Cultural Capital, Habitus, College Persistence and Graduation Among Black Immigrant-Origin Undergraduates: A Basic Interpretive Qualitative Study

Black immigrant-origin students are a significant sub-population of the total Black college student population, and they are persisting and graduating more frequently than Black U.S.-origin students. This study explored cultural capital and habitus and how they shaped the college persistence and graduation of Black immigrant-origin undergraduates and alumni from four-year postsecondary institutions. A basic interpretive qualitative design, guided by cultural capital theory, was used to explore thirteen Black-immigrant-origin students’ and graduates’ perspectives in-depth; and to describe their subjective meanings, actions, and social contexts from their point of view. Participants grew up with a habitus of achievement that came from the family wanting to attain the American Dream as well as racialized experiences they experienced in the United States. This habitus motivated participants to achieve. That same habitus got them into college also got them through college. They had to persist and graduate because they wanted to be able to give back to their families and communities; they wanted to prove their greatness to others; and because time, money, and resources were dedicated to their completion of college. There were several steps the participants’ took to prepare for entering college and graduating. In their early years, participants attained cultural capital in the form of English as their primary language, and from the support of people in their churches who served as cultural resources. Some of the participants’ parents and older siblings had college educations, which exposed them to the rigors and requirements of college. Many of the participants were enrolled in academically rigorous college preparatory or high-performing high schools. In those schools, most participants were scholastically prepared for the rigors of college, given opportunities to gain college credit via AP and College Now courses, and went on college tours. Participants found high school friends who had similar cultural backgrounds and academic goals and supportive teachers and counselors. Furthermore, some participants were able to gain cultural capital from people or programs in their community and pre-college programs. In college, participants attained cultural capital through nurturing professors and academic support offices, participating in co-curricular activities and culturally-related clubs, and resourceful friends or acquaintances

Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial

Background: Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity. Methods: PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545. Findings: Between Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8\ub71%) of 2396 patients in the CPAP group and 197 (8\ub72%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1\ub701 [95% CI 0\ub781-1\ub724]; p=0\ub795). 200 (8\ub79%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3\ub75%] of 2241 patients), oronasal dryness (43 [1\ub79%]), excessive air leak (36 [1\ub76%]), vomiting (26 [1\ub72%]), and pain (24 [1\ub71%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability. Interpretation: In this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended