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In the United Kingdom, undergraduate students from Black, Asian and other minority ethnic backgrounds receive lower classes of degrees than white students, and similar gaps have been reported in other countries. Such award gaps limit ethnic diversity in academic research, and in the broader job market. Whilst there has been some success in reducing the award gap in the UK, a significant gap still persists. Here, based on an analysis of students studying cell biology at University College London, I show that differences in performance at exams contribute significantly more to the award gap than differences in performance in coursework. From these data, plus scrutiny of the literature, alternative policies are identified to speed up the closure of the award gap and to remove the barriers that prevent students from Black, Asian and other minority ethnic backgrounds from progressing to PhD and postdoctoral positions., Competing Interests: LC No competing interests declared, (© 2021, Cramer.)

Background: African Americans are significantly more likely than non-African Americans to have diabetes, chronic kidney disease, and uncontrolled hypertension, increasing their risk for kidney function decline., Objective: The objective of this study was to compare how African Americans and non-African Americans with diabetes responded to a multifactorial telehealth intervention designed to slow kidney function decline., Research Design: Secondary analysis of a randomized trial. Primary care patients (N=281, 56% African American) were allocated to either: (1) a multifactorial, pharmacist-delivered phone-based telehealth intervention focused on behavioral and medication management of diabetic kidney disease; or (2) an education control., Measures: The primary study outcome was change in estimated glomerular filtration rate (eGFR). Linear mixed models were used to explore the moderating effect of race on the relationship between study arm and eGFR decline over time; the mean annual rate of eGFR decline was estimated by race and study arm., Results: Findings demonstrated a differential intervention effect on kidney function over time by race (Pinteraction=0.005). Among African Americans, the intervention arm had significantly greater preservation of eGFR over time than the control arm (difference in the annual rate of eGFR decline=1.5 mL/min/1.73 m; 95% confidence interval: 0.04, 3.02). For non-African Americans, the intervention arm had a faster decline in eGFR over time than the control arm (difference in the annual rate of eGFR decline=-1.7 mL/min/1.73 m; 95% confidence interval: -3.3, -0.02)., Conclusion: A multifactorial, pharmacist-delivered telehealth intervention for diabetic kidney disease may be more effective for slowing eGFR decline among African Americans than non-African Americans.

Objectives: We estimate life expectancy with and without dementia for Americans 65 years and older by education and race to examine how these stratification systems combine to shape disparities in later-life cognitive health., Method: Based on the Health and Retirement Study (2000-2014), we use a multivariate, incidence-based life table approach to estimate life expectancy by cognitive health status for race-education groups. The models also simulate group differences in the prevalence of dementia implied by these rates., Results: The life table results document notable race-education differences in dementia and dementia-free life expectancy, as well as stark differences in implied dementia prevalence. At each education level, blacks can expect to live more years with dementia and they have significantly higher rates of dementia prevalence. This distribution of disparities in the older population is anchored by 2 groups-blacks without a high school diploma and whites with some college or more., Discussion: Dementia experience and dementia burden differ dramatically along race-education lines. Race and education combine to exaggerate disparities and they both have enduring effects. Future research should explicitly consider how race and education combine to influence dementia in the older American population., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Compared to non-Hispanic white individuals, assistive technology (AT) utilization is lower among Hispanic individuals. 1-7 In the US, Spanish is the 2nd most frequently spoken language. Greater than one-fifth of Spanish-speaking households are limited English proficiencty (LEP) households (i.e., all individuals over age 14 in the household speak English less than "very well"). 8 Availability of AT materials in Spanish is one factor influencing knowledge about and utilization of AT among Spanish-speakers., Objective: To examine the availability of Spanish-language AT information on state AT program websites and to assess the relationship between availability and state demographic and linguistic characteristics., Methods: In 2018, we evaluated 56 state and territory AT program websites for the availability of AT information in Spanish. We calculated 4 measures (US Hispanic population in the state/territory; Hispanic individuals as a proportion of state population; overall Spanish-speaking households, and Spanish-speaking, limited English proficient households) from the 2016 American Community Survey and created ranked lists for each measure. Point biserial (r pb ) correlations were calculated to test associations between each measure and availability of AT information in Spanish on each program's website., Results: Sixteen program websites (15 states, 1 territory) provided access to Spanish-language AT information. None of the 4 measures were strongly associated with this outcome (r pb ranged from 0.30 to 0.42). For any of the 4 measures, no more than half of states in the top 10 ranks offered online access to AT information in Spanish., Conclusions: Improving the online availability of AT information in Spanish is necessary to increase equity in AT utilization among Spanish-speaking people with disabilities., Competing Interests: Declaration of competing interest The authors have no conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: African Americans (AA) and socioeconomic status (SES) disadvantaged older breast cancer survivors (BCS) are more likely to experience poor functional and health outcomes. However, few studies have evaluated the putative beneficial effects of exercise on these outcomes in older racial minority and SES-disadvantaged BCS., Methods: This is a mixed-methods study that includes a randomized-controlled trial, "IMPROVE", to evaluate a group-based exercise intervention compared to a support group program in older BCS, followed by post-intervention semi-structured interviews to evaluate the intervention. The trial aims to recruit 220 BCS with 55 in each of four strata defined by race (AA versus Non-Hispanic Whites) and SES (disadvantaged vs. non-disadvantaged). Participants are ≥65 years old and within five years of treatment completion for stage I-III breast cancer. Participants are randomized to a 52-week, three sessions/week, one-hour/session, moderate intensity aerobic and resistance group exercise intervention, (n = 110) or a 52-week, one hour/week, support group intervention [attention-control arm], (n = 110). The first 20 weeks of both programs are supervised and the last 32 weeks, unsupervised. The primary outcome is the change in Short Physical Performance Battery (SPPB) Scores at 20 weeks from baseline, between the two arms. Secondary outcomes include change in SPPB scores at 52 weeks, change in body composition and biomarkers, at 20 and 52 weeks from baseline, between arms., Discussion: Results of the trial may contribute to a better understanding of factors associated with recruitment, and acceptability, and will inform future exercise programs to optimally improve health outcomes for older BCS., (Copyright © 2020 Elsevier Inc. All rights reserved.)

To examine whether (a) non-minority participants differed from racial minority participants in the understanding of biospecimens collected for research purposes, (b) patients differed from comparison group in their understanding of the ways their biospecimens could be used by researchers, and (c) participants received adequate information before consenting to donate blood for research studies. We analyzed cross-sectional data from female breast cancer patients scheduled to receive chemotherapy at the National Cancer Institute (NCI) Community Oncology Research Program (NCORP) clinical sites and a healthy comparison group. After reading a consent form related to biospecimens and consenting to participate in a clinical trial, participants' understanding of biospecimen collection was evaluated. Linear models were used to compare scores between non-minority and racial minority participants as well as cancer and non-cancer comparisons adjusting for possible confounding factors. A total of 650 participants provided evaluable data; 592 were non-minority (Caucasian) and 58 participants were a racial minority (71% Black and 29% other). There were 427 cancer patients and 223 comparisons. Non-minority participants scored higher than racial minorities on relevance-to-care items (diff. = 0.48, CI 0.13-0.80, p = 0.001). Comparison group scored higher than cancer patients on relevance-to-care items (diff. = 0.58, CI 0.37-0.78). A moderate number of the participants exhibited a poor understanding of biospecimen collection across all racial/ethnic backgrounds, but racial minority participants' scores remained lower in the relevance-to-care subscale even after adjusting for education and reading level. Differences were also noted among the patients and comparison group. Researchers should facilitate comprehension of biospecimen collection for all study participants, especially racial minority participants.

Genetic ancestry testing is a billion-dollar industry, with more than 26 million tests sold by 2018, which raises concerns over how it might influence test-takers' understandings of race. While social scientists argue that genetic ancestry tests may promote an essentialist view of race as fixed and determining innate abilities, others suggest it could reduce essentialist views by reinforcing a view of race as socially constructed. Essentialist views are a concern because of their association with racism, particularly in its most extreme forms. Here we report the first randomized controlled trial of genetic ancestry testing conducted to examine potential causal relationships between taking the tests and essentialist views of race. Native-born White Americans were randomly assigned to receive Admixture and mtDNA tests or no tests. While we find no significant average effect of genetic ancestry testing on essentialism, secondary analyses reveal that the impact of these tests on racial essentialism varies by type of genetic knowledge. Within the treatment arm, essentialist beliefs significantly declined after testing among individuals with high genetic knowledge, but increased among those with the least genetic knowledge. Additional secondary analysis show that essentialist beliefs do not change based on the specific ancestries reported in test-takers' results. These results indicate that individuals' interpretations of genetic ancestry testing results, and the links between genes and race, may depend on their understanding of genetics., Competing Interests: The authors have declared that no competing interests exist.

Background: Parental educational attainment is shown to be protective against health problems; the Minorities' Diminished Returns theory, however, posits that these protective effects tend to be smaller for socially marginalized groups particularly blacks than whites., Aims: To explore racial differences in the effect of parental educational attainment on body mass index (BMI) in a national sample of US adolescents., Methods: In this cross-sectional study, we used baseline data of 10,701 (8678 white and 2023 black) 12-17 years old adolescents in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the predictor. Youth BMI (based on self-reported weight and height) was the dependent variable. Age, gender, ethnicity, and family structure were covariates. Race was the focal moderator., Results: Overall, higher parental educational attainment was associated with lower youth BMI. Race, however, moderated the effect of parental educational attainment on BMI, suggesting that the protective effect of parental educational attainment on BMI is significantly smaller for black than white youth., Conclusions: In the United States, race alters the health gains that are expected to follow parental educational attainment. While white youth who are from highly educated families are fit, black youth have high BMI at all levels of parental educational attainment. This means, while the most socially privileged group, whites, gain the most health from their parental education, blacks, the least privileged group, gain the least. Economic, social, public, and health policymakers should be aware that health disparities are not all due to lower socioeconomic status (SES) of the disadvantaged group but also diminished returns of SES resources for them. Black-white health disparities exist across all high socioeconomic status (SES) levels.

Background: Gay, bisexual, and other men who have sex with men (GBM) have the highest proportion of incident HIV infection. Pre-exposure prophylaxis (PrEP) use and screening for sexually transmitted infections (STIs) are primary HIV prevention strategies, however, uptake remains low. Social capital, collective resources generated through social connections, are associated with lower HIV risk and infection. We investigated social capital in association with PrEP indicators among GBM., Methods: Analyses included (N = 376) GBM from the 2014 National HIV Behavioral Surveillance (NHBS) in New Orleans. Multiple regression methods assessed the association between one item within each of eight domains from the Onyx and Bullen Social Capital Scale and: awareness and willingness to use PrEP. Analyses are adjusted for age, race, education, sexual intercourse with women, and health insurance., Results: Forty percent of GBM were 18-29 years, 52 percent White. Sixty percent were willing to use PrEP. Social capital was above 50 percent across 7 of 8 indicators. Community group participation (vs no participation) was associated with higher likelihoods of PrEP awareness (adjusted Prevalence Ratio [aPR] = 1.41, 95% Confidence Interval [CI] = 1.02, 1.95). None of the seven remaining social capital indicators were significantly associated with any of the PrEP outcomes., Conclusions: Community groups and organizations could be targeted for interventions to increase uptake of HIV prevention strategies among GBM in New Orleans., Competing Interests: The authors have declared that no competing interests exist.

Background: Children with nonsyndromic orofacial clefts (NS OFCs) may require exceptional children's (EC) services for academic delays. We examined EC service use of children with and without NS OFCs in NC in elementary school., Methods: We included 559 children with NS OFCs and 6,822 children without birth defects who had NC educational records. We estimated prevalence ratios, trends in enrollment, and characteristics of eligibility classification using descriptive statistics and logistic regression by cleft subtype and race/ethnicity. We estimated the odds of third grade retention by EC enrollment using logistic regression with inverse probability of treatment weights., Results: Children with NS OFCs were 3.02 (95% CI: 2.50, 3.64) times as likely to receive third grade special education (SE) services compared to unaffected peers. The prevalence odds was highest among children with CL+P (OR: 4.61, 95% CI: 3.49, 6.09) declining by 54% by fifth grade. The prevalence odds of SE for white children was approximately 1.50 times that for African American children in fourth and fifth grades. Approximately 33% of children with NS OFCs within each racial/ethnic group received SE in third grade. African American children were twice as likely to receive services under specific learning disability. Children with NS OFCs receiving EC services were 44% (OR: 0.56; 95% CI: 0.13, 2.38) less likely to be retained in third grade compared to children with NS OFCs who were not receiving services., Conclusions: Children with NS OFCs are more likely to receive SE services in elementary school compared to their unaffected peers. The eligibility category differed by racial/ethnic group., (© 2018 Wiley Periodicals, Inc.)

Background: Although higher socioeconomic status (SES) indicators such as educational attainment are linked with health behaviors, the Blacks’ Diminished Return theory posits that the protective effects of SES are systemically smaller for Blacks than Whites., Aims: To explore the Black/White differences in the association between education and smoking., Methods: This cross-sectional study used the Health Information National Trends Survey (HINTS) 2017 ( n = 3217). HINTS is a national survey of American adults. The current analysis included 2277 adults who were either Whites ( n = 1868; 82%) or Blacks ( n = 409; 18%). The independent variable was educational attainment, and the dependent variables were ever and current (past 30-day) smoking. Demographic factors (age and gender) were covariates. Race was the focal moderator., Results: In the pooled sample, higher educational attainment was associated with lower odds of ever and current smoking. Race interacted with the effects of higher educational attainment on current smoking, suggesting a stronger protective effect of higher education against current smoking for Whites than Blacks. Race did not interact with the effect of educational attainment on odds of ever smoking., Conclusions: In line with previous research in the United States, education is more strongly associated with health and health behaviors in Whites than Blacks. Smaller protective effects of education on health behaviors may be due to the existing racism across institutions such as the education system and labor market.

Purpose: Mental illness stigma disproportionately affects help seeking among youth, men, and ethnic minorities. As part of a comprehensive statewide initiative to reduce mental illness stigma and discrimination in California, a broad set of contact-based educational programs were widely disseminated. This study examined whether the effects of contact-based educational programs varied depending on the age, gender, and race-ethnicity of participants., Methods: Participants (N = 4122) attended a contact-based educational program that was delivered as part of the statewide initiative to reduce mental illness stigma and discrimination. Self-administered surveys assessing beliefs, attitudes, and intentions toward mental illnesses and treatment were conducted immediately before and after participation in contact-based educational programs., Results: Participant age, gender, and race-ethnicity significantly moderated pre-post changes in mental illness stigma. Although all groups exhibited significant pre-post changes across most of the stigma domains assessed, young adults, females, and Asian and Latino American participants reported larger improvements compared to older adults, males, and Whites, respectively., Conclusions: Findings suggest that contact-based educational programs can achieve immediate reductions in mental illness stigma across a variety of sociodemographic groups and may particularly benefit young adults and racial-ethnic minorities. Further research is needed to assess whether contact-based educational programs can sustain longer-term changes and aid in the reduction of disparities in mental illness stigma and treatment.

Social, emotional, and behavioral skills are foundational to learning and long-term success. However, poverty and exposure to adverse childhood experiences reduce the chances of children entering kindergarten socially-behaviorally ready to learn. This study examined the unique impact of 5-year-old children (N = 11,412) entering kindergarten not socially-behaviorally ready on three costly school outcomes by fourth grade in Baltimore City Public Schools: being retained in grade, receiving services and supports through an IEP or 504 plan, and being suspended/expelled. Controlling for all other types of school readiness, students not identified as socially-behaviorally ready for kindergarten were more likely to experience all three school outcomes. Findings underscore the importance of early prevention and intervention strategies targeting parents and social-behavioral readiness skills during the first 5 years of life.

The effects of responding to social pressure (external motivation) are short-lived. Multicultural training, however, seeks to promote change in students and trainees that will be transformative and long-lasting. To this end, understanding the motivational factors that inform training is key. The present study was an investigation of the factors underlying external motivation to respond without prejudice for White individuals from the perspective of Higgins's regulatory focus (promotion and prevention) and regulatory mode (assessment and locomotion) theories. The results indicate that locomotion was negatively associated with external motivation to respond without prejudice, while assessment and prevention were positively associated with external motivation. Taken together, findings highlight the importance of cultivating locomotion (action oriented) motivation and inhibiting prevention (loss oriented) and assessment (preoccupation with finding the correct answer) motivations in multicultural training. Implications for training, effective action for justice, and future research are discussed. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Nearly 50% of African-American adults are obese. Obesity is a known contributor to chronic diseases such as type 2 diabetes mellitus (type 2 DM). Short-term Diabetes Prevention Programs (DPPs) achieve short-term weight loss success, but weight regain is common. African-Americans, compared to Whites, are particularly challenged by weight maintenance. In collaboration with community health workers, translation scientists have delivered successful short-term DPPs in community settings, such as African-American churches. Evidence of the salient components of effective weight maintenance intervention is minimal, especially among African-Americans in churches, and there is no known research that specifically explores the insights of community health workers. We report findings from a qualitative study to identify the necessary components of a sustainable church-based weight maintenance program from the perspective of community health workers. Two main themes emerged: overemphasis of short-term goals and consistent support. These findings have relevancy for developing faith-based weight maintenance programs.

Background: Breast cancer is a leading cause of cancer death among Hispanic women in the U.S., and mammography is the recommended screening for early diagnosing and preventing breast cancer. Several barriers exist to influence mammography utilization including poor health literacy. However, it is unclear whether the effect of health literacy on mammography utilization is consistent between Hispanic women and non-Hispanic White women. The main objective of this study was to examine association between functional health literacy and the receipt of mammography among Hispanic women compared to non-Hispanic White women in the U.S., Methods: A cross-sectional design using participants engaged in the National Assessment of Adult Literacy. Study sample comprised of 4,249 Hispanic and non-Hispanic U.S.-born White women ≥ 40 years of age who completed the functional health literacy assessment. Regression analyses were performed to test the association between health literacy and receipt of mammography. Among Hispanic women, analyses considered the influence of language-preference acculturation., Results: Equal percentages of Hispanic (59.3%) and non-Hispanic White (60.6%) women received mammography. After adjusting for covariates, health literacy was positively associated with receiving mammography among U.S.-born White women (β = 0.14, p<0.001), but negatively associated with mammography among Hispanic women (β = -0.13, p<0.001). Analyses stratified by acculturation status revealed that higher health literacy was associated with lower mammography among language-preference acculturated Hispanic women (β = -0.48, p<0.001), yet an opposite result among less acculturated Hispanic women (β = 0.08, p<0.001)., Conclusion: Functional health literacy has different associations with mammography depending upon ethnicity. Language-preference acculturation may explain the differing association., Competing Interests: The authors have declared that no competing interests exist.

Purpose: Representation of persons from diverse backgrounds remains a persistent challenge for medicine and dentistry workforces. Past research has focused on quantifying factors such as markers of educational achievement to explain the difficulty of increasing diversity within the professions. There has been less effort toward understanding the perspectives of undergraduate students on the threshold of applying to medical/dental school about distinct barriers to pursuing a medical or dental career and continuing through the training pipeline., Method: In 2012 and 2013, the authors conducted a qualitative study of undergraduate students participating in the Tour for Diversity in Medicine, a program where minority physicians and dentists visit colleges with large fractions of minority students to encourage careers in the health professions. Focus groups were convened during the visits to examine perceived barriers to pursuing careers in medicine and dentistry and challenges identified through thematic content analysis., Results: Eighty-two students participated in discussions at 11 colleges visited between September 2012 and February 2013. Students described challenges including inadequate institutional resources (e.g., sparse clinical opportunities), strained personal resources (e.g., conflict arising from familial pressure), inadequate guidance and mentoring to assist with key career decisions, and societal barriers. For participants, these challenges caused them to question the viability of persisting in the pipeline to a medical or dental career., Conclusions: Solving the issue of diversity in medicine and dentistry is multifaceted, but elucidated challenges from the undergraduate student perspective offer targeted areas where intervention may help remedy barriers and decrease pipeline leakiness.

The educational gradient in life expectancy is well documented in the United States and in other low-mortality countries. Highly educated Americans, on average, live longer than their low-educated counterparts, who have recently seen declines in adult life expectancy. However, limiting the discussion on lifespan inequality to mean differences alone overlooks other dimensions of inequality and particularly disparities in lifespan variation. The latter represents a unique form of inequality, with higher variation translating into greater uncertainty in the time of death from an individual standpoint, and higher group heterogeneity from a population perspective. Using data from the National Vital Statistics System from 1990 to 2010, this is the first study to document trends in both life expectancy and S25--the standard deviation of age at death above 25--by educational attainment. Among low-educated whites, adult life expectancy declined by 3.1 years for women and by 0.6 years for men. At the same time, S25 increased by about 1.5 years among high school-educated whites of both genders, becoming an increasingly important component of total lifespan inequality. By contrast, college-educated whites benefited from rising life expectancy and record low variation in age at death, consistent with the shifting mortality scenario. Among blacks, adult life expectancy increased, and S25 plateaued or declined in nearly all educational attainment groups, although blacks generally lagged behind whites of the same gender on both measures. Documenting trends in lifespan variation can therefore improve our understanding of lifespan inequality and point to diverging trajectories in adult mortality across socioeconomic strata.

The aim of this study was to assess the measurement invariance of 2 commonly used measures of youth psychopathic characteristics across sex and racial/ethnic groups. Among a community sample of Hispanic and Black adolescents (N = 355; 50.5% female; mean age = 15.09) and their parents, this study tested the configural and metric invariance of the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Fitzpatrick, & Kiehl, 1995) and the parent-report version of the Inventory of Callous-Unemotional Traits (Frick, 2004). Preliminary analyses indicated that the adolescents in the present study reported similar rates of psychopathic characteristics as those reported by other studies of adolescents and young adults. Results of the multigroup invariance analyses indicated that these measures are invariant across sex and between Hispanic and Black youth. In addition, further analyses assessing associations between these measures and a number of behavioral and emotional characteristics indicated that scores on the LSRP Scale and Callous-Unemotional Traits demonstrate good convergent and discriminant validity with few differences by sex or race/ethnicity. To date, research on psychopathy has focused predominantly on samples of White males. Therefore, it is important that research examines the equivalence of measures of psychopathic characteristics across different populations, so that accurate assessments can be made to inform intervention and treatment efforts., ((c) 2015 APA, all rights reserved).)

Background: MRCGP and MRCP(UK) are the main entry qualifications for UK doctors entering general [family] practice or hospital [internal] medicine. The performance of MRCP(UK) candidates who subsequently take MRCGP allows validation of each assessment. In the UK, underperformance of ethnic minority doctors taking MRCGP has had a high political profile, with a Judicial Review in the High Court in April 2014 for alleged racial discrimination. Although the legal challenge was dismissed, substantial performance differences between white and BME (Black and Minority Ethnic) doctors undoubtedly exist. Understanding ethnic differences can be helped by comparing the performance of doctors who take both MRCGP and MRCP(UK)., Methods: We identified 2,284 candidates who had taken one or more parts of both assessments, MRCP(UK) typically being taken 3.7 years before MRCGP. We analyzed performance on knowledge-based MCQs (MRCP(UK) Parts 1 and 2 and MRCGP Applied Knowledge Test (AKT)) and clinical examinations (MRCGP Clinical Skills Assessment (CSA) and MRCP(UK) Practical Assessment of Clinical Skills (PACES))., Results: Correlations between MRCGP and MRCP(UK) were high, disattenuated correlations for MRCGP AKT with MRCP(UK) Parts 1 and 2 being 0.748 and 0.698, and for CSA and PACES being 0.636. BME candidates performed less well on all five assessments (P < .001). Correlations disaggregated by ethnicity were complex, MRCGP AKT showing similar correlations with Part1/Part2/PACES in White and BME candidates, but CSA showing stronger correlations with Part1/Part2/PACES in BME candidates than in White candidates. CSA changed its scoring method during the study; multiple regression showed the newer CSA was better predicted by PACES than the previous CSA., Conclusions: High correlations between MRCGP and MRCP(UK) support the validity of each, suggesting they assess knowledge cognate to both assessments. Detailed analyses by candidate ethnicity show that although White candidates out-perform BME candidates, the differences are largely mirrored across the two examinations. Whilst the reason for the differential performance is unclear, the similarity of the effects in independent knowledge and clinical examinations suggests the differences are unlikely to result from specific features of either assessment and most likely represent true differences in ability.

Importance: Given minority patients' unequal access to quality care, patient activation and self-management strategies have been suggested as a promising approach to improving mental health care., Objective: To determine whether the DECIDE (Decide the problem; Explore the questions; Closed or open-ended questions; Identify the who, why, or how of the problem; Direct questions to your health care professional; Enjoy a shared solution) intervention, an educational strategy that teaches patients to ask questions and make collaborative decisions with their health care professional, improves patient activation and self-management, as well as engagement and retention in behavioral health care., Design, Setting, and Patients: In this multisite randomized clinical trial performed from February 1, 2009, through October 9, 2011 (date of last follow-up interview), we recruited 647 English- or Spanish-speaking patients 18 to 70 years old from 13 outpatient community mental health clinics across 5 states and 1 US territory. A total of 722 patients were included in analyses of secondary outcomes., Interventions: Three DECIDE training sessions delivered by a care manager vs giving patients a brochure on management of behavioral health., Main Outcomes and Measures: Primary outcomes were patient assessment of activation (Patient Activation Scale) and self-management (Perceived Efficacy in Patient-Physician Interactions). Secondary outcomes included patient engagement (proportion of visits attended of those scheduled) and retention (attending at least 4 visits in the 6 months after the baseline research assessment), collected through medical record review or electronic records., Results: Patients assigned to DECIDE reported significant increases in activation (mean β = 1.74, SD = 0.58; P = .003) and self-management (mean β = 2.42, SD = 0.90; P = .008) relative to control patients, but there was no evidence of an effect on engagement or retention in care., Conclusions and Relevance: The DECIDE intervention appears to help patients learn to effectively ask questions and participate in decisions about their behavioral health care, but a health care professional component might be needed to augment engagement in care. DECIDE appears to have promise as a strategy for changing the role of minority patients in behavioral health care., Trial Registration: clinicaltrials.gov Identifier: NCT01226329

Definitions of caring include the global concept of showing concern and empathy of others. This may be especially true in the online classroom in the absence of face to face interactions. This quantitative study focused on RN-BSN completion students' preferred online instructor caring behaviors. Online RN-BSN students (N = 100) were invited to participate in the study. The research question was: What are historically black colleges universities nursing students' preferred instructor caring behaviors in the online classroom? All of the respondents (N = 48) agreed that an instructor can create a caring online learning environment, while the vast majority agreed that the presence of a caring environment influenced their success in the course. As ranked by the respondents the three most important items in creating a caring online learning environment were instructors': 1) attention to detail in organization and clarity, 2) prompt and detailed feedback to assignments, and 3) prompt response to students' questions.

The current study tests a model of academic satisfaction in engineering based on Lent, Brown, and Hackett's (1994, 2000) social cognitive career theory among a sample of 527 engineering majors attending a Hispanic serving institution. The findings indicated that (a) an alternative bidirectional model fit the data for the full sample; (b) all of the hypothesized relations were significant for the full sample, except the path from engineering interests to goals; (c) social cognitive career theory predictors accounted for a significant amount of variance in engineering goals (26.6%) and academic satisfaction (45.1%); and (d) the model parameters did not vary across men and women or across Latino/a and White engineering undergraduate students. Implications for research and practice are discussed in relation to persistence in engineering among women and Latinos/as., ((c) 2014 APA, all rights reserved.)

This study explored the extent to which transportation difficulties were associated with social, psychological, and academic experiences of urban, at-risk students who recently experienced a school transition. Participants included 165 predominantly African American and Latino/a high school youth with and without disabilities, a critical population for community psychology to address given their likelihood of multiple marginalizations. Results suggested transportation problems within school predicted more school stressors and aggressive behavior. Transportation problems to and from school predicted fewer school resources, less school belonging, and more school stressors, anxiety, and depression. Greater time to get to school predicted fewer school resources, less school belonging, and more depressive symptoms. This study demonstrates the importance of including transportation in how the school day is conceptualized, and offers several implications for how transportation services can be best addressed.

School experiences can have positive effects on student academic achievement, yet less is known about intermediary processes that contribute to these positive effects. We examined pathways between school experiences and academic achievement among 117 low-income urban students of color, many with disabilities, who transitioned to other schools following a school closure. Using structural equation modeling, we tested two ecological models that examined the relationships among self-reported school experiences, school support, academic self-efficacy, and school-reported academic achievement. The model in which the relationship between school experiences and academic achievement is mediated by both school support and academic self-efficacy, and that takes previous academic achievement into account, was an excellent fit with the data. The roles of contextual and individual factors as they relate to academic achievement, and the implications of these findings, are discussed.

Objective: To determine the difference in failure rates in the postgraduate examination of the Royal College of General Practitioners (MRCGP) by ethnic or national background, and to identify factors associated with pass rates in the clinical skills assessment component of the examination., Design: Analysis of data provided by the Royal College of General Practitioners and the General Medical Council., Participants: Cohort of 5095 candidates sitting the applied knowledge test and clinical skills assessment components of the MRCGP examination between November 2010 and November 2012. A further analysis was carried out on 1175 candidates not trained in the United Kingdom, who sat an English language capability test (IELTS) and the Professional and Linguistic Assessment Board (PLAB) examination (as required for full medical registration), controlling for scores on these examinations and relating them to pass rates of the clinical skills assessment., Setting: United Kingdom., Results: After controlling for age, sex, and performance in the applied knowledge test, significant differences persisted between white UK graduates and other candidate groups. Black and minority ethnic graduates trained in the UK were more likely to fail the clinical skills assessment at their first attempt than their white UK colleagues (odds ratio 3.536 (95% confidence interval 2.701 to 4.629), P<0.001; failure rate 17% v 4.5%). Black and minority ethnic candidates who trained abroad were also more likely to fail the clinical skills assessment than white UK candidates (14.741 (11.397 to 19.065), P<0.001; 65% v 4.5%). For candidates not trained in the UK, black or minority ethnic candidates were more likely to fail than white candidates, but this difference was no longer significant after controlling for scores in the applied knowledge test, IELTS, and PLAB examinations (adjusted odds ratio 1.580 (95% confidence interval 0.878 to 2.845), P=0.127)., Conclusions: Subjective bias due to racial discrimination in the clinical skills assessment may be a cause of failure for UK trained candidates and international medical graduates. The difference between British black and minority ethnic candidates and British white candidates in the pass rates of the clinical skills assessment, despite controlling for prior attainment, suggests that subjective bias could also be a factor. Changes to the clinical skills assessment could improve the perception of the examination as being biased against black and minority ethnic candidates. The difference in training experience and other cultural factors between candidates trained in the UK and abroad could affect outcomes. Consideration should be given to strengthening postgraduate training for international medical graduates.

There are striking disparities in the academic achievement of American youth, with Latino students being a particularly vulnerable population. Adolescents' academic expectations have been shown to predict educational outcomes, and thus are an important factor in understanding educational disparities. This article examines racial/ethnic differences in the future expectations of adolescents, with a particular focus on how expectations about higher education may differ in frequency and meaning for Latino youth. Participants included 375 urban ninth-grade students (49 % Latino, 23 % White, 22 % Black, and 6 % other; 51 % female) who gave written descriptions of how they pictured their lives in 5 years. Responses were subsequently coded for content and themes. Results demonstrate that Latino youth were less likely to picture themselves attending college when compared to Black and White youth, and more likely to hold social goals, such as starting their own family. Ethnic/racial differences also were found in the themes present in responses, with Latino and Black students more likely than White students to describe individuation and materialistic goals, and to give more unrealistic responses. For Latino youth only, higher education goals were associated significantly with individuation themes. In addition, for Latino youth, adolescents who wished to pursue higher education reported more depressive symptoms and emotional distress than those who did not picture going to college, whereas the opposite pattern was evident for Black and White youth. These differences may reflect cultural values, such as familismo. Practice implications include the importance of culturally tailoring programs aimed at promoting higher education.

Blacks, Hispanics, and American Indians/Alaskan Natives are underrepresented in science and engineering fields. A comparison of race-ethnic differences at key transition points was undertaken to better inform education policy. National data on high school graduation, college enrollment, choice of major, college graduation, graduate school enrollment, and doctoral degrees were used to quantify the degree of underrepresentation at each level of education and the rate of transition to the next stage. Disparities are found at every level, and their impact is cumulative. For the most part, differences in graduation rates, rather than differential matriculation rates, make the largest contribution to the underrepresentation. The size, scope, and persistence of the disparities suggest that small-scale, narrowly targeted remediation will be insufficient.

Now that most UK universities have increased their tuition fees to £9,000 a year and are implementing new Access Agreements as required by the Office for Fair Access, it has never been more important to examine the extent of fair access to UK higher education and to more prestigious UK universities in particular. This paper uses Universities and Colleges Admissions Service (UCAS) data for the period 1996 to 2006 to explore the extent of fair access to prestigious Russell Group universities, where 'fair' is taken to mean equal rates of making applications to and receiving offers of admission from these universities on the part of those who are equally qualified to enter them. The empirical findings show that access to Russell Group universities is far from fair in this sense and that little changed following the introduction of tuition fees in 1998 and their initial increase to £3,000 a year in 2006. Throughout this period, UCAS applicants from lower class backgrounds and from state schools remained much less likely to apply to Russell Group universities than their comparably qualified counterparts from higher class backgrounds and private schools, while Russell Group applicants from state schools and from Black and Asian ethnic backgrounds remained much less likely to receive offers of admission from Russell Group universities in comparison with their equivalently qualified peers from private schools and the White ethnic group., (© London School of Economics and Political Science 2013.)

Little is known about women's knowledge of breast density or between-race differences in this knowledge. In the current study, we examined knowledge of breast density and awareness of its role as a breast cancer risk factor among women who had previously taken part in a breast imaging study. Seventy-seven women (54.5 % Black) returned a survey assessing perceptions and accuracy of breast density knowledge, knowledge of one's own breast density, and breast cancer risk awareness. White women had greater perceived knowledge of breast density compared to Black women; however, differences in the accuracy of definitions of breast density were due to education. Black women were less likely to know how dense their own breasts were. Black and White women both lacked awareness that having dense breast increased breast cancer risk. The results highlight the need to disseminate information regarding breast density to women, while ensuring that the information is equally accessible to both Black and White women.

OBJECTIVE Numerous articles have identified that medical technologies diffuse more rapidly among non-Latino whites compared with other racial-ethnic groups. However, whether health risk warnings also diffuse differentially across racial-ethnic minority groups is uncertain. This study assessed racial-ethnic variation in children's antidepressant use before and after the 2004 black-box warning concerning risks of antidepressants for youths. METHODS Data consisted of responses for white, black, and Latino youths ages five through 17 from the 2002-2008 Medical Expenditure Panel Survey (N=44,422). The dependent variable was any antidepressant use in the prior year. Independent variables were race-ethnicity, year, psychological impairment, income, insurance status, region, and parents' education level. Logistic regression models were used to assess antidepressant use conditional on race-ethnicity, time, interaction between race-ethnicity and time, need, socioeconomic status, and Institute of Medicine-concordant estimates of disparities in predicted antidepressant use before and after the warning. RESULTS The warnings affected antidepressant use differentially for whites, blacks, and Latinos. Usage rates among whites decreased from 3.3 to 2.1 percentage points between prewarning and postwarning, whereas usage rates remained steady among Latinos and increased among blacks. Findings were significant in multiple regression analyses, in which predictions were adjusted for need. CONCLUSIONS The findings indicate that health safety information on antidepressant usage among children diffused faster among whites than nonwhites, suggesting the need to improve infrastructure for delivering important health messages to racial-ethnic minority populations.

Background: Few studies have examined racial and educational disparities in recent population-based trends., Methods: We analyzed data of a nationally representative sample of 174,228 US-born adults in the National Health Interview Survey from 1997 to 2008. We determined mean BMI trends by educational attainment and race and black-white prevalence ratios (PRs) for overweight/obesity (BMI > 25 kg/m(2)) using adjusted Poisson regression with robust variance., Results: From 1997 to 2008, BMI increased by ≥1 kg/m(2) in all race-sex groups, and appeared to increase faster among whites. Blacks with greater than a high school education (GHSE) had a consistently higher BMI over time than whites in both women (28.3 ± 0.14 to 29.7 ± 0.18 kg/m(2) versus 25.8 ± 0.58 to 26.5 ± 0.08 kg/m(2)) and men (28.1 ± 0.17 kg/m(2) to 29.0 ± 0.20 versus 27.1 ± 0.04 kg/m(2) to 28.1 ± 0.06 kg/m(2)). For participants of all educational attainment levels, age-adjusted overweight/obesity was greater by 44% (95% CI: 1.42-1.46) in black versus white women and 2% (1.01-1.04) in men. Among those with GHSE, overweight/obesity prevalence was greater (PR: 1.52; 1.49-1.55) in black versus white women, but greater (1.07; 1.05-1.09) in men., Conclusions: BMI increased steadily in all race-sex and education groups from 1997 to 2008, and blacks (particularly women) had a consistently higher BMI than their white counterparts. Overweight/obesity trends and racial disparities were more prominent among individuals with higher education levels, compared to their counterparts with lower education levels.

Objectives: Adherence to diabetes self care is poor for Hispanic American and African-American patients. This study examined the change in adherence over time and in response to a telemedicine intervention for elderly diabetes patients in these groups compared to white diabetes patients. We also examined whether adherence mediated the effect of the intervention on glycemic control (A1c)., Design: The Informatics for Diabetes Education and Telemedicine project randomized medically underserved Medicare patients (n=1665) to telemedicine case management (televideo educator visits, individualized goal-setting/problem solving) or usual care. Hispanic and African-American educators delivered the intervention in Spanish if needed., Main Outcome Measures: Annual assessment included A1c and self-reported adherence (Summary of Diabetes Self-Care Activities scale). A simple model (only time and group terms) and a model with covariates (e.g., age) were examined for baseline and 5 years of follow-up. SAS PROC Mixed was used with non-linear terms to examine mediating effects of adherence on A1c, by performing tests of the mediating path coefficients., Results: Over time, self-reported adherence improved for the treatment group compared to usual care (p<0.001). There was no significant interaction with racial/ethnic group membership, i.e., all groups improved. However, minority subjects were consistently less adherent than whites. Also, greater comorbidity and diabetes symptoms predicted poorer adherence, greater duration of diabetes and more years of education predicted better adherence. Adherence was a significant mediator of A1c (p<0.001)., Conclusions: A unique, tailored telemedicine intervention was effective in achieving improved adherence to diabetes self care. However, African-American and Hispanic American participants were less adherent than white participants at all time points despite an individualized and accessible intervention. The finding that adherence did mediate glycemic control suggests that unique interventions for minority groups may be needed to overcome this disparity.

Kinesiology departments have recently started to offer allied health education programs to attract additional students to teacher education units (9). Although allied health professions offer increased work opportunities, insufficient enrollment and training of minority students in these academic fields contribute to underrepresentation in the workforce (3). To improve workforce diversity, kinesiology departments must understand how enrollment influences and barriers differ by race among prospective students. Therefore, the purpose of this study was to identify differences in allied health education enrollment influences and enrollment barriers between minority and Caucasian students. Participants (n = 601) consisted of students enrolled in kinesiology-based allied health education programs. Multivariate ANOVA was used to compare group differences in enrollment decision making. "Personal influence," "career opportunity," and "physical self-efficacy" were all significantly stronger enrollment influences among African-American students than among Caucasian students, and "social influence," "experiential opportunity," "academic preparation," and "physical self-efficacy" were all perceived as significantly greater barriers compared with Caucasian students. Findings support the need to recruit African-American students through sport and physical education settings and to market program-based experiential opportunities.

Despite overwhelming improvements in educational levels and opportunity during the past three decades, educational disadvantages associated with race still persist in Brazil. Using the nationally representative Pesquisa Nacional de Amostra por Domicílio (PNAD) data from 1982 and 1987 to 2007, this study investigates educational inequalities between white, pardo (mixed-race), and black Brazilians over the 25-year period. Although the educational advantage of whites persisted during this period, I find that the significance of race as it relates to education changed. By 2007, those identified as blacks and pardos became more similar in their schooling levels, whereas in the past, blacks had greater disadvantages. I test two possible explanations for this shift: structural changes and shifts in racial classification. I find evidence for both. I discuss the findings in light of the recent race-based affirmative action policies being implemented in Brazilian universities.

Body mass index (BMI) values reflect the net balance between nutrition, work effort, and calories consumed to fight disease. Nineteenth-century prison records in the United States demonstrate that the BMI values of blacks and whites were distributed symmetrically; neither underweight nor obese individuals were common among the working class. BMI values declined throughout the nineteenth century. By modern standards, however, nineteenth-century BMIs were in healthy weight ranges, though the biological living standards in rural areas exceeded those in urban areas. The increase in BMIs during the twentieth century did not have its origin in the nineteenth century.

Some of the biggest barriers to increase colorectal cancer screening are negative attitudes to screening tests. These negative attitudes might be evoked through reading cancer prevention information and impede the decision to get screened. Forty-two adults aged ≥50 years completed a 12-item attitude questionnaire after reading colorectal cancer prevention information. African-Americans perceived that others had higher cancer risk than themselves whereas Caucasians did not show the difference. Regardless of ethnicity and adherence to screening guidelines, no participants had strong feelings of fear and embarrassment. However, non-adherent Caucasians had higher anxiety than adherent Caucasians. The degree of negativity was not associated with intention to get screened in non-adherent participants. Adequate health literacy of participants may account for flat responses in negative attitudes. Further research in individuals with limited health literacy is recommended. Moreover, additional education about self-relevance of cancer risk is considered necessary to increase cancer awareness in African-Americans.

The Black-White achievement gap in children's reading and mathematics school performance from 4½ years of age through fifth grade was examined in a sample of 314 lower income American youth followed from birth. Differences in family, child care, and schooling experiences largely explained Black-White differences in achievement, and instructional quality was a stronger predictor for Black than White children. In addition, the achievement gap was detected as young as 3 years of age. Taken together, the findings suggest that reducing the Black-White achievement gap may require early intervention to reduce race gaps in home and school experiences during the infant and toddler years as well as during the preschool and school years., (© 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.)

It is often asserted that the gender gap in educational attainment is larger for blacks than whites, but historical trends comparing the black and white gender gap have received surprisingly little attention. Analysis of historical data from the U.S. census IPUMS samples shows that the gender gap in college completion has evolved differently for whites and blacks. Historically, the female advantage in educational attainment among blacks is linked to more favorable labor market opportunities and stronger incentives for employment for educated black women. Blacks, particularly black males, still lag far behind whites in their rates of college completion, but the striking educational gains of white women have caused the racial patterns of gender differences in college completion rates to grow more similar over time. While some have linked the disadvantaged position of black males to their high risk of incarceration, our estimates suggest that incarceration has a relatively small impact on the black gender gap and the racial gap in college completion rates for males in the United States.

Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States., Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population., Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for "hazardous use." which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic "orphans." These respondents reported 1 or 2 indicators of alcohol dependence as present., Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic "orphans" to better design interventions to address their problems., (Copyright © 2011 by the Research Society on Alcoholism.)

Background: Unintentional poisonings are a major public health issue in the United States (US). With the increasing number of Hispanics in the US, childhood poisoning is a salient public health issue to address within this population. There is a paucity of research examining the relationship between acculturation in Hispanics and the safe storage of medicines and cleaners. The purpose of the study was to determine if demographic variables, such as acculturation in Hispanics, age, gender and education, were predictive of incorrectly storing medicines and household cleaners., Methods: We conducted a study among parents/guardians of small children at two pediatric primary care clinics in the Dallas/Fort Worth (DFW) Metropolitan area. We enrolled 201 parents to identify where they stored medicines and household cleaners, and measured acculturation with the Short Acculturation Scale for Hispanics., Results: Of Hispanic participants, 49% were categorized as less acculturated (n = 99) while 21% were more acculturated (n = 42). Less acculturated participants were over 4 times more likely to store medicines incorrectly, and participants with a high school education or less were over 3 times more likely to improperly store cleaners. With each additional child in the household, the risk for improper storage of cleaners increased by 44%., Conclusion: The fact that children of less acculturated families are at greater risk for poisoning and have lower levels of education demonstrates the need for readable educational materials on this salient topic. Because social networks are integral in Hispanic culture, especially among new immigrants, poison prevention messages should be disseminated by interpersonal communications., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: Past research in medical education has addressed the study of gross anatomy, including the most effective learning techniques, comparing the use of cadavers, dissection, anatomy atlases, and multimedia tools. The aim of this study was to demonstrate similarities and differences among American, Asian, and European medical students (MS) regarding different study methods and to see how these methods affected their clinical skills., Methods: To analyze the varying study methods of European, American, and Asian MS in our program and in order to elucidate any ethnic and cultural differences a survey was conducted. A total of 705 international MS, from the Polish (PD), American (AD), and Taiwanese (TD) divisions, were asked to voluntarily participate in the questionnaire. Students were asked the following questions: which methods they used to study anatomy, and which of the methods they believed were most efficient for comprehension, memorization, and review. The questions were based on a 5-point Likert scale, where 5 was 'strongly agree', and 1 was 'strongly disagree'., Results: The PD and AD preferred the use of dissections and prosected specimens to study anatomy. The TD showed less interest in studying from prosected specimens, but did acknowledge that this method was more effective than using atlases, plastic models, or CD-ROMs. Multimedia tools were mainly used for radiological anatomy and review and also for correctly typing proper names of structures using exact anatomical terminology., Conclusion: The findings highlight the differences in study techniques among students from different ethnic backgrounds. The study approaches used in order to accomplish learning objectives was affected by cultural norms that influenced each student group. These differences may be rooted in technological, religious, and language barriers, which can shape the way MS approach learning.

Background: Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates., Objectives: We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City., Research Design: Retrospective analysis of Vital Statistics and administrative databases., Subjects: VLBW deliveries in New York City from 1996 to 2001 to non-Hispanic Black (n = 4947) and non-Hispanic White (n = 1615) mothers., Results: Black mothers were less likely to deliver in a top-tier hospitals (White = 44%, Black = 28%; P < 0.001) and top-tier hospitals were less likely to be located in Black mothers' neighborhoods (White = 40%, Black = 33%; P < 0.001). Distance, however, did not contribute to the disparity in use of top-tier hospitals. Non-Hispanic Black mothers lived marginally closer to a top-tier hospital than non-Hispanic White mothers (0.65 miles closer; P < 0.001), and mothers of both the races often bypassed their neighborhood hospital (Black = 62% bypassed, White = 71%; P < 0.001). Inattention to recommended prenatal behaviors was associated with using a closer hospital, suggesting that geographic proximity was most important to mothers of vulnerable neonates. Purported measures of hospital quality such as Neonatal Intensive Care Unit level and volume were more strongly associated with use of hospital for White mothers than for Black mothers., Conclusions: The influence of geography on the use of top-tier hospitals for mothers of VLBW neonates is complex. Other personal and hospital characteristics, not just distance or geography, also influenced hospital use in New York City.

Fijian bodies have become a valuable commodity in the economy of war. Remittances from workers overseas are Fiji's largest income – exceeding that of tourism and sugar export. This essay examines historical and contemporary representations of the black male body that perpetuate the exploitation of Fijians by inscribing the Fijian male body as warrior, criminal and protector. Taking a multidisciplinary approach informed by sociology, cultural theory, Pacific studies, visual culture, feminist and post-colonial theory, my practice is the vehicle through which I address issues of neocolonial commodification of Fijian bodies. Through an analysis of my own staged photographs and vernacular images taken by Fijians working for private security military companies and British and US armies, I hope to challenge audiences to consider their own perceptions of Fijian agency and subjectivity. By theorising the politicisation of the black body and interrogating colonial representations of blackness, I argue that we can begin to create links between the historical and contemporary exploitation of Fijians and that at the essence of both is an underlying racial hierarchy and economic requirement for cheap and, arguably, expendable labour.

The influential roles of culture and ethnic identity are frequently cited in developing disordered eating and body dissatisfaction, constituting both protective and risk factors. For African American women, strongly identifying with African American cultural beauty ideals may protect against disordered eating to lose weight, but may actually increase risk in development of disordered eating directed at weight gain, such as binge eating. This study compares African American and Caucasian women on disordered eating measures, positing that African American women show greater risk for binge eating due to the impact of ethnic identity on body dissatisfaction. Findings indicate low levels of ethnic identity represent a risk factor for African American women, increasing the likelihood of showing greater binge eating and bulimic pathology. In Caucasian women, high levels of ethnic identity constitute a risk factor, leading to higher levels of both binge eating and global eating pathology. Implications for prevention and treatment are discussed.

A national, Web-based survey of 1,219 African American, Latina/o, Asian American, and European American psychology graduate students revealed both similarities and differences in experiences and perspectives. Mentoring was found to be the strongest predictor of satisfaction across groups. Academic supports and barriers, along with perceptions of diversity within the academic environment, were also important predictors of satisfaction. Students of color perceived less fairness of representation of their ethnic group within psychology than European American students, and a greater linkage between aspects of the graduate school experience and their ethnicity. Limitations of the study and implications for future research and action are discussed.

Iroquois maize farmers in the seventeenth and eighteenth centuries produced three to five times more grain per acre than wheat farmers in Europe. The higher productivity of Iroquois agriculture can be attributed to two factors. First, the absence of plows in the western hemisphere allowed Iroquois farmers to maintain high levels of soil organic matter, critical for grain yields. Second, maize has a higher yield potential than wheat because of its C4 photosynthetic pathway and lower protein content. However, tillage alone accounted for a significant portion of the yield advantage of the Iroquois farmers. When the Iroquois were removed from their territories at the end of the eighteenth century, US farmers occupied and plowed these lands. Within fifty years, maize yields in five counties of western New York dropped to less than thirty bushels per acre. They rebounded when US farmers adopted practices that countered the harmful effects of plowing.

This article documents the shared patterns of private white male discourse. Drawing from comparative ethnographic research in a white nationalist and a white antiracist organization, I analyze how white men engage in private discourse to reproduce coherent and valorized understandings of white masculinity. These private speech acts reinforce prevailing narratives about race and gender, reproduce understandings of segregation and paternalism as natural, and rationalize the expression of overt racism. This analysis illustrates how antagonistic forms of “frontstage” white male activism may distract from white male identity management in the “backstage.”