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<p>Compared to people who are White and have high socioeconomic status (SES), those who are Black and have low SES are more likely to receive suboptimal pain care. One potential contributor to these disparities is biased provider decision-making—there is compelling evidence that providers are influenced by patient race and SES when making pain treatment decisions. According to the dual process model, people are more likely to be influenced by demographic stereotypes, including implicit beliefs, when they are under high cognitive load (i.e., mental workload). One stereotype belief relevant to pain care is that Black and low SES people are more pain tolerant. Aligned with the dual process model, providers who are under high cognitive load and have strong implicit beliefs that Black and low SES people are more pain tolerant may be particularly likely to recommend fewer pain treatments to them. To test this hypothesis, I recruited physician residents and fellows (n=120) to make pain treatment decisions for 12 computer-simulated patients with back pain that varied by race (Black/White) and SES (low/high). Half of the providers were randomized to the high cognitive load group in which they were interrupted during the decision task to make conversions involving hypertension medications for another patient. Remaining providers completed the task without being interrupted. Providers’ implicit beliefs about race and SES differences in pain tolerance were measured with two separate Implicit Association Tests (IATs). Multilevel modeling indicated that providers recommended stronger medications to low than high SES patients (OR=.68, p=.03). There was also a significant interaction between patient SES and cognitive load (OR=-.56, p=.05) and a trending interaction between patient race and cognitive load (OR=1.7, p=.07). Under low cognitive load, providers recommended more pain treatments to high SES (vs. low SES) and Black (vs. White) patients, but under high cognitive load, providers recommended more pain treatments to low SES (vs. high SES) patients and equivalent treatment to Black and White patients. There were no three-way interactions between patient demographics (race or SES), cognitive load, and providers’ implicit beliefs (race-pain or SES-pain IAT scores). However, there was a trending interaction between patient race and race-pain IAT scores (OR=2.56, p=.09). Providers with stronger implicit beliefs that White people are pain sensitive and Black people are pain tolerant recommended more pain treatments to White patients and fewer pain treatments to Black patients. Lastly, there was a trending effect that providers with stronger implicit beliefs that high SES people are pain sensitive and low SES people are pain tolerant recommended stronger medications in general (OR=13.03, p=.07). Results support that provider cognitive load is clinically relevant and impacts clinical decision-making for chronic pain for racially and socioeconomically diverse patients. Future studies are needed to further understand the impact of cognitive load on providers’ pain care decisions, which may inform evidence-based interventions to improve pain care and reduce disparities.</p> <p>  </p>

This thesis is a report of a survey of a political attitudes at McMaster University. The results are based on the data obtained in interviews with 193 undergraduates chosen in a random sample of the undergraduate population. This information was used to examine the level of interest in politics among the members of the sample, and the different ideological attitudes and party preferences of the students interviewed. The different levels of interest in politics were related to ecological factors such as family and school background, socio-economic status, sex, group involvement and place of residence. Political preferences were related to such factors as socio-economic status, religion, family preferences and academic interests. The more interesting conclusions might be summarized as follows. The students as a whole are more apathetic towards politics than might have been expected. Those who have an above average interest in politics tend to be found among those studying Arts subjects at Honours level and whose parents also have an above average interest. They also tend to be male. Students also tend to agree with their parents’ politics, except those who have a high level of interest in the subject. Finally, the interested students tend to be more radical (at least by the scale set up for this survey) than the apathetic. / Thesis / Master of Arts (MA)

This research study examines the relationship between academic achievement and at-risk students. Many issues today affect the achievement gap and the ability for at-risk students to succeed. Most data, as revealed in the studies included in this review, conclude the factors identifying at-risk students do have significant impact on the academic achievement of individual students and schools. Most often, these students are not successful and eventually drop out of school or pursue a GED. Data indicate that teacher-student relationships, parent or caregiver-student relationships, motivation, SES (socioeconomic status), and peer influence can affect success for at- risk students. Twelfth grade students from two high schools in an urban school district were given the opportunity to participate in a survey. This study investigates correlations between the dependent variable grade point average (GPA), and the independent variables teacher-student relationships, parent or caregiver-student relationships, motivation, SES, and peer influence. Five regressions were run to determine if any of the independent variables predict GPA. Data from this study indicate that the variance between the dependent variable of GPA and each of the five independent variables is significant; however the practicality of these resultsâ having a significant influence on the GPA of the study participants is minimal. The strongest variance found was between GPA and motivation and between GPA and peer influence. Other findings include a relationship between GPA and participation in sports or activities. As GPA increases, the percentage of students participating in sports and activities increased. The students in this study do have positive relationships with their teachers; have a parent or caregiver encouraging them to do well in school; and plan to attend college. / Ed. D.

The study's purpose was to examine large and small high schools in Virginia to try to understand if the high school student population size influenced the student achievement of eleventh grade students based on identified predictor variables. Several studies were identified and included in the literature review. From the literature review, the predictor variables of socioeconomic status, student attendance, minority status, and teacher quality were identified to aid in the development of the main research question and five guiding questions. The main research question investigated if there was a relationship between a high school student population size and student achievement when statistically controlling for selected predictor variables. From the literature review, the main research question, five guiding questions, and a methodology were developed that would best aid in the analysis of the data. Data were collected from the Virginia Department of Education for the 2012-2013 school year that consisted of eleventh grade Virginia Standards of Learning assessments, socioeconomic status, student attendance, minority population, and teacher quality. Hierarchical multiple regression was the statistical method used to analyze the data for the research questions. The results of the study indicate there is a relationship between socioeconomic status and student achievement. However, when student population size was introduced, the result was not significant. The overall conclusion regarding socioeconomic status and student achievement is that the issue is not rooted in the size of a high school population. When student attendance was accounted for, a relationship existed between high school student population size and student achievement. When student attendance was accounted for, an indication existed that the high schools in the study with both large and small student populations had a higher percentage of student achievement when students attended on a regular basis. When the size of a high school student population, whether it was large or small, was taken into account, student achievement declined if a high school had a large percentage of minority students. Teacher quality was found to have a relationship with student achievement when high school student population size was taken into account. Overall, results of the study indicate that there was a relationship between a high school student population size and student achievement when statistically controlling for isolated variables. / Ed. D.

Background: Adolescence is a crucial point in life where choices, behaviors, and environmental influences can significantly shape future outcomes. This research investigates the increasing concerns surrounding adolescent substance use and examines its long-term effects on socioeconomic status (SES) in adulthood. Substance use during adolescence has been shown to have significant long-term physiological impacts, as the brain is still developing at this age. Additionally, many short- and long-term effects are associated with substance use, such as impacts on academics, physical and emotional well-being, and social life. Several studies have been conducted to explore the relationship between substance use and SES, however, there is little research that investigates how the initiation of substance use during adolescence will affect SES-related factors in adulthood while using a nationally representative sample and a comprehensive range of substances. Methods: Data from Wave I and Wave V of the nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset was used to explore the relationship between early initiation of substance use and subsequent socioeconomic-related outcomes during adulthood. Substance use was defined through survey questions addressing the age of initial exposure to alcohol, marijuana, and other illicit drugs reported at Wave I (ages 1-21), while SES in adulthood was assessed through objective indicators (personal income, educational attainment, and poverty indicators such as being unable to pay utility bills) and the subjective MacArthur Scale of Subjective Social Status (SSS) reported at Wave V (ages 33-43). Logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between age at first substance use for each substance [categorized as never used (referent), first use at age 1-11, age 12-17, or 18 or older] and each adulthood SES outcome accounting for the complex survey design. Results: Age of first alcohol use was not significantly associated with adulthood functional poverty indicators, educational attainment, or personal income relative to the federal poverty line. Compared to those who never used, early alcohol use initiation was found to be strongly associated with a decreased SSS (first use at age 1-11, OR = 1.66, 95% CI = 1.08, 2.55). Age of illicit drug use initiation was significantly associated with functional poverty indicators in adulthood (age 12-17, OR = 1.40, 95% CI = 1.02, 1.90) and lower perceived SSS (age 12-17, OR = 1.56, 95% CI = 1.12, 2.27). Lastly, the first age of marijuana use was statistically significant across all measured outcomes, with differences present across age categories. For example, marijuana use was significantly associated with functional poverty indicators in adulthood (first use at age 1-11, OR = 3.40, 95% CI = 1.55, 7.49; first use at age 12-17, OR = 1.56, 95% CI = 1.30, 1.94), a lowered educational attainment (chi-squared = 69.3804, p = 0.0000), reduced personal income relative to the federal poverty line (first use at age 1-11, OR = 2.28, 95% CI = 1.06, 4.93), and a lowered perceived SSS (first use at age 12-17, OR = 1.39, 95% CI = 1.12, 1.74). Conclusions: The insights from this analysis will be beneficial to the local community as they have the potential to benefit adolescents from a reduced socioeconomic status in the long term; it can inform intervention strategies, public health policies, and result in the formation of other initiatives to mitigate potential consequences of the initiation of substance use. Understanding the relationship between the initiation of substance use during adolescence and the resulting repercussions to socioeconomic status during adulthood is essential in crafting targeted and effective measures to support the well-being of adolescents and, by extension, the broader society.