Monolithic Group Research Articles

Inequities in Access to Mental Health Services Among Asian American, Native Hawaiian, and Pacific Islander Medicaid Enrollees.

Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) people are often aggregated into a monolithic group, but when they are disaggregated into ethnic groups (e.g., Chinese), inequities can be identified. Using a representative sample of adult Medicaid enrollees (N=55,215), the authors assessed inequities in self-reported access to mental or behavioral health services between non-Hispanic AA and NHPI Medicaid enrollees and non-Hispanic White Medicaid enrollees, both by racial group and across 10 disaggregated ethnic groups. AA and NHPI enrollees, by race and all 10 ethnicities, reported significantly worse mental health care access than did White enrollees. The magnitude of disparities also differed between ethnic groups, ranging from -14.6 percentage points for Native Hawaiian enrollees to -43.6 percentage points for Vietnamese enrollees.

“Asian” Is a Problematic Category in Research and Practice: Insights From the Bamboo Ceiling

This article spotlights a widespread problem in research and practice: Asians are commonly categorized as a monolithic group in the United States. Regarding research, my 24-year archival analysis of Psychological Science shows that most U.S. studies did not specify which Asian subgroup(s) were examined. Regarding practice, my analysis of the diversity, equity, and inclusion (DEI) webpages and latest diversity reports of S&P 100 companies finds that none of them differentiated between Asian subgroups. Such use of the generic category “Asian” is problematic because it masks important differences among Asian subgroups: (a) Of all ethnic groups in the United States, socioeconomic inequality among Asian subgroups is the highest and fastest growing; (b) U.S. studies show that East Asians (e.g., ethnic Chinese)—but not South Asians (e.g., ethnic Indians)—experience a “bamboo ceiling” in consequential contexts, including leadership attainment, academic performance in law and business schools, and starting salaries. Thus, lumping Asians together can obscure the challenges faced by certain Asian subgroups and jeopardize the attention and resources they need. More broadly, this article demonstrates the importance of differentiating between ethnic subgroups in research (e.g., theorization, surveys, and data analysis) and practice (e.g., diversity reports) to foster DEI.

Impact of aging on the fracture strength of 3D-printed fixed implant prostheses: A comparative analysis of monolithic and bi-layer with or without fiber-reinforced composite frameworks.

This study aims to evaluate the fracture strength of three-unit, implant-supported fixed dental prostheses (FDPs) constructed from 3D-printed resin. It compares structures with and without fiber-reinforced composite (FRC) frameworks under conditions that mimic artificial aging. Forty FDPs were fabricated and divided into two groups: monolithic (n=20) and bi-layer (n=20). The monolithic group (MG) consisted entirely of FDPs made from 3D-printed resin for permanent restorations, while the bi-layer group (BG) featured FDPs with an FRC framework veneered with the same 3D-printed resin. Each group was subdivided into two subgroups: one subjected to artificial aging (MTG, n=10; BTG, n=10), and the other served as the baseline control (n=10). All subgroups underwent a mechanical bending test, applying a single load to failure using a universal testing machine. There was a statistically significant difference in fracture strength due to the presence of the FRC framework (p<0.01). The framework became the FDP more resistant to load. The mean load to failure and standard deviations were as follows: MG 406.59N (±33.84), MTG 286.20N (±152.15), BG 1142N (±162.88), and BTG 945N (±211.52). Although no statistical differences in strength were observed between aged and nonaged subgroups, variations in failure patterns emerged, with the BG and BTG groups showing a predominance of failures compared to the MG. The inclusion of an FRC framework significantly enhanced the fracture strength of the FDPs. While the aging protocol did not alter thestrength, failures predominantly occurred in the 3D-printed resin superstructure at the connectors. The highest rate of fractures occurred in the premolar connector.

Bending light: How cognitive styles influence the pitch evaluations and performance predictions of crowdfunded ventures

ABSTRACT Most entrepreneurial finance studies have treated funders as a monolithic group and ignored individual differences in tastes. This overlook is complicated by prior studies demonstrating how entrepreneurs would utilize either costly to be acquired cues (e.g. patents) that signal venture quality or costless cues that are easily fabricated (e.g. company name fluency) in their pitches to influence investors. We thus investigate how cognitive styles influence heterogeneous crowdfunding backers’ evaluations of pitches in the presence of costly and costless cues. Based on Cognitive-Experiential Self-Theory, we illustrate that a rational thinking style moderate the contrast effect, i.e. costly cues overpowering costless cues, on pitch evaluations and performance predictions for crowdfunded ventures, while an experiential thinking style will attenuate such contrast effect. Findings from two experiments support the moderating effect of a rational thinking style. We demonstrate backers are not monolithic and call for future studies to understand how heterogeneous backers make decisions.

Black identity and internal health attributions of second generation black immigrant women

ABSTRACT Objective Despite second generation Black immigrants being a rapidly growing population, they are often overlooked in health attribution research that treats Black populations as a monolithic group. Very few studies focus on how discrimination, societal pressure, and racial identity play a role in the health attributions of Black immigrant women. Even fewer studies have examined this relationship solely with second generation Black immigrant women. Research has shown, however, that increased racial and ethnic identity but decreased experiences with racism are related to higher internal health attributions in Black populations. Thus, we addressed this dearth in research in the current study by examining the relationship between racial centrality, racism stress, and internal health attributions in a sample of 123 second generation Black immigrant women. Design Health attributions were assessed using the Illness Attribution Scale, racism stress using the Schedule of Racist Events, and racial centrality using the Multidimensional Inventory of Black Identity. Multiple regression analyses were conducted to test the hypotheses that lower levels of racism stress, but higher ratings of racial centrality would relate to higher scores of internal health attributions. Results A positive relationship was found between racial centrality and internal health attributions but not racism stress. Conclusion The results indicated that stronger affirmations with Black identity are associated with a greater importance of the causes of illness to be within one’s perceived control for second generation Black immigrant women, which highlights the importance of examining wthin-group differences via collective identity measures to better explain health attribution behavioirs.

Digital Product Innovation Within Family Firms: A Construal Level Perspective

Digital product innovation (DPI) is critical for the survival of firms, especially those operating in traditional industrial-age industries. While research has started to investigate digital innovation in family firms (FFs) considering them as a monolithic group, we still lack a more nuanced perspective that considers heterogeneity among FFs with respect to DPI and what drives such variance. Drawing on construal level theory to explain the risk behavior and goal time horizon of FF owner-managers, we propose and find that the presence of later family generations in control positively influences DPI in FFs, while the presence of a family CEO is detrimental to DPI. Furthermore, we propose that these relationships are moderated by the size of the top management team (TMT), finding that a larger TMT weakens the positive relationship between later generations in control and DPI. We base our analysis on a longitudinal sample of 103 FFs in the automotive, industrial engineering, and pharmaceutical sectors observed from 2013 to 2020. This first empirical study applying construal level theory to the family business literature has important implications for the FF digital innovation literature and for FF owner-managers interested in achieving DPI.

Emerging Ideas. Suicidal ideation among partnered U.S. adults by sexual identity

AbstractObjectiveWe estimate the prevalence of suicidal ideation among partnered U.S. adults overall and by sexual identity using a population‐representative sample of cohabiting and married adults.BackgroundIntimate partner problems and other aspects of intimate relationships are substantial precipitating factors to suicide. Even so, there are currently no family‐based interventions targeting suicide risk among adults; this may be because little is known as to how prevalent suicidal ideation and behaviors are in the context of intimate relationships. Sexually diverse adults show higher proportions of suicidal ideation than heterosexual adults.MethodWeighted logistic regression was used to analyze data from a subsample of the National Couples' Health and Time Study (n = 3,618), a population‐representative sample of cohabiting and married adults. Unadjusted and model‐adjusted prevalence estimates for suicidal ideation (thoughts and plans) were calculated.ResultsThe model adjusted prevalence estimates for suicide thoughts and plans were similar to estimates among general population samples. Bisexual and queer+ respondents had double the odds of reporting suicide thoughts and plans compared with gay, lesbian, and heterosexual respondents.ConclusionsCohabiting and married adults showed a similar prevalence of suicidal ideation as the general population. Bisexual and queer+ adults are a growing U.S. population and require unique attention because they confront higher suicide risk compared with not only heterosexual but also gay and lesbian adults.ImplicationsFamily‐based interventions are needed to target suicidal ideations and behaviors among adults, including those who are married or cohabiting. Sexually diverse adults should not be treated as a monolithic group when tailoring interventions for sexually diverse populations.

Disaggregation of Asian American, Native Hawaiian, and Pacific Islander populations in postmastectomy breast reconstruction

PurposeAsian American, Native Hawaiian, and Pacific Islander (AANHPI) patient populations are often defined as one monolithic group in medical research despite cultural, socioeconomic, and clinical heterogeneity. Although the general AANHPI population is underrepresented in reception of postmastectomy breast reconstruction, existing literature has not characterized the disaggregation of such rates for AANHPI ethnic subgroups. MethodsPatients who underwent mastectomy were identified in the 2007 to 2020 registries within the Surveillance, Epidemiology and End Results database. Patients were stratified by race and ethnicity, and additional demographic and oncologic variables were collected. Multivariate binary logistic regression was conducted to assess for reception of postmastectomy immediate breast reconstruction (p < 0.05). ResultsAmong 33,422 AANHPI patients who underwent mastectomy, South Asian patients were associated with the highest breast reconstruction rates (33%) and Melanesians with the lowest (15%). Overall, AANHPI patients were associated with a lower breast reconstruction rate than non-Hispanic Whites (27% vs. 35%; p < 0.001). This difference increased from 6.4% in 2007 to 10% in 2020. After controlling for demographic and oncologic covariates, all AANHPI ethnic subgroups predicted a lower likelihood of breast reconstruction than non-Hispanic Whites (p < 0.001). Odds ratios for reconstruction ranged from 0.17 [95% confidence interval (95% CI), 0.11–0.27] for Melanesian patients to 0.45 (95% CI, 0.42–0.48) for South Asian patients. ConclusionsDisparities in the receipt of immediate breast reconstruction exist within the AANHPI patient population in the United States. This analysis supported the need for disaggregation in plastic surgery research for improved knowledge and targeted interventions.

How Southeast Asian Students Develop Their Science Self-Efficacy During the First Year of College

ABSTRACT To contribute to the scant yet growing literature on Southeast Asian students within college STEM, this quantitative study investigated factors that were most salient in science self-efficacy development of these students, which prior scholarship suggests is significant for various STEM success outcomes. Using descriptive and predictive statistical approaches on a multi-institution and nationwide longitudinal sample of first-year STEM students, results suggest that a unique set of predictors are associated with Southeast Asian students’ science self-efficacy development when compared to Asian American and Pacific Islander (AAPI) students in the aggregate. Further, results point to the importance of disaggregating AAPI racial/ethnic data in research to reveal factors that are distinct to each AAPI ethnic subgroup and to dismantle the narrative that AAPI students are a monolithic group. Findings suggest that pedagogical approaches that employ community building among faculty and students within the classroom are associated with Southeast Asian students’ science self-efficacy. Guided by these findings, implications for theory, practice, and policy that center Southeast Asian students and their development within STEM are offered to inform relevant future research, program plans, and policy recommendations.

Not a Monolith: Understanding of Racism and Racialization among Korean, Pacific Islander, South Asian, and Vietnamese Women.

The people within the Asian and Pacific Islander racial/ethnic category used in the United States are often misrepresented as a monolithic group when, in reality, the group includes people from over 48 different countries with diverse cultures, languages, and customs. Asian and Pacific Islander people experience racism and racialization in nuanced ways that are influenced by immigrant generations, histories of colonization, and origin countries' relationship with the US. This study examines the racialized experiences of Asian and Pacific Islander women in the United States. Focus groups were held with 21 Korean, Pacific Islander, South Asian, and Vietnamese women in the United States to explore their experiences of racism and racialization. Data were analyzed using an iterative coding and theme-generation process. Findings indicate that among these groups, there is a heightened awareness of racism both toward their own racial/ethnic group as well as toward other minoritized populations, a recognition of the importance of solidarity among people of color to combat racism and the difficulties in sustaining solidarity, and nuanced ways in which different Asian and Pacific Islander people navigate their own racialization.

Heterogeneity in the Prevalence of Cardiovascular Risk Factors by Ethnicity and Birthplace Among Asian Subgroups: Evidence From the 2010 to 2018 National Health Interview Survey.

Asian people in the United States have different sociodemographic and health-related characteristics that might affect cardiovascular disease (CVD) risk by ethnicity and birthplace. However, they are often studied as a monolithic group in health care research. This study aimed to examine heterogeneity in CVD risk factors on the basis of birthplace among the 3 largest Asian subgroups (Chinese, Asian Indian, and Filipino) compared with US-born non-Hispanic White (NHW) adults. A cross-sectional analysis was conducted using the 2010 to 2018 National Health Interview Survey data from 125 008 US-born and foreign-born Chinese, Asian Indian, Filipino, and US-born NHW adults. Generalized linear models with Poisson distribution were used to examine the prevalence and prevalence ratios of self-reported hypertension, diabetes, high cholesterol, physical inactivity, smoking, and overweight/obesity among Asian subgroups compared with US-born NHW adults. The study included 118 979 US-born NHW and 6029 Asian adults who self-identified as Chinese (29%), Asian Indian (33%), and Filipino (38%). Participants' mean (±SD) age was 49±0.1 years, and 53% were females. In an adjusted analysis, foreign-born Asian Indians had significantly higher prevalence of diabetes, physical inactivity, and overweight/obesity; foreign-born Chinese had higher prevalence of physical inactivity, and foreign-born Filipinos had higher prevalence of all 5 CVD risk factors except smoking compared with NHW adults. This study revealed significant heterogeneity in the prevalence of CVD risk factors among Asian subgroups by ethnicity and birthplace, stressing the necessity of disaggregating Asian subgroup data. Providers should consider this heterogeneity in CVD risk factors and establish tailored CVD prevention plans for Asian subgroups.

UNTANGLING THE MODEL MINORITY STEREOTYPE: PROMOTING HEALTH EQUITY AMONG ASIAN AMERICAN OLDER ADULTS

Abstract The “model minority” stereotype portrays Asian Americans (AAs) as a monolithic group with common traits, e.g., high levels of education and income, and better health status. Five studies in this symposium used multiple data sources and provided rich information to untangling this stereotype. The first study highlighted racial/ethnic disparities in help-seeking behaviors among Americans with subjective cognitive decline, revealing that AAPIs exhibit the lowest likelihood of seeking help for cognitive problems. The second study examined the degree to which socioeconomic disparity contributes to functional impairment among older AAs relative to other racial/ethnic groups, revealing that AAs fare worst in the burden of functional impairment due to education disparity. The third paper explored the cultural adaptation of the NYUCI for Chinese and Korean dementia caregivers, showing that cultural beliefs have a profound effect on caregivers’ views of dementia and caregiving, their use of social and family support, and their understanding of self-care and counseling services. The fourth study assessed factors linked to depressive symptoms among older Southeast AAs, revealing that Vietnamese Americans have significantly more depressive symptoms than Indonesian and Filipino Americans. Resilience and age are negatively related to depressive symptoms, while greater family conflict and inability to speak English fluently are positively associated with depressive symptoms. The fifth study used a large longitudinal survey on older Chinese Americans and demonstrated that higher acculturation levels are associated with a more rapid decline in depression and a slower decline in activities of daily living but are not related to long-term cognitive changes.

Genomics and Biomarkers in older Latinos: Challenges and Opportunities

AbstractThere are fundamental knowledge gaps about normal aging, cognitive decline, and the roles of Alzheimer’s Disease (AD) biomarkers in the Latino population. Previous studies report, ethno‐racial differences in amyloid (A), tau (T), and neurodegeneration (N) biomarkers and genetics of AD. However, most studies including Latino populations consider those as a monolithic group while ignoring the genetic and environmental diversity of this group. Latinos are racially and ethnically diverse, and often reflect a mix of culture, environment, and genetic ancestries drawn from African, Amerindian, and European backgrounds. Research suggest that Latinos are both less likely to carry an APOE‐ε4 allele and have less of a risk for AD due to the ε4 allele than White non‐Latinos. Further, epidemiology, biomarker, and neuroimaging data suggest that vascular risk factors are prevalent in Latinos and may increase risk in midlife, thus impacting dementia rates later in life. The interaction of genetic and environmental factors in the development and progression of AD is complex in Latinos due to the influence of different levels of education, acculturation, socioeconomic conditions, immigration, language proficiency, and bilingualism, among others. In this session, the US Consortium of Aging, Dementia &amp; Latino Studies (CADLAS) Genomics and Biomarkers Special Interest Group (SIG) will discuss recent developments, current challenges and opportunities in this area of research. The SIG was created in 2022 with the main goal of promoting collaborations among investigators to accelerate research and discovery of biomarkers and new diagnostics that work for US Latino populations. Research priorities include validation of biomarkers of proteinopathies and neurodegeneration, as well as vascular contributions to cognitive impairment and dementias, and development of novel and most sensitive biomarkers. Explorations of the unique genomic ancestry of diverse Latinos will also be considered as they are likely to provide new insights into cognitive decline and dementia in this population.

New Image of the Child in Lord of the Flies and the Adventures of Huckleberry Finn

The characteristics of stereotypical characters in literary works may transform over time as the characteristics of the group they represent in society change. Child image is one of those which experiences this change the most. Child, who initially appeared as a little adult, evil born or wax to be molded, has evolved to include more complex and sophisticated depictions because the child in the real world has begun to be seen differently than before and it has been understood that it has a more complex structure than it appears. This indicates that children are not just a monolithic group who look remarkably alike and have common characteristics and behaviors. Factors such as nature, society, and living conditions play an important role in shaping each child's unique character and actions, and therefore a child cannot be exclusively decent, evil, pure, or tainted. However, in any case, the image of the child is shaped by the wishes and expectations of society. To make a long story short, from the past to the present, children have come to be understood as more than stereotypes and as multidimensional individuals, and as a manifestation of this in literature, they have begun to be represented more complexly in works. This process of change is evident when the older literary periods and more recent novels The Adventures of Huckleberry Finn and Lord of the Flies are analyzed.

An Empirical Examination of the In-Prison Behaviors of Foreign-Born Individuals: Does Nationality Predict Misconduct?

The current study investigates how immigrants cope and adapt to the “pains of imprisonment” by examining a specific maladjustment outcome—disciplinary infractions. Like other groups (e.g., females, LGBTQ, elderly), immigrants are regarded as a special population in prison considering that they encounter a unique set of challenges that the typical incarcerated person does not. At the same time, immigrants are not a monolithic group, and there are reasons why misconduct may differ when we separate them by country of birth. To this end, we explore whether the frequency and probability for institutional misconduct varies across Cubans, Puerto Ricans, Haitians, Jamaicans, Mexicans, as well as immigrants from other countries. We also consider whether any nationality group exhibits a higher (or lower or similar) propensity for in-prison offending than the native-born. Our results reveal there are greater differences in disciplinary infractions among our foreign-born groups than between them and natives, a finding that is obscured when immigrants are lumped into a single measure (i.e., all foreign-born).

Integrating Neuroscience Principles into the Development of a Tailored Daily Report: A Universal Design Approach

Abstract Information management environments are typically dynamic, data-rich, and inherently multimodal but often do not support users sufficiently. Information management environments include the tools, supports, and persons which collect, organize, manage, and maintain information. The dynamism of the environment arises because of users’ need to use top-down attentional and memory approaches while attempting to use the available resources. In addition to the specific attentional and cognitive demands, many information management environments treat users as a monolithic group. The complexity of the interaction between the environment, the knowledge worker, and their individual needs creates serious difficulties in developing tailored tools and reports. Despite the intent of these “tailored” reports to simplify the interaction between the knowledge worker and the deluge of data for decision-making purposes, successfully creating a tailored report is still an active area of research. However, in the last decade, technologies that were considered theoretical have now been realized via the fourth industrial revolution. The success of the fourth industrial revolution has resulted in tools such as machine learning to drive the automated tailoring of information for individual knowledge workers. Despite early successes, the drive toward complete individualization and differentiation solely through computational means seems to reduce the effectiveness of the individual and has shown only limited success. To address these shortcomings, the authors of this essay suggest using a more comprehensive framework (Universal Design) to develop a tailored report. Universal Design (UD) is a design framework based upon the Universal Design for Learning framework. UD is a framework that promotes inclusive and equitable access to information for all knowledge workers through the application of “equalizer.” By acknowledging and addressing users’ individual needs and information processing preferences, UD can support creating a generative environment in which every individual has their needs met without individualization and differentiation occurring through specific automation. Keywords: Universal design, Adaptive environments, Information processing, Generative information environments, Knowledge workers.

Emergency department patient-centred care perspectives from deaf and hard-of-hearing patients.

Deaf and hard-of-hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non-DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient-provider communication. This qualitative study aimed to describe ED care-seeking and patient-centred care perspectives among DHH patients. This qualitative study is the second phase of a mixed-methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non-DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language(ASL)-users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach. Two themes were developed: (1) DHH patients engage in a complex decision-making process to determine ED utilization and (2) patient-centred ED care differs between DHH ASL-users and DHH English speakers. The first theme describes the social-behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes. This study underscores the importance of better understanding, and intervening in, DHH patient ED care-seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity-relevant indicator. We also discuss recommendations for emergency medicine. This study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection toolsand validation of the analysis and interpretation of data. Community advisory group members who were interested in co-authorship are listed in the byline, with others in the acknowledgements. In addition, several academic-based co-authors are also deaf or hard of hearing.

A Health Profile of African Immigrant Men in the United States

African immigrants (AI) are the fastest growing group of immigrants to the U.S. however, their health and health practices remains poorly characterized. Thus, this study aimed to describe the health profile of this under-described U.S. population. In order to contextualize their health profiles, we compared AI (n=95) to other U.S. Black populations, namely African Americans (AA, n=271) and Caribbean American (CA, n=203) immigrants. We used cross-sectional survey data from a prostate cancer health study with 569 Black adult male participants, ages 21 years or older. Demographic characteristics were compared using Chi-square tests and prevalence ratios, and prevalence odds ratios (POR) were estimated for AIs compared to AA and CA immigrants using a log-binomial regression model. Results revealed that AI exhibited significantly lower prevalence of asthma and diabetes, when compared to AA and CA immigrants. Furthermore, AI reported lower consumption of alcohol than AA (POR, 0.43, 95%CI 0.24, 0.75) and lower smoking prevalence than AA (POR, 0.19, 95%CI 0.05, 0.70) and CA immigrants (POR, 0.21, 95%CI 0.05, 0.76). Additionally, AI reported significantly lower medical mistrust than CA (POR, 0.51, 95%CI 0.26, 0.95), significantly low financial strain than CAs immigrants (POR, 1.66, 95%CI 1.00, 2.75) and significantly higher levels of religious coping than both AA (POR, 2.43, 95%CI 1.43, 4.12) and CA immigrant men (POR, 1.78, 95%CI 1.03, 3.08). This study further supports emerging evidence that Blacks in the U.S. are not a monolithic group and that it is necessary to assess the Black subgroups separately. In addition, as one of the fastest growing immigrant populations, it is critical for future research to understand African immigrant's health needs and its correlates.

Clinical evaluation and quantitative occlusal change analysis of posterior implant-supported all-ceramic crowns: A 3-year randomized controlled clinical trial.

To compare the survival and complication rates of posterior screw-retained monolithic lithium disilicate (LS2 )/veneered zirconia (ZrO2 ) single implant crowns (SICs), as well as analyze the occlusal changes observed during a 3-year follow-up period. Thirty-three patients were included and randomly divided into two groups. The test group consisted of 17 patients who received monolithic-LS2 -SIC, while the control group consisted of 16 patients who received veneered-ZrO2 -SIC. Implant/prosthesis survival rates, technical complications, peri-implant soft tissue conditions, and quantitative occlusal changes of SIC (obtained by the intra-oral scanner and analyzed in reverse software Geomagic Control 2015) were assessed at 1- and 3-year follow-ups. Bone loss and Functional Implant Prosthodontic Score (FIPS) were evaluated at a 3-year follow-up. After a 3-year follow-up period, one patient dropped out of the follow-up. No implant loss was observed. One crown was fractured, resulting in prosthesis survival rates of 93.75% for the monolithic group and 100% for the veneered group. A technical complication rate of 25% (4/16) was observed in the veneered group (p = .333). No significant differences in the marginal bone loss were observed at the 3-year follow-up (0.00 (-0.22, 0.17) mm versus 0.00 (-0.12, 0.12) mm, p = .956). The total FIPS scores for the test group were 9.0 (9.0, 9.0), while the control group received scores of 9.0 (8.0, 10.0) (p = .953). The changes in mean occlusal clearance were 0.022 ± 0.083 mm for the test and 0.034 ± 0.077 mm for the control group (at 3 years, p = .497). The changes in occlusal contact area were 1.075 ± 2.575 mm2 for the test and 1.676 ± 2.551 mm2 for the control group (at 3 years, p = .873). After a 3-year follow-up, screw-retained monolithic LS2 and veneered ZrO2 SIC demonstrated similar survival rates. The occlusal performance of implant prostheses needs to be closely examined during follow-up, and appropriate occlusal adjustments need to be considered.

Building on cultural and linguistic strengths and recognizing life challenges - a commentary on Paradis' "Sources of individual differences in the dual language development of heritage bilinguals".

Children growing up bilingually are often treated as a monolithic group; however, heritage language (HL) bilinguals constitute an extremely heterogenous group that vary due to a wide variety of factors. In her keynote, Paradis provides a thought-provoking analysis of the research literature and identifies key internal and external factors that lead to individual differences. Specifically, she identifies age of second language (L2) acquisition, cognitive abilities, and social-emotional wellbeing as important internal factors. She also discusses both proximal and distal external factors. Proximal factors include children's cumulative exposure to L2 and HL, L2 and HL usage at home, and the richness of the L2 and HL environment. Distal factors involve education in HL, parent language proficiency, socioeconomic status (SES), and family attitudes and identities. In my commentary, I expand on Paradis' keynote to include the role of culture, which I consider to be both an internal and external factor, and respond to her discussion of two external factors, the impact of SES and the role of the classroom environment.