Increasing Minority Representation Research Articles

Racial Implicit Associations in Child Psychiatry

Racial disparities in diagnosis and treatment are prevalent in child psychiatry, including disparate diagnosis rates of internalizing and externalizing disorders in Black and White children. However, limited research has investigated mechanisms that contribute to these disparities. This study examined child racial implicit associations in psychiatric clinicians and medical students to address this gap. Psychiatrists and trainees completed an online survey including two race Implicit Association Tests (IATs) pairing child faces to words with either positive or negative valence, and words related to internalizing or externalizing behavioral problems. We further investigated psychiatrists and trainees' demographic predictors of implicit associations. Data was analyzed from 235 psychiatrists and trainees (112 child and adolescent psychiatrists and fellows) who met inclusion criteria. Psychiatrists and trainees demonstrated greater moderate-to-strong association between Black child faces and "bad" words (44.3%) versus "good" words (6.4%), and between externalizing words (41.7%) versus internalizing words (7.2%). Psychiatrists and trainees' demographic characteristics including being female (β = -0.12; 95% CI = -0.23 to -0.01; p<0.05), Black (β = -0.36; 95% CI = -0.54 to -0.18; p<0.001), or an attending physician (β = -0.26; 95% CI = -0.45 to -0.06; p=0.01) were significant predictors of decreased association between Black child faces and negative valance words. Being female was a significant predictor of decreased association between Black child faces and externalizing words (β = -0.26; 95% CI = -0.45 to -0.06; p=0.01). Participating psychiatrists and trainees demonstrated bias towards associating Black rather than White child faces with negative words and externalizing behavioral problems. Future research should examine 1) racial implicit associations in a more generalizable sample, 2) the relationship between race IATs and provider behavior, and 3) interventions to reduce racial inequities in psychiatry, including individual and systemic solutions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science.

Ethnic minority MPs as reputational shields? How Western European political parties respond to public opinion shifts on immigration policy

Abstract In recent decades, representation of ethnic minorities increased significantly across Europe, while concurrently many political parties moved to the right on multiculturalism and immigration, a seeming paradox. We explain it by arguing that often it is the same parties that move to the right and simultaneously increase representation. They use this dual strategy in an attempt to positionally converge to the median voter, where the increased minority representation acts as a reputational shield to prevent allegations of intolerance. Looking at parliaments of eight European countries between 1990 and 2015, we find that parties that shifted to the right in response to a public mood swing to the right are indeed significantly more likely to bring more ethnic minority politicians into parliament. This has important implications for the literature on descriptive representation and party platform change.

Collegiate Aviation Student Perceptions of Racial Influences in Aviation Education

The U.S. aviation industry has grown significantly in the last several decades, but existing literature identifies a gap between progress for the industry and representation of minorities (Ison et al, 2016; Stevenson et al, 2020). According to the Bureau of Labor Statistics in 2019, out of the 141,000 persons employed as either “aircraft pilots” or “flight engineers,” 2.6% were Black, 3.4% were Asian, and 2.2% were Hispanic or Latino, while 93.7% were White (BLS, 2019). What has yet to be investigated, however, is how that gap is perceived by students preparing to enter the aviation industry. This exploratory study examines the perceptions of collegiate aviation students, who represent the next generation of the aviation industry, and the impact race may have had on their choice to pursue an aeronautics or aeronautical science degree. Interviews were conducted with students currently enrolled in an aviation career degree program. Results indicated that while a slim majority of participants did not perceive race to be a barrier in aviation education, many participants identified examples of where racial barriers have played a role, in some form, during their aviation education career. In addition, several participants described the U.S. aviation industry’s lack of diversity as an obstacle after beginning their collegiate aviation program. This case study provides an opportunity for institutions to consider how current diversity, equity, and inclusion efforts are impacting students, and what else may need to be done to increase minority representation within the aviation industry.

Outsiders Within

Few Black nurses occupy positions of leadership, and even fewer Black female nurses advance to careers as nurse executives. The purpose of this 2018 study was to explore the lived experience of being Black and female when becoming a nurse executive, specifically the nuances of being both a racial and gender minority. Using a hermeneutic phenomenological method, this study explored the experiences of a purposive sample of 10 Black female nurse executives through semistructured telephone interviews. van Manen's approach and Collins' Black feminist thought as the theoretical framework guided data analysis. Three themes emerged: (a) living in a constant state of readiness; (b) embracing the responsibility beyond the job description; and (c) overcoming. Participants testified of the psychological dynamics of Black womanness, and the burdens of the intersectionality of race, gender, and class discrimination, while managing the complexities and rigors of a thriving career. Discussing the results of this research will help leaders in nursing, health care, and related professions to understand further the experiences of Black female nurse executives, which will inform efforts to (a) increase minority representation in positions of nursing leadership and (b) improve health equity.

Integrating Youth Readiness Intervention and Entrepreneurship in Sierra Leone: A Hybrid Type II Cluster Randomized Trial

Conflict-affected youth are at risk for poor psychological and social outcomes, yet few receive mental health services. Strategies to expand access and sustain evidence-based interventions (EBIs) across novel delivery platforms must be tested. The present study was a hybrid type II implementation-effectiveness trial using a cluster randomized design. The primary goal was to evaluate feasibility and impact of using the collaborative team approach to deliver the Youth Readiness Intervention (YRI), an EBI, integrated into a youth entrepreneurship program (ENTR) with quality control in post-conflict Sierra Leone. Youth were screened and randomly assigned to control, ENTR, or combined YRI and ENTR (YRI+ENTR). Implementation outcomes were dissemination and implementation indicators, competence, and fidelity. Effectiveness outcomes were emotion regulation, psychological distress, and interpersonal functioning. Secondary outcomes were third-party reporter assessments of youth functioning and behavior. Data were collected and analyzed from 1,151 youth participants and 528 third-party reporters. Scores on implementation constructs, competence, and fidelity demonstrated acceptable intervention response and quality. YRI+ENTR participants showed overall improvements in depression (β=-.081, 95% CI-0.124 to-0.038, d=-0.154) and anxiety (β=-.043, 95% CI-0.091 to-0.005, d= 0.082) symptoms compared with control participants. Community leaders indicated that YRI+ENTR participants demonstrated improvements in overall work or training performance compared with control participants (β=-.114, 95% CI 0.004 to 0.232, d= 0.374). Integration of EBIs such as the YRI into youth employment programs has the potential to address limited reach of EBIs in conflict and post-conflict settings. A collaborative team implementation approach can facilitate integration and fidelity. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper received support from a program designed to increase minority representation in science. Youth FORWARD Phase 2 YRI and EPP Study; https://clinicaltrials.gov/; NCT03542500.

Higher Intersubject Variability in Neural Response to Narrative Social Stimuli Among Youth With Higher Social Anxiety

Social anxiety is associated with alterations in socioemotional processing, but the pathophysiology remains poorly understood. Movies present an opportunity to examine more naturalistic socioemotional processing by providing narrative and sensory context to emotion cues. This study aimed to characterize associations between neural response to contextualized social cues and social anxiety symptoms in children. Data from the Healthy Brain Network (final N= 740; age range 5-15 years) were split into discovery and replication samples to maximize generalizability of findings. Associations of parent- and self-reported social anxiety (Screen for Child Anxiety-related Emotional Disorders) with mean differences and person-to-person variability in functional magnetic resonance imaging-measured activation to 2 emotionally dynamic movies were characterized. Though no evidence was found to indicate social anxiety symptoms were associated with mean differences in neural activity to emotional content (fit Spearman rs< 0.09), children with high social anxiety symptoms had higher intersubject activation variability in the posterior cingulate, supramarginal gyrus, and inferior frontal gyrus (Bonferroni familywise error-corrected ps< .05)-regions associated with attention, alertness, and emotion cue processing. Identified regions varied by age group and informant. Across ages, these effects were enhanced for scenes containing greater sensory intensity (brighter, louder, more motion, more vibrance). These results provide evidence that children with high social anxiety symptoms show high person-to-person variability in the neural processing of sensory aspects of emotional content. These data indicate that children with high social anxiety may require personalized interventions for sensory and emotional difficulties, as the underlying neurology differs from child to child. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

Abstract A054: Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model

Abstract Introduction: Despite increasing recognition of the need for diversity in clinical trials, participation from racial and ethnic minorities, particularly from low socioeconomic communities, remains dismally low. This underrepresentation hinders the generalizability of trial results and perpetuates health disparities. Low socioeconomic environments, characterized by economic instability, restricted healthcare access, food scarcity, and deficient educational resources, exacerbate these challenges. Residents of such communities often lean on "Hope Leaders" - trusted community figures - as a strategy to navigate through these adversities. Recognizing the pivotal role of these Hope Leaders, we advocate for a community-centered bi-directional cancer health information flow model, which positions these Leaders at the core of community engagement endeavors. This model fosters a bi-directional health information exchange that synergizes Hope Leaders with the scientific community, thereby promoting improved health equity within clinical intervention research. The implementation of this model commences with a pre-engagement phase, a respectful approach where we familiarize ourselves with the community and its dynamics, without imposing any specific demands or expectations. Approach: The University of Illinois Cancer Center has had 6 community engagement specialists that have engaged with community members through numerous pre-engagement events that encompass activities ranging from mental health, cancer prevention, survivorship events, education, health fairs and community meetings. Based on these insights, we established a dedicated working group to identify hope leaders and to create targeted engagement strategies for specific areas of our catchment region through the bi-directional cancer health information flow model. These strategies are tailored to address the unique challenges and barriers these communities face regarding enrollment in cancer clinical trials. Additionally, the community-driven health communication model was implemented to identify Hope Leaders and engage them with cancer researchers as a part of our phase I activities for this model. Conclusion: This innovative approach aims to leverage the unique position of Hope Leaders in underserved communities to amplify community voices, improve engagement, and ultimately, increase minority representation in cancer clinical trials. The model provides a promising strategy to address the persistent disparity in clinical trial participation, facilitating more equitable and inclusive research outcomes. Citation Format: Joseph Dufraine, Yamile Molina, Jeanette Gonzalez, Maria Olivero, Theresa Mobley, Saria Lofton, Dedra Reis. Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A054.

Enrollment and Scientific Progress of the Multisite SuperAging Research Initiative

AbstractBackgroundThe SuperAging Research Initiative is a multisite consortium focused on identifying factors promoting extraordinary cognitive aging. The designation of SuperAger is reserved for individuals age 80+ who have episodic memory capacity that would be considered at least average for those 2‐3 decades younger. The presence of such outliers raises questions of fundamental importance to the neurobiology of brain aging, resilience, resistance, and avoidance of cognitive decline caused by Alzheimer’s disease. The original study of SuperAgers emerged at Northwestern and helped establish the phenotype. The SuperAging Research Initiative was established in 2021 and is focused on increasing minority representation and expanding deep phenotyping of this unique population.MethodsHarmonized data collection has been initiated across the five sites including behavioral, health, biologic, genetic, environmental, socioeconomic, psychosocial, neuroanatomic, and neuropathologic factors. Here we summarize the initial recruitment progress and baseline characteristics of the current cohort.ResultsWe will present the organizational structure, progress, and baseline characteristics of the cohort to date. The SuperAging Research Initiative includes three Cores (Administrative/Biostatistics, Clinical/Imaging, and Biospecimen/Neuropathology) and two Research Projects. Enrollment (target, n = 500) has commenced across four U.S. Sites located in Illinois, Wisconsin, Michigan, and Georgia, and a Canadian Site in Southwest Ontario, with a focus on enrollment of Black SuperAgers and Cognitively Average Elderly Controls with similar demographics. Project 1 uses state‐of‐the‐art wearable technology to obtain quantitative measurements of daily life including, sleep, physical activity, autonomic responsivity, and social engagement to determine whether SuperAgers have relatively preserved physiologic and behavioral ‘complexity’ compared to Controls. Project 2 focuses on transcriptomic, genetic, and protein profiling to examine central and peripheral immune and inflammatory system parameters of SuperAgers.ConclusionsBy identifying factors contributing to superior memory performance in old age, outcomes may help isolate modifiable factors that promote healthspan and perhaps also prevent age‐related brain diseases such as Alzheimer’s disease.

A Comprehensive, Community‐Engaged Recruitment Strategy to Increase Minority Representation in New IDEAS – an Amyloid Imaging Study

AbstractBackgroundAlthough Black and Hispanic/Latino people have higher rates of clinical Alzheimer disease (AD), evidence indicates lower proportions and odds of positive amyloid positron emission tomography (PET). This may indicate differences in etiology of cognitive impairment, which has implications for prevention and treatment (ie, anti‐amyloid treatments). Unfortunately, Black and Hispanic/Latino people are underrepresented in AD research.MethodTo evaluate amyloid PET in a diverse sample, we designed culturally‐informed, community‐engaged recruitment strategies for New IDEAS (Imaging Dementia—Evidence for Amyloid Scanning), an observational, open‐label, longitudinal cohort study of beta‐amyloid PET. New IDEAS intends to recruit 7,000 U.S. Medicare beneficiaries with mild cognitive impairment (MCI) or dementia including 2,000 Black/African American and 2,000 Latino/Hispanic individuals. To ensure diversity, we developed a comprehensive recruitment strategy using a diverse, culturally‐trained staff that includes:• Identifying Dementia Specialists experienced recruiting minorities• Embedding high‐impact community engagement in select regions• Increasing capacity of specialists and PET facilities to engage minorities• Increasing pipeline of referrals to Dementia Specialists• Creating a culturally‐informed awareness campaignResultNew IDEAS has enrolled 4,524 participants including 954 (21.1%) Black/African American, and 842 (18.6%) Hispanic/Latinx. Median age is 76 years; 54% are female. More Black/African American (46.6%) and Hispanic/Latinx (42.6%) participants had a dementia diagnosis compared to the overall cohort (33.9%). More Black/African American (37.4%) and Hispanic/Latinx (37%) participants were enrolled in Medicare Advantage compared to the overall cohort (19.5%).During implementation, we encountered additional barriers to minority participation including: dementia specialists and PET facilities located greater distance from minority neighborhoods, lack of transportation to visits, fewer academic medical sites registered, concerns about co‐pays, and dementia specialists not accepting new patients. New strategies are being implemented to address some of barriers including coverage of co‐pays and assistance with transportation.ConclusionNew IDEAS has enrolled more Black/African American and Hispanic/Latinx participants than any amyloid PET study published to date. Despite some success with minority enrollment, recruitment has been hampered by underlying structural barriers such as lack of access to dementia care in minority communities and higher Medicare Advantage rates. Additional resources and policy changes are needed to allow more equitable access to research and dementia care.

Dynamic Amygdala Nuclei Alterations in Relation to Weight Status in Anorexia Nervosa Are Mediated by Leptin

The amygdaloid complex is a subcortical limbic group of distinct nuclei. In a previous patient-control study, differential amygdala nuclei alterations were found in acute anorexia nervosa (AN); rostral-medial nuclei involved in fear and reward processing were substantially reduced in volume and associated with hypoleptinemia, a key neuroendocrine characteristic of AN. Here, longitudinal amygdala nuclei alterations in AN were investigated in relation to weight status and their associations with leptin levels. T1-weighted structural magnetic resonance imaging scans were longitudinally processed with FreeSurfer. Amygdala nuclei volumes in young female patients with acute AN before and after short-term weight restoration (n= 110, >14% body mass index increase over 3 months) and female participants with a history of AN (n= 79, long-term [mean 5 years] weight recovered) were compared with female healthy control participants (n= 271) using linear mixed effects models. Rostral-medially clustered amygdala nuclei volumes, accessory basal, cortical, medial nuclei, and corticoamygdaloid transition, increased during short-term weight restoration (Cohen's d range 0.18-0.30). However, volumetric normalization across nuclei was heterogeneous. Right cortical, medial nuclei, bilateral corticoamygdaloid transitions, and anterior amygdaloid areas were only partially normalized following short-term weight restoration. Right anterior amygdaloid area remained reduced after long-term weight recovery compared with control participants (d= 0.36). Leptin increase, accompanying short-term weight restoration, mediated the effect of weight gain on volumetric increase in left corticoamygdaloid transition and bilateral medial nuclei. Rostral-medially clustered amygdala nuclei show pronounced volumetric increase but incomplete normalization in AN during and after short-term weight restoration. Leptin increase may be relevant for the recovery of specific amygdala nuclei in addition to nutritional rehabilitation, indicating links between amygdala substructure and leptin dynamics of potential pathophysiological and clinical relevance in AN. The amygdala plays a critical role in processing fearful and rewarding stimuli, and alterations in the amygdala are associated with anorexia nervosa. In this study, the authors measured amygdala nuclei volumes in female patients with acute anorexia nervosa undergoing weight-restoration treatment (n = 110), long-term weight-recovered individuals with anorexia (n = 79), and healthy control participants (n = 271). Structural magnetic resonance imaging revealed that volumes of specific nuclei, clustered in the rostral-medial amygdala, were substantially reduced in acute anorexia nervosa and only partially normalized following weight restoration treatment. Residual reductions in volume persisted even after long-term weight-recovery, compared to healthy control participants. Short-term weight restoration was associated with increases in the neurohormone leptin, and increasing leptin levels were found to mediate the positive impact of weight gain on increased amygdala volume over the treatment course. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Policing Asian communities in the United States: a systematic literature review and discussion

PurposeThis article aims to synthesize published research on the policing of Asian communities in the United States.Design/methodology/approachThis is a systematic literature review using PRISMA 2020 guidelines.FindingsSixteen studies were reviewed. Five examined violence by police against Asian community members and reported rates for Asians closer to those against Whites than against members of other groups. One study found no relationship between violence against police and increased minority representation on the force. Four studies reported conflicting results regarding traffic stops of Asian motorists and in general perceptions of police anti-Asian bias. One study illustrated how racialization processes reproduce inequality both between racial-ethnic categories and within them. Five studies examined Asian community members’ general attitudes toward/satisfaction with police and reported—with qualifications—generally favorable attitudes and satisfaction with them.Originality/value This is the first systematic literature review of policing Asian communities in the United States.

A Randomized Controlled Trial of a Parenting Intervention During Infancy Alters Amygdala-Prefrontal Circuitry in Middle Childhood

Early adverse parenting predicts various negative outcomes, including psychopathology and altered development. Animal work suggests that adverse parenting might change amygdala-prefrontal cortex (PFC) circuitry, but work in humans remains correlational. The present study leveraged data from a randomized controlled trial examining the efficacy of an early parenting intervention targeting parental nurturance and sensitivity (Attachment and Biobehavioral Catch-up [ABC]) to test whether early parenting quality causally affects amygdala-PFC connectivity later in life. Participants (N= 60, mean age= 10.0 years) included 41 high-risk children whose parents were referred by Child Protective Services and randomly assigned to receive either ABC (n= 21) or a control intervention (n= 20) during the children's infancy and a comparison sample of low-risk children (n= 19). Amygdala-PFC connectivity was assessed via functional magnetic resonance imaging while children viewed fearful and neutral faces. Across facial expressions, ABC produced different changes than the control intervention in amygdala-PFC connectivity in response to faces. The ABC group also exhibited greater responses than the control intervention group to faces in areas classically associated with emotion regulation, including the orbitofrontal cortex and right insula. Mediation analysis suggested that the effect of ABC on PFC activation was mediated by the intervention's effect on amygdala-PFC connectivity. Results provide preliminary causal evidence for the effect of early parenting intervention on amygdala-PFC connectivity and on PFC responses to face viewing. Findings also highlight amygdala-PFC connectivity as a potential mediator of the effects of early parenting intervention on children's emotion regulation development. Intervening Early With Neglected Children; https://clinicaltrials.gov/; NCT02093052. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Improving the visibility of minorities through network growth interventions

Improving the position of minority groups in networks through interventions is a challenge of high theoretical and societal importance. However, a systematic analysis of interventions that alter the network growth process is still missing. In this work, we propose a model to examine how network growth interventions impact the position of minority nodes in degree rankings over time. We distinguish between (i) group size interventions, such as introducing quotas; and (ii) behavioural interventions, such as varying how groups connect to each other. We find that even extreme quotas do not increase minority representation in rankings if the actors in the network do not adopt homophilic behaviour. Thus, interventions need to be coordinated in order to improve the visibility of minorities. In a real-world case study, we explore which interventions can reach gender parity in academia. Our work provides a theoretical and computational framework for investigating the effectiveness of interventions in growing networks.

Racial/Ethnic Diversity in Positions of Power in U.S. Law Enforcement: An Examination of Active Representation and Disparities in Vehicle Stops

Increasing minority representation in law enforcement has long been viewed as a means of improving police-citizen relations. Yet, little scholarly attention has examined whether racial/ethnic diversity translates into desired outcomes. These studies largely measure the racial/ethnic composition of the agency in general—not in positions of power where they are most likely to make an impact on department policy/practice (i.e., ‘active representation’). Using data from the 2016 Law Enforcement Management and Administrative Statistics (LEMAS) survey, the current study 1) provides an overview of Black and Hispanic representation in chief executive, mid-level management, and supervisory roles and 2) explores the impact that diversity in these positions has on racial/ethnic disparities in vehicle stops in Illinois and Missouri. Minority officers are more underrepresented in these positions of power compared to their composition in agencies in general, and higher levels of representation are not significantly associated with reductions in disparities in stops.

IQ Modulates Coupling Between Diverse Dimensions of Psychopathology in Children and Adolescents.

Correlations between cognitive ability and psychopathology are well recognized, but prior research has been limited by focusing on individuals with intellectual disability, single-diagnosis psychiatric populations, or few measures of psychopathology. Here, we quantify relationships between full-scale IQ and multiple dimensions of psychopathology in a diverse care-seeking population, with a novel focus on differential coupling between psychopathology dimensions as a function of IQ. A total of 70 dimensional measures of psychopathology, plus IQ and demographic data, were collated for 2,752 children and adolescents from the Healthy Brain Network dataset. We first examined univariate associations between IQ and psychopathology, and then characterized how the correlational architecture of psychopathology differs between groups at extremes of the IQ distribution. Associations with IQ vary in magnitude between different domains of psychopathology: IQ shows the strongest negative correlations with attentional and social impairments, but is largely unrelated to affective symptoms and psychopathy. Lower IQ is associated with stronger coupling between internalizing problems and aggression, repetitive behaviors, and hyperactivity/inattentiveness. Our analyses reveal that variation in general cognitive ability is associated not only with significant and selective shifts in severity of psychopathology, but also in the coupling between different dimensions of psychopathology. These findings have relevance for the clinical assessment of mental health in populations with varying IQ, and may also inform ongoing efforts to improve the measurement of psychopathology and to understand how relationships between cognition and behavior are reflected in brain organization. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure sex balance in the selection of non-human subjects. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.

The SuperAging Research Initiative: A multisite consortium focused on identifying factors promoting extraordinary cognitive aging

AbstractBackgroundThe designation of SuperAger is reserved for individuals age 80+ who have episodic memory capacity that would be considered at least average for those 2‐3 decades younger. The presence of such outliers raises questions of fundamental importance to the neurobiology of brain aging. Have these superior memory performers resisted age‐related changes, or have they simply started from a much higher baseline? Do they have identifiable peculiarities of genetic background? Is there something special about their brain structure or perhaps their resistance to age‐related processes such as neurofibrillary degeneration and amyloid deposition? These are the questions that were initially addressed by the Northwestern SuperAging Project, which identified unique results encompassing cognitive, psychosocial, molecular, and neuropathologic markers that characterize SuperAgers. Obstacles to further progress have been the relative rarity of this phenotype and, consequently, the barriers to racial diversity in the cohort.MethodsTo address these challenges, we established the SuperAging Research Initiative, a multicenter study focused on increased minority representation, to identify behavioral, health, biologic, genetic, environmental, socioeconomic, psychosocial, neuroanatomic, and neuropathologic factors associated with SuperAging.ResultsHere we provide the organizational structure and progress to date of the SuperAging Research Initiative, which includes three Cores (Administrative/Biostatistics, Clinical/Imaging, and Biospecimen/Neuropathology) and two Research Projects. Enrollment (n = 500) is planned across four US Sites located in Illinois, Wisconsin, Michigan, and Georgia, and a Canadian Site in Southwest Ontario, with a focus on enrollment of Black SuperAgers and Cognitively Average Elderly Controls with similar demographics. Project 1 uses state‐of‐the‐art wearable technology to obtain quantitative everyday measurements of life sleep, physical activity, autonomic responsivity, and social engagement to determine whether SuperAgers have relatively preserved physiologic and behavioral ‘complexity’ compared to Controls. Project 2 focuses on transcriptomic, genetic, and protein profiling to examine central and peripheral immune and inflammatory system parameters of SuperAgers.ConclusionsBy identifying factors contributing to superior memory performance in old age, outcomes may help isolate modifiable factors that promote healthspan and perhaps also prevent age‐related brain diseases such as Alzheimer’s disease.

Roads Diverged: Developmental Trajectories of Irritability From Toddlerhood Through Adolescence

Irritability is a dimensional trait that manifests from early life and is a robust transdiagnostic risk factor for psychopathology and impairment. A large, national dataset was leveraged to identify and broadly characterize trajectories from toddlerhood through adolescence, which is crucial for timely, targeted interventions. Data on irritability and a broad array of potential factors affecting irritability development from 4,462 children assessed longitudinally at ages 3, 5, 9, and 15 were included. Latent class growth models identified groups of children based on their nonlinear irritability trajectories from toddlerhood to adolescence. LASSO regression then identified key characteristics differentiating trajectory groups. Five distinct irritability trajectories were identified, two of which were stable, maintaining medium or high irritability from age 3 to 15. Three trajectories showed undulating change over development, with an inflection point at the transition to adolescence (age 9): Most children had consistently low irritability. Two smaller groups started with high irritability at age 3 but diverged, sharply decreasing or increasing until a turning point at age 9. Developmental patterning of harsh/neglectful parenting and child internalizing symptoms most strongly differentiated trajectory groups. Sociodemographic characteristics, attachment style, neighborhood support, cognitive functioning, and genetic variation also differentiated trajectories. The results demonstrated the importance of the transition to adolescence as a critical inflection point for youths with fluctuating irritability trajectories. Identifying these patterns and multiple malleable factors associated with stably high or rising trajectories is an important step toward targeted interventions for the most vulnerable subgroups. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

Building L2 social connections: the case of learners of Auslan (Australian Sign Language)

ABSTRACT Social interaction, and the attendant negotiation of meaning, is of prime importance for developing second language (L2) skills. Yet how learners go about building L2 social networks – and why some have more success than others in doing so – remains underexplored. This article explores this phenomenon via a 12-month longitudinal case study of three hearing adult learners of Auslan (Australian Sign Language) who were studying the language in a vocational education setting. Drawing on language diaries and stimulated recall interviews, we explore the learner’s contact with deaf signers and use of Auslan with hearing peers, as well as the factors shaping this involvement and how it changed as their language proficiency developed. While one of our learners threw herself into volunteering and emerged from the study with strong L2 social networks, the other two struggled to varying degrees to build networks and balance the demands of paid work and L2 study. Socio-economic factors played an important role in shaping our student’s engagement and investment in L2 learning. From this, we argue that tertiary L2 programs may be subtly reproducing privilege, and need to address this if we are serious about increasing minority representation in L2 programs.

Improving pathways to eliminate underrepresentation in the pediatric surgery workforce: A call to action

Despite progress, diversity and minority representation within the pediatric surgery workforce still does not match the expansive backgrounds of the patients we treat. The problem stems from underrepresentation of minority populations at every step along the pediatric surgery training pathway. Strategies aimed at improving diversity and representation in medical school, general surgery residencies, and ultimately pediatric surgery fellowship are necessary to assemble a more diverse pool of pediatric surgeons. The aim of this paper is to review the current demographic make-up of medical and surgical specialties, highlight the value of diversity, and provide evidence-based strategies for increasing minority representation throughout the pediatric surgery pathway. Future patients will be better served with a more representative pediatric surgery workforce.

COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned?

This state of the art review focuses on bioethical questions and considerations from research findings and methodological issues, including design and recruitment of participants, in studies related to COVID-19 vaccine hesitation in Black individuals. Ethical concerns identified were applied to otolaryngology with recommendations for improving health inequities within subspecialties. An internet search through PubMed, CINAHL, and socINDEX was conducted to identify articles on COVID-19 vaccine hesitation among the Black population between 2020 and 2021. A systematic review approach was taken to search and analyze the research on this topic, which was coupled with expert analysis in identifying and classifying vital ethical considerations. The most common COVID-19 vaccine hesitation factors were related to the development of the vaccine, mistrust toward government agencies, and misconceptions about safety and side effects. These findings raised bioethical concerns around mistrust of information, low health literacy, insufficient numbers of Black participants in medical research, and the unique positions of health professionals as trusted sources. These bioethical considerations can be applied in otolaryngology and other health-related areas to aid the public in making informed medical decisions regarding treatments, which may reduce health inequalities among Black Americans and other racial and ethnic minority groups. Addressing ethical questions by decreasing mistrust, tailoring information for specific populations, increasing minority representation in research, and using health professionals as primary sources for communicating health information and recommendations may improve relationships with Black communities and increase acceptance of new knowledge and therapies such as COVID-19 vaccination.