Separate & Unequal: How Higher Education Reinforces the Intergenerational Reproduction of White Racial Privilege

Clearly class is a powerful cross-cutting factor in explaining postsecondary differences among all students. Yet, controlling for income, race matters: taken together, lower-income AfricanAmerican and Hispanic students just don't do as well as lower-income whites. We find that white students (45%) in the lower half of the family income distribution drop out of college much less frequently than African Americans (55%) and Hispanics (59%). These lower-income whites get Bachelor's degrees at nearly twice the rate of African Americans and Hispanics and obtain many fewer sub-baccalaureate degrees. In particular, African-American students get substantially more certificates.Class and race overlap and are most virulent in combination. Along with many other researchers, we find that the reason for persistent racial inequality begins with the fact that African Americans and Hispanics seem to face barriers not faced by whites. Unequal educational and career outcomes for economically disadvantaged whites can be explained with variables like family income, parental education, and peer expectations. These same variables do not fullyexplain African American and Hispanic educational and economic outcomes. Earlier research shows income effects are more fully explained by observable things, like peer group and tutoring, while differences by race are not so easy to pin down. The preponderance of evidence supports the premise that the disadvantages of race and income must be considered separately in most cases. Yes, differences in readiness and income explain differences in academic and life outcomes; but, independently, so do race and ethnicity

High-altitude Pulmonary Hypertension: An Update on Disease Pathogenesis and Management

High-altitude pulmonary hypertension (HAPH) affects individuals residing at altitudes of 2,500 meters and higher. Numerous pathogenic variables play a role in disease inception and progression and include low oxygen concentration in inspired air, vasculopathy, and metabolic abnormalities. Since HAPH affects only some people living at high altitude genetic factors play a significant role in its pathogenesis. The clinical presentation of HAPH is nonspecific and includes fatigue, shortness of breath, cognitive deficits, cough, and in advanced cases hepatosplenomegaly and overt right-sided heart failure. A thorough history is important and should include a search for additional risk factors for lung disease and pulmonary hypertension (PH) such as smoking, indoor air pollution, left-sided cardiac disease and sleep disordered breathing. Twelve-lead electrocardiogram, chest X-ray and echocardiography can be used as screening tools. A definitive diagnosis should be made with right-sided heart catheterization using a modified mean pulmonary artery pressure of at least 30 mm Hg, differing from the 25 mm Hg used for other types of PH. Treatment of HAPH includes descent to a lower altitude whenever possible, oxygen therapy and the use of medications such as endothelin receptor antagonists, phosphodiesterase 5 blockers, fasudil and acetazolamide. Some recent evidence suggests that iron supplementation may also be beneficial. However, it is important to note that the scientific literature lacks long-term randomized controlled data on the pharmacologic treatment of HAPH. Thus, an individualized approach to treatment and informing the patients regarding the benefits and risks of the selected treatment regimen are essential

What's It Worth? The Economic Value of College Majors

Analyzes, by college major, gender and racial/ethnic distribution, median annual earnings, likelihood of unemployment and advanced degree attainment, and occupation and industry, as well as earnings differences within majors by race/ethnicity and gender

Race, Elite College Admissions, and the Courts: The Pursuit of Racial Equality in Education Retreats to K12 Schools

If the Supreme Court bans race-conscious affirmative action, as expected, selective higher education institutions almost certainly will become less diverse, reducing the rates of degree attainment among students from historically underrepresented racial/ethnic groups. This report explores the legal history of racial equity in education, evaluates alternatives to using race/ethnicity in college admissions, and considers changes to the K–12 education system that would improve educational opportunity. In the long term, the only way to ensure diversity at selective higher education institutions is to confront the segregation and inequity in K–12 education and society at large

Navigating the College-to-Career Pathway: The 10 Rules of Moving from Youth Dependency to Adult Economic Independence

Over the past half century, postsecondary education has played an increasingly important role in career preparation in the United States. Having a college degree or certificate has become both more valuable in the labor market and more expensive, with much of the burden falling directly on students and their families. Meanwhile, the postsecondary landscape has become increasingly complex. Navigating the College-to-Career Pathway: The 10 Rules of Moving from Youth Dependency to Adult Economic Independence, published in partnership with the Postsecondary Value Commission, highlights key considerations for students as they prepare to make one of the biggest financial decisions of their lives

CPAPアドヒランスの予測因子としてのCPAP装着下覚醒時の呼吸不規則性

BACKGROUND AND OBJECTIVE: The standard therapy for obstructive sleep apnoea (OSA) is continuous positive airway pressure (CPAP) therapy. However, long-term adherence remains at ~50% despite improvements in behavioural and educational interventions. Based on prior work, we explored whether regularity of breathing during wakefulness might be a physiologic predictor of CPAP adherence. METHODS: Of the 117 consecutive patients who were diagnosed with OSA and prescribed CPAP, 79 CPAP naïve patients were enrolled in this prospective study. During CPAP initiation, respiratory signals were collected using respiratory inductance plethysmography while wearing CPAP during wakefulness in a seated position. Breathing regularity was assessed by the coefficient of variation (CV) for breath-by-breath estimated tidal volume (VT ) and total duration of respiratory cycle (Ttot). In a derivation group (n = 36), we determined the cut-off CV value which predicted poor CPAP adherence at the first month of therapy, and verified the validity of this predetermined cut-off value in the remaining participants (validation group; n = 43). RESULTS: In the derivation group, the CV for estimated VT was significantly higher in patients with poor adherence than with good adherence (median (interquartile range): 44.2 (33.4-57.4) vs 26.0 (20.4-33.2), P 34.0 confirmed to be predicting poor CPAP adherence (sensitivity, 0.78; specificity, 0.83). CONCLUSION: At the initiation of therapy, breathing regularity during wakefulness while wearing CPAP is an objective predictor of short-term CPAP adherence.博士（医学）・乙第1391号・平成29年3月15日© 2016 Asian Pacific Society of RespirologyThis is the peer reviewed version of the following article: Respirology Vol.22 No.2 p.386-393 (2017 Feb), which has been published in final form at http://dx.doi.org/10.1111/resp.12900. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving

Paradoxical Sleep Suppresses Immediate Early Gene Expression in the Rodent Suprachiasmatic Nuclei

Light stimulates neuronal activity with subsequent expression of the protein product of the immediate early gene, c-fos, in the Suprachiasmatic Nuclei (SCN). Non-photic stimuli is also thought to modulate activity within the SCN. Here, we sought to determine the effects intrinsic stimuli, specifically, the states of sleep upon c-fos protein expression in the SCN. In 16 rats, c-fos protein expression was evaluated at a fixed time of 1600 h (subjective night), following 1 h of electroencephalographically defined sleep. During sleep, as the state of paradoxical sleep (PS) increased, c-fos protein expression decreased (r = −0.41, p < 0.033). The PS-associated reduction of c-fos positive cells occurred equally between animals asleep in the light and those asleep in the dark. We propose a model whereby PS duration might function as a homeostatic-entraining mechanism to reduce neuronal activity within the SCN, and thereby modulate circadian rhythms during sleep

The Determining Risk of Vascular Events by Apnea Monitoring (DREAM) Study: Design, Rationale and Methods

Purpose The goal of the Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study is to develop a prognostic model for cardiovascular outcomes, based on physiologic variables—related to breathing, sleep architecture, and oxygenation—measured during polysomnography in US veterans. Methods The DREAM study is a multi-site, retrospective observational cohort study conducted at three Veterans Affairs (VA) centers (West Haven, CT; Indianapolis, IN; Cleveland, OH). Veterans undergoing polysomnography between January 1, 2000 and December 31, 2004 were included based on referral for evaluation of sleep-disordered breathing, documented history and physical prior to sleep testing, and ≥2-h sleep monitoring. Demographic, anthropomorphic, medical, medication, and social history factors were recorded. Measures to determine sleep apnea, sleep architecture, and oxygenation were recorded from polysomnography. VA Patient Treatment File, VA–Medicare Data, Vista Computerized Patient Record System, and VA Vital Status File were reviewed on dates subsequent to polysomnography, ranging from 0.06 to 8.8 years (5.5 ± 1.3 years; mean ± SD). Results The study population includes 1840 predominantly male, middle-aged veterans. As designed, the main primary outcome is the composite endpoint of acute coronary syndrome, stroke, transient ischemic attack, or death. Secondary outcomes include incidents of neoplasm, congestive heart failure, cardiac arrhythmia, diabetes, depression, and post-traumatic stress disorder. Laboratory outcomes include measures of glycemic control, cholesterol, and kidney function. (Actual results are pending.) Conclusions This manuscript provides the rationale for the inclusion of veterans in a study to determine the association between physiologic sleep measures and cardiovascular outcomes and specifically the development of a corresponding outcome-based prognostic model