This study was designed to identify what, if any, communications occurred between working-class mothers, who had experience as sole supporters of families, and their adolescent daughters to socialize the daughters to the role of education in the daughters' lives. Additionally, this study was designed to determine whether there was an intergenerational transmission of educational values between working-class mothers and their daughters, and to determine if mothers are their daughters' first educational role models or mentors. The participants were a homogeneous sampling of seven Caucasian working-class mother and daughter pairs from two rural western Massachusetts mill towns. After an initial questionnaire which helped to identify prospective participants, semi-structured, in-depth interviews were conducted with the pairs and a topical guide was used to gather comparable data from all participants. Thematic analysis was conducted to analyze the data. Participants in this study provided insights into both multigenerational and intergenerational messages transmitted across generations and the mechanisms by which those messages were transmitted. They also provided insights into how messages from their working-class work ethic both shaped and contradicted their aspirations for success. The intersection of social class and the mothers' experiences as sole supporters revealed specific messages about working-class values and what it meant for the participants to be successful or not. The mothers in this study used these messages to purposefully push their daughters toward success, which they believed began with a four-year college degree. Finally, this study revealed that these working-class mothers were their daughters' first educational role models and mentors. However, due to gaps in procedural knowledge and the mothers' passivity in assisting daughters in obtaining information that would help them prepare for college, there became a point where most mothers became ineffective mentors, thus highlighting the need for positive role models and mentors, for both mothers and daughters. Additionally, several unarticulated contradictions emerged between the messages and with regard to the participants' desire for success. The paper concludes with a discussion about implications for future research and practice.

Introduction Hypertension occurs when there is persistent increase in the pressure of blood vessels in the body; this condition affects about 75 million people in the United States (U.S.). Hypertension is a major risk factor for Peripheral Artery Disease (PAD). PAD is a narrowing of the peripheral arteries in legs, stomach, arms and head regions of the body except the heart. Research has shown that hypertension can be life-threatening for patients with PAD. Moreover, research supports an evidence of a low threshold for blood pressure treatment in patients with PAD. Additionally, current American Heart Association guidelines recommend treating hypertension in patients with PAD to reduce the risk of other cardiovascular disease (CVD) comorbidities. In Central Appalachia, the rate of hypertension and the corresponding risk factors is higher than the national average. As such, this study examined the multiple risk factors of hypertension in patients with PAD within the Central Appalachian region. Method The study population consists of patients diagnosed with PAD in a large health system in Central Appalachia from 2008 to 2018. We extracted 13,455 patients with PAD from Electronic Medical Records (EMR) system using ICD- 9 and ICD-10 codes. The outcome variable of the study was hypertension in PAD patients. Explanatory variables included gender, age, and cardiovascular risk factors (myocardial infarction (MI), Body Mass Index (BMI), diabetes mellitus, smoking status, low-density lipoprotein, high-density lipoprotein, triglycerides, and hypercholesterolemia). Multivariable logistic regression was performed to assess the association between risk factors of hypertension in male and female PAD patients. All analyses were performed using SPSS version 24. RESULTS Of the total PAD patients in the study, 45.8% were females and 54.2% were males. Of these patients, 79.1%, 45.7% and 22.6% had hypertension, diabetes and a history of MI, respectively. Upon stratifying based on gender, the odds of hypertension in PAD female patients with a history of MI was approximately 5.4 times (OR: 5.4, CI : 1.80-16.21) and 2.6 times higher with diabetes (OR: 2.6, CI: 1.43-4.83). Whereas in PAD male patients, the odds of hypertension was 3.9 (OR: 2.6, CI: 1.61-9.21) and 2.6 times (OR: 2.6, CI: 1.43-4.83) higher in those with a history of MI and diabetes, respectively. Stratifying by MI, the odds of hypertension in PAD increased by 2.8 times in patients with diabetes (OR: 2.6, CI: 1.75-4.49). Stratifying by diabetes showed that the odds of hypertension in PAD increased by 4.7 times in patients with MI (OR: 4.7, CI: 1.32-17.07). CONCLUSION The study showed that odds of hypertension in PAD patients is increased in the presence of diabetes and history of MI in both genders. Therefore, controlling diabetes and myocardial infarction will have the greatest impact in reducing the likelihood of hypertension leading to decreased morbidity and mortality in patients with PAD.

Background: Over 100 million people in the United States (U.S.) have diagnosed diabetes or pre-diabetes. People with this condition are at an increased risk of Peripheral Arterial Disease (PAD). There is a high prevalence of people with risk factors of diabetes especially in the rural Central Appalachia region. People with diabetes are at a higher risk of developing atherosclerosis, which is the most common cause of PAD. Although about 20–30% of 12 million people affected with PAD in the U.S. have diabetes, little is known about diabetes in PAD patients in Central Appalachia. Therefore, this study aimed to examine the risk factors of diabetes in patients with PAD within the Central Appalachian region. Methods: The study population consisted of patients with PAD with medical comorbidities of Cardiovascular disease (CVD). All patients were admitted to a large health system in Central Appalachia between 2008 and 2018. 13,455 index cases were extracted from the Electronic Medical Records (EMR) using the ICD-9 and ICD-10 codes. With diabetes as the outcome variable under study, the risk factors included Myocardial Infarction (MI) history, hypertension, smoking status and hypercholesterolemia. Socio-demographic variables considered in the study included gender, age, ethnicity and marital status and the covariates were Body Mass Index (BMI), Low density lipoproteins (LDL), High density lipoproteins (HDL), Total Cholesterol, and Triglycerides (TG). Multivariable logistic regression was performed to examine potential risk factors of diabetes in PAD patients. Results: The results showed that BMI {OR =1.056 (CI: 1.039, 1.073)}, HDL {OR =0.980 (CI: 0.965, 0.995)}, TG {OR=1.003 (CI: 1.001, 1.005)}, MI history {OR= 1.375 (CI: 1.111, 1.703)}, hypertension {OR=2.822 (CI: 1.804, 4.415)} and smoking {OR =0.802(CI: 0.641, 1.003)} were significant for diabetes in known PAD. To control for potential confounders, Stratification was used. Among males and females with PAD, diabetes was associated with last BMI, MI, hypertension and TG. HDL seemed to be negatively associated with hypertension and female diabetics while smoking seemed to be negatively associated in males. Upon stratification with hypertension, diabetes in PAD patients was significant with BMI, TG, MI history and HDL. After stratification with MI, diabetes in PAD female patients was associated with BMI, and previous MI history. On the other hand, patients without MI had an elevated TG level and an increased risk of hypertension. Conclusion: CVD risk factors are strongly associated with PAD comorbidities, which are worsened in the presence of diabetes. We suggest that hospitals and health care systems should strongly control for the risk factors of diabetes and adopt a multi-risk-factor approach for improving health outcomes for PAD patients.

Syftet med kunskapsöversikten är att ta reda på hur en till en (ETE)-digitaliseringen påverkar undervisningspraktiker både ur ett elev- och lärarperspektiv med huvudsakligt fokus på samhällskunskap. Översikten är gjord med stöd från relevant forskning. Frågeställningen lyder: “Vad säger tidigare forskning om ETE-påverkan på undervisningspraktiker ur ett lärar- ochelevperspektiv med huvudsakligt fokus på samhällskunskap?” För att kunna svara på frågeställningen har en sökprocess i databaserna ERIC via EBSCO, Libsearch och Swepub genomförts där texter som berör ämnet kartlagts och sammanställts. I översikten presenteras nya undervisningspraktiker som möjliggörs med ETE, till exempel flipped classroom, samt anledningar till att ett motstånd till ETE råder bland lärare och elever. Slutsatsen som dras är att digitaliseringen av skolan måste ses som en förändringsprocess där lärare behöver navigera på ett hav fyllt med nya möjligheter. Slutligen förs en diskussion som berör ETE-digitaliseringens konsekvenser, innan tankar gällande framtida forskning presenteras. / The purpose of the knowledge overview is to find out how one-to-one (ETE) digitization affects teaching practices from both a student and teacher perspective with the main focus on social studies. The overview is made with support from relevant research. The question is: "What does previous research say about the impact of ETE on teaching practices from a teacher and student perspective with a main focus on social studies?" In order to be able to answer the question, a search process has been carried out in the ERIC databases via EBSCO, Libsearch and Swepub, where texts concerning the subject have been mapped and compiled. The overview presents new teaching practices that are made possible with ETE, such as a flipped classroom, as well as reasons why there is opposition to ETE among teachers and students. The conclusion drawn is that the digitalisation of the school must be seen as a process of change where teachers need to navigate a sea filled with new opportunities. Finally, a discussion is held concerning the consequences of ETE digitization, before thoughts regarding future research are presented.

Sex and relations has an important role in society. Students have the right to sex education. Studies have shown that Swedish sex education is inadequate. It is important to strengthen youth’s ability to conscious and responsible choices regarding sexuality and relationships. To raise a student perspective on how the education can be improved. The study was conducted using qualitative, semi-structured interviews. Six students were interviewed, and the data was later analyzed through a content analysis. The result showed that students are satisfied with the biological aspects of sex education. However, the students lacked a psychological perspective. Few students had received sex education in other subjects than biology. Students want more time for sex education, and that the education has a greater depth. They believe that young adults need to learn more about consent, sexuality, relationships and how to talk about sex. Students want to study the subject from a broader perspective. Students also want to have a greater influence over the education they are given. Teachers have an important role to play in counteracting the fact that sex is a taboo area, and they need to talk more with students about these topics.

Educational quality is a way to influence the future of the American economy (Hanushek, 1986). Large-scale assessments are designed to determine quality in education by measuring student achievement. A connection exists between the standards, teachers, and assessments that form a system of accountability within education. State and national accountability policies place value in certain educational fields, thereby preferring some while excluding others. As a result, accountability systems influence the field of social studies in several unanticipated ways. Consequential validity suggests that assessments should include value implications and relevance (Messick, 1989). While assessment research examines the disciplines of mathematics, science, and language arts in a more holistic manner, the few social studies assessments are often divided among the field’s various disciplines. The purpose of social studies, and its development of standards, is firmly linked to the current state of disunity within the social studies field. These issues are reflected in teacher preparation policies as well as state assessment policies. Social studies advocates have proven that, in other subjects, teachers and instructional methods are influenced by assessment. Fortunately, the National Assessment of Educational Progress (NAEP) provides an opportunity to determine whether the exclusion of social studies within the state/national accountability system is impacting student achievement in social studies. The current systems make social studies uniquely positioned for studying the effects of large-scale assessment upon the field. Uses and interpretations of assessment data by researchers have been limited in social studies because the subject is not incorporated into most accountability policies. State policy governs educational standards, teacher licensure, and the extent of assessments upon students. For this study, the social studies NAEP assessment is divided into three separate tests (U.S. History, Geography, and Civics). By looking at data from the fourth-, eighth-, and twelfth-grade 2010 social studies NAEP tests, this study will investigate some of the unintended consequences of educational assessment culture. I will examine social studies through different lenses and apply the concept of consequential validity to social studies in order to understand the value of social studies within education.

Undervisningen i samhällskunskap på gymnasieskolan ska enligt anvisningarna i ämnesplanen bedrivas ”med utgångspunkt i samhällsfrågor”. Vad innebär det? I denna licentiatuppsats diskuteras ämnet samhällskunskap och dess potential, analyserat utifrån samhällsfrågor som didaktiskt begrepp. Studien är en sammanläggning av tre artiklar som bygger på tre studier. I den första studien analyseras begreppet samhällsfrågor i styrdokument över tid. Den andra studien bygger på en enkät som 74 gymnasielärare i samhällskunskap besvarat. Den tredje studien är slutligen en intervjustudie med sju av de lärare som medverkat i enkätstudien. Studiens design medger en successiv förflyttning av fokus från struktur till aktör. När analysen riktas mot samhällsfrågor som didaktiskt begrepp framträder samhällskunskapsämnet som ett ämne som är öppet för det oväntade och som låter såväl aktuella händelser som elevers genuina frågor forma ämnet. I uppsatsen diskuteras argument för att undervisning som sker med utgångspunkt i samhällsfrågor kan motverka ett instrumentellt förhållningssätt till ämnet. Göran Morén är verksam som lärarutbildare vid Högskolan Dalarna. Han har tidigare erfarenhet som samhällskunskapslärare i gymnasieskola. Sedan 2013 har han ingått i forskarskolan Skolnära, ett samarbete mellan Karlstads universitet och Högskolan Dalarna. / This licentiate thesis examines and discusses the potential of the subject social studies by way of an analysis of the concept social issues. It comprises three articles which are based on three separate studies. The first was a discourse analysis on the concept of social issues in steering documents for social studies in upper secondary school from the 1960’s until the current curriculum. The second was a questionnaire in which 74 social studies teachers answered questions regarding their understanding and teaching of social studies, specifically in relation to the concept of social issues. The third study was based on interviews with seven teachers who had completed the questionnaire. The study allows for a shift in focus between structure and agency. Whereas the structure dominates the analysis in the first article the teachers, with agency, gradually move into the foreground in the other articles. With a social-constructionist perspective, phenomena like a school subject and teaching practice are seen as formed by both structure, such as discourse, and agents, in this case professional teachers. The text analysis shows that social issues as a didactical concept is shifting in its meaning and didactical function for the subject depending on the discourse. It is argued that social issues, in the current steering documents, are downplayed in relation to concepts like “core content” and “knowledge requirements”. The questionnaire that followed showed that teachers had an understanding of social issues that challenged the logic of the previous discourse analysis. They seemed to find it possible to combine “teaching with social issues as the point of departure” with the predefined content and knowledge requirements of the subject syllabus. Based on the results of the final interview study the third article argues that the subject social studies, when seen through the lens of social issues, is one that is open, strives beyond the limitations of  core content and calls for  authentic, sometimes controversial content. The conclusion of the licentiate thesis is that the concept of social issues carries the potential to create a subject that is meaningful for students and that challenges the risk of school becoming instrumental.

The aim of the study is to examine how the labour market is depicted in course booksfor Sweden's upper secondary social studies courses, by comparing textbook contentfor different educational tracks. The case study is based on qualitative text analysiscombined with some quantitative elements. It investigates themes, language andassignments as well as the extent and depth of depictions of the labour market. Thetheoretical lens used draws on Basil Bernstein's concept of knowledge organisation;the distinction between vertical and horizontal knowledge structures.Although the results show some similarities between the tracks, the findings point todifferences in expectations placed on students in different tracks in terms of languageproficiency, cognitive load and their expected societal roles. The study aligns withprevious research within the field suggesting that tracking contributes to sustainingsocial divisions. / <p>21-01-20</p>

Adolescents are individuals who are gradually approaching adulthood and begin to experience some changes in their lives owing to their exposure to environmental influences. These individuals also indulge in behaviors that may be harmful to them and will require the guidance of health providers to stay healthy. However, many adolescents have reported unmet health care needs or guidance from health care providers. The purpose of this study was to determine the prevalence of provider anticipatory guidance reported by adolescents in rural Appalachia. The study participants were aged 16 to 19 years and a total of 762 participants in rural Appalachia were recruited from the 2016 Adolescent Community Health Survey. Participants were asked to indicate whether a provider asked them about a series of health behaviors in a 12-month period. Health behaviors included healthy eating/diet, physical activity, school performance/grades, friends, emotions, feeling sad, suicide, chewing tobacco, drug use, use of steroids, risks of drinking, smoking, and the importance of wearing seatbelts whilst driving. Descriptive statistics were conducted using SAS 9.4. Of the 762 study participants, 53.4% were females. Less than 30% of the study participants reported a doctor had talked to them about their weight/ healthy eating in the last 12 months. In the last 12 months,18.3% reported a doctor had talked to them about suicide, 26.4% reported a doctor had talked to them about their moods and emotions. Less than 25% reported a doctor had talked to them about drug use and 22.31% reported a doctor had talked to them about wearing a seat belt while driving in the last 12 months. Adolescents are in need of anticipatory guidance from health care providers. Our studies reveal more than 70% of adolescents report not receiving anticipatory guidance in several areas including drug use, chewing tobacco, use of steroid pills or shots without a doctor’s prescription, weight, school performance, healthy eating/diet, suicide, their emotions and the importance of wearing a seatbelt whilst driving. The prevalence of anticipatory guidance as reported by these adolescents in Appalachia is low. Therefore, there is a need to create awareness amongst healthcare providers such as physicians, nurses, psychologists, etc. to ensure that whilst they treat medical illnesses, they also talk to young adolescents about risky behaviors. This awareness will go a long way in mitigating adolescent risky behaviors. This study also has implications that drive policy decision-making.

Bodies of Data challenges the promise of big data in knowing and organizing people by explicating how data are made and theorizing mismatches between actors, data, and institutions. Situated at a large public university in the United States that hosts approximately 30,000 undergraduate students, this research ethnographically traces the development and deployment of an app for student success that draws from traditional (demographic information, enrollment history, grade distributions) and non-traditional (WiFi network usage, card swipes, learning management systems) student data to anticipate the likelihood of graduation in a four-year period. The app, which offers an interface for students based on nudging, is the product of collaborations between actors who specialize in educational technology. As these actors manage the app, they must also interpret data against the students who generate those data, many of whom do not neatly mirror their data counterparts. The central question animating this research asks how the designers of the app create order—whether through material bodies that are knowable to data collection or reorganized demographic groupings—as they render students into data.<br><br>To address this question and investigate practices of making data, I conducted 12 months of ethnographic fieldwork, using participant observation and interviewing with university administrators, data scientists, app developers, and undergraduate students. Through a theoretical approach informed by anthropology, science and technology studies, critical data studies, and feminist theory, I analyze how data and the institution make each other through the modeling of student bodies and reshaping of subjectivity. I leverage technical glitches—slippages between students and their data—and failure at large at the institution as analytics to both expose otherwise hidden processes of ordering and productively read failure as an opportunity for imagining what data could do. Predictive projects that derive from big data are increasingly common in higher education as institutions look to data to understand populations. Bodies of Data empirically provides evidence regarding how data are made through sociotechnical processes, in which data are not for understanding but for ordering. As universities look to big data to inform decision-making, the findings of this research contradict assumptions that data provide neutral and objective ways of knowing students.