Archive for January, 2011

You and Yr Children Should Listen to This

Posted by jcmaziquemd on January 30, 2011

To the Best of Our Knowledge: Integration Stories

Sun., Jan 30 at 6 p.m. and Sun., Feb. 6 at 6 a.m. on WAMU 88.5 and 88.3 Ocean City

It’s been more than four decades since the Civil Rights movement ended racial segregation in America, yet few would say African-Americans are now fully integrated – or assimilated.

In this hour of To the Best of Our Knowledge, African American writers talk about race and how black history – from segregation to the Great Migration to the culture of hip hop – continues to shape our racial conversation today.

For more information on this program, visit the To the Best of Our Knowledge website.


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Young Writer Searches for Harlem

Posted by jcmaziquemd on January 27, 2011

Young Writer Searches for Harlem



A Journey to the Mecca of Black America

By Sharifa Rhodes-Pitts

Illustrated. 296 pages. Little, Brown & Company. $24.99.

Sharifa Rhodes-Pitts’s first book, “Harlem Is Nowhere,” takes its title from a 1948 essay by Ralph Ellison, and it pays homage, in grainy and shifting ways, to many other classics of black literature and thought.

It reads, in fact, as if Ms. Rhodes-Pitts had taken W. E. B. Du Bois’s “Souls of Black Folk” and Maya Angelou’s “I Know Why the Caged Bird Sings” and spliced them together and remixed them, adding bass, Auto-Tuned vocals, acoustic breaks, samples (street sounds, newsreel snippets, her own whispered confessions) and had rapped over the whole flickering collage. It makes a startling and alive sound, one you cock your head at an angle to hear.

At the end you may decide, as I did, that this ambitious racket is somewhat hollow: the book never coheres or locates its own beating heart. But Ms. Rhodes-Pitts’s is a voice you’ll want to hear again, to recapture the scratchy buzz she’s put into your head.

Ms. Rhodes-Pitts is in her early 30s. She grew up in Texas and graduated from Harvard. She doesn’t tell us that she attended Harvard in her book, as if that fact might soil her street cred. But then, her past is mostly a gray smudge in “Harlem Is Nowhere,” her personal exposition of the neighborhood. She was the only black student in her high school English class. She has a Texan sense of personal space. She read a lot as a teenager. That’s about all we learn.

“Harlem Is Nowhere” is personal in a different way. Ms. Rhodes-Pitts drops us inside her wide-scanning cranium as she searches for her own version of Harlem, one she strains to see through all the graceful and angry words that have already been written about it. You climb inside her skull as if this book were a first-person thinker video game: Call of Duty: Memoir Academy.

Ms. Rhodes-Pitts makes her meta-processes part of this story. She confides her “single-girl-doing-research fantasies.” She tries not to “turn my daily life into a hunt for ‘material.’ ” She says, “I would like to reach for a more hopeful tone.” On certain days in the library, she feels smothered — “buried,” in her words — by the weight of the past. She listens to a man who tells her, “Watch the walking, not the dead.”

“Harlem Is Nowhere” commences as Ms. Rhodes-Pitts moves to the neighborhood and rents her first apartment. She has a job nearby, working for a book publisher. But that vanishes as the book moves forward, and charting the sensorium of Harlem’s ghosts becomes her primary occupation.

This book scrambles over a lot of ground. The author talks with neighbors and people on the street. She studies old photos and spends days in the Schomburg Center for Research in Black Culture in Harlem.

She writes about the neighborhood’s first black bookstores, as well as its politicians and famous characters from the past, like Raven Chanticleer, who ran an African-American wax and history museum, and the scrapbook artist Alexander Gumby. She can be pleasantly dry. About Gumby’s writing, she declares, “He was a young man of great feeling who could not spell.”

Ms. Rhodes-Pitts seems most at home when’s she flipping, pointedly, through the work of writers like Langston Hughes, Zora Neale Hurston, James Baldwin and Ellison himself. She has interesting, complicated things to say about each of them.

She writes about the Ellison essay that provides her title, “His beautiful, clinical descriptions emit a kind of hostility.” Excellently, she characterizes one of Baldwin’s signature nonfiction moves — the suave shift from specific detail to poetic generalization — this way: “In almost every essay James Baldwin wrote about Harlem, there is a moment when he commits a literary sleight-of-hand so particular that, if he’d been an athlete, sportscasters would have codified the maneuver and named it ‘the Jimmy.’ ”

She can be just as excellent — funny and endearing — about her own way of being in the world. Her Texas childhood taught her to look people in the eye on the street, a practice that can turn weird in Harlem. She says, “When crossing paths with young men who seemed about to make an unwanted advance, I smiled brightly and shouted Hi! like an overexcited flight attendant, and then kept walking while they were too stunned to reply.”

What doesn’t work about “Harlem Is Nowhere”? Some of her sentences wheeze instead of glide. One example: “My study effort about the numbers racket was accompanied by other research fulfilling a separate line of inquiry, an article I was writing about the national movement seeking reparations for slavery.”

She strews italics across almost every page, to denote both direct quotation and poetic emphasis, and you’re sometimes confused about which she intends. The effect can be lovely but can also seem cheap and pretentious: “I did not speculate as to what he meant to tell me,” she writes, “but I was sure it was something pertinent.”

There are curious omissions. Hip-hop music — which defines Harlem’s sonic atmosphere, as well as its street fashion — is barely mentioned. This is a loss: we need young, black female intellectuals who can size up rap’s sacred and profane monologues. It’s like talking about Harlem in the 1920s without mentioning jazz.

The more general problem with “Harlem Is Nowhere” might be put like this: Ms. Rhodes-Pitts has shrugged off the burden of the historian — her book is too scattershot to count as any form of real research — in an attempt to pick up a greater burden, that of the literary artist. She nearly, but ultimately doesn’t, get that second, squirming load off the ground.

There’s a telling scene in which a man known only as “the Chief” confronts Ms. Rhodes-Pitts and asks what her “platform” is. (It’s this book’s “What’s the frequency, Kenneth?” moment.) She stumbles and doesn’t give much of an answer.

Later she provides a sentence that she calls perhaps “the closest I will ever come to having a political platform.” It’s a quotation from the Martinique-born French philosopher and revolutionary Frantz Fanon: “Oh my body, make of me always a man who questions!” As platforms go, that one will take her a long way, but in “Harlem Is Nowhere” she questions more widely than deeply.

This book’s alive, though. It’s intoxicating, and lighted by the promise of better things to come.


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A Factor of Success As Adults: Self-Control

Posted by jcmaziquemd on January 25, 2011

A Factor of Success As Adults: Self-Control


Kids who scored low on assessments of self-control as toddlers were more likely to have adult difficulties, including health problems, alcohol and drug dependence, financial problems and a criminal record, a new study suggests.

The research, published Tuesday in the Proceedings of the National Academy of Sciences, tracked a socioeconomically diverse group of 1,037 children in New Zealand from birth to age 32. Kids were assessed on measures of self-control by parents, researchers and teachers every few years during childhood. They also did self-assessments.

Some 96% of the original participants were evaluated at age 32. Even after accounting for differences in social class, intelligence and home life, kids with lower self-control scores at age 3 were more likely to have adult health problems, such as sexually transmitted diseases, gum disease, high cholesterol, high blood pressure and excess weight, the study found. Among kids who scored in the highest 20% on self-control measures, 11% had multiple health problems in adulthood, compared with 27% of kids who scored in the lowest 20%. Kids with low self-control were more likely to later be dependent on drugs or alcohol, to have lower incomes, to be single parents and to have been convicted of a crime.

The researchers separately sampled fraternal twins in the U.K. and found that the sibling with lower self-control scores at age 5 was more likely to start smoking, to earn bad grades in school and to show antisocial behaviors at age 12, supporting the notion that self-control isn’t simply dependent on family situation.

"Self-control is a vital skill for scanning the horizon to be prepared for what might happen to you, for envisaging your own future possibilities, … and for waiting for the really good things that are worth waiting for, instead of jumping for short-term enticements," wrote Terrie Moffitt and Avshalom Caspi, the Duke University psychologists who led the research, in an email.

Scientists have known for a while that self-control affects behavioral development, said Jay Belsky, a professor in the department of human and community development at the University of California, Davis, who wasn’t involved in the study. But the study breaks new ground by showing self-control affects "a diverse array of long-term, real-world developmental outcomes" such as health or the ability to stay in a relationship or keep finances in check, he said.

Drs. Moffitt and Caspi said that while children tend to improve their self-control skills as they get older, they’re also likely to keep their relative position. So if a child trails his peers in self-control, he’s likely to be behind his adult peers. Still, 7% of the children in the study "improved markedly," they said, likely stemming from a variety of individual circumstances, such as a good school or changed family situation that improved structure in their lives.

Dr. Belsky said that research shows infants and kids who develop secure attachments to parents and caregivers learn early on "my actions have consequences, and I can manage and regulate those reactions," which is key to developing self-control.

The new paper notes that programs aimed at improving self-control in kids or teens could help improve rates of disease, crime and welfare dependency. Some programs have shown positive results, but larger-scale, less-focused and longer-term efforts haven’t been as successful, Dr. Moffitt and Dr. Caspi wrote. "The decisive answer is not in yet, and more programs should be designed, and evaluated rigorously," they wrote.

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Where I Used to Work

Posted by jcmaziquemd on January 25, 2011

With Poem, Broaching the Topic of Death


FORT DEFIANCE, Ariz. — Mitzie Begay, an elegant 76-year-old Navajo, can interpret the nuances of her language and traditions with contemporary verve and understated wit — qualities that make her a good fit for a job that could hardly have been imagined in the Navajo Nation a generation ago.

Ms. Begay, whose title is cross-cultural coordinator for the home-based care program at the Fort Defiance Indian Hospital here in northeastern Arizona, helps Navajos deal with the complex and confusing process of decision-making at the end of life.

In Navajo culture, talking about death is thought to bring it about, so it is not discussed. A dead person’s name is never spoken. Only designated tribal members are permitted to touch and bury the dead.

So it is up to Ms. Begay and her colleagues to find ways to teach people (many with little or no English) about things like living wills, durable powers of attorney, do-not-resuscitate orders, electroencephalograms, feeding tubes and ventilators. In spite of the taboos, they are trying to find a comfortable way to begin a conversation with patients and their families about death and dying.

Until last month, the program’s director was Dr. Timothy Domer, a geriatrician who practiced medicine for more than 20 years in this remote, high-desert, red-rock landscape on the eastern fringe of the vast Navajo reservation. Its goal, he said, is to keep elderly patients healthy, starting with a thorough physical exam and a comprehensive, interdisciplinary assessment, followed by home visits.

Dr. Domer, who is moving to New York State to practice geriatrics and palliative care, said it soon became clear that when it came to end-of-life matters, his patients had a different perspective from many other Americans.

“When I explained to an old Navajo patient of mine that we sometimes have to shock the heart to get it started, he said, ‘Why would anybody do a crazy thing like that?’ ” he said. “That made me think there were people who didn’t necessarily want the standard resuscitative efforts that we routinely practice at the end of life.”

When Dr. Domer started the home-based care program five years ago, he reviewed hospital records to see how many charts contained advance directives. “There were none — zero,” he said.

For patients who had terminal illnesses, Dr. Domer wanted to be able to provide hospice and palliative care.

“Our goal is not just to change the way people die,” he said, “but to change the way dying people live, and how their families experience and will remember the death.”

On this day Ms. Begay and Gina Nez, the program’s director of nursing, are bumping along in a four-wheel-drive S.U.V. to visit elderly patients in isolated communities. They drive past hogans, the six-sided traditional Navajo dwellings, past herds of cattle and sheep that dot the grass meadows.

“At first I was uncomfortable,” Ms. Begay said about her introduction to end-of-life discussions. “But the staff got together and we talked about it, and we agreed on a way to approach it.”

The vehicle was a poem: “When that time comes, when my last breath leaves me, I choose to die in peace to meet Shi’ dy’ in” — the creator. Written in both Navajo and English, it serves to open a discussion about living wills and advance directives.

Fewer than 30 percent of Americans have signed advance directives for health care. But Dr. Domer says almost 90 percent of patients in theprogram have signed the poem and other standard directives.

“Our elders tell us they want to die with dignity — the way they lived,” he said. “We’ve changed how patients live their final days by opening the discussion on death and dying, and giving patients and families the opportunity to tell us what is important to them.

“Before we started this program, the subject was generally avoided out of ‘cultural sensitivity,’ depriving patients and families of preparing for death spiritually, emotionally and practically.”

When someone dies in the family hogan, for example, a hole is made in the north wall to let the good spirit out, and then the hogan is abandoned.

“I’ve seen my share of dying patients, particularly elderly patients who spoke only Navajo, whose families brought them to the hospital to die,” Dr. Domer said. “One of the reasons they came to the hospital was that if they died in the hogan, the rest of the family would have to leave, and for poor people that’s a real hardship.”

James S. Taylor, a bioethicist who teaches philosophy at the College of New Jersey, has written about Navajo views of end-of-life care.

“Navajos value the principle of autonomy or self-determination,” he said in a telephone interview. “But their cultural taboos — you can’t think negatively, or it will happen — restrict their ability to autonomously plan for their end-of-life care, since the planning itself requires such negative thinking.

“Using the poem and open-ended questions allows nuanced and respectful solutions to this problem because it gives people the opportunity to discuss end-of-life planning impersonally. It’s a compassionate approach, and it’s in accord with the twin values that Navajos share with mainstream American culture — individual autonomy and personal dignity.”

Ms. Begay and Ms. Nez visit Jimmy Begay (no relation), a bright-eyed man of 87 who lives with his wife in the little community of Sawmill. In World War II, Mr. Begay was one of the Navajo “code talkers” whose radio transmissions were never deciphered by the Japanese; the walls of his modest home are covered with photos, a squadron’s worth of family members who have served in the military.

Mr. Begay has signed the poem and the advance directives, and so has Mitzie Begay.

“Traditionally, it’s our belief to always have a positive attitude,” even when someone is dying, she said. “The family has a five-day sing” — a Navajo ceremony — “drink herbs and paint their bodies. All these things are done for the patient, and then we know we did all we could.

“After a patient dies, you don’t hang on, because the deceased is no longer on Mother Earth. You wash up, take your corn pollen and go on with life.”

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To Really Learn, Quit Studying and Take a Test

Posted by jcmaziquemd on January 25, 2011

To Really Learn, Quit Studying and Take a Test


Taking a test is not just a passive mechanism for assessing how much people know, according to new research. It actually helps people learn, and it works better than a number of other studying techniques.

The research, published online Thursday in the journal Science, found that students who read a passage, then took a test asking them to recall what they had read, retained about 50 percent more of the information a week later than students who used two other methods.

One of those methods — repeatedly studying the material — is familiar to legions of students who cram before exams. The other — having students draw detailed diagrams documenting what they are learning — is prized by many teachers because it forces students to make connections among facts.

These other methods not only are popular, the researchers reported; they also seem to give students the illusion that they know material better than they do.

In the experiments, the students were asked to predict how much they would remember a week after using one of the methods to learn the material. Those who took the test after reading the passage predicted they would remember less than the other students predicted — but the results were just the opposite.

“I think that learning is all about retrieving, all about reconstructing our knowledge,” said the lead author, Jeffrey Karpicke, an assistant professor of psychology at Purdue University. “I think that we’re tapping into something fundamental about how the mind works when we talk about retrieval.”

Several cognitive scientists and education experts said the results were striking.

The students who took the recall tests may “recognize some gaps in their knowledge,” said Marcia Linn, an education professor at the University of California, Berkeley, “and they might revisit the ideas in the back of their mind or the front of their mind.”

When they are later asked what they have learned, she went on, they can more easily “retrieve it and organize the knowledge that they have in a way that makes sense to them.”

The researchers engaged 200 college students in two experiments, assigning them to read several paragraphs about a scientific subject — how the digestive system works, for example, or the different types of vertebrate muscle tissue.

In the first experiment, the students were divided into four groups. One did nothing more than read the text for five minutes. Another studied the passage in four consecutive five-minute sessions.

A third group engaged in “concept mapping,” in which, with the passage in front of them, they arranged information from the passage into a kind of diagram, writing details and ideas in hand-drawn bubbles and linking the bubbles in an organized way.

The final group took a “retrieval practice” test. Without the passage in front of them, they wrote what they remembered in a free-form essay for 10 minutes. Then they reread the passage and took another retrieval practice test.

A week later all four groups were given a short-answer test that assessed their ability to recall facts and draw logical conclusions based on the facts.

The second experiment focused only on concept mapping and retrieval practice testing, with each student doing an exercise using each method. In this initial phase, researchers reported, students who made diagrams while consulting the passage included more detail than students asked to recall what they had just read in an essay.

But when they were evaluated a week later, the students in the testing group did much better than the concept mappers. They even did better when they were evaluated not with a short-answer test but with a test requiring them to draw a concept map from memory.

Why retrieval testing helps is still unknown. Perhaps it is because by remembering information we are organizing it and creating cues and connections that our brains later recognize.

“When you’re retrieving something out of a computer’s memory, you don’t change anything — it’s simple playback,” said Robert Bjork, a psychologist at the University of California, Los Angeles, who was not involved with the study.

But “when we use our memories by retrieving things, we change our access” to that information, Dr. Bjork said. “What we recall becomes more recallable in the future. In a sense you are practicing what you are going to need to do later.”

It may also be that the struggle involved in recalling something helps reinforce it in our brains.

Maybe that is also why students who took retrieval practice tests were less confident about how they would perform a week later.

“The struggle helps you learn, but it makes you feel like you’re not learning,” said Nate Kornell, a psychologist at Williams College. “You feel like: ‘I don’t know it that well. This is hard and I’m having trouble coming up with this information.’ ”

By contrast, he said, when rereading texts and possibly even drawing diagrams, “you say: ‘Oh, this is easier. I read this already.’ ”

The Purdue study supports findings of a recent spate of research showing learning benefits from testing, including benefits when students get questions wrong. But by comparing testing with other methods, the study goes further.

“It really bumps it up a level of importance by contrasting it with concept mapping, which many educators think of as sort of the gold standard,” said Daniel Willingham, a psychology professor at the University of Virginia. Although “it’s not totally obvious that this is shovel-ready — put it in the classroom and it’s good to go — for educators this ought to be a big deal.”

Howard Gardner, an education professor at Harvard who advocates constructivism — the idea that children should discover their own approach to learning, emphasizing reasoning over memorization — said in an e-mail that the results “throw down the gauntlet to those progressive educators, myself included.”

“Educators who embrace seemingly more active approaches, like concept mapping,” he continued, “are challenged to devise outcome measures that can demonstrate the superiority of such constructivist approaches.”

Testing, of course, is a highly charged issue in education, drawing criticism that too much promotes rote learning, swallows valuable time for learning new things and causes excessive student anxiety.

“More testing isn’t necessarily better,” said Dr. Linn, who said her work with California school districts had found that asking students to explain what they did in a science experiment rather than having them simply conduct the hands-on experiment — a version of retrieval practice testing — was beneficial. “Some tests are just not learning opportunities. We need a different kind of testing than we currently have.”

Dr. Kornell said that “even though in the short term it may seem like a waste of time,” retrieval practice appears to “make things stick in a way that may not be used in the classroom.

“It’s going to last for the rest of their schooling, and potentially for the rest of their lives.”

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The sexual cost of female success

Posted by jcmaziquemd on January 24, 2011

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: What Story Will National Black History Museum Tell?

Posted by jcmaziquemd on January 24, 2011

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Voices: On Black Parents and Amy Chua

Posted by jcmaziquemd on January 24, 2011

Voices: On Black Parents and Amy Chua

via Racialicious – the intersection of race and pop culture by Andrea on 1/24/11

Amy Chua — author of the controversial parenting memoir Battle Hymn of the Tiger Mother, which gained notoriety recently when an excerpt from it, about the superiority of strict Chinese mothers, appeared in the Wall Street Journal — would agree that assimilation into the American system doesn’t make much sense. In many ways, her experience as Tiger Mother represents both the disease of and cure for modern parenting.

Many have inferred from her much discussed new memoir that disproportionate Asian academic success can be attributed to a regimen of no sleepovers, no playdates, no quitting, no coddling, no praising mediocrity and lots of drills. The ancient Chinese secret is, in short, demand perfection and accept nothing less. Children are not so fragile that they will break under these expectations.

This is the same immigrant work ethic that catapulted my parents from poverty in Guyana to the country-club class of North America. Ditto for my husband’s parents in Jamaica, and Allison’s husband’s parents in the Caribbean. Ditto, it should be said, for Allison’s grandparents, who, as Isabel Wilkerson’s brilliant book on the Great Migration showed, had their own immigrant experience moving from the South to Northern cities, where their achievements in culture and society forever changed America.

But Chua is also part of the disease, because she has essentially written a manual for how to create superior sheep. But I still share many of her philosophies on the sturdiness of children, and in general have enormous respect for her. There she is, a Yale Law School professor, married to a white professor at the same school — technocratic royalty in the land where privilege was invented — and yet she has not allowed that success to be a reason to lose her identity, melting away into the American pot.

–Natalie Hopkinson, How to Raise a Model Minority

Since people are dabbling in gross generalizations about motherhood, children, parenting and ethnicity, I thought I’d compare the ‘Battle Hymn of the Tiger Mother‘ to that of black mamas… or at least my mama.

Chua defines her children’s success as their ability to get good grades and play musical instruments. My mother defined her children’s success by their behavior. . . and securing their eternal salvation through regular church attendance, but that’s another post.

I’m not alone in noting the similarity. Culture writer Danielle Deadwyler did her own comparison between Chua’s Tiger Mother and “Southern Black Mothers,” showing they have a great deal in common:

No wuss nurturers are allowed below the Mason Dixon line; Southern black women have been hardcore disciplinarians for generations. Results have been varied… However, there seems to be a ‘get it done’ through line in black parenting that echoes Malcolm’s ‘by any means necessary’. (Danielle Deadwyler)

Danielle goes on to tell a familiar tale about the time her classmate’s mother came to school and whipped him “in front of the whole school” — something we have all seen, heard about, or worse, experienced. Her friend wasn’t alone. We all know many black parents tend to favor corporal punishment, also known as spanking, as a preferred form of behavior modification. In addition, many people of other groups are horrified by this. Yet just as Chua bragged to her peers over dinner about her harsh mothering methods, the black mother is not ashamed to administer punishment in broad daylight.

Having the correct answer wasn’t nearly as important as knowing how to navigate yourself in a world where your “backtalk” would result in death. So frequent beatings were not only the lesser of two evils; a beating was also a lesson that could save your life. Much higher stakes than what Chua is dealing with. But the intensity of her methods is something that black mothers can understand.

Alexis Stodghill, Tiger Mother vs. Black Mamas: Is an Iron Hand the Key to Prosperous Children?

Chua has the kind of theory of life that many black people just cannot stand. There is no mention in the book of a larger purpose, God, community or interest in anything other than herself, her kids, and their grades and accolades — preferably from famous people like the jurists she invited to her home to listen to her children perform.

While she does pause to care for two very ill family members and has potlucks for her students, you really get the sense that she is oblivious to the lives of everybody else in the world who does not touch her life directly; that, say, a drunk driver could mow down somebody else’s kid on her street and she would be too busy drilling her kids with flash cards to take the bereaved parents a casserole. Perhaps most aggravating is that Chua has no patience with those who challenge the status quo, implying that people who challenge the power structure — no matter how stacked or rigged it may be — are just too lazy and selfish to master it.

And that’s all too bad, but black people should still buy this book and study it for its underlying message, which is this: There are no shortcuts to achievement — and no racial secrets — only strategies.

..[W]e need to keep talking about the habits of success, especially the habit of persistence in the face of failure. Ironically, those are the kinds of habits for which our top black athletes, such as Donovan McNabb and LeBron James, are best known, even in the face of the ongoing stereotype that they are all about luck and raw talent. And it is all the more crucial for black parents, who, unlike Asians, are burdened with the stereotype of being considered lazy, unintellectual and all about the party.

Every day, I see kids who will practice jump shots and blocking and tackling for hours a day, with their parents’ support, because they know that the harder they work, the more talented they get. Yet they shut down when it comes to applying that same effort to their academic work.

Similarly, I’ve personally seen white and Asian kids apply time and time again for coveted fellowships and internships, despite rejection, while black kids react to rejection by withdrawing altogether from contention. I know heads of schools who have to fight with black parents to get them to fight to turn off the Playstations and the televisions until the grades go up — and fight they must, because that is what the job of being a parent entails.

We all know this, and it’s time to name it and fight it.

But we also know that even as we try to teach our kids the habits of success for a tough, new world, there is a time for everything: for joy, for laughter, to lift as we climb and to speak truth to power. Without the sacrifices that African-American parents made and continue to make to advance the cause of equal opportunity in education, I very much doubt that women and other minorities like Chua would have the opportunities they have today.

And this is something that Chua can stand to learn from us.

Michel Martin, Parenting to Win

Image Credit: Chua/You Offend Me, You Offend MyFamily; Black Family/mymajicdc.com


Things you can do from here:

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Race Affects Obesity Counseling

Posted by jcmaziquemd on January 19, 2011

Race Affects Obesity Counseling
By Nancy Walsh, Staff Writer, MedPage Today
January 17, 2011
MedPage Today Action Points

  • Obese African American patients generally seem to receive less counseling for diet and exercise — regardless of the race of their physician.
  • Note that obese black patients were also less likely to be counseled on weight reduction than whites, even when the physician was black.

African Americans who are obese generally receive less counseling for diet and exercise — regardless of their physicians’ race, according to national population-based data.

The data, encompassing more than 2,200 visits among black and white obese individuals ages 20 and older to their family physicians or internists, revealed that obese black patients were less likely to be given counseling on exercise from white doctors than white obese patients also seen by a white physician (OR 0.54, 95% CI 0.31 to 0.95), Sara N. Bleich, PhD, of Johns Hopkins University, and colleagues reported.

At the same time, obese black patients were also less likely to be counseled on weight reduction than whites, even when the physician was black (OR 0.34, 95% CI 0.13 to 0.90), Bleich and co-authors reported online in Obesity.

Increasing evidence indicates that medical care for obesity is inadequate, with the issue being broached less frequently for blacks — despite their high rates of obesity and related health problems.

Some research has suggested that one factor that may contribute to this is race concordance between physician and patient.

To explore this — and the hypothesis that race concordance might have a greater impact on weight-related counseling among blacks — Bleich and colleagues analyzed data from the National Ambulatory Medical Care Surveys to determine rates of counseling on weight reduction, diet and nutrition, and exercise.

The sample included 2,231 visits by obese patients to their physicians, 82.7% of which involved white patients and 56.7% women. The doctors were either in general/family practice or general internal medicine.

Three-quarters of the patients were 45 and older, and 65% were considered to be at high or very high risk because of comorbidities such as osteoarthritis, hypertension, and hyperlipidemia.

Among the physicians, 83% were white, 27% were women, and 58% were younger than 55.

Race concordance was as follows:

  • Discordant white (white patient/black physician), 2%
  • Discordant black (black patient/white physician), 12%
  • Concordant white (white patient/white physician), 81%
  • Concordant black (black patient/black physician), 5%

Weight-reduction counseling was documented in 22% of the doctor visits, diet and nutrition counseling in 30% of visits, and exercise advice in 23%.

The lowest frequency of weight reduction counseling was for concordant black pairs (11.8%, 95% CI 4 to 29.4), while the highest was for discordant white pairs (25.5%, 95% CI 12.3 to 45.6), the researchers found.

The lowest frequency of diet and nutrition counseling was for discordant black pairs (24.3%, 95% CI 17 to 33.5) and the highest was for concordant blacks (36.5%, 95% CI 22.7 to 52.9).

For exercise counseling, the lowest frequency was discordant among blacks (15%, 95% CI 9.7 to 22.3), and the highest was for discordant whites (29.4%, 95% CI 12.1 to 55.7).

Significant predictors other than race for patients’ having received weight-related counseling included the patients’ age, comorbidity risks, whether the visit was for preventive or chronic care, and the duration of the doctor visit.

A predictor for the other types of counseling was living in the Northeast U.S.

"Despite prior research suggesting greater use of needed medical services among race-concordant pairs, we did not find support for our hypothesis that race concordance would be positively associated with obesity care," observed Bleich and colleagues.

But black patients did receive less obesity counseling overall, for several possible reasons, according to the researchers.

For example, physicians may perceive blacks as less likely to be adherent to anti-obesity programs and more likely to persist in unhealthy behaviors.

Cultural differences and perceptions of body image may also contribute, with black physicians in particular trying to be sensitive to these concerns.

Also, provision of counseling in general was inadequate for both black and white physicians, which may reflect their lack of awareness of resources, training, and guidelines.

Bleich and co-authors pointed out a number of limitations to their study, including inadequate sample sizes in the discordant groups, underreporting of counseling, lack of information on the quality of counseling, and missing data that could create bias.

"Further research is needed to understand how to improve counseling, particularly for black obese patients," they concluded.

The authors declared no conflicts of interest.

Primary source: Obesity
Source reference:
Bleich S, et al "Impact of patient-doctor race concordance on rates of weight-related counseling in visits by black and white obese individuals" Obesity 2011; DOI:10.1038/oby.2010.330.

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Are Undergraduates Actually Learning Anything?

Posted by jcmaziquemd on January 18, 2011

Are Undergraduates Actually Learning Anything?

By Richard Arum and Josipa Roksa

Drawing on survey responses, transcript data, and results from the Collegiate Learning Assessment (a standardized test taken by students in their first semester and at the end of their second year), Richard Arum and Josipa Roksa concluded that a significant percentage of undergraduates are failing to develop the broad-based skills and knowledge they should be expected to master. Here is an excerpt from Academically Adrift: Limited Learning on College Campuses (University of Chicago Press), their new book based on those findings.

"With regard to the quality of research, we tend to evaluate faculty the way the Michelin guide evaluates restaurants," Lee Shulman, former president of the Carnegie Foundation for the Advancement of Teaching, recently noted. "We ask, ‘How high is the quality of this cuisine relative to the genre of food? How excellent is it?’ With regard to teaching, the evaluation is done more in the style of the Board of Health. The question is, ‘Is it safe to eat here?’" Our research suggests that for many students currently enrolled in higher education, the answer is: not particularly. Growing numbers of students are sent to college at increasingly higher costs, but for a large proportion of them the gains in critical thinking, complex reasoning, and written communication are either exceedingly small or empirically nonexistent. At least 45 percent of students in our sample did not demonstrate any statistically significant improvement in Collegiate Learning Assessment [CLA] performance during the first two years of college. [Further study has indicated that 36 percent of students did not show any significant improvement over four years.] While these students may have developed subject-specific skills that were not tested for by the CLA, in terms of general analytical competencies assessed, large numbers of U.S. college students can be accurately described as academically adrift. They might graduate, but they are failing to develop the higher-order cognitive skills that it is widely assumed college students should master. These findings are sobering and should be a cause for concern.

While higher education is expected to accomplish many tasks—and contemporary colleges and universities have indeed contributed to society in ways as diverse as producing pharmaceutical patents as well as prime-time athletic games—existing organizational cultures and practices too often do not put a high priority on undergraduate learning. Faculty and administrators, working to meet multiple and at times competing demands, too rarely focus on either improving instruction or demonstrating gains in student learning.

More troubling still, the limited learning we have observed in terms of the absence of growth in CLA performance is largely consistent with the accounts of many students, who report that they spend increasing numbers of hours on nonacademic activities, including working, rather than on studying. They enroll in courses that do not require substantial reading or writing assignments; they interact with their professors outside of classrooms rarely, if ever; and they define and understand their college experiences as being focused more on social than on academic development.

Moreover, we find that learning in higher education is characterized by persistent and/or growing inequality. There are significant differences in critical thinking, complex reasoning, and writing skills when comparing groups of students from different family backgrounds and racial/ethnic groups. More important, not only do students enter college with unequal demonstrated abilities, but those inequalities tend to persist—or, in the case of African-American students relative to white students, increase—while they are enrolled in higher education.

Despite the low average levels of learning and persistent inequality, we have also observed notable variation in student experiences and outcomes, both across and within institutions. While the average level of performance indicates that students in general are embedded in higher-education institutions where only very modest academic demands are placed on them, exceptional students, who have demonstrated impressive growth over time on CLA performance, exist in all the settings we examined. In addition, students attending certain high-performing institutions had more-beneficial college experiences in terms of experiencing rigorous reading/writing requirements and spending more hours studying. Students attending these institutions demonstrated significantly higher gains in critical thinking, complex reasoning, and writing skills over time than did students enrolled elsewhere.

The Implications of Limited Learning

Notwithstanding the variation and the positive experiences in certain contexts, the prevalence of limited learning on today’s college campuses is troubling indeed. While the historian Helen Horowitz’s work reminds us that the phenomenon of limited learning in higher education has a long and venerable tradition in this country—in the late 18th and early 19th centuries, "college discipline conflicted with the genteel upbringing of the elite sons of Southern gentry and Northern merchants"—this outcome today occurs in a fundamentally different context. Contemporary college graduates generally do not leave school with the assumption that they will ultimately inherit the plantations or businesses of their fathers. Occupational destinations in modern economies are increasingly dependent on an individual’s academic achievements. The attainment of long-term occupational success in the economy requires not only academic credentials, but very likely also academic skills. As report after blue-ribbon report has reminded us, today’s jobs require "knowledge, learning, information, and skilled intelligence." These are cognitive abilities that, unlike Herrnstein and Murray’s immutable IQ construct, can be learned and developed at school.

Something else has also changed. After World War II, the United States dramatically expanded its higher-education system and led the world for decades, often by a wide margin, in the percentage of young people it graduated from college. Over the past two decades, while the U.S. higher-education system has grown only marginally, the rest of the world has not been standing still. As Patrick Callan, president of the National Center for Public Policy and Higher Education, has observed: "In the 1990s, however, as the importance of a college-educated work force in a global economy became clear, other nations began making the kinds of dramatic gains that had characterized American higher education earlier. In contrast, by the early 1990s, the progress the United States had made in increasing college participation had come to a virtual halt. For most of the 1990s, the United States ranked last among 14 nations in raising college-participation rates, with almost no increase during the decade."

For the first time in recent history, many countries today graduate higher percentages of their youth from college than does the United States. While the United States still ranks second among Organisation of Economic Co-operation and Development (OECD) countries in terms of adult workers’ bachelor-level-degree attainment, it has dropped to sixth when higher-education attainment of only the most recent cohort of young adults is considered. "We may still have more than our share of the world’s best universities. But a lot of other countries have followed our lead, and they are now educating more of their citizens to more advanced levels than we are," the recent federal report "A Test of Leadership" observed. "Worse, they are passing us by at a time when education is more important to our collective prosperity than ever."

The U.S. higher-education system has in recent years arguably been living off its reputation as being the best in the world. The findings in our study, however, should remind us that the system’s international reputation—largely derived from graduate programs at a handful of elite public and private universities—serves as no guarantee that undergraduate students are being appropriately challenged or exposed to educational experiences that will lead to academic growth throughout the wide range of diverse U.S. colleges and universities. While the U.S. higher-education system still enjoys the competitive advantage of a sterling international reputation, in recent decades it has been increasingly surpassed in terms of quantity (i.e., the percentage of young adults it graduates), and its quality is coming under increasing scrutiny. The U.S. government’s recent decision to participate in international efforts led by the OECD to measure higher-education academic performance on a comparative basis cross-nationally, following the less-than-stellar comparative results observed in international comparisons of adult literacy, provides little reassurance that the system’s reputation will not become increasingly challenged and debated. In an increasingly globalized and competitive world system, the quality and quantity of outcomes of a country’s education system is arguably related to a nation’s future trajectory and international economic position.

The changing economic and global context facing contemporary college graduates convinces us that the limited learning that exists on U.S. campuses—even if it has been a part of the higher-education landscape since the system’s inception—qualifies today as a significant social problem and should be the subject of concern of policy makers, practitioners, parents, and citizens alike. While the phenomenon can accurately be described as a social problem, the situation that exists on today’s college campuses in no way qualifies as a crisis, and we have consciously avoided the use of rhetoric here that would point to "a crisis in higher education."

Limited learning in the U.S. higher-education system cannot be defined as a crisis, because institutional and system-level organizational survival is not being threatened in any significant way. Parents—although somewhat disgruntled about increasing costs—want colleges to provide a safe environment where their children can mature, gain independence, and attain a credential that will help them be successful as adults. Students in general seek to enjoy the benefits of a full collegiate experience that is focused as much on social life as on academic pursuits, while earning high marks in their courses with relatively little investment of effort. Professors are eager to find time to concentrate on their scholarship and professional interests. Administrators have been asked to focus largely on external institutional rankings and the financial bottom line. Government funding agencies are primarily interested in the development of new scientific knowledge. In short, the system works. No actors in the system are primarily interested in undergraduates’ academic growth, although many are interested in student retention and persistence. Limited learning on college campuses is not a crisis, because the institutional actors implicated in the system are receiving the organizational outcomes that they seek, and therefore neither the institutions themselves nor the system as a whole is in any way challenged or threatened.

Richard Arum is a professor of sociology and education at New York University and director of the Education Research Program of the Social Science Research Council. Josipa Roksa is an assistant professor of sociology at the University of Virginia. Their book, Academically Adrift: Limited Learning on College Campuses, is being published this month by the University of Chicago Press.

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