College textbooks often present a biased interpretation of affirmative action policies

Affirmative action policies go beyond race; they now also cover women, age, disability, and veterans. But such policies are often framed by a misinterpretation of their intent. In new research into how college textbooks discuss affirmative action policies, Sherri L. Wallace and Marcus D. Allen find that such policies tend to be framed as being “controversial” rather than as being aimed towards legal redress. This leads to a conservative interpretation of affirmative action policy as being race-based, and therefore morally wrong. They argue that in order to eliminate such confusion and misinterpretations, college textbooks need to explicitly define affirmative action and spell out the policy’s inten

Affirmative Action in American Government Introductory Textbooks

The history of affirmative action policy consists of a broad collection of executive orders, bureaucratic decisions, course cases, and state legislation designed to eliminate unlawful discrimination of applicants to educational programs or professional employment, to remedy the results of such prior discrimination, and to prevent discrimination in the future. Although targeted legislation has expanded protections beyond underrepresented racial and ethnic groups in education and employment to include women, people of a certain age, people with disabilities and veterans, the actual policy intent of affirmative action remains a source of confusion for students, particularly when college textbooks define the topics within a race-only paradigm and without the inclusion of gender, age, disability or other protected categories. This study posits that Fisher v. University of Texas at Austin cases can be useful for teaching college students about why affirmative action policy is still relevant for diversity and inclusion in higher education and beyond

Conditional Cross-Design Synthesis Estimators for Generalizability in Medicaid

While much of the causal inference literature has focused on addressing internal validity biases, both internal and external validity are necessary for unbiased estimates in a target population of interest. However, few generalizability approaches exist for estimating causal quantities in a target population when the target population is not well-represented by a randomized study but is reflected when additionally incorporating observational data. To generalize to a target population represented by a union of these data, we propose a class of novel conditional cross-design synthesis estimators that combine randomized and observational data, while addressing their respective biases. The estimators include outcome regression, propensity weighting, and double robust approaches. All use the covariate overlap between the randomized and observational data to remove potential unmeasured confounding bias. We apply these methods to estimate the causal effect of managed care plans on health care spending among Medicaid beneficiaries in New York City.Comment: 25 pages, 4 figures; supplement of 31 pages, 12 figures, and 4 table

Understanding student evaluations : a black faculty perspective.

Student evaluations of faculty teaching are critical components to the evaluation of faculty performance. These evaluations are used to determine teaching effectiveness and they influence tenure and promotion decisions. Although they are designed as objective assessments of teaching performance, extraneous factors, including the instructors’ race, can affect the composition and educational atmosphere at colleges and universities. In this reflection, we briefly review some literature on the use and utility of student evaluations and present narratives from social work faculty in which students’ evaluation contained perceived racial bias

Inclusive teaching circles : mechanisms for creating welcoming classrooms.

This essay examines the Inclusive Teaching Circle (ITC) as a mechanism for faculty development in creating instructional tools that embrace an inclusive pedagogy reflecting diversity, cultural competence and social justice. We describe one group’s year-long participation in an ITC at a large, metropolitan research university in the south. Next, we share several members’ strategies for promoting more inclusive and equitable learning for students in our classrooms. Finally, we consider the implications of ITCs for its group participants and the professorate at large

Trends and determinants of stillbirth in developing countries: results from the Global Network\u27s Population-Based Birth Registry.

BACKGROUND: Stillbirth rates remain high, especially in low and middle-income countries, where rates are 25 per 1000, ten-fold higher than in high-income countries. The United Nations\u27 Every Newborn Action Plan has set a goal of 12 stillbirths per 1000 births by 2030 for all countries. METHODS: From a population-based pregnancy outcome registry, including data from 2010 to 2016 from two sites each in Africa (Zambia and Kenya) and India (Nagpur and Belagavi), as well as sites in Pakistan and Guatemala, we evaluated the stillbirth rates and rates of annual decline as well as risk factors for 427,111 births of which 12,181 were stillbirths. RESULTS: The mean stillbirth rates for the sites were 21.3 per 1000 births for Africa, 25.3 per 1000 births for India, 56.9 per 1000 births for Pakistan and 19.9 per 1000 births for Guatemala. From 2010 to 2016, across all sites, the mean stillbirth rate declined from 31.7 per 1000 births to 26.4 per 1000 births for an average annual decline of 3.0%. Risk factors for stillbirth were similar across the sites and included maternal age \u3c 20 years and age \u3e 35 years. Compared to parity 1-2, zero parity and parity \u3e 3 were both associated with increased stillbirth risk and compared to women with any prenatal care, women with no prenatal care had significantly increased risk of stillbirth in all sites. CONCLUSIONS: At the current rates of decline, stillbirth rates in these sites will not reach the Every Newborn Action Plan goal of 12 per 1000 births by 2030. More attention to the risk factors and treating the causes of stillbirths will be required to reach the Every Newborn Action Plan goal of stillbirth reduction. TRIAL REGISTRATION: NCT01073475

Metformin Plus Insulin for Preexisting Diabetes or Gestational Diabetes in Early Pregnancy: The MOMPOD Randomized Clinical Trial

IMPORTANCE: Insulin is recommended for pregnant persons with preexisting type 2 diabetes or diabetes diagnosed early in pregnancy. The addition of metformin to insulin may improve neonatal outcomes. OBJECTIVE: To estimate the effect of metformin added to insulin for preexisting type 2 or diabetes diagnosed early in pregnancy on a composite adverse neonatal outcome. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial in 17 US centers enrolled pregnant adults aged 18 to 45 years with preexisting type 2 diabetes or diabetes diagnosed prior to 23 weeks\u27 gestation between April 2019 and November 2021. Each participant was treated with insulin and was assigned to add either metformin or placebo. Follow-up was completed in May 2022. INTERVENTION: Metformin 1000 mg or placebo orally twice per day from enrollment (11 weeks -\u3c23 \u3eweeks) through delivery. MAIN OUTCOME AND MEASURES: The primary outcome was a composite of neonatal complications including perinatal death, preterm birth, large or small for gestational age, and hyperbilirubinemia requiring phototherapy. Prespecified secondary outcomes included maternal hypoglycemia and neonatal fat mass at birth, and prespecified subgroup analyses by maternal body mass index less than 30 vs 30 or greater and those with preexisting vs diabetes early in pregnancy. RESULTS: Of the 831 participants randomized, 794 took at least 1 dose of the study agent and were included in the primary analysis (397 in the placebo group and 397 in the metformin group). Participants\u27 mean (SD) age was 32.9 (5.6) years; 234 (29%) were Black, and 412 (52%) were Hispanic. The composite adverse neonatal outcome occurred in 280 (71%) of the metformin group and in 292 (74%) of the placebo group (adjusted odds ratio, 0.86 [95% CI 0.63-1.19]). The most commonly occurring events in the primary outcome in both groups were preterm birth, neonatal hypoglycemia, and delivery of a large-for-gestational-age infant. The study was halted at 75% accrual for futility in detecting a significant difference in the primary outcome. Prespecified secondary outcomes and subgroup analyses were similar between groups. Of individual components of the composite adverse neonatal outcome, metformin-exposed neonates had lower odds to be large for gestational age (adjusted odds ratio, 0.63 [95% CI, 0.46-0.86]) when compared with the placebo group. CONCLUSIONS AND RELEVANCE: Using metformin plus insulin to treat preexisting type 2 or gestational diabetes diagnosed early in pregnancy did not reduce a composite neonatal adverse outcome. The effect of reduction in odds of a large-for-gestational-age infant observed after adding metformin to insulin warrants further investigation

The Pictorial Fit-Frail Scale: developing a visual scale to assess frailty

Background: Standardized frailty assessments are needed for early identification and treatment. We aimed to develop a frailty scale using visual images, the Pictorial Fit-Frail Scale (PFFS), and to examine its feasibility and content validity. Methods: In Phase 1, a multidisciplinary team identified domains for measurement, operationalized impairment levels, and re-viewed visual languages for the scale. In Phase 2, feedback was sought from health professionals and the general public. In Phase 3, 366 participants completed preliminary testing on the revised draft, including 162 UK paramedics, and rated the scale on feasibility and usability. In Phase 4, following translation into Malay, the final prototype was tested in 95 participants in Peninsular Malaysia and Borneo. Results: The final scale incorporated 14 domains, each conceptualized with 3–6 response levels. All domains were rated as “understood well” by most participants (range 64–94%). Percentage agreement with positive statements regarding appearance, feasibility, and usefulness ranged from 66% to 95%. Overall feedback from health-care professionals supported its content validity. Conclusions: The PFFS is comprehensive, feasible, and appears generalizable across countries, and has face and content validity. Investigation into the reliability and predictive validity of the scale is currently underway