You Can't Be What You Can't See

This chapter presents the policy, practice, and societal contexts of initial teacher education in Ireland as a backdrop to the TOBAR programme. Primary teaching in Ireland is a high status and high demand profession, yet the teaching body is predominately white, female, and Catholic. In recent years, in response to changes in Irish society, and in initial teacher education and higher education policy, new initiatives have been introduced to diversify the teaching body. In the second section of this chapter, the authors present an overview of one such initiative: the TOBAR programme. The TOBAR programme supports Irish travellers to participate in initial teacher education programmes. Drawing on a series on interviews with students on the TOBAR programme, the authors report that the programme is having a positive impact on the students but that many challenges and barriers still exist.

Computerization and Occupational Change: Assessing the Impact of Automation on Racial and Gender Employment Densities

The current wave of technological change is driven by automation, the process of using computers to improve the labor process, viz., increasing the quantity and quality of work “by means of computer-controlled equipment.” Automation has had and will continue to have heterogeneous economic effects across alternative social groups—altering racial and gender inequality. This study empirically examines the relationship between the racial and gender density of occupations and the probability of automation of both minor and broad occupations. Regression analysis is used to uncover correlations between future employment change and the current racial and ethnic composition of occupations, alerting us to whether future employment growth will have a negative or positive association with occupations where each racial group of workers is currently concentrated. Increases in automation are correlated with increases in labor income inequality and increases in racial and gender employment differences. Male jobs may suffer more technological unemployment than female jobs. Specifically, within each racial group high density male jobs have a greater probability of automation (and lower probability of future demand) than high density female jobs. High density White female jobs appear to be most complementary to automation, while the high density occupations of racial minority men appear to be least complementary to automation.

Assessing Efforts to Diversify Kentucky’s K–12 Teacher Workforce: A Mixed-Methods Analysis of a Grow-Your-Own-Teacher Pathway

We examined the characteristics of 77 high school participants from four school districts who participated in the Teaching and Learning Career Pathway (TLCP) at the University of Louisville during the 2018–2019 school year. The program seeks to support the recruitment of a diverse and effective educator workforce by recruiting high school students as potential teachers for dual-credit courses that explore the teaching profession. Utilizing descriptive and inferential analysis (χ2 tests) of closed-ended item responses as well as qualitative analysis of program documents, Web sites, and students’ open-ended item responses, we compared the characteristics of the participants with those of their home school districts and examined their perceptions of the program. When considering gender and race/ethnicity, our analysis revealed the program was unsuccessful in its first year, reaching predominantly white female high school students who were already interested in teaching. Respondents reported learning about the TLCP from school personnel, specifically, guidance counselors (39%), non-TCLP teachers (25%), or TLCP teachers (20%). We found that the TLCP program has not defined diversity in a measurable way and the lack of an explicit program theory hinders the evaluation and improvement of TLCP. Program recruitment and outcomes are the result of luck or idiosyncratic personnel recommendations rather than intentional processes. We identified a need for qualitative exploration of in-school recruitment processes and statewide longitudinal studies to track participant outcomes in college and in the teacher labor market.

Two cases of multi-inflammatory syndrome in children (MIS-C) in adults in 2020

Background Late complications and longer-lasting sequelae of COVID-19 infection in adults can occur. Cardiovascular involvement including reduced ejection fraction, coronary artery aneurysms, and pericardial involvement have been reported. Prompt recognition is the first step and secondly, these cardiovascular phenomena require an alternative set of therapeutics from the standard of care for acute COVID-19 infection. Case presentation Here we describe two cases that fulfill the current case definition of the recently defined multisystem inflammatory syndrome in adults (MIS-A). One patient is a 27-year-old white female and the other a 21-year-old French creole male, both without any prior medical history. Both were hospitalized and found to have significant cardiac dysfunction and treated with IVIG, high dose aspirin, and corticosteroids with resolution of their acute illnesses and cardiac sequelae. Conclusion Not only does the immediate impact of this viral infection need to be addressed, but also the long-term complications that could arise if not recognized and treated promptly as seen in our two cases. Patients can develop acute cardiovascular collapse and cardiogenic shock which requires high level of care and treatment within an intensive care unit. Depending on the complications, patients may require treatment for congestive heart failure, pericarditis, or even coronary artery disease acutely with close follow up to ensure improvement or resolution.

Double and Triple Binds: How Status, Gender, and Race Influence the Work of State Prekindergarten Leaders

This paper examines how state prekindergarten (PreK) leaders in the United States believe their gender, race, and the status of the field influenced their work experiences. Qualitative methods were used to collect data from 10 state PreK leaders through two semistructured interviews. Leaders worked in different states and the majority identified as female (80%) and White/non-Hispanic (60%). Analysis of the data revealed the status of PreK and the ECE field as “less than” in comparison with the kindergarten through twelfth grade (K–12) education system affected the work of all participating PreK leaders. White female leaders experienced a double bind due to their gender and the status of the field, leading them to conform to gender and social role stereotypes to avoid backlash. BIPOC PreK leaders experienced various instances of gendered racism and for one female BIPOC leader this resulted in a triple bind, as the intersections of the field’s status and her race and gender presented additional challenges. While leaders tried to navigate these different binds successfully, there were unintentional consequences: Male leaders enjoyed privilege that further marginalized female PreK leaders; White female leaders’ decisions to conform with stereotypes reinforced the status of ECE; and a BIPOC female leader replicated challenges for BIPOC individuals in an effort to protect herself. For the ECE field to advance its equity goals and increase its professional standing, state ECE leaders need specific training to address their implicit biases, strengthen their own professional ECE identities, and advocate a unified ECE profession across auspices.

Investigating the Influence of Mentor–Mentee Race and Gender Pairs on Public Health Persistence

Background. Mentoring and immersive experiences through internships are important means of increasing underrepresented (UR) students’ persistence in public health. However, while the positive effects of mentoring are well established, studies on the effect of race/ethnicity and gender mentor matching on persistence have produced mixed results. Aims. This article investigates the impact of homogeneous and heterogeneous mentor–mentee pairs on UR intern persistence for Project Imhotep, a summer internship program at Morehouse College. Method. The authors employ multivariable logistic regression analyses to examine the relationship between mentor and mentee race/ethnicity and gender characteristics on undergraduate intern academic persistence and career attainment. Results. Mentor demographics and institution type are predictors associated with intern academic and career persistence; however, the predictive importance of model attributes varied by outcome. Mentees paired with UR mentors (female or male) were more likely to attend graduate school, and mentees mentored by female mentors (UR female or White female) were more likely to pursue a graduate degree in public health. Finally, mentees mentored by UR females had the highest likelihood of either pursuing a graduate degree in public health or a public health career. Discussion. This article advances our understanding of how mentor–mentee race/ethnicity and gender affects the recruitment and retention of undergraduate students from racially and ethnically UR populations into public health. Conclusions. The findings suggest that the degree of shared racial/ethnic and/or gender identity between a public health intern and mentor influenced the likelihood of the intern pursuing further education or a public health career.

Health and Social Determinants Associated With Delay of Health Care Among Rural Older Adults

Delaying healthcare has the capacity to increase morbidity and mortality, especially among individuals with chronic and acute health conditions. Older adults in rural areas are more likely to have chronic health conditions and are more likely to delay care due to financial barriers than their urban counterparts. To further investigate these associations, we conducted descriptive, bivariate, and regression analyses using data from a needs assessment designed to identify health needs and service delivery gaps among an economically diverse eight-county region. A random sample of adults responded to the survey, with 1,226 respondents aged 60+ (mean age = 71). The majority of respondents were White, female, and had insurance coverage. Overall, 35% of respondents experienced a delay in healthcare. We used logistic regression to determine the associations of age, gender, number of health conditions, household income, distance from medical facility, and perceived quality of neighborhood with delay of healthcare. Individuals with younger age (p = .017), more chronic conditions (p < .001), lower income (p < .001), and lower perceived quality of neighborhood (p = .008) were more likely to experience a delay in healthcare. These findings highlight risk factors that were salient prior to the onset of the COVID-19 pandemic. However, the pandemic has contributed to an increasing trend of delaying healthcare and may have amplified existing challenges. Findings may inform efforts led by healthcare providers and policy makers to facilitate timely and preventive healthcare use. Future research is needed to investigate the compounding long-term health implications of delaying healthcare.

National Fontan Operation outcomes at or below 2-years-of-age compared to older than 2- years-of-age

Introduction: Opinion is divided about optimal early timing of the Fontan Operation (FO). While some studies have suggested 3 years-of-age, others have shown good outcomes below 2 years-of -age. We analyzed the impact of age ≤2-years as compared age >2-years on short-term outcome of the FO using a large national database. Methods: A retrospective analysis of the Kids Inpatient Database (2009-16) for the FO was done. The groups were divided into those who underwent FO at age ≤2-years (EF) as compared to age >2-years (LF). The data was abstracted for demographics, clinical characteristics, and operative outcomes. Standard statistical tests were used. Results: 3381 patients underwent FO during this period of which 1482 (44%) were EF. The mean ages of the EF and LF were 1.6 and 4.3, respectively (p< 0.001). LF were more likely to be non-White, female, and have Heterotaxy syndrome. HLHS was more common in EF. There was no difference in the discharge mortality, length of stay, disposition (majority went home), and mean total charges incurred. The overall discharge mortality was low at 0.7% (24/3381). In multivariate analysis: cardiac arrest, acute kidney injury, mechanical ventilation >96 hours, endocardial cushion defect and non-White ethnicity were predictors of a mortality and not age. Conclusion: Contemporary outcomes for FO are excellent with equivalent short-term outcomes in both the age groups. Occurrence of postoperative complications, non-white ethnicity and endocardial cushion defect diagnosis were predictive of a negative outcome.

Conservative approach for the treatment of urethral prolapse in children: case report and literature review of 278 pediatric cases

Background Urethral prolapse (UP) is a rare, benign condition that often goes misdiagnosed and mistreated. It consists of the eversion of the distal urethral mucosa through the outer urethral meatus, leading to vascular obstruction and prolapsed tissue edema, which aggravates the prolapse. Although many review articles were reported on this condition, none of them focused on the conservative approach nor targeted the pediatric population. In this paper, we present successful medical management of UP in a 13-month-old Caucasian female and perform an extensive review of the literature to include articles that reported a conservative approach in patients under 18-years-old. We also suggested a practical algorithm for both diagnosis and management of this condition. Case presentation A 13-month-old Caucasian white female was presented with a urinary tract infection and vaginal bleeding. Genital examination showed a hyperemic donut-shaped mass covering the urinary meatus, of 0.7 cm diameter, with an actively bleeding open center. After confirming the diagnosis of UP with catheterization, a conservative approach was decided; antibiotics associated with topical corticosteroids including betamethasone 1% cream. The first-week outcome showed regression of the prolapsed tissue and the examination after four months showed normal vaginal mucosa with no evidence of relapse. Conclusions 20 studies were retained after PubMed search with a total of 278 female patients aged between 1 month and 15 years old. The main reasons for referral were vaginal bleeding and mass, urinary symptoms followed by sexual abuse. Non-surgical treatment was tried for 162 patients. 53 of them were successfully managed, while 92 reported unsuccessful outcomes. The conservative approach was successful in 19% of all patients and raised to 32.7% in the portion of children selected for the initial conservative approach. Even though this review showed good results with medical treatment in children with UP, additional comparative studies are required to evaluate the effectiveness of conservative treatment in comparison with surgical interventions. In addition, Long-term follow-up is required as recurrence was reported up to 2 years following conservative treatment.

Age-Related Injuries From Escalators

Introduction Escalators and moving stairways are omnipresent in modern life. No study to date has examined nationwide incidence and outcomes associated with injuries directly related to escalator use. The aim of this study was to describe the injury patterns, incidence, and disposition as it pertains to youth compared to adults. Methods Descriptive and comparative analyses were performed using National Electronic Injury Surveillance System data. The frequencies of categorical variables were calculated across the two age groups. Chi-squared test was performed on all categorical variables. Significance was defined as two-tailed P < 0.05. Logistic regression was used on variables that were determined to be significant from the frequency tables, with additional variable selection being used to arrive on a final model for each outcome. Results From 2009 to 2019, there were 810 youth and 3669 adults injured in escalator-associated emergency department visits. Incidence in the youth population decreased over time. Disposition was similar between groups. Injury types were similar among groups. White female adults were more likely to sustain injuries related to escalator use. Adult patients were also significantly more likely to sustain head/neck/facial trauma. Last, adult patients were found to be more likely to suffer a fatal event in comparison to the youth population. Discussion Differences in the injury patterns between youth and adult patients related to the use of escalators illustrate a need for improved injury prevention. Improved education and safety guidelines, particularly in individuals in ages 18 and up, would likely lessen the discrepancies between age groups identified in this study.