Journal articles: 'Multi/mixed ethno-racial identity'

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Cardwell, Megan E., Jordan Soliz, Lisa J. Crockett, and Gretchen L. Bergquist. "Critical incidents in the development of (multi)ethnic-racial identity: Experiences of individuals with mixed ethnic-racial backgrounds in the U.S." Journal of Social and Personal Relationships 37, no. 5 (February 19, 2020): 1653–72. http://dx.doi.org/10.1177/0265407520906256.

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Secure ethnic-racial identity (ERI) is tied to well-being, especially for minority individuals; however, there is still little consensus on the key processes and optimal outcomes of various multiethnic-racial (ME-R; i.e., individuals with parents from different ethnic-racial groups) identity development models. In this study, we examine the critical incidents in personal and social relationships that are central to ME-R identity development. Twenty-nine ME-R individuals provided retrospective accounts of incidents and conversations they self-perceived to be critical to their ERI development. Four major themes emerged: incidents and conversations surrounding intergroup contact, confrontation, heritage, and appearance were all recalled as critical to ME-R identity development. These findings highlight the importance of studying the ways that ERI is constituted through interaction with others. Implications and directions for future research are discussed.

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Makala, Melissa Edmundson. "BETWEEN TWO WORLDS: RACIAL IDENTITY IN ALICE PERRIN'S THE STRONGER CLAIM." Victorian Literature and Culture 42, no. 3 (June 6, 2014): 491–508. http://dx.doi.org/10.1017/s1060150314000114.

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Like many Anglo-Indian novelists of her generation, Alice Perrin (1867–1934) gained fame through the publication and popular reception of several domestic novels based in India and England. However, within the traditional Anglo-Indian romance plot, Perrin often incorporated subversive social messages highlighting racial and cultural problems prevalent in India during the British Raj. Instead of relying solely on one-dimensional, sentimental British heroes and heroines, Perrin frequently chose non-British protagonists who reminded her contemporary readers of very real Anglo-Indian racial inequalities they might wish to forget. In The Stronger Claim (1903), Perrin creates a main character who has a mixed-race background, but who, contrary to prevailing public opinion of the time, is a multi-dimensional, complex, and perhaps most importantly, sympathetic character positioned between two worlds. Even as Victorian India was coming to an end, many of the problems that had plagued the British Raj intensified in the early decades of the twentieth century. Perrin's novel is one of the earliest attempts to present a sympathetic and heroic mixed-race protagonist, one whose presence asked readers to question the lasting negative effects of race relations and racial identity in both India and England.

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YAP, FELICIA. "Eurasians in British Asia during the Second World War." Journal of the Royal Asiatic Society 21, no. 4 (October 2011): 485–505. http://dx.doi.org/10.1017/s135618631100040x.

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One of the most important minorities in the British colonial empire in Asia consisted of those of mixed European and Asian parentage and/or ancestry, or Eurasians, as they were widely known. It is perhaps surprising that despite the voluminous literature written about British colonial communities in the East, relatively little scholarly attention has been paid to Eurasians and their histories. A closer examination of the members of this marginalised colonial category is nevertheless crucial as they stood at the problematic boundaries of racial politics and identity, and are therefore vital to our understanding of the tensions of empire. The few existing studies of Eurasians in British Asia have tended to focus on the experiences of Eurasians either before or after the Second World War, neglecting the period of Japanese occupation as a significant epoch in the evolution of these communities. In reality, if we intend to unravel the multi-layered history of Eurasians in this region, we must examine the critical position of these colonial communities during this tumultuous period. The nuances of their intriguing wartime relationships with both the British and the Japanese also merit serious attention. With these aims in mind, this article will investigate the compelling experiences of Eurasian communities in Japanese-occupied British Asia, with an especial focus on those who were incarcerated by the Japanese in civilian internment camps in Hong Kong and Singapore.

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Yong, Aizaiah. "All Mixed up: Multi/Racial Liberation and Compassion-Based Activism." Religions 11, no. 8 (August 6, 2020): 402. http://dx.doi.org/10.3390/rel11080402.

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This paper seeks to identify pathways of liberation amidst contemporary challenges faced by those who identify as multiracial by re-imagining various approaches to confronting racial oppression through compassion-based activism. The primary question of this study focuses on how compassion (as broadly understood by and across the world’s spiritual traditions) might sustain, invigorate, or be adapted to aid the struggle for racial justice in the United States. This paper begins with reviewing theories from critical mixed race studies and brings them into dialogue with the eight themes of compassion-based activism. The results of this interdisciplinary study provide both the promises and challenges to a compassion-based approach when it comes to multi/racial liberation and proposes a reinterpretation that centers multi/racial experiences.

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Shannon-Baker, Peggy. "Centering Race in Mixed and Multi-Method Research on Implicit Bias: A Systematic Review." International Journal of Multiple Research Approaches 13, no. 1 (April 30, 2021): 55–73. http://dx.doi.org/10.29034/ijmra.v13n1a3.

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Understanding how we form and maintain implicit racial biases can help identify how to disrupt them. With this goal in mind, mixed and multi-method research approaches offer researchers the ability to combine various methodological approaches to explore the formation, experiences, and impact of implicit racial bias. This article therefore provides a critical descriptive systematic review of empirical mixed and multi-method studies on implicit bias and race. This review is based on the following research questions: (a) What are the theoretical and methodological features among empirical studies on race and implicit bias that use mixed or multi-method approaches? and (b) what are the opportunities for theoretical and/or methodological expansion in this literature? The criteria for inclusion in the review are the use of a multi-method (e.g., qualitative and quantitative) or mixed method (e.g., integrating qualitative and quantitative) approach in an empirical study, implicit racial bias is the main or one of the main concepts being studied, and the work (published or unpublished) was dated 1995-2019. The studies in this review often had no theoretical framework or one that did not center race. This is noteworthy because race-specific theoretical frameworks can be used to contextualize the study of implicit bias and race in racism, to define race, and to align with the following important features of mixed and multi-method studies: substantiating the use of multiple methods, prioritizing one or more methodological approaches, analyzing and integrating data, and reflecting on the researcher’s own positionality.

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Carder, Paula, Lindsey Smith, Wenhan Zhang, Sheryl Zimmerman, Philip Sloane, and Kali Thomas. "A Typology of Health Services Regulated in U.S. Assisted Living Communities." Innovation in Aging 5, Supplement_1 (December 1, 2021): 526. http://dx.doi.org/10.1093/geroni/igab046.2028.

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Abstract State agencies regulate assisted living (AL) with varying approaches across and within states. The implications of this variation for resident case mix, health service use, and policy, are not well described. We collected health services-relevant AL regulatory requirements for all 50 states and DC and used a mixed-methods approach (thematic analysis; k-means cluster analysis) to identify six types: Housing, Affordable, Hybrid, Hospitality, Healthcare, and Hybrid-Healthcare. We stratified Medicare claims data by regulatory type, identifying variation in resident case mix and health service use. Housing and Affordable clusters have larger proportions of dual-eligible beneficiaries, Black residents, and residents of Affordable had more long-term nursing home use compared to other clusters. Dual-eligible beneficiaries account for 26.6% of Housing cluster residents compared to 8.1% of Hybrid Healthcare cluster residents. We provide other examples and explain the implications in terms of sampling AL for single and multi-state studies, racial disparities, and health-related policies.

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Broton, Katharine, Kari Weaver, and Minhtuyen Mai. "Hunger in Higher Education: Experiences and Correlates of Food Insecurity among Wisconsin Undergraduates from Low-Income Families." Social Sciences 7, no. 10 (September 28, 2018): 179. http://dx.doi.org/10.3390/socsci7100179.

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There is growing awareness that a substantial share of undergraduates are food insecure, potentially undermining investments in higher education and hindering upward social mobility. This mixed-methods paper uses survey and interview data from low-income students at 42 public colleges and universities in Wisconsin to illuminate the day-to-day experiences of food insecurity and examine how food security status varies across background characteristics. Results indicate that students who grew up in food insecure homes, self-identify as a racial/ethnic minority, live off-campus, and attend college in an urban area are significantly more likely to report the lowest level of food security, often associated with hunger. Students explain that challenges stemming from the interrelationship of lack of time and inadequate money are their biggest barriers to food security. Most rely on friends or family for support, but few students draw on the social safety net, in part due to eligibility restrictions. In recognition of the diversity of students’ experiences, we discuss the need for a multi-faceted response to promote food security and student success.

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Montiel Ishino, Francisco Alejandro, Claire E. Rowan, Kevin Villalobos, Janani Rajbhandari-Thapa, and Faustine Williams. "A Time-Varying Effect Model (TVEM) of the Complex Association of Tobacco Use and Smoke Exposure on Mean Telomere Length: Differences between Racial and Ethnic Groups Assessed in the National Health and Nutrition Examination Survey." International Journal of Environmental Research and Public Health 19, no. 17 (September 4, 2022): 11069. http://dx.doi.org/10.3390/ijerph191711069.

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Telomere length is affected by lifestyle and environmental factors and varies between racial and ethnic groups; however, studies are limited, with mixed findings. This study examined the effects of tobacco use and smoke exposure on mean telomere length to identify critical age periods by race/ethnicity. We used time-varying effect modeling on the National Health and Nutrition Examination Survey for continuous years 1999–2002 to observe the effects of active tobacco use and environmental tobacco smoke—measured through serum cotinine—and mean telomere length for adults 19 to 85 and older (N = 7826). Models were run for Mexican American, other Hispanic, non-Hispanic White, non-Hispanic Black, and other/multi-race categories to allow for time-varying group differences, and controlled for biological sex, socioeconomic status, education, and ever-smoker status. Serum cotinine was found to have an increasing effect on telomere length from age 37 to approximately age 74 among Mexican Americans. Among other/multi-race individuals serum cotinine was found to have a decreasing effect at approximately age 42, and among Blacks, it had an overall decreasing effect from age 61 to 78. Findings reveal a further need to focus additional support and resources to intervene regarding disparate health effects from tobacco use and environmental smoke exposure for already vulnerable groups at particular ages.

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Than, Hein, Weng Kit Lye, Chiu Hong Seow, Colin Nicholas Sng, John Carson Allen, and Charles Chuah. "Genetic Profiling Augments Prognostic Value of the EUTOS Long-Term Survival Score for Disease-Specific Mortality in Imatinib-Treated Asian Chronic Myeloid Leukaemia Patients." Blood 128, no. 22 (December 2, 2016): 3077. http://dx.doi.org/10.1182/blood.v128.22.3077.3077.

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Abstract Introduction: Long-term survival rates among patients with chronic-phase chronic myeloid leukaemia (CP-CML) have remarkably improved since the introduction of imatinib, a BCR-ABL1 tyrosine-kinase inhibitor (TKI), as the standard first-line therapy. Several prognostic scores have been employed to predict clinical response and survival of CP-CML patients treated with TKIs. The EUTOS long-term survival (ELTS) score was recently introduced and shown to predict the probability of CML-specific death in long-term surviving patients on imatinib therapy, more effectively than the existing scores. The ELTS score was calculated by a formula that included age at diagnosis, spleen size below costal margin, platelet count and blast percentage in peripheral blood as prognostic factors. In our study, we evaluated the ELTS score in predicting the probabilities of CML-specific death, long-term overall survival (OS) and progression-free survival (PFS) rates in Asian CML patients treated with imatinib. As genetic differences, particularly the BCL-2 like 11 (BIM) deletion polymorphism, have been shown to confer intrinsic resistance to imatinib in East-Asian patients, we also explored the role of BIM deletion polymorphism profiling as a prognostic biomarker for CML-specific death among different risk groups stratified by the ELTS score. Methods: A retrospective analysis was performed on CP-CML patients treated with first-line imatinib within one year of diagnosis in Singapore General Hospital from June 2001 to November 2014. The ELTS score was obtained with online calculator at www.leukemia-net.org. Low-risk group was defined as a score ≤1.568, intermediate-risk group as a score >1.568 but ≤2.2185, and high-risk group as a score >2.2185. Progression was defined as transformation to accelerated or blast phase or death from any cause. OS and PFS were calculated with the Kaplan-Meier method and compared by the log-rank test. Cumulative incidence probabilities of CML-specific death were compared by the Gray test. Findings: 134 patients were included for analysis. 63% were Chinese, 17% were Malays, 8% were Indians and 12% were of mixed ethnic origin. Median age at diagnosis was 45 years and 60% were male. Median follow-up was 7.7 years (range: 0.4 to 13.2 years). 17 deaths out of 134 patients (13%) were recorded, of which 11 were CML-specific (65%). 54% of patients were categorised as low-risk, 36% as intermediate-risk and 10% as high-risk by the ELTS score. The cumulative incidence probabilities of CML-specific death at 10 years were 43% in high-risk (hazard ratio (HR): 11.76, 95% confidence interval (CI): (2.32, 59.71), p=0.003) and 9% in intermediate-risk (HR: 2.24, 95% CI: (0.37, 13.49), p=0.38) compared to 3% in low-risk groups.10-year OS probabilities were 50%, 82% and 93% in high-, intermediate- and low-risk ELTS groups respectively (p=0.001). 10-year PFS probabilities were 50%, 84% and 89% in high-, intermediate- and low-risk ELTS groups respectively (p=0.004). Among 103 East-Asian patients with low- and intermediate-risk ELTS sub-groups, 15% harboured BIM deletion polymorphism. The probability of CML-specific death at 10 years in this subset was 16% with BIM deletion polymorphism, but 4% without polymorphism (HR 4.30, 95% CI: (0.76, 24.35), p=0.099). 10-year OS probabilities in the subset were 75% and 89% in patients with and without BIM deletion polymorphism respectively (p=0.014). Conclusions: The ELTS score was able to predict the probability of CML-specific death and identify high-risk patients in our multi-racial Asian CML patients treated with imatinib. Genetic profiling using BIM deletion polymorphism provided further stratification by identifying a subset of inferior long-term survivors with high probability of CML-specific death among otherwise non high-risk patients. Disclosures Chuah: Bristol-Myers Squibb: Honoraria; Novartis: Honoraria; Chiltern: Honoraria.

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Johnson, G., K. Hickey, A. Azin, K. Guidolin, K. Guidolin, F. Shariff, J. Gentles, et al. "2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis." Canadian Journal of Surgery 64, no. 6 Suppl 2 (December 14, 2021): S80—S159. http://dx.doi.org/10.1503/cjs.021321.

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Park, Mi Yung, and Katalina Chung. "Identity and heritage language learning: a case study of two mixed-heritage Korean university students in New Zealand." Multilingua, August 12, 2022. http://dx.doi.org/10.1515/multi-2022-0044.

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Abstract This narrative case study examines the identity development of two mixed-heritage (Korean/White and Korean/Japanese) university students in relation to Korean as a heritage language (HL) in New Zealand. The narratives of the two participants (Mia and Hannah) revealed that they grew up with different levels of exposure to the HL, which impacted their HL proficiency, and experienced different struggles with identity construction. While Mia’s White appearance helped her explore multiple ethnic/cultural identities, Hannah was deemed completely non-White by White New Zealanders, assigned a minority “Asian” identity, and subjected to racial discrimination. The dominant group’s confusion about intra-race mixedness and perceptions of Hannah as non-mixed complicated her situation. Hannah had little access to a majority heritage (New Zealander) identity, but also found her specific heritage identities occluded by an imposed single (“Asian”) identity. Nonetheless, on entering university both participants showed a strong desire to embrace their Koreanness through HL education or socialization with coethnic peers. HL learning played a crucial role in their construction of mixed-heritage identity; for Mia, the HL was valuable social capital, while for Hannah, the HL was a means of claiming her ethnic identity. This study highlights the complexity and plurality of mixed-heritage identities and offers implications for educators.

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Priest, Naomi, Oishee Alam, Mandy Truong, Rachel Sharples, Jacqueline Nelson, Kevin Dunn, Kate L. Francis, Yin Paradies, and Anne Kavanagh. "Promoting proactive bystander responses to racism and racial discrimination in primary schools: a mixed methods evaluation of the ‘Speak Out Against Racism’ program pilot." BMC Public Health 21, no. 1 (July 21, 2021). http://dx.doi.org/10.1186/s12889-021-11469-2.

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Abstract Background Racism and racial discrimination are fundamental causes and determinants of health and health inequalities globally, with children and adolescents particularly vulnerable. Racial discrimination is a common stressor in the lives of many children and adolescents, with growing evidence of negative associations between racial discrimination and multiple domains of child and adolescent health. Addressing racism and racial discrimination must be core public health priorities, even more so among children and young people. Schools are key settings in the lives of children and adolescents and become increasingly more important to identity formation. School communities, teachers and peers greatly influence children and adolescents’ beliefs about race and difference. Schools are therefore key sites for the delivery of population-based programs to reduce racism and promote proactive bystander behaviour and healthy resistance to racism among all children and adolescents as well as among the adults. Methods This study examines the feasibility and acceptability of the ‘Speak Out Against Racism (SOAR)’ program, a whole of school, multi-level, multi-strategy program that aimed to promote effective bystander responses to racism and racial discrimination in primary schools. A mixed-methods, quasi-experimental design was used. Students in Years 5 and 6 (10–12 years) across six schools completed surveys pre- and post- intervention (N = 645; 52% female; 6% Indigenous, 10% Middle Eastern, African, Latinx or Pacific Islander, 21% Asian, 52% Anglo/European). Focus groups with students and interviews with staff collected qualitative data about their experiences of the program and their views about the program’s perceived need, implementation, impacts and suggested improvements. Results Quantitative data showed student prosocial skills and teacher inter-racial climate improved in intervention schools compared to comparison schools. Qualitative data highlighted teacher attitudinal and behaviour change regarding racism, and student reduced interpersonal racial discrimination, improved peer prosocial norms, commitment to anti-racism, knowledge of proactive bystander responses and confidence and self-efficacy to intervene to address racism. Conclusions This study provides quantitative evidence of the potential of the SOAR program to improve the prosocial skills of students and their perceptions of the inter-racial school climate provided by their teachers. This program also provided qualitative evidence of the potential to promote teacher and student attitudinal and behavioural change. Further refinement and testing of the program in a large scale implementation trial is recommended.

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Ettinger, Anna K., Doug Landsittel, Kaleab Z. Abebe, Jamil Bey, Val Chavis, Judith D. Navratil, Felicia Savage Friedman, Terence S. Dermody, and Elizabeth Miller. "THRIVE Conceptual Framework and Study Protocol: A Community-Partnered Longitudinal Multi-Cohort Study to Promote Child and Youth Thriving, Health Equity, and Community Strength." Frontiers in Pediatrics 9 (February 4, 2022). http://dx.doi.org/10.3389/fped.2021.797526.

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BackgroundGiven the profound inequities in maternal and child health along racial, ethnic, and socioeconomic lines, strength-based, community-partnered research is required to foster thriving children, families, and communities, where thriving is defined as optimal development across physical, mental, cognitive, and social domains. The Pittsburgh Study (TPS) is a community-partnered, multi-cohort study designed to understand and promote child and youth thriving, build health equity, and strengthen communities by integrating community partners in study design, implementation, and dissemination. TPS launched the Tracking Health, Relationships, Identity, EnVironment, and Equity (THRIVE) Study to evaluate children's developmental stages and contexts from birth through completion of high school and to inform a child health data hub accessible to advocates, community members, educators, health professionals, and policymakers.Methods and AnalysisTPS is rooted in community-partnered participatory research (CPPR), health equity, antiracism, and developmental science. Using our community-informed conceptual framework of child thriving, the THRIVE Study will assess cross-cutting measures of place, environment, health service use, and other social determinants of health to provide longitudinal associations with developmentally appropriate child and youth thriving outcomes across participants in six cohorts spanning from pregnancy through adolescence (child ages 0-18 years). Data from electronic health records, school records, and health and human services use are integrated to assess biological and social influences of thriving. We will examine changes over time using paired t-tests and adjusted linear regression models for continuous thriving scores and McNemar tests and adjusted logistic regression models for categorical outcomes (thriving/not thriving). Data analyses will include mixed models with a random intercept (in combination with the previously-specified types of regression models) to account for within-subject correlation.DiscussionBy enhancing assessment of child and youth well-being, TPS will fill critical gaps in our understanding of the development of child and youth thriving over time and test strategies to support thriving in diverse communities and populations. Through CPPR and co-design, the study aims to improve child health inequities across multiple socioecological levels and developmental domains.

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Johnson-Hunt, Nancy. "Dreams for Sale: Ideal Beauty in the Eyes of the Advertiser." M/C Journal 23, no. 1 (March 18, 2020). http://dx.doi.org/10.5204/mcj.1646.

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Introduction‘Dream’ has been researched across numerous fields in its multiplicity within both a physical and emotional capacity. For Pagel et al., there is no fixed definition of what ‘dream’ is or are. However, in an advertising context, ’dream’ is the idealised version of our desires, re-visualised in real life (Coombes and Batchelor 103). It could be said that for countless consumers, advertising imagery has elicited dreams of living the perfect life and procuring material pleasures (Manca et al.; Hood). Goodis asserts, “advertising doesn’t always mirror how people are acting but how they are dreaming, in a sense what we are doing is wrapping up your emotions and selling them back to you” (qtd. in Back and Quaade 65). One component of this notion of ‘dream’ in advertising is captured by wishful images of the face and body in their ‘perfect form’ presented in a field of other beauty ideals. For our purposes, ‘dream’ is a “philosophical concept” (Pagel et al. 14) by which dreams are a series of aspirations and desires that consumers internalise, while at the same time, find difficult to achieve. ‘Dream’, then, will be used to critically explore how the beauty and advertising industries collectively employ ethnic ambiguity in addition to other tactics and strategies to sell us dream-like visions of idealised beauty. Forever Dreaming: The Introduction of Ethnic AmbiguityWe can link dreams to beauty as both areas of analysis contain many cultural interpretations and can be deconstructed to reveal different meanings (Sontag). In many ways, beauty is another dream and Sontag notes that the concept of beauty is often linked to certain physical traits that an individual possesses. These physical traits are capitalised upon by product marketing by which Hood claims, aims to enhance one, or even more, of them. For example, lipstick is not marketed as simply as a mixture of wax and pigment but rather a way to “obtain beauty, find romance or gain confidence” (7). As a result, global beauty brands can find long term marketing success through meaningful product marketing. This long-term marketing success relies on influencing human behaviour and perceptions. As a result of meaningful marketing, consumers may find themselves driven to purchase implicit qualities in products advertised to reflect their dreams (Hood).Following the 1980s, this version of meaningful marketing has become a driving purpose for advertising agencies around the globe (Steel). Advertising agencies rely on deeper human insights, identifying latent desires to create a brief that must ultimately sell a dream (Steel). The ideal strategy needs to define something that will build brand loyalty and encourage consumers to have a symbiotic relationship connecting their dreams with the product being sold. As Hood argues, “advertising consists of selling not just things but also dreams”. While this concept is one that “some see as inherently damning”, it is also inherently necessary (7). We understand that people are emotional beings, investing in the artefacts they build, obtain or use with significance “beyond merely utilitarian” (7). For these reasons, beauty advertisers act as the purveyors of dreams in the form of physical perfection as an articulation of consumer’s own aspirations of beauty.These aspirations of dream beauty are a direct representation of our thoughts and feelings. As such, it should be noted that we as consumers are often encouraged to draw inspiration from imagery that is often times seen as ethnically ambiguous. “Ethnic ambiguity” is the absence of any one prominent ethnic or racial feature that is easily discernible to one specific group (Garcia 234; Harrison et al.). An example of this ethnic ambiguity can be seen in marketing campaigns by high end makeup artist and her eponymous range of cosmetics, Charlotte Tilbury. Most notably, in a 2015 launch for her “Makeup Wardrobe”, Tilbury’s makeup palettes boasted 10 aspirational ‘looks’ and personas that could be achieved simply through purchase. The images of women featured on a figurative ‘wheel of fortune’ digital display used to market products online. This digital ‘wheel of fortune’ comprised of ethnically ambiguous models against descriptive persona’s such as “The Dolce Vita” and “The Glamour Muse”. These kinds of digital marketing tools required consumers to make a decision based on what their dream ‘look’ is through an ethnically ambiguous lens and from here are guided to purchase their desired aesthetic. Like Charlotte Tilbury, the beauty industry has seen a growing body of cosmetic brands that employ ethnic ambiguity to sell dreams of homogenised beauty. We will see the ways in which modern day beauty brands, such as Kylie Jenner Cosmetics and Fenty Beauty have come to adopt ethnic ambiguity or embrace entire ethnic and racial groups in order to expand their consumer influence.Aspirational Ambiguity: Dreams of DisempowermentSince the early 2000s, beauty advertising has seen a prominent rise in the use of ethnically ambiguous models. Some see this as an effort to answer the global desire for diversity and inclusion. However, the notion that beauty standards transcend racial boundaries and is inclusive, is simply another form of appropriating and fetishising ethnicity (R. Sengupta). In many ways, these manufactured dream-like versions of beauty have evolved to reach wider markets, in the hope that consumers will be emboldened to both embrace their racial heritage, and at the same time conform to homogenised standards of beauty (Frith et al.; Harrison et al.).In this bid to diversify and extend consumer reach, there are three prominent reasons why ethnically ambiguous models are more likely to be featured over models whose African, Indigenous, and/or Asian heritage is more prominent. Firstly, ethnically ambiguous models do not seem to conform to a particular notion of what is considered beautiful. For many decades, popular culture has been saturated with images of thin, of young, of narrow noses and hips, of blonde, blue eyes, and Caucasian hair textures (Harrison et al.; Hunter; Saraswati). These Westernised beauty ideals have been historically shaped through years of colonial influence, grounded in an imbalance of power and imposed to create a culture of dominance and oppression (Saraswati). Secondly, ethnic models are featured to convey “the sense of the ‘exotic’, and their ‘otherness’ acts to normalise and entrench the dominant ideal of white beauty” (qtd. in Redmond 175). ‘Otherness’ can be defined as the opposite of the majority, in Westernised society this ‘other’ can mean “people who are other than white, male, able bodied, heterosexual” (qtd. in Graycar 74). This ‘otherness’ showcased by ethnically ambiguous models draws viewers in. Physical features that were possessed by one specific ethnic group such as African, Asian, Latinx or Indigenous peoples have now become blended and are no longer confined to one race. Additionally, ethnically ambiguous models enable white consumers to dream about an exotic local or lifestyle, while at the same time providing ethnic audiences a way to see themselves.Finally, it is undeniable that ethnically ambiguous and mixed-race models have become desirable due to a historical preference for light skin (Saraswati). The visual references of light-skinned beauty epitomise a colonial dream and this standardisation has been transferred to indigenous peoples, or ethnic minorities in Western countries. According to Harrison et al, “marketers use mixed-race representations as cultural currency by mythologising mixed-race bodies as the new beauty standard” to represent a racial bridge, “tailored to ameliorate perceived racial divides” (503). Therefore, ethnically ambiguous models have an assumed advantage over their racially dominant counterparts, because they appear to straddle various racial boundaries. They are constructed to embody whomever, from wherever and whenever, fetishising their roleplay for the industry, when it pleases. This further exoticises multi-racial beauty models and renders them a commodified fantasy for many consumers alike. The continued commodification of ethnic ambiguity is problematic as it exploits models with distinctly mixed-race heritage to continue to sell images of white-washed beauty (Solomon et al.). An argument could be made that scarcity contributes to mixed-race models’ value, and therefore the total number of advertising opportunities that are offered to mixed-race models remains limited. To date, numerous studies highlight a limited use of racially diverse models within the beauty industry and does not reflect the growing global body of diverse consumers with purchasing power (Wasylkiw et al.; Redmond; Johnson; Jung and Lee; Frith et al.). In fact, prior to globalisation, Yan and Bissell claim that “each culture had a unique standard of attractiveness, derived from traditional views about beauty as well as the physical features of the people” (197) and over time the construction of dream beauty is characterised using Western features combined with exoticised traits of indigenous ethnic groups. Akinro and Mbunyuza-Memani claim that this “trend of normalising white or 'western' feminine looks as the standard of beauty” has pervaded a number of these indigenous cultures, eventually disseminated through the media as the ultimate goal (308). It can also be argued that the “growing inclusion of mixed-race models in ads is driven less by the motivation to portray diversity and driven more by pragmatism,” and in a more practical sense has implications for the “financial future of the advertised brands and the advertising industry as a whole” (Harrison et al. 513). As a result, uses of mixed-race models “are rather understood as palatable responses within dominant white culture to racial and ethnic minority populations growing in … cultural prominence” (513) in a tokenistic bid to sell a dream of unified beauty.The Dream Girl: Normalisation of Mixed-RaceIn 2017, an article in CNN’s Style section highlighted the growing number of mixed-race models in Japan’s fashion and beauty industry as a modern-day phenomenon from Japan’s interlocking history with the United States (Chung and Ogura). These beauty and fashion influencers refer to themselves as hafu, an exclusionary term that historically represented an “othered” minority of mixed-race heritage in Japanese society signalling complex and troubled interactions with majority Japanese (Oshima). The complications once associated with the term ‘hafu’ are now being reclaimed by bi-racial beauty and fashion models and as such, these models are beginning to defy categorisation and, in some ways, national identity because of their chameleon-like qualities. However, while there is an increasing use of mixed-race Japanese models, everyday mixed-race women are regularly excluded within general society; which highlights the incongruent nature of ‘half’ identity. And yet there is an increasing preference and demand from fashion and beauty outlets to feature them in Japanese and Western popular culture (Harrison et al.; Chung and Ogura). Numéro Tokyo’s editorial director Sayumi Gunji, estimated that almost 30-40 per cent of runway models in present day Japan, identify as either bi-racial mixed-race or multi-racial (Chung and Ogura).Gunji claims:"Almost all top models in the their 20s are hafu, especially the top models of popular fashion magazines ... . [In] the Japanese media and market, a foreigner's flawless looks aren't as readily accepted -- they feel a little distant. But biracial models, who are taller, have bigger eyes, higher noses [and] Barbie-doll-like looks, are admired because they are dreamy looking but not totally different from the Japanese. That's the key to their popularity," she adds. (Qtd. in Chung and Ogura)The "dreamy look" that Gunji describes is attributed to a historical preference toward light skin and a kind of willingness and sensuality, that once, only white models could be seen to tout (Frith et al. 58). Frith et al. and O’Barr discuss that beauty in Japanese advertising mirrors “the way women are portrayed in advertising in the West” (qtd. in Frith et al. 58). The emergence of hafu in Japanese beauty advertising sees these two worlds, a mixture of doll-like and sensual beauty, converging to create a dream-like standard for Japanese consumers. The growing presence of Japanese-American models such as Kiko Mizuhara and Jun Hasegawa are both a direct example of the unattainable ‘dreamy look’ that pervades the Japanese beauty industry. Given this ongoing trend of mixed-race models in beauty advertising, a recent article on Refinery29 talks about the significance of how mixed-race models are disassembling their once marginalised status.A. Sengupta writes:In contrast to passing, in which mixedness was marginalized and hidden, visibly multiracial models now feature prominently in affirmative sites of social norms. Multiracial looks are normalized, and, by extension, mixed identity is validated. There’s no cohesive social movement behind it, but it’s a quiet sea change that’s come with broadened beauty standards and the slow dismantling of social hierarchies.Another example of the normalisation in multi-racial identity is Adwoa Aboah, a mixed-race British model and feminist activist who has been featured on the covers of numerous fashion publications and on runways worldwide. In British Vogue’s December 2017 issue, titled “Great BRITAIN”, Adwoa Aboah achieved front cover status, alongside her image featured other politically powerful names, perhaps suggesting that Aboah represents not only the changing face of a historically white publication but as an embodiment of an increasingly diverse consumer landscape. Not only is she seen as both as a voice for those disenfranchised by the industry, by which she is employed, but as a symbol of new dreams. To conclude this section, it seems the evolution of advertising’s inclusion of multi-racial models reveals a progressive step change for the beauty industry. However, relying simply on the faces of ethnically ambiguous talent has become a covert way to fulfil consumer’s desire for diversity without wholly dismantling the destructive hierarchies of white dominance. Over this time however, new beauty creations have entered the market and with it two modern day icons.Architecting Black Beauty through the American DreamAccording to Kiick, the conception of the ‘American Dream’ is born out of a desire to “seek out a more advantageous existence than the current situation” (qtd. in Manca et al. 84). As a result of diligent hard work, Americans were rewarded with an opportunity for a better life (Manca et al.). Kylie Jenner’s entry into the beauty space seemed like a natural move for the then eighteen-year-old; it was a new-age representation of the ‘American Dream’ (Robehmed 2018). In less than five years, Jenner has created Kylie Cosmetics, a beauty empire that has since amassed a global consumer base, helping her earn billionaire status. A more critical investigation into Jenner’s performance however illustrates that her eponymous range of beauty products sells dreams which have been appropriated from black culture (Phelps). The term cultural appropriation refers to the way dominant cultures “adopt and adapt certain aspects of another’s culture and make it their own” (qtd. in Han 9). In Jenner’s case, her connection to ethnic Armenian roots through her sisters Kourtney, Kim, and Khloe Kardashian have significantly influenced her expression of ‘othered’ culture and moreover ethnic beauty ideals such as curvier body shapes and textured hair. Jenner’s beauty advertisements have epitomised what it means to be black in America, cherry picking racialised features of black women (namely their lips, hips/buttocks and afro-braided hairstyles) and rearticulated them through a white lens. The omission of the ‘black experience’ in her promotion of product is problematic for three reasons. Firstly, representing groups or people without invitation enables room for systemic stereotyping (Han). Secondly, this stereotyping can lead to continued marginalisation of minority cultures (Kulchyski). And finally, the over exaggeration of physical attributes, such as Jenner’s lips, hips and buttocks, reinforces her complicity in exoticising and fetishising the “other”. As a result, consumers of social media beauty advertising may pay less attention to cultural appropriation if they are already unaware that the beauty imagery they consume is based on the exploitation of black culture.Another perspective on Jenner’s use of black culture is in large part due to her cultural appreciation of black beauty. This meaning behind Jenner’s cultural appreciation can be attributed to the inherent value placed on another person’s culture, in the recognition of the positive qualities and the celebration of all aspects of that culture (Han). This is evidenced by her recent addition of cosmetic products for darker complexions (Brown). However, Jenner’s supposed fascination with black culture may be in large part due to the environment in which she was nurtured (Phelps). As Phelps reveals, “consider the cultural significance of the Kardashian family, and the various ways in which the Kardashian women, who are tremendously wealthy and present as white, have integrated elements of black culture as seemingly “natural” in their public bodily performances” (9). Although the Kardashian-Jenner family have faced public backlash for their collective appropriation they have acquired a tremendous “capital gain in terms of celebrity staying power and hyper-visibility” (Phelps 9). Despite the negative attention, Kylie Jenner’s expression of black culture has resurfaced the very issues that had once been historically deemed insignificant. In spite of Jenner’s cultural appropriation of black beauty, her promotion through Kylie Cosmetics continues to sell dreams of idealised beauty through the white lens.In comparison, Rihanna Fenty’s cosmetic empire has been touted as a celebration of diversity and inclusion for modern-age beauty. Unlike Kylie Cosmetics, Fenty’s eponymous brand has become popular for its broader message of inclusivity across both skin tone, body shape and gender. Upon her product release, Fenty Beauty acknowledged a growing body of diverse consumers and as a direct response to feature models of diverse skin tones, cultural background and racial heritage. Perhaps more importantly, Fenty Beauty’s challenge to the ongoing debate around diversity and inclusion has been in stark contrast to Kylie Jenner’s ongoing appropriation of black culture. Images featured at the first brand and product launch of Fenty Beauty and in present day advertising, show South Sudanese model Duckie Thot and hijab-wearing model Halima Aden as central characters within the Fenty narrative, illustrating that inclusion need not remain ambiguous and diversity need not be appropriated. Fenty’s initial product line up included ninety products, but most notably, the Pro Filt’r foundation caused the most publicity. Since its introduction in 2017, the foundation collection contained range of 40 (now 50) inclusive foundation shades, 13 of these shades were designed to cater for much darker complexions, an industry first (Walters). As a result of the brand’s inclusion of diverse product shades and models, Fenty Beauty has been shown to push boundaries within the beauty industry and the social media landscape (Walters). Capitalising on all races and expanding beauty ideals, Fenty’s showcase of beauty subscribes to the notion that for women everywhere in the world, their dreams can and do come true. In conclusion, Fenty Beauty has played a critical role in re-educating global consumers about diversity in beauty (Walters) but perhaps more importantly Rihanna, by definition, has become a true embodiment of the ‘American Dream’.Conclusion: Future Dreams in BeautyIt is undeniable that beauty advertising has remained complicit in selling unattainable dreams to consumers. In the context of ‘dream’ as a philosophical concept, it is more important than ever to ensure our dreams are mirrored, not as an ambiguous body of consumers, but as diverse and unique individuals. Changemakers in the industry such as Fenty Beauty are challenging this status quo and beauty advertising in general will have to evolve their strategy in a bid to answer to an increasingly globalised market. It must be reinforced however, that while “beauty companies and advertisers work effectively to reach a growingly multicultural market, scholars have a responsibility to assess the ramifications that accompany such change,” (Harrison et al. 518). If advertising’s role is to mirror consumers’ dreams then, our roles as dreamers have never been so important. ReferencesAkinro, Ngozi, and Lindani Mbunyuza-Memani. "Black Is Not Beautiful: Persistent Messages and the Globalization of 'White' Beauty in African Women’s Magazines." 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British Vogue, 2017: 240-310. 28 Jan. 2020 <https://www.zinio.com/gb/british-vogue/december-2017-i392997>.Han, Hsiao-Cheng (Sandrine). “Moving from Cultural Appropriation to Cultural Appreciation.” Art Education 72.2 (2019): 8–13.Harrison, Robert L., Kevin D. Thomas, and Samantha N.N. Cross. “Restricted Visions of Multiracial Identity in Advertising.” Journal of Advertising 46.4 (2017): 503–520.Hood, John McDonald. Selling the Dream: Why Advertising Is Good Business. Westport: Praeger, 2005.Hunter, Margaret L. ““If You’re Light, You’re Alright”: Light Skin Color as Social Capital for Women of Color.” Gender & Society 16.2 (2002): 175–193.Johnson, Melissa A. "How Ethnic Are U.S. Ethnic Media: The Case of Latina Magazines." Mass Communication and Society 3.2–3 (2000): 229–248.Jung, Jaehee, and Yoon-Jung Lee. “Cross-Cultural Examination of Women’s Fashion and Beauty Magazine Advertisements in the United States and South Korea.” Clothing and Textiles Research Journal 27.4 (2009): 274–286.Manca, Luigi, Alessandra Manca, and Gail W. Pieper. Utopian Images and Narratives in Advertising: Dreams for Sale. Maryland: Lexington Books, 2012.Ohmann, Richard. "Review of Culture and the Ad: Exploring Otherness in the World of Advertising." Contemporary Sociology 24.6 (1995): 821–823.Oshima, Kimmie. "Perception of Hafu or Mixed-Race People in Japan: Group-Session Studies among Hafu Students at a Japanese University." Intercultural Communication Studies 23.3 (2014): 22-34.Pagel, J.F., et al. “Definitions of Dream: A Paradigm for Comparing Field Descriptive Specific Studies of Dream.” Dreaming 11 (2001). DOI: 10.1023/A:1012240307661.Peter Kulchyski. “From Appropriation to Subversion: Aboriginal Cultural Production in the Age of Postmodernism.” American Indian Quarterly 21.4 (1997): 605.Phelps, Katherine. “Lil’ Gangstas and Good Girls: Tween Girls’ Racial Performances Online.” Conference Papers -- American Sociological Association. (2019): 1–29.Redmond, Sean. “Thin White Women in Advertising: Deathly Corporeality.” Journal of Consumer Culture 3.2 (2003): 170–190.Robehmed, Natalie. “How 20-Year-Old Kylie Jenner Built a $900 Million Fortune in Less than 3 Years.” Forbes Magazine, 11 July 2018. 29 Jan. 2020 <https://www.forbes.com/sites/forbesdigitalcovers/2018/07/11/how-20-year-old-kylie-jenner-built-a-900-million-fortune-in-less-than-3-years/#33e64869aa62>.Saraswati, L. Ayu. “Cosmopolitan Whiteness: The Effects and Affects of Skin-Whitening Advertisements in a Transnational Women’s Magazine in Indonesia.” Meridians: Feminism, Race, Transnationalism 10.2 (2010): 15–41.Sengupta, Anita. “Is Fashion’s Newfound ‘Inclusivity’ Only Skin Deep?” Refinery29, 8 May 2018. 27 Jan. 2020 <https://www.refinery29.com/en-us/multiracial-women-fetishized-in-fashion-industry-controversy>.Sengupta, Rhea. “Reading Representations of Black, East Asian, and White Women in Magazines for Adolescent Girls.” Sex Roles 54.11 (2006): 799–808.Solomon, Michael R., Richard D. Ashmore, and Laura C. Longo. “The Beauty Match-Up Hypothesis: Congruence between Types of Beauty and Product Images in Advertising.” Journal of Advertising 21.4 (1992): 23–34.Sontag, Susan. “An Argument about Beauty.” Daedalus 134.4 (2005): 208–213.Steel, Jon. Truth, Lies, and Advertising: The Art of Account Planning. New Jersey: Wiley, 1998.Walters, Jenna. “‘FINALLY SOME DIVERSITY’: An Exploration into the Public’s Perceptions of the ‘Fenty Beauty’ Campaign in Relation to How It Challenges the Lack of Diversity in the Mainstream Westernized Beauty Industry.” Hons. diss. Cardiff: Cardiff Metropolitan University, 2018. 27 Jan. 2020 <https://repository.cardiffmet.ac.uk/handle/10369/9985>.Wasylkiw, L., et al. “Are All Models Created Equal? A Content Analysis of Women in Advertisements of Fitness versus Fashion Magazines.” Body Image 6.2 (2009): 137–140.Yan, Yan, and Kim Bissell. “The Globalization of Beauty: How Is Ideal Beauty Influenced by Globally Published Fashion and Beauty Magazines?” Journal of Intercultural Communication Research 43.3 (2014): 194–214.

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Corchete, Charlotte. "A White and Secular Habitus?" Religion and Gender, July 12, 2022, 1–23. http://dx.doi.org/10.1163/18785417-bja10009.

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Abstract While about half of the French population declare themselves to be non-religious, there is little research on how norms of secularization and secularism shape majority/minority stereotypes in France. Based on ethnographic research conducted through participant observation and semi-directive interviews in a multi-cultural Parisian neighborhood, this paper investigates these issues. It specifically analyzes the relations between white women and ethnic minority men in the context of an ethnically diverse neighborhood. The findings show that religiosity intersects with ethno-racial origin and gender in producing stereotypes about male ethnic minorities. Moreover, religiosity shapes white women’s discourses and behaviors about their own gender identity.

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Low, Sharon Yin Yee, He Cheng, Ruiyang Zou, Lee Ping Ng, Chik Hong Kuick, Nurfarhanah Bte Syed Sulaiman, Kenneth Tou En Chang, David Chyi Yeu Low, Lihan Zhou, and Wan Tew Seow. "Molecular exploration of paediatric intracranial germinomas from multi-ethnic Singapore." BMC Neurology 20, no. 1 (November 14, 2020). http://dx.doi.org/10.1186/s12883-020-01981-0.

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Abstract Background Germinomas (IG) account for up to 50% of all intracranial germ cell tumours. These tumours are reputed to be more prevalent in Oriental populations in comparison to Western cohorts. Biological characteristics of IG in other ethnic groups are unknown. Singapore is a multi-ethnic country with diverse cultures. Owing to inter-racial heterogeneity, the authors hypothesize there are molecular differences between paediatric IG patients in our local population. The aims of this study are exploratory: firstly, to identify molecular characteristics in this tumour type and circulating CSF unique to different racial cohorts; and next, to corroborate our findings with published literature. Methods This is a single-institution, retrospective study of prospectively collected data. Inclusion criteria encompass all paediatric patients with histologically confirmed IG. Excess CSF and brain tumour tissues are collected for molecular analysis. Tumour tissues are subjected to a next generation sequencing (NGS) targeted panel for KIT and PDGRA. All CSF samples are profiled via a high-throughput miRNA multiplexed workflow. Results are then corroborated with existing literature and public databases. Results In our cohort of 14 patients, there are KIT exon variants in the tumour tissues and CSF miRNAs corroborative with published studies. Separately, there are also KIT exon variants and miRNAs not previously highlighted in IG. A subgroup analysis demonstrates differential CSF miRNAs between Chinese and Malay IG patients. Conclusion This is the first in-depth molecular study of a mixed ethnic population of paediatric IGs from a Southeast Asian cohort. Validation studies are required to assess the relevance of novel findings in our study.

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Cassim, Farzana, Amy Pearlman, Ethan Matz, Ryan Terlecki, Andre van der Merwe, John Lazarus, Cecelia Lloyd, and Bhavish Kowlessur. "Trends in testicular germ cell tumors among native black African men do not mirror those of African Americans: multi-institutional data from South Africa." African Journal of Urology 27, no. 1 (April 7, 2021). http://dx.doi.org/10.1186/s12301-021-00154-w.

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Abstract Background Testicular germ cell tumor (TGCT) is most frequently diagnosed in young males and its etiology remains poorly understood. Cases of newly diagnosed TGCT have been rising in the United States and incidence among African Americans (AA) has increased nearly 40%. Incidence of TGCT in native black African (BA) males, conversely, has remained low. We sought to determine the racial identification of patients diagnosed with TGCT in Cape Town, South Africa. We hypothesize that the rise in TGCT among AA males is distinct from that of BA males in South Africa. Methods A retrospective review involving two tertiary care centres in the Western Cape was performed. Data were extracted for males > 13 years of age diagnosed with TGCT from January 1, 2000 to June 30, 2015. Racial status was self-declared and included BA, Caucasian, Mixed Ancestry (MA), and Asian. Patients were identified from combined Urology–Oncology clinic logs at both institutions, as well as from pathology records at the National Health Laboratory Service indicating any form of testicular cancer. Results 225 patients were identified. 97% of cases involved males identified as MA (130) or Caucasian (88). Only 2% of the study population identified as BA, with complete absence of self-identifying BA males for several years within the queried interval. Among males diagnosed with TGCT, the percentage self-identifying as Caucasian increased over time (R2 0.92). Conclusions Males diagnosed with TGCT in the Western Cape predominantly self-identify as MA or Caucasian. Exceedingly few cases are attributed to BA, and even less to Asian males. The trend in racial distribution suggests that the increasing incidence reported for AAs may be due to interracial gene exchange, environmental factors, or a combination thereof.

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Hinkle, Stefanie, Mengying Li, Jagteshwar Grewal, Katherine Grantz, Samrawit Yisahak, Ellen Francis, Aparna Ajjarapu, and Cuilin Zhang. "Do Pregnant Women Change Their Diet and Physical Activity After Gestational Diabetes Diagnosis? Findings from a Longitudinal Multi-racial U.S. Prospective Cohort (P16-016-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz050.p16-016-19.

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Abstract Objectives Women diagnosed with gestational diabetes (GDM) are usually advised to reduce carbohydrate intake and increase physical activity (PA). There is limited longitudinal population-based evidence on whether these women change their diet and PA after diagnosis. Our aim was to examine if women with GDM do in fact alter their diet and PA post diagnosis and identify characteristics of women with favorable changes. Methods This study included 1735 women from the NICHD Fetal Growth Studies-Singletons (2009–2013) who completed an Automated Self-Administered 24-Hour dietary recall and a Pregnancy PA Questionnaire at 16–22, 24–29, 30–33, 34–37, and 38–41 (PA only) gestational weeks (GW). GDM was ascertained by medical records (n = 85; 4.9%), diagnosed at a mean of 27.7 GW (S.D. 4.7). We used adjusted linear mixed models with random effects to estimate changes in diet/PA post-GDM screening (non-GDM)/diagnosis (GDM) and tested for differences by GDM status. For factors that changed among women with GDM, we tested for differences by covariates. Results Women with GDM significantly reduced total sugar intake after diagnosis by 27.9 g/d (95% confidence interval −41.5, −14.3), while it increased in women without GDM by 3.7 g/d (0.7, 6.7) after screening (Figure). Specifically, women with GDM reduced added sugars [−12.0 g/d (−22.0, −2.0)] and fruit juice [−0.4 serving/d (−0.6, −0.2)], and increased artificially sweetened beverage intake [0.2 servings/d (0.1, 0.3)]. The significant reduction in total sugar persisted in all women except Hispanics [−9.0 g/d (−27.2, 9.3); P-interaction = 0.08] and non-nulliparous women [−10.7 g/d (−25.5, 4.2); P-interaction = 0.001]. Women with GDM performed less moderate intensity PA [−30.6 MET-hr/wk (−43.2, −18.0)] after diagnosis than before, which was less than women without GDM [−17.1 (−19.9, −14.3)]. Conclusions Majority of women with GDM undergoing usual care substantially decreased their overall sugar intake after diagnosis primarily by reducing added sugars and fruit juice, and increasing artificially sweetened beverages. Greater dietary counseling efforts may be needed among Hispanic and multiparous women, and for PA in all women with GDM. Funding Sources This research was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Supporting Tables, Images and/or Graphs

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Schoenthaler, Antoinette, Franzenith De La Calle, Amanda Soto, Derrel Barrett, Jocelyn Cruz, Leydi Payano, Marina Rosado, Samrachana Adhikari, Gbenga Ogedegbe, and Milagros Rosal. "Bridging the evidence-to-practice gap: a stepped-wedge cluster randomized controlled trial evaluating practice facilitation as a strategy to accelerate translation of a multi-level adherence intervention into safety net practices." Implementation Science Communications 2, no. 1 (February 17, 2021). http://dx.doi.org/10.1186/s43058-021-00111-2.

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Abstract Background Poor adherence to antihypertensive medications is a significant contributor to the racial gap in rates of blood pressure (BP) control among Latino adults, as compared to Black and White adults. While multi-level interventions (e.g., those aiming to influence practice, providers, and patients) have been efficacious in improving medication adherence in underserved patients with uncontrolled hypertension, the translation of these interventions into routine practice within “real world” safety-net primary care settings has been inadequate and slow. This study will fill this evidence-to-practice gap by evaluating the effectiveness of practice facilitation (PF) as a practical and tailored strategy for implementing Advancing Medication Adherence for Latinos with Hypertension through a Team-based Care Approach (ALTA), a multi-level approach to improving medication adherence and BP control in 10 safety-net practices in New York that serve Latino patients. Methods and design We will conduct this study in two phases: (1) a pre-implementation phase where we will refine the PF strategy, informed by the Consolidated Framework for Implementation Research, to facilitate the implementation of ALTA into routine care at the practices; and (2) an implementation phase during which we will evaluate, in a stepped-wedge cluster randomized controlled trial, the effect of the PF strategy on ALTA implementation fidelity (primary outcome), as well as on clinical outcomes (secondary outcomes) at 12 months. Implementation fidelity will be assessed using a mixed methods approach based on the five core dimensions outlined by Proctor’s Implementation Outcomes Framework. Clinical outcome measures include BP control (defined as BP< 130/80 mmHg) and medication adherence (assessed using the proportion of days covered via pharmacy records). Discussion The study protocol applies rigorous research methods to identify how implementation strategies such as PF may work to expedite the translation process for implementing evidence-based approaches into routine care at safety-net practices to improve health outcomes in Latino patients with hypertension, who suffer disproportionately from poor BP control. By examining the barriers and facilitators that affect implementation, this study will contribute knowledge that will increase the generalizability of its findings to other safety-net practices and guide effective scale-up across primary care practices nationally. Trial registration ClinicalTrials.gov NCT03713515, date of registration: October 19, 2018.

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Young, Deborah R., Brit I. Saksvig, Tong Tong Wu, Kathleen Zook, Steven Champaloux, and Xia Li. "Abstract P259: Multilevel Predictors of Physical Activity For Early, Mid, and Late Adolescent Girls." Circulation 125, suppl_10 (March 13, 2012). http://dx.doi.org/10.1161/circ.125.suppl_10.ap259.

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Physical activity is critical for obesity prevention and maintenance of cardiovascular health. In order to effectively promote this behavior, we must understand predictors, including contextual ones, of adolescent physical activity and recognize that they may change throughout adolescence. Most previous studies of determinants of physical activity have only examined one level of variable (e.g., personal or psychosocial factors). This study examined potential determinants ranging from intrapersonal to spatial environmental variables. Three racial/ethnic diverse independent cross-sectional, randomly-selected participants from the Trial of Activity for Adolescent Girls (TAAG 2003-2005; 6 field sites; grade 6 and 8) and TAAG 2 (2009, Baltimore/Washington DC area; grade 11) provided 6 days of accelerometry data to assess physical activity. We used questionnaires to obtain demographic and psychosocial information, height, weight and triceps skinfold to assess body composition (individual and social level variables), interviews and surveys to obtain school-level data, and geographical information systems for neighborhood variables. Lasso selection was used to identify significant variables at individual and social levels. Mixed models (13 individual, 5 social, 15 school, 12 neighborhood level variables) were used to determine multilevel predictors of physical activity. Mean minutes of moderate to vigorous physical activity (MVPA) were 23.7±11.7 in 6th grade, 22.2±11.2 in 8th grade, and 20.1±11.8 in 11th grade. Results show that all four levels influence MVPA but change across grades. The factors that influence MVPA are different at 11th grade than 6th and 8th grades. For instance, percent body fat and social support from friends were not predictors at 11th grade. Only barriers to physical activity predicted MVPA at all grades. In conclusion, MVPA is a complex behavior with fluid, multi-level predictors that researchers must consider when planning interventions. Multilevel predictors of MVPA among adolescent girls at 6th, 8th, and 11th grade 6 th Grade 2003 All sites (n=1579) 8 th grade 2005 All sites (n=3085) 11 th Grade 2009 MD only (n=563) Parameter (SE) P value Parameter (SE) P value Parameter (SE) P value White race 1.80 (1.02) 0.08 2.40 (0.68) <0.01 0.43 (1.44) 0.76 Percent body fat −0.16 (0.03) <0.01 −0.11 (0.03) <0.01 −0.04 (0.08) 0.58 Average time spent alone per week 0.05 (0.04) 0.21 0.08 (0.03) <0.01 0.05 (0.06) 0.40 Physical activity enjoyment −0.12 (0.06) 0.06 0.06 (0.05) 0.17 −0.25 (0.11) 0.02 Physical activity barriers −0.14 (0.06) 0.01 −0.16 (0.04) <0.01 −0.40 (0.10) <0.01 Outcome expectancies −0.01 (0.01) 0.04 −0.00 (0.00) 0.38 −0.02 (0.01) 0.11 Enjoyment of physical education 0.57 (0.28) 0.04 0.34 (0.19) 0.07 0.03 (0.41) 0.94 Depressive symptoms 0.05 (0.04) 0.21 0.05 (0.02) 0.04 0.02 (0.07) 0.81 Social support from friends 0.37 (0.12) <0.01 0.20 (0.09) 0.03 0.36 (0.23) 0.11 % students passing standardized math −0.11 (0.03) <0.01 −0.07 (0.04) 0.07 0.33 (0.29) 0.27 Perceived access to recreational facilities 0.22 (0.10) 0.02 0.03 (0.16) 0.79 −0.00 (0.21) 0.97 Perceived sidewalk availability 0.05 (0.21) 0.80 −0.06 (0.15) 0.71 −1.49 (0.42) <0.01 Perceived neighborhood safety 0.26 (0.26) 0.32 0.44 (0.18) 0.02 0.87 (0.46) 0.06 Distance to participant's school −0.33 (0.17) 0.05 0.02 (0.10) 0.83 −0.41 (0.26) 0.12 Number of parks 1 mile from home 0.19 (0.12) 0.13 0.36 (0.09) <0.01 0.10 (0.85) 0.90

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Broderick, Mick, Stuart Marshall Bender, and Tony McHugh. "Virtual Trauma: Prospects for Automediality." M/C Journal 21, no. 2 (April 25, 2018). http://dx.doi.org/10.5204/mcj.1390.

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Unlike some current discourse on automediality, this essay eschews most of the analysis concerning the adoption or modification of avatars to deliberately enhance, extend or distort the self. Rather than the automedial enabling of alternative, virtual selves modified by playful, confronting or disarming avatars we concentrate instead on emerging efforts to present the self in hyper-realist, interactive modes. In doing so we ask, what is the relationship between traumatic forms of automediation and the affective impact on and response of the audience? We argue that, while on the one hand there are promising avenues for valuable individual and social engagements with traumatic forms of automediation, there is an overwhelming predominance of suffering as a theme in such virtual depictions, comingled with uncritically asserted promises of empathy, which are problematic as the technology assumes greater mainstream uptake.As Smith and Watson note, embodiment is always a “translation” where the body is “dematerialized” in virtual representation (“Virtually” 78). Past scholarship has analysed the capacity of immersive realms, such as Second Life or online games, to highlight how users can modify their avatars in often spectacular, non-human forms. Critics of this mode of automediality note that users can adopt virtually any persona they like (racial, religious, gendered and sexual, human, animal or hybrid, and of any age), behaving as “identity tourists” while occupying virtual space or inhabiting online communities (Nakamura). Furthermore, recent work by Jaron Lanier, a key figure from the 1980s period of early Virtual Reality (VR) technology, has also explored so-called “homuncular flexibility” which describes the capacity for humans to seemingly adapt automatically to the control mechanisms of an avatar with multiple legs, other non-human appendages, or for two users to work in tandem to control a single avatar (Won et. al.). But this article is concerned less with these single or multi-player online environments and the associated concerns over modifying interactive identities. We are principally interested in other automedial modes where the “auto” of autobiography is automated via Artificial Intelligences (AIs) to convincingly mimic human discourse as narrated life-histories.We draw from case studies promoted by the 2017 season of ABC television’s flagship science program, Catalyst, which opened with semi-regular host and biological engineer Dr Jordan Nguyen, proclaiming in earnest, almost religious fervour: “I want to do something that has long been a dream. I want to create a copy of a human. An avatar. And it will have a life of its own in virtual reality.” As the camera followed Nguyen’s rapid pacing across real space he extolled: “Virtual reality, virtual human, they push the limits of the imagination and help us explore the impossible […] I want to create a virtual copy of a person. A digital addition to the family, using technology we have now.”The troubling implications of such rhetoric were stark and the next third of the program did little to allay such techno-scientific misgivings. Directed and produced by David Symonds, with Nguyen credited as co-developer and presenter, the episode “Meet the Avatars” immediately introduced scenarios where “volunteers” entered a pop-up inner city virtual lab, to experience VR for the first time. The volunteers were shown on screen subjected to a range of experimental VR environments designed to elicit fear and/or adverse and disorienting responses such as vertigo, while the presenter and researchers from Sydney University constantly smirked and laughed at their participants’ discomfort. We can only wonder what the ethics process was for both the ABC and university researchers involved in these broadcast experiments. There is little doubt that the participant/s experienced discomfort, if not distress, and that was televised to a national audience. Presenter Nguyen was also shown misleading volunteers on their way to the VR lab, when one asked “You’re not going to chuck us out of a virtual plane are you?” to which Nguyen replied “I don't know what we’re going to do yet,” when it was next shown that they immediately underwent pre-programmed VR exposure scenarios, including a fear of falling exercise from atop a city skyscraper.The sweat-inducing and heart rate-racing exposures to virtual plank walks high above a cityscape, or seeing subjects haptically viewing spiders crawl across their outstretched virtual hands, all elicited predictable responses, showcased as carnivalesque entertainment for the viewing audience. As we will see, this kind of trivialising of a virtual environment’s capacity for immersion belies the serious use of the technology in a range of treatments for posttraumatic stress disorder (see Rizzo and Koenig; Rothbaum, Rizzo and Difede).Figure 1: Nguyen and researchers enjoying themselves as their volunteers undergo VR exposure Defining AutomedialityIn their pioneering 2008 work, Automedialität: Subjektkonstitution in Schrift, Bild und neuen Medien, Jörg Dünne and Christian Moser coined the term “automediality” to problematise the production, application and distribution of autobiographic modes across various media and genres—from literary texts to audiovisual media and from traditional expression to inter/transmedia and remediated formats. The concept of automediality was deployed to counter the conventional critical exclusion of analysis of the materiality/technology used for an autobiographical purpose (Gernalzick). Dünne and Moser proffered a concept of automediality that rejects the binary division of (a) self-expression determining the mediated form or (b) (self)subjectivity being solely produced through the mediating technology. Hence, automediality has been traditionally applied to literary constructs such as autobiography and life-writing, but is now expanding into the digital domain and other “paratextual sites” (Maguire).As Nadja Gernalzick suggests, automediality should “encourage and demand not only a systematics and taxonomy of the constitution of the self in respectively genre-specific ways, but particularly also in medium-specific ways” (227). Emma Maguire has offered a succinct working definition that builds on this requirement to signal the automedial universally, noting it operates asa way of studying auto/biographical texts (of a variety of forms) that take into account how the effects of media shape the kinds of selves that can be represented, and which understands the self not as a preexisting subject that might be distilled into story form but as an entity that is brought into being through the processes of mediation.Sidonie Smith and Julia Watson point to automediality as a methodology, and in doing so emphasize how the telling or mediation of a life actually shapes the kind of story that can be told autobiographically. They state “media cannot simply be conceptualized as ‘tools’ for presenting a preexisting, essential self […] Media technologies do not just transparently present the self. They constitute and expand it” (Smith and Watson “Virtually Me” 77).This distinction is vital for understanding how automediality might be applied to self-expression in virtual domains, including the holographic avatar dreams of Nguyen throughout Catalyst. Although addressing this distinction in relation to online websites, following P. David Marshall’s description of “the proliferation of the public self”, Maguire notes:The same integration of digital spaces and platforms into daily life that is prompting the development of new tools in autobiography studies […] has also given rise to the field of persona studies, which addresses the ways in which individuals engage in practices of self-presentation in order to form commoditised identities that circulate in affective communities.For Maguire, these automedial works operate textually “to construct the authorial self or persona”.An extension to this digital, authorial construction is apparent in the exponential uptake of screen mediated prosumer generated content, whether online or theatrical (Miller). According to Gernalzick, unlike fictional drama films, screen autobiographies more directly enable “experiential temporalities”. Based on Mary Anne Doane’s promotion of the “indexicality” of film/screen representations to connote the real, Gernalzick suggests that despite semiotic theories of the index problematising realism as an index as representation, the film medium is still commonly comprehended as the “imprint of time itself”:Film and the spectator of film are said to be in a continuous present. Because the viewer is aware, however, that the images experienced in or even as presence have been made in the past, the temporality of the so-called filmic present is always ambiguous” (230).When expressed as indexical, automedial works, the intrinsic audio-visual capacities of film and video (as media) far surpass the temporal limitations of print and writing (Gernalzick, 228). One extreme example can be found in an emergent trend of “performance crime” murder and torture videos live-streamed or broadcast after the fact using mobile phone cameras and FaceBook (Bender). In essence, the political economy of the automedial ecology is important to understand in the overall context of self expression and the governance of content exhibition, access, distribution and—where relevant—interaction.So what are the implications for automedial works that employ virtual interfaces and how does this evolving medium inform both the expressive autobiographical mode and audiences subjectivities?Case StudyThe Catalyst program described above strove to shed new light on the potential for emerging technology to capture and create virtual avatars from living participants who (self-)generate autobiographical narratives interactively. Once past the initial gee-wiz journalistic evangelism of VR, the episode turned towards host Nguyen’s stated goal—using contemporary technology to create an autonomous virtual human clone. Nguyen laments that if he could create only one such avatar, his primary choice would be that of his grandfather who died when Nguyen was two years old—a desire rendered impossible. The awkward humour of the plank walk scenario sequence soon gives way as the enthusiastic Nguyen is surprised by his family’s discomfort with the idea of digitally recreating his grandfather.Nguyen next visits a Southern California digital media lab to experience the process by which 3D virtual human avatars are created. Inside a domed array of lights and cameras, in less than one second a life-size 3D avatar is recorded via 6,000 LEDs illuminating his face in 20 different combinations, with eight cameras capturing the exposures from multiple angles, all in ultra high definition. Called the Light Stage (Debevec), it is the same technology used to create a life size, virtual holocaust survivor, Pinchas Gutter (Ziv).We see Nguyen encountering a life-size, high-resolution 2D screen version of Gutter’s avatar. Standing before a microphone, Nguyen asks a series of questions about Gutter’s wartime experiences and life in the concentration camps. The responses are naturalistic and authentic, as are the pauses between questions. The high definition 4K screen is photo-realist but much more convincing in-situ (as an artifact of the Catalyst video camera recording, in some close-ups horizontal lines of transmission appear). According to the project’s curator, David Traum, the real Pinchas Gutter was recorded in 3D as a virtual holograph. He spent 25 hours providing 1,600 responses to a broad range of questions that the curator maintained covered “a lot of what people want to say” (Catalyst).Figure 2: The Museum of Jewish Heritage in Manhattan presented an installation of New Dimensions in Testimony, featuring Pinchas Gutter and Eva SchlossIt is here that the intersection between VR and auto/biography hybridise in complex and potentially difficult ways. It is where the concept of automediality may offer insight into this rapidly emerging phenomenon of creating interactive, hyperreal versions of our selves using VR. These hyperreal VR personae can be questioned and respond in real-time, where interrogators interact either as casual conversers or determined interrogators.The impact on visitors is sobering and palpable. As Nguyen relates at the end of his session, “I just want to give him a hug”. The demonstrable capacity for this avatar to engender a high degree of empathy from its automedial testimony is clear, although as we indicate below, it could simply indicate increased levels of emotion.Regardless, an ongoing concern amongst witnesses, scholars and cultural curators of memorials and museums dedicated to preserving the history of mass violence, and its associated trauma, is that once the lived experience and testimony of survivors passes with that generation the impact of the testimony diminishes (Broderick). New media modes of preserving and promulgating such knowledge in perpetuity are certainly worthy of embracing. As Stephen Smith, the executive director of the USC Shoah Foundation suggests, the technology could extendto people who have survived cancer or catastrophic hurricanes […] from the experiences of soldiers with post-traumatic stress disorder or survivors of sexual abuse, to those of presidents or great teachers. Imagine if a slave could have told her story to her grandchildren? (Ziv)Yet questions remain as to the veracity of these recorded personae. The avatars are created according to a specific agenda and the autobiographical content controlled for explicit editorial purposes. It is unclear what and why material has been excluded. If, for example, during the recorded questioning, the virtual holocaust survivor became mute at recollecting a traumatic memory, cried or sobbed uncontrollably—all natural, understandable and authentic responses given the nature of the testimony—should these genuine and spontaneous emotions be included along with various behavioural ticks such as scratching, shifting about in the seat and other naturalistic movements, to engender a more profound realism?The generation of the photorealist, mimetic avatar—remaining as an interactive persona long after the corporeal, authorial being is gone—reinforces Baudrillard’s concept of simulacra, where a clone exists devoid of its original entity and unable to challenge its automedial discourse. And what if some unscrupulous hacker managed to corrupt and subvert Gutter’s AI so that it responded antithetically to its purpose, by denying the holocaust ever happened? The ethical dilemmas of such a paradigm were explored in the dystopian 2013 film, The Congress, where Robyn Wright plays herself (and her avatar), as an out of work actor who sells off the rights to her digital self. A movie studio exploits her screen persona in perpetuity, enabling audiences to “become” and inhabit her avatar in virtual space while she is limited in the real world from undertaking certain actions due to copyright infringement. The inability of Wright to control her mimetic avatar’s discourse or action means the assumed automedial agency of her virtual self as an immortal, interactive being remains ontologically perplexing.Figure 3: Robyn Wright undergoing a full body photogrammetry to create her VR avatar in The Congress (2013)The various virtual exposures/experiences paraded throughout Catalyst’s “Meet the Avatars” paradoxically recorded and broadcast a range of troubling emotional responses to such immersion. Many participant responses suggest great caution and sensitivity be undertaken before plunging headlong into the new gold rush mentality of virtual reality, augmented reality, and AI affordances. Catalyst depicted their program subjects often responding in discomfort and distress, with some visibly overwhelmed by their encounters and left crying. There is some irony that presenter Ngyuen was himself relying on the conventions of 2D linear television journalism throughout, adopting face-to-camera address in (unconscious) automedial style to excitedly promote the assumed socio-cultural boon such automedial VR avatars will generate.Challenging AuthenticityThere are numerous ethical considerations surrounding the potential for AIs to expand beyond automedial (self-)expression towards photorealist avatars interacting outside of their pre-recorded content. When such systems evolve it may be neigh impossible to discern on screen whether the person you are conversing with is authentic or an indistinguishable, virtual doppelganger. In the future, a variant on the Turning Test may be needed to challenge and identify such hyperreal simulacra. We may be witnessing the precursor to such a dilemma playing out in the arena of audio-only podcasts, with some public intellectuals such as Sam Harris already discussing the legal and ethical problems from technology that can create audio from typed text that convincingly replicate the actual voice of a person by sampling approximately 30 minutes of their original speech (Harris). Such audio manipulation technology will soon be available to anybody with the motivation and relatively minor level of technological ability in order to assume an identity and masquerade as automediated dialogue. However, for the moment, the ability to convincingly alter a real-time computer generated video image of a person remains at the level of scientific innovation.Also of significance is the extent to which the audience reactions to such automediated expressions are indeed empathetic or simply part of the broader range of affective responses that also include direct sympathy as well as emotions such as admiration, surprise, pity, disgust and contempt (see Plantinga). There remains much rhetorical hype surrounding VR as the “ultimate empathy machine” (Milk). Yet the current use of the term “empathy” in VR, AI and automedial forms of communication seems to be principally focused on the capacity for the user-viewer to ameliorate negatively perceived emotions and experiences, whether traumatic or phobic.When considering comments about authenticity here, it is important to be aware of the occasional slippage of technological terminology into the mainstream. For example, the psychological literature does emphasise that patients respond strongly to virtual scenarios, events, and details that appear to be “authentic” (Pertaub, Slater, and Barker). Authentic in this instance implies a resemblance to a corresponding scenario/activity in the real world. This is not simply another word for photorealism, but rather it describes for instance the experimental design of one study in which virtual (AI) audience members in a virtual seminar room designed to treat public speaking anxiety were designed to exhibit “random autonomous behaviours in real-time, such as twitches, blinks, and nods, designed to encourage the illusion of life” (Kwon, Powell and Chalmers 980). The virtual humans in this study are regarded as having greater authenticity than an earlier project on social anxiety (North, North, and Coble) which did not have much visual complexity but did incorporate researcher-triggered audio clips of audience members “laughing, making comments, encouraging the speaker to speak louder or more clearly” (Kwon, Powell, and Chalmers 980). The small movements, randomly cued rather than according to a recognisable pattern, are described by the researchers as creating a sense of authenticity in the VR environment as they seem to correspond to the sorts of random minor movements that actual human audiences in a seminar can be expected to make.Nonetheless, nobody should regard an interaction with these AIs, or the avatar of Gutter, as in any way an encounter with a real person. Rather, the characteristics above function to create a disarming effect and enable the real person-viewer to willingly suspend their disbelief and enter into a pseudo-relationship with the AI; not as if it is an actual relationship, but as if it is a simulation of an actual relationship (USC). Lucy Suchman and colleagues invoke these ideas in an analysis of a YouTube video of some apparently humiliating human interactions with the MIT created AI-robot Mertz. Their analysis contends that, while it may appear on first glance that the humans’ mocking exchange with Mertz are mean-spirited, there is clearly a playfulness and willingness to engage with a form of AI that is essentially continuous with “long-standing assumptions about communication as information processing, and in the robot’s performance evidence for the limits to the mechanical reproduction of interaction as we know it through computational processes” (Suchman, Roberts, and Hird).Thus, it will be important for future work in the area of automediated testimony to consider the extent to which audiences are willing to suspend disbelief and treat the recounted traumatic experience with appropriate gravitas. These questions deserve attention, and not the kind of hype displayed by the current iteration of techno-evangelism. Indeed, some of this resurgent hype has come under scrutiny. From the perspective of VR-based tourism, Janna Thompson has recently argued that “it will never be a substitute for encounters with the real thing” (Thompson). Alyssa K. Loh, for instance, also argues that many of the negatively themed virtual experiences—such as those that drop the viewer into a scene of domestic violence or the location of a terrorist bomb attack—function not to put you in the position of the actual victim but in the position of the general category of domestic violence victim, or bomb attack victim, thus “deindividuating trauma” (Loh).Future work in this area should consider actual audience responses and rely upon mixed-methods research approaches to audience analysis. In an era of alt.truth and Cambridge Analytics personality profiling from social media interaction, automediated communication in the virtual guise of AIs demands further study.ReferencesAnon. “New Dimensions in Testimony.” Museum of Jewish Heritage. 15 Dec. 2017. 19 Apr. 2018 <http://mjhnyc.org/exhibitions/new-dimensions-in-testimony/>.Australian Broadcasting Corporation. “Meet The Avatars.” Catalyst, 15 Aug. 2017.Baudrillard, Jean. “Simulacra and Simulations.” Jean Baudrillard: Selected Writings. Ed. Mark Poster. Stanford: Stanford UP, 1988. 166-184.Bender, Stuart Marshall. Legacies of the Degraded Image in Violent Digital Media. 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David. “Persona Studies: Mapping the Proliferation of the Public Self.” Journalism 15.2 (2014): 153-170.Mathews, Karen. “Exhibit Allows Virtual ‘Interviews’ with Holocaust Survivors.” Phys.org Science X Network, 15 Dec. 2017. 18 Apr. 2018 <https://phys.org/news/2017-09-virtual-holocaust-survivors.html>.Maguire, Emma. “Home, About, Shop, Contact: Constructing an Authorial Persona via the Author Website” M/C Journal 17.9 (2014).Miller, Ken. More than Fifteen Minutes of Fame: The Evolution of Screen Performance. Unpublished PhD Thesis. Murdoch University. 2009.Milk, Chris. “Ted: How Virtual Reality Can Create the Ultimate Empathy Machine.” TED Conferences, LLC. 16 Mar. 2015. <https://www.ted.com/talks/chris_milk_how_virtual_reality_can_create_the_ultimate_empathy_machine>.Nakamura, Lisa. “Cyberrace.” Identity Technologies: Constructing the Self Online. Eds. Anna Poletti and Julie Rak. Madison, Wisconsin: U of Wisconsin P, 2014. 42-54.North, Max M., Sarah M. North, and Joseph R Coble. "Effectiveness of Virtual Environment Desensitization in the Treatment of Agoraphobia." International Journal of Virtual Reality 1.2 (1995): 25-34.Pertaub, David-Paul, Mel Slater, and Chris Barker. “An Experiment on Public Speaking Anxiety in Response to Three Different Types of Virtual Audience.” Presence: Teleoperators and Virtual Environments 11.1 (2002): 68-78.Plantinga, Carl. "Emotion and Affect." The Routledge Companion to Philosophy and Film. Eds. Paisley Livingstone and Carl Plantinga. New York: Routledge, 2009. 86-96.Rizzo, A.A., and Sebastian Koenig. “Is Clinical Virtual Reality Ready for Primetime?” Neuropsychology 31.8 (2017): 877-99.Rothbaum, Barbara O., Albert “Skip” Rizzo, and JoAnne Difede. "Virtual Reality Exposure Therapy for Combat-Related Posttraumatic Stress Disorder." Annals of the New York Academy of Sciences 1208.1 (2010): 126-32.Smith, Sidonie, and Julia Watson. Reading Autobiography: A Guide to Interpreting Life Narratives. 2nd ed. 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