Low socio-economic status (SES) students are less likely to gain access to the gatekeeper mathematics courses necessary for high school graduation and entrance to college. This study examined the effects of a constructivist-based fraction intervention on mathematics achievement, self-efficacy beliefs, and Algebra One enrollment of mathematically at risk low SES sixth grade students. Students' fifth grade mathematics CST and sixth grade fraction benchmark scores served as covariates in each analysis. Achievement was measured by the students' scores on their seventh grade fraction benchmark and mathematics California Standards Test (CST). A Fraction Self-Efficacy Survey measured students' beliefs. The sixth grade fraction intervention was a one week, 35 hour program. The experiment included 45 students who attended the intervention and 43 matched students who served as the comparison group. Teacher effects were controlled. The scores of students in the treatment group were significantly higher on both their seventh grade fraction benchmark (p < 0.001) and mathematics CST (p < 0.001). Students in the treatment group scored higher in overall self-efficacy beliefs than students in the comparison group and, although there was a trend towards significance (p = 0.065), the difference was not statistically significant. Additionally, logistic regression was used to determine that students' self-efficacy beliefs partially mediated the relationship between participation in the fraction intervention and their enrollment in Algebra One. Students who attended the intervention were three times as likely to enroll in Algebra One as their matched peers.

The purpose of this study was to analyze the impact of the socioeconomic factors of parent education level and family income on the academic achievement of students of Hispanic and white ethnicities. Scaled scores from the 2009 administration of the California Standards Tests in English language arts and mathematics and matched demographic information for 18,000 second through fifth grade students from six school districts in the San Joaquin Valley constituted the data source for this study. Multiple regressions were the primary statistical test used to analyze the data. The results showed a statistically significant gap in achievement between Hispanic and white students. After correcting for socioeconomic status and students of limited English proficiency, a residual achievement gap of roughly 0.1 of a standard deviation remained between white and Hispanic students. Further analysis showed no gap at low socioeconomic levels and a widening discrepancy in scores with increasing family income and parental education levels. These results may be indicative of differential expectations for white and Hispanic students. Additional testing for the effects of school-wide variables found a small negative impact on student achievement for schools with high average parental education levels, possibly caused by stronger interventions at schools with low average parental education.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that causes progressive autonomy loss and need for care. This does not only affect patients themselves, but also the patients’ informal caregivers (CGs) in their health, personal and professional lives. The big efforts of this multi-center study were not only to evaluate the caregivers’ burden and to identify its predictors, but it also should provide a specific understanding of the needs of ALS patients’ CGs and fill the gap of knowledge on their personal and work lives. Using standardized questionnaires, primary data from patients and their main informal CGs (n = 249) were collected. Patients’ functional status and disease severity were evaluated using the Barthel Index, the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and the King’s Stages for ALS. The caregivers’ burden was recorded by the Zarit Burden Interview (ZBI). Comorbid anxiety and depression of caregivers were assessed by the Hospital Anxiety and Depression Scale. Additionally, the EuroQol Five Dimension Five Level Scale evaluated their health-related quality of life. The caregivers’ burden was high (mean ZBI = 26/88, 0 = no burden, ≥24 = highly burdened) and correlated with patients’ functional status (rp = −0.555, p < 0.001, n = 242). It was influenced by the CGs’ own mental health issues due to caregiving (+11.36, 95% CI [6.84; 15.87], p < 0.001), patients’ wheelchair dependency (+9.30, 95% CI [5.94; 12.66], p < 0.001) and was interrelated with the CGs’ depression (rp = 0.627, p < 0.001, n = 234), anxiety (rp = 0.550, p < 0.001, n = 234), and poorer physical condition (rp = −0.362, p < 0.001, n = 237). Moreover, female CGs showed symptoms of anxiety more often, which also correlated with the patients’ impairment in daily routine (rs = −0.280, p < 0.001, n = 169). As increasing disease severity, along with decreasing autonomy, was the main predictor of caregiver burden and showed to create relevant (negative) implications on CGs’ lives, patient care and supportive therapies should address this issue. Moreover, in order to preserve the mental and physical health of the CGs, new concepts of care have to focus on both, on not only patients but also their CGs and gender-associated specific issues. As caregiving in ALS also significantly influences the socioeconomic status by restrictions in CGs’ work lives and income, and the main reported needs being lack of psychological support and a high bureaucracy, the situation of CGs needs more attention. Apart from their own multi-disciplinary medical and psychological care, more support in care and patient management issues is required.

Thèse de doctorat présenté en vue de l'obtention du doctorat en psychologie - recherche intervention, option psychologie clinique (Ph.D) / L’adversité socioéconomique, définie comme l’expérience de conditions sociales et économiques défavorables, engendrerait des répercussions majeures sur la vie familiale. Un vaste courant de recherche a notamment lié l’adversité socioéconomique à des comportements parentaux sous-optimaux pour le développement des enfants, dont des pratiques plus hostiles, moins structurantes et soutenant moins l’autonomie des enfants, en plus d’être davantage contrôlantes. Toutefois, les études précédentes ont pu surestimer l’association entre l’adversité socioéconomique et les pratiques parentales sous-optimales en omettant de prendre en considération (1) les mécanismes explicatifs sous-tendant cette relation et (2) l’influence d’autres facteurs de risque dont dépend celle-ci. En se basant sur l’approche dimensionnelle des pratiques parentales mise de l’avant par la théorie de l’autodétermination, le modèle du stress familial et le modèle des déterminants des pratiques parentales, la présente thèse a pour objectif de revisiter la relation entre l’adversité socioéconomique, opérationnalisée à l’aide du statut socioéconomique (SSE), et les pratiques parentales en examinant le rôle médiateur des stresseurs contextuels dans cette relation (Étude 1), ainsi qu’en considérant l’influence potentielle des caractéristiques de l’enfant au sein de la relation parent-enfant (Étude 2). Les deux études de la thèse mettent à profit des méthodologies variées et complémentaires. Entre autres, les résultats de l’Étude 1 sont basés sur un échantillon diversifié et une approche multi-répondants, alors que l’Étude 2 examine des données prospectives et des mesures observationnelles des pratiques parentales. L’Étude 1 a examiné, auprès de 156 dyades mère-enfant (M âge = 11 ans) issues de la classe faible à moyenne, le rôle médiateur potentiel des stresseurs contextuels dans la relation entre le SSE et le soutien à l’autonomie (vs les pratiques contrôlantes). Précisément, les mères rapportaient leur SSE et leurs stresseurs contextuels, alors que les enfants rapportaient leur perception générale des pratiques parentales de leurs mères. L’Étude 2 avait plutôt pour objectif d’examiner le rôle respectif du SSE des mères et des facteurs de risque liés aux caractéristiques de l’enfant (son tempérament et son niveau de compétence) dans l’estimation des pratiques parentales, cette fois observées dans un contexte plus circonscrit, c.-à-d. le domaine de l’apprentissage guidé. Un échantillon de 192 mères et leur enfant de 4 ans, recrutés dans le cadre d’un projet de recherche longitudinal, ont participé à une tâche d’apprentissage guidé durant laquelle leurs interactions furent filmées puis codées. Le SSE et les caractéristiques de l’enfant furent mesurés avant la tâche de résolution de problème, créant ainsi un devis prospectif. Les analyses acheminatoires de l’Étude 1 n’ont pas soutenu le modèle de médiation proposé lorsque les stresseurs contextuels étaient considérés dans leur ensemble, sans distinction concernant leur nature ou leur gravité. Toutefois, des analyses exploratoires ont suggéré que certains stresseurs contextuels plus sérieux, menaçant les besoins de base des parents, étaient liés au SSE et, qu’en retour, ces stresseurs contextuels plus spécifiques étaient négativement associés au soutien parental à l’autonomie, tout en étant positivement liés aux pratiques parentales contrôlantes. Les analyses acheminatoires de l’Étude 2, quant à elles, ont révélé que certaines relations entre le SSE et les pratiques parentales en contexte d’apprentissage guidé s’avèrent plus faibles que ce que la documentation antérieure permettait de présager lorsque celles-ci sont évaluées en ajustant pour des facteurs de risque plus proximaux. Certaines pratiques parentales sous-optimales semblent donc plus fortement liées aux caractéristiques de l’enfant (c.-à-d., un tempérament difficile ou des niveaux de compétence moindres) qu’au SSE, suggérant que ces défis supplémentaires pourraient affecter ces pratiques parentales de manière plus directe que le SSE. Une analyse des profils de risque de notre échantillon a également suggéré que la présence simultanée des facteurs de risque était généralement associée à des pratiques parentales sous-optimales. En somme, les résultats de la thèse soulignent l’importance de décrire avec plus de nuances l’expérience des parents vulnérables notamment en spécifiant la nature des stresseurs avec lesquels ils composent, mais également en contrôlant pour d’autres facteurs de risque pouvant survenir de façon concomitante à l’adversité socioéconomique. Les implications théoriques et pratiques de cette thèse pour les relations parent-enfant en contexte d’adversité, de même que ses limites et des directions pour des recherches futures, sont discutées. / Socioeconomic adversity, defined as the experience of disadvantageous social and economic conditions, carries major implications for family life. A vast body of research has indeed linked socioeconomic adversity to suboptimal parenting practices that may thwart children’s development, including less warm, structuring, and autonomy-supportive practices, along with more controlling ones. However, past studies may have overestimated this association by omitting to consider (1) its underlying explanatory mechanisms and (2) the role of other, potentially confounding, risk factors. Grounded in the dimensional approach to parenting put forth by self-determination theory, the family stress model, and models on parenting determinants, this thesis aims at revisiting the relation between socioeconomic adversityoperationalized as socioeconomic status (SES)and parenting practices, by examining the mediating role of contextual stressors (Study 1) as well as considering the potential influence of child characteristics on parenting practices (Study 2). Two studies using varied and complementary research designs are proposed. Notably, Study 1 was conducted among a diversified sample and adopted a multi-informant approach, whereas Study 2 relied on prospective and observational data. Study 1, which included 156 mother-child dyads (M age = 11), examined the potentially mediating role of contextual stressors in the relation between SES and autonomy-supportive vs. controlling parenting practices. Specifically, mothers reported their SES and contextual stressors, while their children reported their general perceptions of their mothers’ practices. Study 2 assessed the unique role of SES and child characteristics (i.e., temperament and competence level) in estimating parenting practices, based on observations of parent-child interactions in a more specific context (i.e., guided learning domain). To do so, a sample of 192 mothers and their 4-year-old children, recruited through a longitudinal research project, engaged in a guided learning task during which their interactions were filmed and later coded. SES and child characteristics were assessed before these interactions, yielding a prospective design. First, path analyses from Study 1 did not confirm the proposed mediational model when contextual stressors were aggregated without distinction in terms of their nature or intensity. However, exploratory analyses suggested that more serious contextual stressors, such as those threatening parents’ basic physical and psychological needs, were linked to SES and, in turn, were negatively associated with autonomy support, while being positively linked to controlling parenting. Path analyses from Study 2 then showed that relations between SES and parenting practices in the guided learning domain may be more modest than previously reported when they are adjusted for more proximal risk factors. Some suboptimal parenting practices were indeed more strongly linked to child characteristics (i.e., difficult temperament and lower level of competence) than to SES, suggesting that these additional risk factors may affect some parenting components more directly. Latent profile analyses also suggested the co-occurrence of SES and demanding child characteristics, which could then lead to suboptimal parenting practices. Altogether, the present results underline the importance of describing the experience of vulnerable parents with more nuance, particularly by specifying the nature of the stressors they encounter, but also by controlling for other risk factors they might be facing. Theoretical and practical implications of this thesis for parent-child relationships in the context of socioeconomic adversity are discussed, as well as limitations and future research directions.

Contexte : Bien qu’il ait été proposé que l’exposition à un faible statut socioéconomique (SSE) familial altère l’activité de l’axe hypothalamo-pituito-surrénalien et sa production de l’hormone cortisol, les résultats actuels sont incohérents et suggèrent la présence de facteurs supplémentaires susceptibles de modifier ces associations. Pourtant, peu d’études à ce jour ont adopté une approche développementale sensible au timing, à la stabilité et aux changements au sein du SSE familial lors de l’étude de l’association liant le SSE au cortisol. En outre, peu de travaux empiriques ont évalué si cette association est non linéaire ou si elle est modulée par le soutien social. Enfin, rares sont les études qui ont examiné dans quelle mesure cette association est affectée par les facteurs génétiques et par les processus gène-environnement, notamment à l’adolescence. Objectifs : Ancré dans une perspective de psychopathologie développementale, l’objectif principal de cette thèse est d’examiner les processus gène-environnement impliqués dans les associations entre le SSE et divers indicateurs de sécrétion cortisolaire mesurés à l’adolescence. Cette thèse a également examiné dans quelle mesure ces associations sont affectées par le timing, la chronicité et les changements au sein du SSE familial et sont atténuées par le soutien social. Méthodes : Les participants proviennent de l’Étude des jumeaux nouveau-nés du Québec, un échantillon populationnel de jumeaux recrutés à la naissance. Le SSE familial a été recueilli au cours de la petite enfance (0-5 ans) et à la mi-adolescence (14 ans). Le soutien social a été rapporté par les jumeaux à l’âge de 14 et de 19 ans. Le cortisol diurne (n=569) a été mesuré à l’âge de 14 ans au réveil, 30 minutes plus tard, l’après-midi et le soir pendant quatre jours non consécutifs. Le cortisol capillaire (n=704) a été mesuré à l’âge de 19 ans. Résultats : Cette thèse est composée de trois articles. Les résultats des deux premiers articles indiquent que l’étiologie génétique du cortisol au réveil et capillaire fluctuent au long du continuum du SSE mesuré à la petite enfance. Les formes que prennent ces interactions gène-environnement sont toutefois distinctes pour ces indicateurs. De plus, nos résultats révèlent la présence d’associations uniques entre le SSE familial mesuré à la mi-adolescence et la plupart des indicateurs cortisolaire, soit suivant une relation linéaire, ou non linéaire. Nous avons également trouvé que l’association liant le SSE au cortisol capillaire n’est pas expliquée par une étiologie génétique commune, mais semble refléter les effets de l’environnement partagé par les jumeaux. Enfin, les résultats du troisième article suggèrent que l’effet synergique du SES familial mesuré à la petite enfance et à la mi-adolescence prédisent la sécrétion cortisolaire. De plus, l’association concomitante entre le SSE et le cortisol au réveil est modulée par le soutien social. Conclusions : Collectivement, ces résultats soulignent l’importance d’adopter une approche développementale et génétiquement informative lors de l’étude de l’association liant l’adversité aux systèmes physiologiques de stress. Un tel examen pourrait contribuer à une meilleure compréhension des mécanismes sous-tendant les disparités socioéconomiques précoces documentées en matière de santé, d’apprentissage et de comportements. / Background: While exposure to lower family socioeconomic status (SES) has been proposed to induce alterations in hypothalamic-pituitary-adrenal (HPA) axis activity and its production of the hormone cortisol, existing findings are inconsistent and suggest the presence of additional factors that may modify these associations. Yet, few of the past studies have taken a developmental approach sensitive to the timing, stability, and change within family SES when investigating the association between SES and cortisol secretion. Furthermore, little empirical attention has been devoted to assessing the possibility that this association might be nonlinear or is modulated by youth’s perceived availability of social support. Lastly, the extent to which this association is affected by genetic factors as well as gene-environmental interplays has seldom been investigated, particularly in adolescence. Objectives: Rooted in a developmental psychopathology perspective, the present thesis’s main objective is to examine the gene-environment processes implicated in the associations of family SES with multiple indicators of cortisol secretion during adolescence. This thesis also investigated to what extent these associations are affected by the timing, chronicity and change in SES and buffered by perceived social support. Methods: Participants are from the Québec Newborn Twin Study, a population-based sample of twin pairs recruited at birth. Family SES was collected in early childhood (ages 0–5) and mid-adolescence (age 14). Perceived social support was reported by twins at aged 14 and 19. Diurnal cortisol (n=569) was measured at age 14 at awakening, 30 min later, in the afternoon and evening over four non-consecutive days. Hair cortisol (n=704) was measured at age 19. Results: This thesis is comprised of three articles. The results of the first two papers indicate that the genetic etiology of adolescence awakening cortisol and HCC fluctuated along the continuum of early childhood family SES. The patterns of these gene-environment interactions were, however, distinct for these indicators. Furthermore, our results pointed to unique associations between mid-adolescence family SES and most of the diurnal and hair cortisol indicators, either according to a linear or nonlinear function. We also found that the association linking mid-adolescence family SES to HCC is not explained by a common genetic etiology but appears to reflect shared environmental effects. Finally, the results of the third paper revealed that the synergistic effect of early childhood and mid-adolescence SES predicted cortisol secretion. Moreover, the concomitant association between SES and awakening cortisol was found to be modulated by mid-adolescence social support. Conclusions: Collectively, these findings underscore the necessity of espousing a developmental and genetically sensitive approach in studies investigating the impact of adversity on stress physiological systems. Such investigations may pave the way to a fuller understanding of the mechanisms underlying the early roots of socioeconomic disparities in health, learning and behaviours.

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Healthcare resources in Sweden are limited, and not everyone that wants care can receive it. Restrictions on access to care are therefore necessary. The restrictions can be implemented in various ways, but in Sweden, waiting lists are used. Waiting lists are often considered a more equitable way to distribute healthcare compared to using prices. Research has however shown that these waiting lists sometimes lead to inequalities, where, for example, higher income is associated with shorter waiting times. We study the relationship between socioeconomic status and waiting times for elective care in Region Östergötland during the period 2018-2023. Linear regression analysis is used to study this link. The overall delivery of care appears equal, but the specialty of Ophthalmology shows disparities in waiting times related to socioeconomic factors. A more detailed analysis also shows that the relationship varies depending on the length of the waiting time within Ophthalmology / Hälso- och sjukvårdens resurser i Sverige är knappa och alla som vill ha vård kan inte få det. Begränsningar i tillgången till vård är således ett måste. Det kan ske på flera olika sätt men i Sverige används vårdköer för detta. Köer anses ofta vara ett mer jämlikt sätt att fördela vård än att använda priser. Det finns dock studier som visar att dessa vårdköer ibland leder till ojämlikheter, där exempelvis högre inkomst är kopplat till kortare väntetider. Vi studerar sambandet mellan socioekonomisk status och väntetid till elektiv kirurgi i Region Östergötland under 2018-2023. Linjär regressionsanalys används för att analysera sambandet. Resultaten visar att vården i stor utsträckning levereras på ett jämlikt sätt. Det existerar dock ojämlikheter inom specialistområdet Ögonsjukvård kopplat till socioekonomisk status. En mer detaljerad analys visar även att sambandet varierar beroende på väntetidens längd inom Ögonsjukvård.

Individuelle Unterschiede in der kognitiven Entwicklung von Kindern korrelieren mit ihrem sozioökonomischen Status (engl. socioeconomic status, SES). Allerdings hat die bisherige Forschung längsschnittliche Dynamiken meist ignoriert. Des Weiteren sind die Mechanismen, die zu SES–bedingten Diskrepanzen in der kognitiven Entwicklung führen, weitgehend unbekannt. Gemäß einer Hypothese ist es die Dysregulation der Sekretion des Stresshormons Cortisol die SES Unterschiede vermittelt, da niedriger SES robust mit höherem chronischen Stress assoziiert. Die vorliegende Dissertation weist im Längsschnitt nach, dass Veränderungen im Familieneinkommen die kognitive Entwicklung von armen Kindern im späteren Kindesalter vorhersagen (Studie I). Bemerkenswerterweise wirkt kindliche Kognition auch auf Veränderungen im elterlichen Einkommen, was auf bisher vernachlässigte bidirektionale Familiendynamiken hinweist. Zudem liefert die Dissertation querschnittliche empirische Evidenz für die Hypothese, dass ein stressbezogener Mechanismus in SES–bedingten Unterschieden kognitiver Entwicklung involviert ist. Höherer Stress und ein geringeres Einkommen waren beide mit Anzeichen des Hypocortisolismus in Kindern charakterisiert (Studie II und III). Außerdem gab es Hinweise, dass kognitive Kontrolle vor den Effekten von Stress schützen könnte (Studie II). Schließlich zeigt die Dissertation erstmalig, dass hyporeaktive Cortisolprofile in Reaktion auf akuten Stress in ärmeren Kindern mit deren niedrigerer Gedächtnisleistung assoziiert ist (Studie III). Beachtenswert ist, dass Ergebnisse dieser Dissertation nicht auf Umwelt oder genetisch vermittelte Kausalität schließen lassen. In zukünftigen Interventionsstudien sollte weiter untersucht werden, ob Interventionen die Einkommensgewinne stärken, Stress reduzieren oder die Reaktion von Kindern auf akuten Stress verbessern, kognitive Unterschiede im Zusammenhang mit SES verringern. / Individual differences in cognitive development in childhood vary along gradients of socioeconomic status (SES). Yet, research has largely ignored longitudinal dynamics, despite evidence that SES, especially income, also changes over time. Furthermore, fairly little is known about the mechanisms by which SES explains cognitive disparities. Lower SES environments are marked by high chronic stress exposure, which has led to the hypothesis that dysregulation of the stress response system resulting in altered cortisol secretion mediates disparities in cognition. This dissertation provides longitudinal evidence for the notion that family income gains and losses predict poor children’s cognitive development throughout later childhood (Paper I). Remarkably, children’s cognition also predicts their parents’ earning ability, indicating previously neglected bidirectional family dynamics. Moreover, this dissertation provides cross–sectional evidence for a stress mechanism involved in SES disparities of cognitive functioning. Both higher stress and lower income are associated with patterns of hypocortisolism in middle childhood (Paper II & III). Further, cognitive control skills may buffer against the embedding of stress exposure in diurnal cortisol secretion (Paper II). Lastly, cortisol hyporeactivity to stress found in low–income children is uniquely associated with their lower memory performance. Notably, this dissertation does not warrant environmentally– or genetically–mediated assumptions of causality. Future intervention studies should continue to explore whether facilitating family income gains, reducing stress exposure, normalizing cortisol secretion, or improving children’s stress coping by training cognitive control alleviates SES–related disparities in cognition.

In Victorian Britain, music circulating libraries libraries operated by music publishers Novello & Co. and Augener & Co. supported upper- and upper-middle-class patrons in their pursuit of cultural capital that would help them perform their socioeconomic status. Studying these libraries in the context of domestic music-making reveals the economic and social impact of these libraries in the lives of amateur musicians and in the music publishing industry. An analysis of the account books in the Novello Business Archives demonstrates that the direct income that Novello & Co., Ltd.'s Universal Circulating Musical Library generated was negligible at best. Yet the fact that the library continued to be part of the business for over forty years indicates that Novello & Co., Ltd. found it to be profitable in some way. In this case, the library could have helped the publisher to attract customers through branding and advertising, in addition to informing publishing decisions by tracking demand. Catalogs for music circulating libraries, as well as for the publishers who owned them, contain lists of library and publisher inventory and pricing. Studying changes in these catalogs reveals how patrons' tastes changed over time. A case study of violin-piano duets in multiple catalogs confirms a continued preference for continental composers over British composers, and another case study of violin-piano duets by Felix Mendelssohn shows a growing taste for arrangements of pieces originally composed for large ensemble. Changing tastes had an effect not only on what music Victorians performed, but also on what pieces publishers offered, and, ultimately, on works' places in the canon.