Status, respect, and adolescents’ responsiveness to educational interventions

As adolescents progress through school, they exhibit declining interest and motivation, which can have lifelong negative consequences. The adolescent status-respect sensitivity hypothesis posits that adolescents do not only consider how beneficial education is to their long-term success, but they also pay disproportionate attention to whether their environment is affording them respect before deciding whether they will align their behavior with their long-term educational interests. Here, respect is defined as a gestalt judgment of whether one's rights, beliefs, and abilities are being afforded. In this dissertation, we test for the first time, a key prediction of the status-respect sensitivity hypothesis: adolescents’ feelings of being respected in their environment should moderate the extent to which they profit from an attempt to influence their academic motivation and achievement (Study 1). We do this by examining the moderating effect of feeling respected on a growth mindset of intelligence intervention delivered in a nationally representative sample. Then we show this effect operates on an individual level, that is, how different students in the same class report different levels of respect from the same teacher and these within classroom differences explain variation in intervention effects. Next, we address the most significant barrier standing in the way of teachers being able to act on these findings: a lack of clarity about which teacher practices communicate respect to adolescents most effectively (Study 2). Using an inductive qualitative process, involving adolescents’ own descriptions of teacher’s respectful practices, we show that there is very little consensus about specific behaviors that were respectful or disrespectful. However, there were higher-order organizations of practices that led to a simple and practical framework of respect. Respect emerged from the combination of high standards conveying that a student could be competent and valuable and therefore has worth to the group (i.e., academic press), and providing the necessary support to help the student meet these high expectations. These inductive conclusions were confirmed using applications of natural language processing and machine learning with the language data. While promising, Study 2’s results were based on a small number of adolescents. To assess whether the framework generalized, we applied it to student reports of teacher behavior in a nationally representative dataset (Study 3). Using a machine learning analytical technique, we found comparable results, whereby students reported feeling more respected by teachers if those teachers had high academic press and offered supports to meet high standards. Overall, these studies highlight respect as a potential mechanism through which adults’ behaviors influence adolescent behavior. This is important because it suggests that during this developmental stage of adolescence, individual experiences of respect from the environment could be having powerful effects on adolescent trajectories. Furthermore, by providing educators with a “recipe” for respectful interactions in the classroom, this dissertation simplifies for teachers the challenge of motivating and engaging their students. This theory could be extended beyond academic motivation to other key areas of adolescent behavior, e.g., drug use, school discipline, reckless driving, healthy eating, and more.Psycholog

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8–13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05–6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50–75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron

Student Classification of Respectful Teacher Practices

This study will use student feedback and ratings to identify which teacher practices are respectful with the aim of informing future interventions

How Respectful Teacher Practices Promote Motivation

This study seeks to demonstrate that teacher practices that fulfill adolescents' need for respect can lead to greater engagement and motivation

A dual-system, machine-learning approach reveals how daily pubertal hormones relate to psychological well-being in everyday life

10.1016/j.dcn.2022.101158DEVELOPMENTAL COGNITIVE NEUROSCIENCE5

Chemiluminescent immunoassay overestimates hormone concentrations and obscures testosterone sex differences relative to LC-MS/MS in a field study of diverse adolescents

10.1016/j.cpnec.2022.100132Comprehensive Psychoneuroendocrinology10100132-10013

Shifting the mindset culture to address global educational disparities

Abstract Educational outcomes remain highly unequal within and across nations. Students’ mindsets—their beliefs about whether intellectual abilities can be developed—have been identified as a potential lever for making adolescents’ academic outcomes more equitable. Recent research, however, suggests that intervention programs aimed at changing students’ mindsets should be supplemented by programs aimed at the changing the mindset culture, which is defined as the shared set of beliefs about learning in a school or classroom. This paper reviews the theoretical and empirical origin of the mindset culture and examines its potential to reduce group-based inequalities in education. In particular, experiments have identified two broad ways the mindset culture is communicated by teachers: via informal messages about growth (e.g., that all students will be helped to learn and succeed), and formal opportunities to improve (e.g., learning-focused grading policies and opportunities to revise and earn credit). New field experiments, applying techniques from behavioral science, have also revealed effective ways to influence teachers’ culture-creating behaviors. This paper describes recent breakthroughs in the U.S. educational context and discusses how lessons from these studies might be applied in future, global collaborations with researchers and practitioners

Fish oil and postoperative atrial fibrillation : the Omega-3 Fatty Acids for Prevention of Post-operative Atrial Fibrillation (OPERA) randomized trial

Context: Postoperative atrial fibrillation or flutter (AF) is one of the most common complications of cardiac surgery and significantly increases morbidity and health care utilization. A few small trials have evaluated whether long-chain n-3-polyunsaturated fatty acids (PUFAs) reduce postoperative AF, with mixed results. Objective: To determine whether perioperative n-3-PUFA supplementation reduces postoperative AF. Design, Setting, and Patients: The Omega-3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) double-blind, placebo-controlled, randomized clinical trial. A total of 1516 patients scheduled for cardiac surgery in 28 centers in the United States, Italy, and Argentina were enrolled between August 2010 and June 2012. Inclusion criteria were broad; the main exclusions were regular use of fish oil or absence of sinus rhythm at enrollment. Intervention: Patients were randomized to receive fish oil (1-g capsules containing 65840 mg n-3-PUFAs as ethyl esters) or placebo, with preoperative loading of 10 g over 3 to 5 days (or 8 g over 2 days) followed postoperatively by 2 g/d until hospital discharge or postoperative day 10, whichever came first. Main Outcome Measure: Occurrence of postoperative AF lasting longer than 30 seconds. Secondary end points were postoperative AF lasting longer than 1 hour, resulting in symptoms, or treated with cardioversion; postoperative AF excluding atrial flutter; time to first postoperative AF; number of AF episodes per patient; hospital utilization; and major adverse cardiovascular events, 30-day mortality, bleeding, and other adverse events. Results: At enrollment, mean age was 64 (SD, 13) years; 72.2% of patients were men, and 51.8% had planned valvular surgery. The primary end point occurred in 233 (30.7%) patients assigned to placebo and 227 (30.0%) assigned to n-3-PUFAs (odds ratio, 0.96 [95% CI, 0.77-1.20]; P=.74). None of the secondary end points were significantly different between the placebo and fish oil groups, including postoperative AF that was sustained, symptomatic, or treated (231 [30.5%] vs 224 [29.6%], P=.70) or number of postoperative AF episodes per patient (1 episode: 156 [20.6%] vs 157 [20.7%]; 2 episodes: 59 [7.8%] vs 49 [6.5%]; 653 episodes: 18 [2.4%] vs 21 [2.8%]) (P=.73). Supplementation with n-3-PUFAs was generally well tolerated, with no evidence for increased risk of bleeding or serious adverse events. Conclusion: In this large multinational trial among patients undergoing cardiac surgery, perioperative supplementation with n-3-PUFAs, compared with placebo, did not reduce the risk of postoperative AF. Trial Registration: clinicaltrials.gov Identifier: NCT0097048