Investigations of an individual with a Marfanoid habitus, mild intellectual disability, and severe social anxiety identifies PCDHGA5 as a candidate neurodevelopmental disorder gene.

Marfanoid habitus and intellectual disability (MHID) co-occur in multiple neurodevelopmental disorders (NDD). Among those, Lujan-Fryns, an X-linked genetic disorder associated with variants in MED12 was the first such syndrome identified. Accurate molecular diagnosis for these MHID syndromes remains a challenge due to significant clinical and genetic heterogeneity. We present a case report of a 20-year-old male patient with MHID and severe social anxiety. A comprehensive clinical evaluation, including morphotype assessment, cognitive, and psychometric and genetic testing, was conducted to provide a detailed understanding of the patient's complex clinical presentation. Psychometric assessments revealed severe social anxiety and various cognitive and emotional challenges. Despite some autism-like symptoms, the patient's clinical presentation was more aligned with mild intellectual disability. Exome sequencing was inconclusive but identified a heterozygous de novo missense variant in the PCDHGA5 gene. This gene is not known in human pathology yet, but we also report a second patient with a syndromic neurodevelopmental disorder and a rare de novo variant which leads us to propose this as a candidate gene. Our findings emphasize the importance of multidisciplinary approach in the diagnosis and management of MHID. This case report underscores the need for objective clinical evaluations and standardized tools to better understand the complex clinical profiles of patients with NDDs. The identification of novel PCDHGA5 gene variants adds this gene's candidacy to the genetic landscape of MHID-NDD, warranting further investigation to determine its potential contribution.

Making sense of COVID-19: manifestations of health capital during the pandemic.

BACKGROUND: Grounded in Bourdieu's theory of human practice, this study aims to examine how individuals as social agents made sense of and acted upon their COVID-19 experiences. A recent conceptualization of health capital is utilized to explain the practices of patients in the pandemic, in relation to their biographical background. METHODS: This is a qualitative research in which the data were collected by biographical narrative interviews through a theoretical sampling approach. Eighteen interviews with COVID-19 patients were conducted and 8 of them were analyzed by the Documentary Method. RESULTS: The informants made sense of their illness experiences through their health capital, which is manifested in their self-perception of health, their attitudes towards the healthcare system, their conception of terms such as luck, their work status, and the gendered division of labour at home in the COVID-19 pandemic. All the manifestations are mediated by the social, cultural, and economic capital of the informants, and their habitual practices are based on their symbolic capital. CONCLUSION: The study depicts how social agents' health capital manifested in the pandemic, relying on their symbolic capital, and shaping their practices. Further research across diverse contexts is needed to fully understand extra dimensions of health capital as a descriptor of the social determinants of health.

Balletic bodies under lockdown: The consequences of a pandemic for highly disciplined habitus.

Like other elite athletes, ballet dancers are highly dedicated to the pursuit of their vocation. They work to perfect their bodies, their movements and their expression of the art form. The lockdowns that occurred during the COVID-19 pandemic represented a significant interruption to the extraordinary but everyday lives of ballet dancers, creating unique environments where exploration of the embodied habitus of ballet can be further investigated. The impacts of lockdown upon dancers were explored via a series of interviews with 12 professional dancers from Germany. Framed by previous research, theorising the balletic body from a Bourdieusian perspective, interview data were analysed using Interpretative Phenomenological Analysis. Our research highlights the way in which COVID-19 lockdowns and associated restrictions disrupt the habitus of dancers and results in a form of suffering that is comparable to injury or chronic illness. Our research suggests that individuals respond to the 'structural injuries' of lockdown measures in a manner comparable to the way they respond to physiological injury. Thus, dancers sought to repair or re-establish the social structures they ordinarily inhabit whilst the inevitable limitations of such efforts engendered occasions for reflexive thinking about their role, careers and identity as dancers.

Reframing the public/private debate on healthcare services: Tracking boundaries in the National Health Service.

This paper intervenes in the dichotomous debate on the 'privatisation' of the UK's National Health Service (NHS). Whilst research suggests that involving private-sector actors and principles deviates from the founding aims of the NHS to deliver equitable healthcare for all, the opposing argument to 'keep our NHS public' also limits understanding and alternative possibilities. Through focusing on maintaining overarching structures, these campaigns fail to address everyday medical practices that have long been critiqued by those allied with the sociology of health and illness. This paper draws on feminist critiques of public/private to expand the structural economic lens of mainstream political debates and explore how multiple forms of economic, social, cultural, and symbolic capital, operate in everyday healthcare practices. Through an historically-informed ethnographic exploration of routine hip replacements, I find that capital itself emerges through relations between people and things, and that public/private boundaries play an integral role in forming these relations to instil value on particular patients and forms of labour, demarcating what kind of healthcare is given to whom. I therefore suggest future action should focus on assembling healthcare relations beyond the dualism of public/private categories, to create multiple safe places and relations for all.

Surgical Approach and Body Mass Index Impact Risk of Wound Complications Following Total Hip Arthroplasty.

BACKGROUND: Previous studies have suggested that wound complications may differ by surgical approach after total hip arthroplasty (THA), with particular attention toward the direct anterior approach (DAA). However, there is a paucity of data documenting wound complication rates by surgical approach and the impact of concomitant patient factors, namely body mass index (BMI). This investigation sought to determine the rates of wound complications by surgical approach and identify BMI thresholds that portend differential risk. METHODS: This multicenter study retrospectively evaluated all primary THA patients from 2010 to 2023. Patients were classified by skin incision as having a laterally based approach (posterior or lateral approach) or DAA (longitudinal incision). We identified 17,111 patients who had 11,585 laterally based (68%) and 5,526 (32%) DAA THAs. The mean age was 65 years (range, 18 to 100), 8,945 patients (52%) were women, and the mean BMI was 30 (range, 14 to 79). Logistic regression and cut-point analyses were performed to identify an optimal BMI cutoff, overall and by approach, with respect to the risk of wound complications at 90 days. RESULTS: The 90-day risk of wound complications was higher in the DAA group versus the laterally based group, with an absolute risk of 3.6% versus 2.6% and a multivariable adjusted odds ratio of 1.5 (P < .001). Cut-point analyses demonstrated that the risk of wound complications increased steadily for both approaches, but most markedly above a BMI of 33. CONCLUSIONS: Wound complications were higher after longitudinal incision DAA THA compared to laterally based approaches, with a 1% higher absolute risk and an adjusted odds ratio of 1.5. Furthermore, BMI was an independent risk factor for wound complications regardless of surgical approach, with an optimal cut-point BMI of 33 for both approaches. These data can be used by surgeons to help consider the risks and benefits of approach selection. LEVEL OF EVIDENCE: Level III.

"Sense for Gambling" Among Jewish Ultra-Orthodox Men With Gambling Disorder.

Making sense of the social world is an intricate process heavily influenced by cultural elements. Gambling is a prevalent leisure-time activity characterized by risk-taking conduct. While some individuals who engage in it do so without experiencing any harm, others will develop gambling problems. Judaism tends to perceive gambling negatively since it contradicts fundamental Jewish principles. The current study focuses on the Jewish Ultra-Orthodox community in Israel which is characterized as a cultural enclave with minimal interaction with the secular world. Hence, it provides a unique and novel socio-cultural context to inquire how individuals with gambling disorder (GD) from this community make sense of gambling. Following constructivist grounded theory guidelines, 22 Ultra-Orthodox men with GD were interviewed using a purposeful sampling design. Sixteen Rabbis were also interviewed, illuminating the socio-cultural context of Halachic regulations and norms regarding gambling in this community. An abductive analysis of the data, interwoven with Bourdieu's concept of habitus, yielded an overarching theme that we dub as "sense for gambling," encompassing matrices of Ultra-Orthodox external (e.g., a conservative cultural structure with numerous prohibitions and life marked by poverty) and internal (e.g., feelings of loneliness, dissatisfaction, and deviance) dispositions imprinted onto the body, creating diverse embodied reactions (emotional and sensory) to gambling, and leading to developing GD. We recommend placing the body, as the locus of internalized dispositions, at the core of examination when researching pathways to GD. We propose that this intricate interplay between external and internal dispositions shapes the decision-making regarding gambling, thus mitigating individual responsibility for GD.

Exploring normative frameworks of fairness through (relational) institutional habitus in Oxford's undergraduate admissions process.

In the UK's stratified HE system the question of who is able to access the most selective and prestigious universities is fraught with issues of fairness. This paper explores how decision-makers in Oxford's undergraduate admissions process construct norms of fairness and how such norms inform their reflexive considerations and actions around admissions decisions. Framing such norms as multiple institutional habituses, the paper considers how decision-makers compromise and negotiate between institutional habituses in tension. Further, it presents an augmented conception of institutional habitus - the relational institutional habitus - which offers a conceptual tool to make sense of the existence of multiple contested institutional norms and their partial and fragile reconciliation in institutional action.

Paranirvar manis (dependent people)? Rethinking humanitarian dependency syndrome: a Bourdieusian perspective.

Disaster survivors are often criticised for being dependent on humanitarian (and development) assistance. This dependency is perceived pejoratively by civil servants and other elites, including non-governmental organisation staff. Officials offered up such narratives in relation to the disaster response and recovery programmes following the Nepal earthquake of 2015. Using a Bourdieusian framework, and undertaking qualitative inquiry in four earthquake-affected districts of Nepal, this paper contrasts the official narratives of dependency syndrome with people's perspectives and lived experiences. The findings problematise official discourse. Aid was frequently insufficient, poorly targeted, or non-existent. Moreover, the Bourdieusian framing highlights the agency of survivors, as their habitus predisposed them to help others. It broadens the notion of assistance and dependence, suggesting that social and cultural (as well as economic) capital are vital resources for recovery. Lastly, it shows that dependencies are not necessarily bad. Greater attention to these non-economic capitals and 'good dependencies' could expedite recovery from future disasters.

Maternal COVID vaccination and breastfeeding during a pandemic: Habitus and health behavior decision making.

OBJECTIVE: To examine the influence of habitus on women's health behavior regarding breastfeeding and subsequent COVID-19 vaccination. DESIGN: A qualitative descriptive design, guided by Pierre Bourdieu's concept of habitus. SAMPLE: Eighteen women who were postpartum, breastfeeding, and vaccinated against COVID- 19 either during pregnancy or while breastfeeding postpartum. MEASURES: Individual semi-structured interviews. RESULTS: Two major themes shaped participants' habitus: health-focused knowledge, and attitudes and beliefs. Attitudes and beliefs included five subthemes: (1) exposure/acceptance/expectations from family, (2) community acceptance of breastfeeding and COVID-19 vaccination, (3) socioeconomic status, (4) easily accessed support, and (5) outside experiences and exposure. DISCUSSION: An individual's habitus impacts one's knowledge, attitudes, and beliefs and interacts with past behaviors when discussing options for infant feeding and health promoting behaviors such as vaccinations. A better understanding of how health care providers assess and utilize habitus in clinical management is needed.

The ambivalent role of Urdu and English in multilingual Pakistan: a Bourdieusian study.

Pakistan, one of the eight countries comprising South Asia, has more than 212.2 million people, making it the world's fifth most populous country after China, India, USA, and Indonesia. It has also the world's second-largest Muslim population. Eberhard et al. (Ethnologue: languages of the world, SIL International, 2020) report 77 languages used by people in Pakistan, although the only two official languages are Urdu and English. After its Independence from the British colonial rule in 1947, it took much deliberation for the country to make a shift from its monolingual Urdu orientation to a multilingual language policy in education in 2009. This entailed a shift from the dominant Urdu language policy for the masses (and English exclusively reserved for elite institutions), to a gradual and promising change that responded to the increasing social demand for English and for including regional languages in the curriculum. Yet English and Urdu dominate the present policy and exclude regional non-dominant languages in education that themselves are dynamic and unstable, and restructured continually due to the de facto multilingual and plurilingual repertoire of the country. Using Bourdieu's (Outline of a theory of practice Cambridge University Press, Cambridge, 1977a, The economics of linguistic exchanges. Soc Sci Inform 16:645-668, 1977b, The genesis of the concepts of habitus and field. Sociocriticism 2:11-24 1985, Language and symbolic power Polity Press, Cambridge, 1991) conceptualization of habitus, this study analyzes letters to the editor published between 2002-2009 and 2018-2020 in a leading English daily of Pakistan. The analysis unveils the linguistic dispositions that are discussed in the letters and their restructuring through market forces, demonstrating a continuity between the language policy discourse and public aspirations. The findings also indicate the ambivalences towards Urdu and English in relation to nationalistic ideologies, modernity and identity.

Vein of Galen aneurysm, dilated cardiomyopathy, and slender habitus in a patient with a recurrent pathogenic variant in PACS2.

The PACS2 gene encodes a multifunctional sorting protein involved in nuclear gene expression and pathway traffic regulation that has been shown to be highly expressed during human prenatal brain development. Pathogenic variants in PACS2 have been recently shown to be implicated in a phenotype with global developmental delay/intellectual disability, seizures, autistic traits, facial dysmorphic features, and cerebellar dysgenesis. Here, we report a 25-year-old male with intellectual disability, epileptic encephalopathy, cerebellar dysgenesis, facial dysmorphism, and a previously reported pathogenic variant in PACS2. To our knowledge, this is the oldest patient reported who, in addition to the known phenotype described in PACS2 patients, presented with a vein of Galen malformation and dilated cardiomyopathy as previously unreported findings.

Overweight and obesity among children in rural areas: The importance of culture.

AIMS: This paper focuses on how social inequality is associated with overweight and obesity in children. There is a lack of research with a focus on an important distinction in social inequality, namely geography. The aim of this study was to reduce this knowledge gap by looking closely at the links between rurality and overweight. METHODS: The findings in this paper are based on in-depth interviews with school nurses and teachers in rural Norway. The focus was on their experiences with and knowledge about overweight and obesity numbers in rural versus urban areas. RESULTS: We used Bourdieu's terminology to address the challenges related to urban-rural differences, and found that cultural factors connected to tradition, identity and courtesy play an important role in the rural overweight and obesity discourse. CONCLUSIONS: Actors and 'experts' working with overweight and obesity and national guidelines need to understand rural contexts and customs and address problems of the countryside on rural, not exclusively urban, premises. Different contexts imply different needs when it comes to reducing the inequalities between rural and urban areas regarding overweight and obesity.

Nutritional status in female patients with nontuberculous mycobacterial lung disease and its association with disease severity.

BACKGROUND: In women, slender body habitus has been reported to be one of the predisposing factors underlying the development and poor prognosis of non-tuberculous mycobacterial lung disease (NTM-LD). Given the lack of nutritional data contributing to treatment strategies, we aimed to clarify the nutritional status of female patients with NTM-LD and its association with disease severity. METHODS: In this single-center observational study, we enrolled 81 female outpatients with NTM-LD. Data on healthy women of similar ages were selected from our previous survey data and categorized as controls. First, we compared anthropometric and dietary survey data between patients and controls. Second, after the patients were categorized into relatively mild (mild, n = 40) and relatively severe groups (severe, n = 41) based on pulmonary X-ray-image finding scores, body composition, nutritional intake, and biochemical markers were compared between the groups. To identify nutritional factors associated with disease severity, logistic regression analyses were performed. RESULTS: Compared with controls, patients with NTM-LD had significantly lower energy intake, body mass index, body fat, and skeletal muscle mass (all p < 0.001). Compared with the mild group, the severe group had significantly lower skeletal muscle mass (p = 0.037), albumin (p = 0.029), transthyretin (prealbumin) (p = 0.002), retinol-binding protein (p = 0.011), and hemoglobin (p = 0.001); however, no between-group differences were observed in energy or nutrient intake. Logistic analyses revealed that transthyretin (p = 0.025) and hemoglobin (p = 0.003) levels were independent factors associated with disease severity. CONCLUSIONS: This is the first study to comprehensively report the association between NTM-LD severity and nutritional status, including body composition, nutrient intake, and biomarkers. The results suggest that initiating nutritional therapy from the mild stage of the disease to prevent undernutrition is warranted.

Escaping social rejection, gaining total capital: the complex psychological experience of female genital mutilation/cutting (FGM/C) among the Izzi in Southeast Nigeria.

BACKGROUND: While the deleterious effects of FGM/C on physical health are well documented, the psychological experience of this harmful practice is a neglected area of research, which limits global mental health actions. As FGM/C was a traditional practice in some areas of Nigeria, the study aimed to understand the psychological experience of FGM/C in context. METHODS: This qualitative study was completed in urban and rural Izzi communities in Southeast Nigeria where FGM/C was widely practiced. In-depth interviews were completed with 38 women of the same ethnicity using the McGill Illness Narrative Interview (MINI) to explore the collective psychological experience of FGM/C before, during and after the procedure. The MINI was successfully adapted to explore the meaning and experience of FGM/C. We completed thematic content analysis and used the concepts of total capital and habitus by Bourdieu to interpret the data. RESULTS: During the period of adolescence, Izzi young women who had not yet undergone FGM/C reported retrospectively being subjected to intense stigma, humiliation and rejection by their cut peers. Alongside the social benefits from FGM/C the ongoing psychological suffering led many to accept or request to be cut, to end their psychological torture. Virtually all women reported symptoms of severe distress before, during and after the procedure. Some expressed the emotion of relief from knowing their psychological torture would end and that they would gain social acceptance and total capital from being cut. Newly cut young women also expressed that they looked forward to harassing and stigmatizing uncut ones, therein engaging in a complex habitus that underscores their severe trauma as well as their newly acquired enhanced social status. CONCLUSION: FGM/C is profoundly embedded in the local culture, prevention strategies need to involve the whole community to develop preventive pathways in a participatory way that empowers girls and women while preventing the deleterious psychological effects of FGM/C and corresponding stigma. Results suggest the need to provide psychological support for girls and women of practicing Izzi communities of Southeast Nigeria.

The influence of obesity on incidence of complications in patients hospitalized with ovarian hyperstimulation syndrome.

OBJECTIVE: To study the impact of body habitus on risk of complications resulting from ovarian hyperstimulation syndrome (OHSS) in hospitalized patients. METHODS: This is a retrospective observational study examining the National Inpatient Sample between January 2012 and September 2015. Patients were women < 50 years of age diagnosed with OHSS, classified as non-obese, class I-II obesity, or class III obesity. Intervention included multinomial logistic regression to identify factors associated with obesity and binary logistic regression for independent risk factors for complications. Main outcome measures were incidence of (i) any or (ii) multiple complication(s). RESULTS: Of 2745 women hospitalized with OHSS, 2440 (88.9%) were non-obese, 155 (5.6%) had class I-II obesity, and 150 (5.5%) had class III obesity. Obese women (either class I-II or III) had a higher degree of comorbidity, had lower incomes, and were less likely to have private insurance than non-obese women (all P < 0.001). Obese women had lower rates of OHSS-related complications than non-obese women (any complication: non-obese 65.2%, class I-II 54.8%, and class III 46.7%, P < 0.001; and multiple complications: non-obese 38.5%, class I-II 32.3%, and class III 20.0%, P < 0.001). In the multivariable model, obesity remained independently associated with a decreased risk of complications (class I-II odds ratio 0.57, 95% confidence interval 0.39-0.83, P = 0.003; class III odds ratio 0.30, 95% confidence interval 0.20-0.44, P < 0.001). Obese women were also less likely to require paracentesis (non-obese 32.8%, class I-II 9.7%, and class III 13.3%, P < 0.001). CONCLUSION: Our study suggests that obesity is associated with decreased OHSS-related complication rates in hospitalized patients.

Conceptualising disaster social capital: what it is, why it matters, and how it can be enhanced.

Social capital discourse occupies an important place in disaster studies. Scholars have adopted various inflections of social capital to explain how those with greater amounts of this crucial resource are generally more resilient to disasters and experience speedier recovery. Disaster scholars have also discovered that people typically display altruistic tendencies in the wake of disasters and develop novel networks of mutual support, known as 'communitas', which is also seen to build resilience and boost recovery. In this paper, we use the work of Pierre Bourdieu to synthesise these literatures, conceptualising communitas as 'disaster social capital'. We offer a fleshed-out definition of disaster social capital to distinguish it from regular social capital and discuss the barriers to, and the enablers of, its formation. While primarily a conceptual discussion, we believe that it has practical and policy value for disaster scholars and practitioners interested in inclusive disaster risk reduction as well as full and just recoveries.

Factors influencing farmer and resident willingness to adopt an agri-environmental scheme in Israel.

Providing for growing food demand while minimizing environmental degradation is a major contemporary environmental challenge. Agri-environmental schemes (AESs) are often promoted to meet this challenge by providing subsidies to farmers who adopt agri-environmental practices (AEPs). The success of these schemes depends on the ability to engage farmers, thus understanding farmers' perceptions about AEPs is pivotal. Yet, current knowledge is limited as most research explores farmer's attitudes towards existing AESs, often based on subsidies. We explored the attitudes of farmers and their communities towards five different AEPs, and towards a potential AES, in an area of intensive agriculture in Israel, where currently no AES are implemented. We conducted five focus group sessions with 41 farmers, 12 follow-up interviews, and a survey with 296 community members. Findings indicate that farmers' willingness to implement AEPs was driven by environmental, personal, and social considerations, particularly perceptions of "good farming" practices, such as community cohesiveness and maintaining control of one's field. Farmers' lack of trust in the government, and lack of personal or local experience with specific AEPs, are other major barriers for joining a potential AES. Farmers perceived financial compensation as a safety net, but placed social and cultural values on par with, or above, financial considerations for joining an AES. Farmers' communities demonstrated high support for implementing AEPs, indicating that communities could be an asset for AES development. Therefore, while incentives for many AESs are based primarily on monetary compensation, to achieve their desired long-term results they should also focus on farmer resilience, independence, knowledge creation, and socio-cultural capital development.

Moral habitus: An approach to understanding embedded disrespectful practices.

The moral habitus shows how morally oriented clinical interactions through everyday social evaluations generate and sustain disrespectful attitudes and behaviours that disregard patients and family members. These attitudes and behaviours often result from the habitual nature of interaction styles and embodied bodily dispositions within particular hospital settings. By utilising the data of a qualitative study in two hospitals in the south Indian city of Chennai, I illustrate the role of moral habitus in understanding these disrespectful attitudes and behaviours. I show how the stereotyping and embodied bodily dispositions by healthcare professionals raise moral and ethical questions, such as those related to ethical value of respect for persons. I conclude that studying the moral habitus of hospital settings is significant for proposing ways to respect patients and family members of patients in practice and uphold ethical values, and to have meaningful healthcare interactions. Furthermore, the concept of moral habitus offers theoretical grounds for understanding these attitudes and behaviours in hospital settings, while engaging in ethics and patient-centred care debates, to bridge the gap between theory and practice of respect.

Submission or subversion: survival and resilience of Chinese international research students in neoliberalised Australian universities.

Although scholars have noted the detrimental nature of the various changes in higher education prompted by neoliberalism, its impact on the experiences of international Higher Degree by Research (HDR) students has yet to be adequately studied. Informed by Bourdieu's concepts of doxa, field, habitus, and capital, this paper examines the ways in which neoliberalism as doxa in the Australian higher education field has colonised the perception and practice of Chinese international HDR students whilst some students were able to demonstrate resilience to the pervasive neoliberal practices. The paper draws on a larger qualitative research project including interviews with 18 Chinese HDR students from four Australian universities. Data suggest that Chinese HDR research students gradually developed intensified dispositions of self-reliance and self-exploitation in response to neoliberal academic practices whilst others were enculturated into a floating habitus (or vulnerable position) in relation to academic publishing as they attempted to negotiate the tensions across fields and over time. Data further reveal that some participants demonstrated resilience to neoliberalism when empowered by their supervisors with less utilitarian and more critically reflexive supervisory practices. The paper argues that the embrace of neoliberalism in the Australian higher education field has become widespread yet controversial, and that thinking and enacting resilience sociologically may de-neoliberalise the higher education field in Australia and beyond.

Social class inequalities in attitudes towards mathematics and achievement in mathematics cross generations: a quantitative Bourdieusian analysis.

Drawing on Bourdieu's theory of social and cultural reproduction, this article utilizes the conceptual tools of habitus and cultural capital to examine intergenerational inequalities in attitudes towards mathematics and mathematics learning in three secondary schools in England. Data from 1079 students aged 14-16 included mathematics achievement, survey measures of attitudes towards mathematics, perceived parental attitudes towards mathematics, newly developed scales for cultural capital and habitus, and social class. There was a very strong relationship between student's attitudes towards mathematics and students' perceptions of their parents' attitudes towards mathematics. Middle-class students reported more positive attitudes towards mathematics, more positive perceived parental attitudes towards mathematics, and had higher mathematics achievement than working-class students. Cultural capital had a significant positive effect on students' attitudes towards mathematics but a minor effect on their achievement in mathematics. However, cultural capital's effect on students' attitudes and achievement in mathematics faded when habitus was included in the model. We suggest that habitus may play a more central role than cultural capital in the reproduction of mathematics inequalities. School quality had a modest but significant impact on mathematics outcomes in this study, so we argue that challenges to mathematics inequalities will require changes both within and outside of mathematics classrooms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10649-021-10078-5.