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We review three decades of literature across multiple disciplines that demonstrate the efficacy of narrative story stem methodologies (NSSM) to elicit responses that are projective of mental processes and to reveal what would otherwise be too complex or sensitive to communicate. The review synthesizes evidence for the extensive and diverse utility of NSSM. To accomplish this, we provide theoretical framing and historical background, describe assessment methods, resulting data and analytic approaches, and chart the empirical work of the past decade that relates story stem narratives to a range of developmental outcomes, and meaning-making processes. This synthesis of cross-disciplinary research provides the first comprehensive review of a truly innovative narrative methodology and includes work across periods of development, representing research that has primarily focused on children with increasing emphasis on adolescents and adults.

Given the increasing emphasis of communicative competence in English as a foreign language (EFL) contexts and the lack of validation research on speaking assessments for adolescent EFL learners, in the current study we examined the validity of the TOEFL Junior® speaking test, a relatively new speaking assessment developed by Educational Testing Service. We utilized Messick’s integrative view of construct validity (1996) and Kane’s interpretation argument framework (Kane, 2013), and focused on two sources of validity evidence: internal structure and external relations to other variables (AERA, APA, and NCME, 2014). We used a cross-sectional design with 252 seventh-to-ninth graders in Taiwan, which aligns with the spectrum of the TOEFL Junior®’s target age group. All adolescent participants took the TOEFL Junior® speaking test and two researcher-developed speaking tests. They also completed a survey reporting their history of English learning experiences from kindergarten to present and evaluating their own English language skills. Adolescent participants’ teachers provided evaluations of participants’ English language skills. Results from correlational tests and confirmatory factor analysis showed robust evidence for the test’s internal structure. Correlation and multiple regression models also demonstrated strong positive relationships between TOEFL Junior® test scores and external variables, providing evidence for TOEFL Junior®’s construct validity.

Cardiovascular disease (CVD) remains the leading cause of death for both women and men worldwide. In the United States (U.S.), there are significant disparities in cardiovascular risk factors and CVD outcomes among racial and ethnic minority populations, some of whom have the highest U.S. CVD incidence and mortality. Despite this, women and racial/ethnic minority populations remain underrepresented in cardiovascular clinical trials, relative to their disease burden and population percentage. The lack of diverse participants in trials is not only a moral and ethical issue, but a scientific concern, as it can limit application of future therapies. Providing comprehensive demographic data by sex and race/ethnicity and increasing representation of diverse participants into clinical trials are essential in assessing accurate drug response, safety and efficacy information. Additionally, diversifying investigators and clinical trial staff may assist with connecting to the language, customs, and beliefs of study populations and increase recruitment of participants from diverse backgrounds. In this review, a working group for the American Society for Preventive Cardiology (ASPC) reviewed the literature regarding the inclusion of women and individuals of diverse backgrounds into cardiovascular clinical trials, focusing on prevention, and provided recommendations of best practices for improving enrollment to be more representative of the U.S. society into trials.

This article addresses the importance of supporting specific language practices of emergent bilingual students in classroom settings that are tied to the development of disciplinary knowled...

This study points to ways in which the amount and complexity of teacher talk in two preschool classrooms during transitions between activities differed from instructional activity settings throughout the day. What emerged were language characteristics that suggest not all transitions are created equal. In fact, as shown by qualitative excerpts of teacher–student interactions, some transitions are quite substantive and provide opportunities for rich extended conversations. The findings of this study suggest that, despite the popular perception of transitions as lost instructional time, the informal setting of transitions can be used to reinforce concepts taught in more formal instructional settings such as circle time, as well as opportunities to introduce new concepts and vocabulary following children’s lead. Interviews with the teachers of these two classrooms, while revealing their acknowledgment of some challenges (e.g. children’s engagement), mostly emphasized the intentional and potentially instructional nature of transitions.

Backgrounds: Perceptions of health are important to motivate people to change behaviors. Non-adherence to healthy behaviors that prevent cardiovascular disease may result from inadequate health perceptions. However, there are few studies investigating relationships between health perceptions and psychological states. Objective: To determine whether psychological states (ie, depressive symptoms and anxiety) are associated with the congruency between health perception and estimated risk for cardiovascular disease in adults with 2 or more cardiovascular disease risk factors. Methods: Community dwellers at risk for cardiovascular disease were asked to complete the Patient Health Questionnaire-9 and the anxiety subscale of the Brief Symptom Inventory to measure depressive symptoms and anxiety, respectively. Participants rated their perceived health from excellent to poor. The estimated cardiovascular disease risks were measured with the 10-year cardiovascular disease Framingham risk scores. Participants were grouped into three health perception groups based on congruency between levels of health perception and cardiovascular disease risk. Multivariate multinomial logistic regression was done to examine the association between psychological states and health perception groups. Results: Of 828 participants 54.7%, 12.0%, and 33.3% had congruent, pessimistically biased, and optimistically biased health perception, respectively. Depressive symptoms were significantly associated with pessimistic bias (adjusted odds ratio: 1.070, 95% confidence interval 1.010-1.133), but not anxiety. Optimistic bias was not associated with either depressive symptoms or anxiety. Conclusions: A mismatch between individual health perceptions and cardiovascular disease risks was associated with depressive symptoms. As health perception is affected by depressive symptoms, clinicians should assess depressive symptoms when exploring health perceptions and engaging individuals in decision-making about a healthy lifestyle.

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIH/National Institute of Nursing Research, 1RC2NR011948 Introduction Approximately 10% of the 2.2 million prisoners in the US have a diagnosis of cardiovascular disease (CVD) and in 2016, 28% of all deaths in custody were attributable to CVD. Black race, inadequate health literacy, and poor perceived control are predictors of increased cardiovascular disease (CVD) risk, which are prevalent in prisoners. However, little is known about the relationships among race, health literacy, and perceived control in CVD risk for male prisoners. Objective The purpose of this study was to explore the relationships among race, health literacy, perceived control, and CVD risk while controlling for well-known risk factors (education, partner status, and body mass index) in male prisoners. Methods We used baseline data from 349 male prisoners in a biobehavioral CVD risk reduction intervention. Health literacy was measured using the Newest Vital Sign and perceived control by the Control Attitudes Scale- Revised. CVD risk was quantified with the Framingham Risk Score (FRS). Three indirect effects of race on CVD risk were examined using serial mediation model with two sequential mediators (i.e., health literacy and perceived control) and 95% confidence intervals from 5000 bootstrap samples. Results Of the participants (mean age = 36 + 10 years), 64.2% were white and 35.8% were black. Mean education level was 12 years and most (85.8%) were not married or partnered. Mean BMI was 28.3 + 5.0. Mean FRS was 6.63 + 4.90, indicating risk percentages of 2.3 to 13.3% over the next ten years. Black prisoners were younger (35 + 9 versus 37 + 10, p = .047) and had lower levels of health literacy (3.84 + 1.90 versus 4.69 + 1.63, p < .001) than white prisoners. No statistically significant differences in perceived control, education, partner status, or body mass index were noted between races. All three indirect effects of race on CVD were significant while the direct effect of race was not. Compared to white prisoners, black prisoners had higher levels of CVD risk through health literacy (a1b1 = .3571, 95% CI [.0948, .7162]) and lower levels of CVD risk through perceived control (a2b2 = -.1855, 95% CI [-.4388, -.0077]). Black prisoners had higher levels of CVD risk through health literacy influenced by perceived control (a1b2d21 = .0627, 95% CI [.0028, .1409]) indicating that despite the protective effect of higher levels of perceived control in black prisoners, CVD risk remained higher compared to their white counterparts. Conclusion Future CVD risk reduction interventions in prisoners of all races, but specifically black male prisoners, should include goals of improving health literacy and perceived control in addition to the traditional modifiable risk factors often included in biobehavioral interventions.

Hepatitis C virus (HCV) and atherosclerotic cardiovascular disease (ASCVD) are two diseases that affect millions around the globe. Hepatitis C affects more than 70 million individuals globally. ASCVD is commonly encountered and remains the top cause of death worldwide. A link has been identified between HCV and atherosclerosis. A review of recent studies which define the association between HCV infection and an increased risk of subclinical ASCVD and experiencing cardiovascular (CV) events. It is now recognized that there is an increased burden of atherosclerosis in individuals infected with HCV that translates into increased cardiovascular events. An increase in the number of diagnosed cases of HCV is expected as screening recommendations for the virus have expanded. Strategies to educate healthcare professionals about this increased CV risk will need to be considered as well as the optimal strategy to lower CV risk in this growing population.

Given rapid advancements in medical science, it is often challenging for the busy clinician to remain up-to-date on the fundamental and multifaceted aspects of preventive cardiology and maintain awareness of the latest guidelines applicable to cardiovascular disease (CVD) risk factors. The “American Society for Preventive Cardiology (ASPC) Top Ten CVD Risk Factors 2021 Update” is a summary document (updated yearly) regarding CVD risk factors. This “ASPC Top Ten CVD Risk Factors 2021 Update” summary document reflects the perspective of the section authors regarding ten things to know about ten sentinel CVD risk factors. It also includes quick access to sentinel references (applicable guidelines and select reviews) for each CVD risk factor section. The ten CVD risk factors include unhealthful nutrition, physical inactivity, dyslipidemia, hyperglycemia, high blood pressure, obesity, considerations of select populations (older age, race/ethnicity, and sex differences), thrombosis/smoking, kidney dysfunction and genetics/familial hypercholesterolemia. For the individual patient, other CVD risk factors may be relevant, beyond the CVD risk factors discussed here. However, it is the intent of the “ASPC Top Ten CVD Risk Factors 2021 Update” to provide a succinct overview of things to know about ten common CVD risk factors applicable to preventive cardiology.

Background Acute myocardial infarction in pregnancy is occasionally due to spontaneous coronary artery dissection (SCAD). Although uncommon, the majority of cases of pregnancy-associated SCAD (pSCAD) has critical presentations with more profound defects that portend high maternal and foetal mortality, and frequently necessitate preterm delivery. This is a case of pSCAD with ongoing ischaemia that required temporary mechanical circulatory support (MCS) and emergent revascularization, while the pregnancy was successfully continued to early-term. Case summary A 30-year-old woman G2P1 at Week 32 of gestation with no medical history, presented to the emergency department with severe chest pain. An electrocardiogram showed ST-segment elevation in the anterolateral leads. An emergent cardiac catheterization revealed dissection of the proximal left anterior descending (LAD) artery with TIMI (thrombolysis in myocardial infarction) 3 flow. Although initially stable, she later experienced recurrent chest pain and developed cardiogenic shock, necessitating MCS, and emergent revascularization. She was stabilized and remained closely monitored in the hospital prior to vaginal delivery at early-term. Discussion This case of pSCAD at Week 32 of gestation complicated by refractory ischaemia illustrates the complexity of management, which requires a multi-disciplinary team to reduce both maternal and foetal mortality. Conservative management of SCAD, while preferred, is not always possible in the setting of ongoing ischaemia, particularly if complicated by cardiogenic shock. A thorough weighing of risks vs. benefits and ongoing discussions among multiple subspecialists in this case allowed for the stabilization of the patient and subsequent successful early-term delivery.

Students’ self-assessment of language features in their oral explanations of a mathematics task was supported by language learning progressions. Learning progressions map a continuum of knowledge or skills development as they increase in sophistication over time. Learning progressions can be a framework to support formative assessment by both teachers and students. Fifty-eight predominantly English-speaking US elementary students used language learning progressions to complete their self-assessment of either discourse stamina or vocabulary usage in the elicited oral explanations. Students were guided through a four-step, highly scaffolded self-assessment protocol that was analyzed for (1) concordance with researcher placements of their explanations on the progressions, and (2) student commentary on their own placements. Overall, 50% of the students self-assessed in accordance with researchers’ independent placement of their explanations on the progressions. However, significant grade-level and gender differences in concordance were found. Results were consistent with prior research findings that upper-elementary students’ self-assessments are more aligned with external measures than are younger students’ self-assessments (e.g., Butler & Lee, 2006). However, even the youngest students in the current study were able to complete the self-assessment activity, if not always with the same degree of concordance. Successful participation may be attributable to the format, scaffolding, and contextualization of the self-assessment activity with its use of language learning progressions. Also consistent with prior research, girls were more likely to agree with researchers’ placements than boys. Student self-assessment differed by the two language features. Most students found the self-assessment activity to be a useful learning experience. Implications for research and practice are discussed.

Young children’s oral narration typically progresses from telling disordered events to production of well-sequenced stories. To investigate how this development is supported and whether effects of ...

Few studies have detailed the emergence and growth of the oral language and discourse characteristics of school-age students at different grades and across time (Bailey, 2010; Hoff, 2013). Yet general education teachers and English language specialists need well-articulated, preferably empirically derived progressions of language learning to support their students’ oral language development, particularly with those students who are acquiring English as a new or second language. Explanation skills, which encompass the development of many different language and discourse features, were the focus of this study. The language learners whose elicited oral explanations were used to characterize the order of emergence of features were in kindergarten and third grade (5–6 and 8–9 years old). These students were acquiring English in school with predominantly Spanish as their first language. Development of explanations by a cohort of English monolingual or proficient students provides grade-specific comparison language trajectories. The results are placed within the context of a formative assessment framework in order to assist teachers and students in placing explanations at different phases of sophistication on the progressions. This facilitates charting development and identifying with greater specificity which language and discourse features might be effective targets of contingent instruction to promote students’ oral explanation abilities.

Patient: Female, 62 Final Diagnosis: Persistent vein of Marshall Symptoms: Chest discomfort Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Congenital defects/diseases Background: The persistence of a vein of Marshall (VoM) from the left subclavian vein to the coronary sinus is a rare cardiac anomaly known as a persistent left superior vena cava (PLVC). This anatomical variant is usually asymptomatic but can lead to serious complications during catheterization via the left subclavian or internal jugular vein, as described here. In our case, the patent vein of Marshall directly connected the coronary sinus with the left subclavian vein discovered in a cardiac arrest patient because of pericardial effusion during the insertion of a central venous catheter (CVC). Case Report: A 62-year-old patient required a central line insertion through a left internal jugular vein. The patient immediately went into cardiac arrest after CVC insertion with a pericardial effusion. The patient was successfully resuscitated with the drainage of a pericardial effusion. A chest X-ray revealed that the central venous catheter (CVC) was located along the left border of the mediastinum rather than the right border. It was evident that the central venous catheter was inadvertently placed into the pericardial space, resulting in tamponade. This complication occurred through inadvertent access of a small persistent vein of Marshall. Conclusions: This case illustrates the importance of knowledge of anatomical variants of the persistent vein of Marshall to prevent or correctly interpret and manage procedural complications.

Glenn N. Levine, MD, FACC, FAHA, Chair Patrick T. O’Gara, MD, MACC, FAHA, Chair-Elect Jonathan L. Halperin, MD, FACC, FAHA, Immediate Past Chair [‡‡‡][1] Sana M. Al-Khatib, MD, MHS, FACC, FAHA Joshua A. Beckman, MD, MS, FAHA Kim K. Birtcher, PharmD, MS, AACC Biykem Bozkurt, MD, PhD

Background/Context Children from Asian ethnic backgrounds currently constitute the second largest group of child immigrants in the United States. Although stereotyped as model minority students due to their academic and economic success, studies have revealed that many Asian immigrant students struggle in school. Research has also shown that, compared to child immigrants from an Indo-European language background such as Spanish and French, Asian child immigrants experience more challenges in learning English as a second language (L2) due to greater cross-linguistic differences. However, little is known about the long-term English language outcomes of first-generation Asian child immigrants. Purpose/Objective The present study examines the effects of learner-level and input-level factors on first-generation Asian child immigrants’ long-term English outcomes. Research Design Data for the current study are selected from a larger correlational and cross-sectional study that examined the effect of the age of arrival variable on Chinese immigrants’ English L2 outcomes. We used two criteria to select participants from the larger study: (1) those who had arrived in the United States between the ages of 5 to 18 (to qualify as a “child immigrant”), and (2) those who had resided in the United States for at least 10 years (to examine long-term outcomes). These criteria resulted in the current sample of 69 participants. The English language proficiency data include participants’ phonological production ratings, performances on a grammaticality judgment task, and their self-ratings of English proficiency in listening, speaking, reading, and writing. Conclusions/Recommendations The current study showed a complex interplay of factors affecting former child immigrants’ English L2 acquisition. Although age of arrival played a critical role in their L2 learning outcomes, it exerted varying degrees of influence by L2 domain. Age of arrival was a strong predictor of L2 phonological production, grammar knowledge, and oral language proficiency, but not literacy skills. L2 input, language learning aptitude, and child immigrants’ affective status also contributed to their L2 outcomes, and carried more weight than age of arrival. We interpreted the results to be in line with the multiple sensitive period hypothesis in developmental psycholinguistics research. The results also suggested that literacy is not susceptible to age-related effects in the same way in which oral language and more specifically the phonological and syntactic systems are. Literacy as a cultural construct rather than a biologically unique human system is intensively taught throughout the school years and curriculum. Malleable factors, such as instruction and reading strategies, are thus perhaps more important in determining child immigrants’ long-term literacy outcomes.

A growing body of evidence indicates that cardiorespiratory fitness attenuates some age-related cerebral declines. However, little is known about the role that myocardial function plays in this relationship. Brain regions with high resting metabolic rates, such as the default mode network (DMN), may be especially vulnerable to age-related declines in myocardial functions affecting cerebral blood flow (CBF). This study explored the relationship between a measure of myocardial mechanics, global longitudinal strain (GLS), and CBF to the DMN. In addition, we explored how cardiorespiratory affects this relationship. Participants were 30 older adults between the ages of 59 and 69 (mean age = 63.73 years, SD = 2.8). Results indicated that superior cardiorespiratory fitness and myocardial mechanics were positively associated with DMN CBF. Moreover, results of a mediation analysis revealed that the relationship between GLS and DMN CBF was accounted for by individual differences in fitness. Findings suggest that benefits of healthy heart function to brain function are modified by fitness.

© The Author(s) 2017. We hypothesized that risk factors for cardiovascular disease (CVD) would be associated with worse health perceptions in prison inmates. This study included 362 inmates recruited from four medium security prisons in Kentucky. Framingham Risk Score was used to estimate the risk of developing CVD within the next 10 years. A single item on self-rated health from the Medical Outcomes Survey–Short Form 36 was used to measure health perception. Multinomial logistic regression showed that for every 1-unit increase in Framingham Risk Score, inmates were 23% more likely to have rated their health as fair/poor and 11% more likely to rate their health as good rather than very good/excellent. These findings demonstrate that worse health perceptions may serve as a starting point for discussing cardiovascular risk factors and prevention with inmates.

Backgrounds: Perceptions of health are important to motivate people to change behaviors. Non-adherence to healthy behaviors that prevent cardiovascular disease may result from inadequate health perceptions. However, there are few studies investigating relationships between health perceptions and psychological states. Objective: To determine whether psychological states (ie, depressive symptoms and anxiety) are associated with the congruency between health perception and estimated risk for cardiovascular disease in adults with 2 or more cardiovascular disease risk factors. Methods: Community dwellers at risk for cardiovascular disease were asked to complete the Patient Health Questionnaire-9 and the anxiety subscale of the Brief Symptom Inventory to measure depressive symptoms and anxiety, respectively. Participants rated their perceived health from excellent to poor. The estimated cardiovascular disease risks were measured with the 10-year cardiovascular disease Framingham risk scores. Participants were grouped into three health perception groups based on congruency between levels of health perception and cardiovascular disease risk. Multivariate multinomial logistic regression was done to examine the association between psychological states and health perception groups. Results: Of 828 participants 54.7%, 12.0%, and 33.3% had congruent, pessimistically biased, and optimistically biased health perception, respectively. Depressive symptoms were significantly associated with pessimistic bias (adjusted odds ratio: 1.070, 95% confidence interval 1.010–1.133), but not anxiety. Optimistic bias was not associated with either depressive symptoms or anxiety. Conclusions: A mismatch between individual health perceptions and cardiovascular disease risks was associated with depressive symptoms. As health perception is affected by depressive symptoms, clinicians should assess depressive symptoms when exploring health perceptions and engaging individuals in decision-making about a healthy lifestyle.

Purpose Learning mathematics is a complex process, requiring many conceptual lenses and rich data sources to document and understand students’ construction of knowledge. The purpose of this article is both to introduce a unique database on students’ mathematical learning and to describe analytical techniques used to study students’ growth of the knowledge of mathematics and language. Design/Approach/Methods Our approach includes the following aspects: First, we describe a unique collection of video-taped recordings of longitudinal and cross-sectional studies of diverse, U.S. students, learning mathematics (Video Mosaic Collaborative, VMC). Second, we introduce our analytical methods, which utilize the database for collaborative study of students’ learning. These methods include video-narrative analyses that display fine-grained examinations of interactions among students who are solving engaging problems that require them to reason mathematically and to represent their understandings with language and non-language forms. These analyses, referenced as VMCAnalytics, demonstrate the accessibility and flexibility of the database to study relationships among students’ mathematics and language learning. Findings The findings generated are illustrated by two examples demonstrating the accessibility and flexibility of the database to study relationships between mathematics and language learning (mathematics register). Originality/Value The contribution of our work is illustrated by describing the rich database; employing a collaborative research approach; and signifying our understanding of relationships among students’ mathematical and language learning.