx, and San Diego. The analytic sample included 6,710 participants who did not have MetSyn at baseline. The evenness and exposure dimensions of neighborhood segregation, based on the Gini and Isolation indices, respectively, were categorized into quintiles (Q). Racialized economic concentration was measured with the Index of Concentration at the Extremes (continuously and Q). RESULTS: Exposure, but not evenness, was associated with higher disease odds (Q1 (lower segregation) vs. Q4, OR = 1.53, 95% CI = 1.082.17; Q5, OR = 2.29, 95% CI = 1.493.52). Economic concentrationprivilege (continuous OR = 0.87, 95% CI = 0.770.98), racial concentrationracialized privilege (Q1 (greater concentration) vs. Q2 OR = 0.75, 95% CI = 0.541.04; Q3 OR = 0.68, 95% CI = 0.441.05; Q4 OR = 0.68, 95% CI = 0.451.01; Q5 OR = 0.64, 95% CI = 0.420.98)(continuous OR = 0.93, 95% CI = 0.821.04), and racialized economic concentrationprivilege (i.e., higher SES non-Hispanic White, continuous OR = 0.86, 95% CI = 0.760.98) were associated with lower disease odds. CONCLUSION: Hispanics/Latino adults residing in neighborhoods with high segregation had higher risk of incident MetSyn compared to those residing in neighborhoods with low segregation. Research is needed to identify the mechanisms that link segregation to poor metabolic health.

Morphological abnormalities of the recto-anal inhibitory reflex reflects symptom pattern in neurogenic bowel.

BACKGROUND: Bowel dysfunction amongst multiple sclerosis (MS) and spinal cord injury (SCI) patients often manifests as fecal incontinence (FI) or constipation, but the pathophysiology is poorly understood. Anorectal physiology provides an objective assessment of lower bowel functions and is increasingly being used in clinical practice. AIM: The purpose of this study was to correlate symptoms of bowel dysfunction in patients with spinal cord disease with findings in anorectal physiology. We hypothesized that specific abnormalities will correlate with symptoms: prolonged recto-anal inhibitory reflex in patients with incontinence and decreased rectal mucosal blood flow in patients with constipation. METHODS: Forty-nine patients with MS (35 with predominant FI and 14 constipation), 46 supraconal SCI (mixed symptom load), and 21 healthy volunteers matched for age and sex were studied. Subjects completed validated constipation and FI symptom questionnaires. Patients underwent standard anorectal physiology, including assessment of rectal mucosal blood flow and recto-anal inhibitory reflex (RAIR). RESULTS: Severity of constipation correlates significantly with distension sensitivity (urge volume [r = 0.68, p = 0.002] and maximal volume [r = 0.39, p = 0.03]). Severity of constipation also correlated with diminished rectal mucosal blood flow in both patient groups (r = -0.51, p = 0.006). In both groups, constipation correlated with diminished relaxation of the sphincters in the RAIR whilst fecal incontinence correlated with a prolonged duration of RAIR (r = 0.33, p = 0.009) and recovery phase (r = 0.37, p = 0.05). CONCLUSION: Bowel symptoms in patients with MS and SCI correlate with specific alterations of anorectal physiology. This provides objective assessment of bowel symptoms and may allow tailored treatment to individual patients.

Intersecting experiences, motivating beliefs: The joint roles of class and race/ethnicity in the development of youths' sociopolitical perceptions and participation.

Positioning our analyses within two theoretical frameworks, system justification (SJ) theory and critical consciousness (CC), we examine relationships between social class and endorsement of SJ and CC beliefs and behaviors within a sample of low-income, Latinx and Black youth living in Chicago. We operationalize social class using five indicators: income-to-needs ratio (INR), subjective social status (SSS), financial strain, violence exposure, and neighborhood income. We find that for Black youth, higher INR is related to a greater likelihood of rejecting the status quo. Comparatively, living in a higher income neighborhood is negatively related to and being exposed to violence is positively related to the likelihood of engaging in social change behaviors. A different pattern emerged for Latinx youth where, higher perceived status was positively associated with accepting the status quo and greater exposure to violence was negatively related to youths' perceived ability to make a difference in the world around them.