Speaking of Kinds: How Correcting Generic Statements can Shape Children's Concepts.

Generic language (e.g., "tigers have stripes") leads children to assume that the referenced category (e.g., tigers) is inductively informative and provides a causal explanation for the behavior of individual members. In two preregistered studies with 4- to 7-year-old children (N = 497), we considered the mechanisms underlying these effects by testing how correcting generics might affect the development of these beliefs about novel social and animal kinds (Study 1) and about gender (Study 2). Correcting generics by narrowing their scope to a single individual limited beliefs that the referenced categories could explain what their members would be like while broadening the scope to a superordinate category (Study 2) uniquely limited endorsement of gender norms. Across both studies, correcting generics did not alter beliefs about feature heritability and had mixed effects on inductive inferences, suggesting that additional mechanisms (e.g., causal reasoning about shared features) contribute to the development of full-blown essentialist beliefs. These results help illuminate the mechanisms by which generics lead children to view categories as having rich inductive and causal potential; in particular, they suggest that children interpret generics as signals that speakers in their community view the referenced categories as meaningful kinds that support generalization. The findings also point the way to concrete suggestions for how adults can effectively correct problematic generics (e.g., gender stereotypes) that children may hear in daily life.

Prevalence of prescription and non-prescription polypharmacy by frailty and sex among middle-aged and older Canadians.

Background: Estimates of polypharmacy have primarily been derived from prescription claims, and less is known about the use of non-prescription medications (alone or in combination with prescription medications) across the frailty spectrum or by sex. Our objectives were to estimate the prevalence of polypharmacy (total, prescription, non-prescription, and concurrent prescription and non-prescription) overall, and by frailty, sex and broad age group. Data: Canadian Health Measures Survey, Cycle 5, 2016 to 2017. Methods: Among Canadians aged 40 to 79 years, all prescription and non-prescription medications used in the month prior to the survey were documented. Polypharmacy was defined as using five or more medications total (prescription and non-prescription), prescription only and non-prescription only. Concurrent prescription and non-prescription use was defined as two or more and three or more of each. Frailty was defined using a 31-item frailty index (FI) and categorized as non-frail (FI ≤ 0.1) and pre-frail or frail (FI > 0.1). Survey-weighted descriptive statistics were calculated overall and age standardized. Results: We analyzed 2,039 respondents, representing 16,638,026 Canadians (mean age of 56.9 years; 51% women). Overall, 52.4% (95% confidence interval [CI] = 47.3 to 57.4) were defined as pre-frail or frail. Age-standardized estimates of total polypharmacy, prescription polypharmacy and concurrent prescription and non-prescription medication use were significantly higher among pre-frail or frail versus non-frail adults (e.g., total polypharmacy: 64.1% versus 31.8%, respectively). Polypharmacy with non-prescription medications was common overall (20.5% [95% CI = 16.1 to 25.8]) and greater among women, but did not differ significantly by frailty. Interpretation: Polypharmacy and concurrent prescription and non-prescription medication use were common among Canadian adults, especially those who were pre-frail or frail. Our findings highlight the importance of considering non-prescribed medications when measuring the exposure to medications and the potential risk for adverse outcomes.

How children's media and teachers communicate exclusive and essentialist views of science and scientists.

Language that uses noun labels and generic descriptions to discuss people who do science (e.g., "Let's be scientists! Scientists discover new things") signals to children that "scientists" is a distinctive category. This identity-focused language promotes essentialist beliefs and leads to disengagement from science among young children in experimental contexts. The extent to which these cues shape the development of children's beliefs and behaviors in daily life, however, depends on (a) the availability of identity-focused language in children's environments and (b) the power of these cues to shape beliefs over time, even in the noisier, more variable contexts in which children are exposed to them. Documenting the availability of this language, linguistic coding of children's media (Study 1) and prekindergarten teachers' language from one science lesson (Study 2; n = 103; 98 female, one male, four unknown; 66% White, 8% African American, 6% Asian/Asian American, 3% mixed/biracial; 21% of the sample, of any race, identified as Hispanic/Latinx) confirmed that identity-focused language was the most common form of science language in these two samples. Further, children (Study 3; n = 83; Mage = 4.36 years; 43 female, 40 male; 64% White, 12% Asian/Asian American, 24% mixed/biracial; 36% of the sample, of any race, identified as Hispanic/Latinx) who were exposed to lower proportions of identity-focused language from their teachers developed increasingly inclusive science beliefs and greater science engagement over time. These findings suggest that linguistic input is an important mechanism through which exclusive beliefs about science are conveyed to children in daily life. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does It Matter How We Speak About Social Kinds? A Large, Preregistered, Online Experimental Study of How Language Shapes the Development of Essentialist Beliefs.

A problematic way to think about social categories is to essentialize them-to treat particular differences between people as marking fundamentally distinct social kinds. From where do these beliefs arise? Language that expresses generic claims about categories elicits some aspects of essentialism, but the scope of these effects remains unclear. This study (N = 204, ages 4.5-8 years, 73% White; recruited predominantly from the United States and the United Kingdom to participate online in 2019) found that generic language increases two critical aspects of essentialist thought: Beliefs that (a) category-related properties arise from intrinsic causal mechanisms and (b) category boundaries are inflexible. These findings have implications for understanding the spread of essentialist beliefs across communities and the development of intergroup behavior.

Asking young children to "do science" instead of "be scientists" increases science engagement in a randomized field experiment.

Subtle features of common language can imply to young children that scientists are a special and distinct kind of person-a way of thinking that can interfere with the development of children's own engagement with science. We conducted a large field experiment (involving 45 prekindergarten schools, 130 teachers, and over 1,100 children) to test if targeting subtle properties of language can increase science engagement in children's daily lives. Despite strong tendencies to describe scientists as a special kind of person (in a baseline control condition), brief video-based training changed the language that teachers used to introduce science to their students. These changes in language were powerful enough to predict children's science interest and behavior days later. Thus, subtle features of language shape children's beliefs and behaviors as they unfold in real world environments. Harnessing these mechanisms could promote science engagement in early childhood.

Adolescent Female Perspectives in an Urban Safety Net: Developing an Intervention Focusing on Sexual Health and Text-Messaging.

Our goal was to develop a patient-centered text-message intervention for adolescent females in an urban safety-net health system. We conducted interviews with adolescent females to explore sexual health knowledge and inform the development of a text-messaging intervention. Focused group discussions (FGDs) verified or challenged interview themes and elicited preferences for intervention design. Forty-two females participated, including 15 interviewees and 27 FGD participants. Over half (67%) were Hispanic/Latina, 19% Black, 10% White and 5% Asian. The average age was 16 (±1.5) and 55% reported ever having sex. Participants felt susceptible to and were more concerned with preventing unintended pregnancies than sexually transmitted infections, and described more barriers to condom use than other contraceptive methods. Their input informed the development of a text-messaging intervention, which is described. This study supports the acceptability of a patient-centered texting intervention for promoting and normalizing healthy sexual behaviors among adolescent females in an urban safety-net setting.

Acceptability and Efficacy of a Sexual Health Texting Intervention Designed to Support Adolescent Females.

OBJECTIVE: To evaluate the feasibility, acceptability, and initial efficacy of a pilot texting intervention ("t4she") in primary care designed to increase sexual health knowledge and promote dual protection strategies to reduce unintended pregnancies and sexually transmitted infections among adolescent females. METHODS: Participants were recruited from 2 federally qualified health centers. Eligibility included: being 13 to 18 years of age; assigned female at birth; English-speaking; not currently pregnant and/or intending to become pregnant; and having texting capabilities. A randomized controlled trial assessed between-group differences at 3 and 6 months on knowledge, Health Belief Model constructs, and sexual behaviors. Input on intervention acceptability was obtained at 3 months. RESULTS: Among 244 participants enrolled and randomized, the average age was 16 (±1.6), 80% were Hispanic/Latina, 53% had ever had vaginal sex, and 50% had used prescription birth control with 24% currently using a long-acting reversible method. Among those sexually active, 29% reported consistent condom use and 24% reported engaging in dual protection behaviors at last sex. Among participants with all follow-up data (N = 136), intervention participants had significant increases in sexual health knowledge and reported more prescription birth control use at follow-up than control participants. No significant outcome differences were found for condom use or dual protection behaviors. Intervention participants reported receiving messages, being introduced to new information, and reading and sharing the messages. CONCLUSIONS: The pilot t4she sexual health intervention significantly improved knowledge and use of short-acting prescription birth control among young females in primary care and was acceptable by youth and feasible to implement.

Children lose confidence in their potential to "be scientists," but not in their capacity to "do science".

Over the course of middle childhood, children's interest and beliefs about their own capacities for success in science often decline. This pernicious decline is especially evident among underrepresented groups, including girls, members of some racial and ethnic minorities, and children from lower socioeconomic backgrounds. The present research (N = 306, ages 6-11) found that while children lose interest and feelings of efficacy about their potential to "be scientists" across middle childhood, they maintain more robust interest and efficacy about "doing science." These patterns were confirmed in both longitudinal and cross-sectional analyses; effects were stable or increased across time and age. Mediation analyses revealed that the positive effect of action framing is partially accounted for by children's views that the group of people who do science is more inclusive than the category of scientists. These findings suggest that using action-focused language to encourage children in science is more inclusive and may lead to more science engagement across middle childhood than language that emphasizes scientists as an identity category. Implications for educational practices will be discussed.

Subtle Linguistic Cues Increase Girls' Engagement in Science.

The roots of gender disparities in science achievement take hold in early childhood. The present studies aimed to identify a modifiable feature of young children's environments that could be targeted to reduce gender differences in science behavior among young children. Four experimental studies with children ( N = 501) revealed that describing science in terms of actions ("Let's do science! Doing science means exploring the world!") instead of identities ("Let's be scientists! Scientists explore the world!") increased girls' subsequent persistence in new science games designed to illustrate the scientific method. These studies thus identified subtle but powerful linguistic cues that could be targeted to help reduce gender disparities in science engagement in early childhood.

Evidence of bias against girls and women in contexts that emphasize intellectual ability.

Despite the numerous intellectual contributions made by women, we find evidence of bias against them in contexts that emphasize intellectual ability. In the first experiment, 347 participants were asked to refer individuals for a job. Approximately half of the participants were led to believe that the job required high-level intellectual ability; the other half were not. A Bayesian mixed-effects logistic regression revealed that the odds of referring a woman were 38.3% lower when the job description mentioned intellectual ability, consistent with the possibility of gender bias. We also found evidence of gender bias in Experiment 2, which was a preregistered direct replication of Experiment 1 with a larger and more diverse sample (811 participants; 44.6% people of color). Experiment 3 provided a developmental investigation of this bias by testing whether young children favor boys over girls in the context of intellectually challenging activities. Five- to 7-year-olds (N = 192) were taught how to play a team game. Half of the children were told that the game was for "really, really smart" children; the other half were not. Children then selected 3 teammates from among 6 unfamiliar children. Children's initial selections were driven by ingroup bias (i.e., girls chose girls and boys chose boys), but children subsequently showed bias against girls, choosing girls as teammates for the "smart" game only 37.6% of the time (vs. 53.4% for the other game). Bias against women and girls in contexts where brilliance is prized emerges early and is a likely obstacle to their success. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Variation in the health outcomes associated with frailty among home care clients: relevance of caregiver distress and client sex.

BACKGROUND: The identification of contextual factors that modify associations between client frailty and their health and service use outcomes is essential for informed home health care and policy planning. Our objective was to examine variation in the associations between frailty and select 1-year health outcomes by caregiver distress and client sex among community-residing older care recipients. METHODS: We conducted a retrospective cohort study using linked population-based clinical and health administrative databases for all long-stay home care clients (n = 234,552) aged 66+ years assessed during April 2010-2013 in Ontario, Canada. Frailty was assessed using a previously validated 72-item frailty index (FI). Presence of caregiver distress was derived from clinical assessment items administered by trained home care assessors. Multivariable log-binomial regression models were used to examine variations in the associations between frailty and outcomes of interest (mortality, nursing home [NH] placement, all-cause and prolonged hospitalization) by caregiver distress, with further model stratification by client sex. RESULTS: Frailty prevalence varied little by sex (19.3% women, 19.9% men) despite significant sex-differences in clients' sociodemographic and health characteristics. In both sexes, frailty was significantly associated with all outcomes, particularly NH placement (RR = 3.84, 95%CI 3.75-3.93) and death (RR = 2.32, 95%CI 2.27-2.37), though risk ratios were greater for women. Caregiver distress was more common with increasing frailty and for male clients, and a significant independent predictor of NH placement and prolonged hospitalization in both sexes. The association between frailty and NH placement (but not other outcomes) varied by caregiver distress for both men and women (p < 0.001 interaction terms), showing a greater magnitude of association among clients without (vs. with) a distressed caregiver. CONCLUSIONS: As caregiver distress varies by client sex, represents a key driver of NH placement (even among relatively robust clients), and modifies the impact of other risk factors such as frailty, it should be routinely assessed. Further, sex-differences should be considered when developing and evaluating community-based services for older adults and their caregivers.

The Role of Generic Language in the Early Development of Social Categorization.

Classifying people into categories not only helps humans simplify a complex social world but also contributes to stereotyping and discrimination. This research examines how social categorization develops by testing how language imbues with meaning otherwise arbitrary differences between people. Experimental studies (N = 129) with 2-year-olds showed that generic language-language that refers to abstract kinds-guides the development of social categorization. Toddlers learned a new category after hearing generic language about individuals who shared an arbitrary perceptual feature but not after hearing matched specific language, simple labels, or plural (but nongeneric) language about the same set of individuals. These findings show how subtle linguistic cues shape the development of social categorization.

How does social essentialism affect the development of inter-group relations?

Psychological essentialism is a pervasive conceptual bias to view categories as reflecting something deep, stable, and informative about their members. Scholars from diverse disciplines have long theorized that psychological essentialism has negative ramifications for inter-group relations, yet little previous empirical work has experimentally tested the social implications of essentialist beliefs. Three studies (N = 127, ages 4.5-6) found that experimentally inducing essentialist beliefs about a novel social category led children to share fewer resources with category members, but did not lead to the out-group dislike that defines social prejudice. These findings indicate that essentialism negatively influences some key components of inter-group relations, but does not lead directly to the development of prejudice.

A Qualitative Study of Hospitalists' Perceptions of Patient Satisfaction Metrics on Pain Management.

Hospital initiatives to promote pain management may unintentionally contribute to excessive opioid prescribing. To better understand hospitalists' perceptions of satisfaction metrics on pain management, the authors conducted 25 interviews with hospitalists. Transcribed interviews were systematically analyzed to identify emergent themes. Hospitalists felt institutional pressure to earn high satisfaction scores for pain, which they perceived influenced practices toward opioid prescribing. They felt tying compensation to satisfaction scores commoditized pain. Hospitalists believed satisfaction would improve with increased time spent at the bedside. Focusing on methods to improve patient-physician communication, while maintaining efficiency in clinical practice, may promote both patient-centered pain management and satisfaction.

Cultural context shapes essentialist beliefs about religion.

The present study investigates the processes by which essentialist beliefs about religious categories develop. Children (ages 5 and 10) and adults (n = 350) from 2 religious groups (Jewish and Christian), with a range of levels of religiosity, completed switched-at-birth tasks in which they were told that a baby had been born to parents of 1 religion but raised by parents of another religion. Results indicated that younger children saw religion-based categories as possible essential kinds, regardless of the child's own religious background, but that culture-specific patterns emerged across development. This work shows that cultural context plays a powerful role in guiding the development of essentialist beliefs about religious categories. (PsycINFO Database Record

Gender stereotypes about intellectual ability emerge early and influence children's interests.

Common stereotypes associate high-level intellectual ability (brilliance, genius, etc.) with men more than women. These stereotypes discourage women's pursuit of many prestigious careers; that is, women are underrepresented in fields whose members cherish brilliance (such as physics and philosophy). Here we show that these stereotypes are endorsed by, and influence the interests of, children as young as 6. Specifically, 6-year-old girls are less likely than boys to believe that members of their gender are "really, really smart." Also at age 6, girls begin to avoid activities said to be for children who are "really, really smart." These findings suggest that gendered notions of brilliance are acquired early and have an immediate effect on children's interests.

My Heart Made Me Do It: Children's Essentialist Beliefs About Heart Transplants.

Psychological essentialism is a folk theory characterized by the belief that a causal internal essence or force gives rise to the common outward behaviors or attributes of a category's members. In two studies, we investigated whether 4- to 7-year-old children evidenced essentialist reasoning about heart transplants by asking them to predict whether trading hearts with an individual would cause them to take on the donor's attributes. Control conditions asked children to consider the effects of trading money with an individual. Results indicated that children reasoned according to essentialism, predicting more transfer of attributes in the transplant condition versus the non-bodily money control. Children also endorsed essentialist transfer of attributes even when they did not believe that a transplant would change the recipient's category membership (e.g., endorsing the idea that a recipient of a pig's heart would act pig-like, but denying that the recipient would become a pig). This finding runs counter to predictions from a strong interpretation of the "minimalist" position, an alternative to essentialism.

The hospitalist perspective on opioid prescribing: A qualitative analysis.

BACKGROUND: Pain is a frequent symptom among patients in the hospital. Pain management is a key quality indicator for hospitals, and hospitalists are encouraged to frequently assess and treat pain. Optimal opioid prescribing, described as safe, patient-centered, and informed opioid prescribing, may be at odds with the priorities of current hospital care, which focuses on patient-reported pain control rather than the potential long-term consequences of opioid use. OBJECTIVE: We aimed to understand physicians' attitudes, beliefs, and practices toward opioid prescribing during hospitalization and discharge. DESIGN: In-depth, semistructured interviews. SETTING: Two university hospitals, a safety-net hospital, a Veterans Affairs hospital, and a private hospital located in Denver, Colorado or Charleston, South Carolina. PARTICIPANTS: Hospitalists (N = 25). MEASUREMENTS: We systematically analyzed transcribed interviews and identified emerging themes using a team-based mixed inductive and deductive approach. RESULTS: Although hospitalists felt confident in their ability to control acute pain using opioid medications, they perceived limited success and satisfaction when managing acute exacerbations of chronic pain with opioids. Hospitalists recounted negative sentinel events that altered opioid prescribing practices in both the hospital setting and at the time of hospital discharge. Hospitalists described prescribing opioids as a pragmatic tool to facilitate hospital discharges or prevent readmissions. At times, this left them feeling conflicted about how this practice could impact the patient over the long term. CONCLUSIONS: Strategies to provide adequate pain relief to hospitalized patients, which allow hospitalists to safely and optimally prescribe opioids while maintaining current standards of efficiency, are urgently needed. Journal of Hospital Medicine 2016;11:536-542. © 2016 Society of Hospital Medicine.