Ionised hypocalcaemia in emergency and acute medicine.

Acute hypocalcaemia can be life-threatening and must be diagnosed promptly. The gold-standard investigation is ionised calcium, which is measured on most blood gas analysers. Total calcium measurements are inaccurate in severe depletion even if 'corrected' or 'adjusted' for albumin. We present an illustrative case of a woman in her 30s with symptomatic hypocalcaemia and a very low ionised calcium on VBG analysis. Emergency calcium replacement was delayed due to a falsely reassuring corrected calcium result. Our discussion includes a systematic literature review on the use of ionised calcium in emergency and acute medical settings. We suggest cognitive biases that may explain clinical over-reliance on corrected calcium, and call for the inclusion of ionised calcium values in major treatment guidelines for acute hypocalcaemia.

English proficiency and peer interethnic relations as predictors of math achievement among Latino and Asian immigrant students.

Studies show math achievement to be the best predictor of entering post-secondary education. However, less is known about the predictors of math achievement, particularly among immigrant youth. This study examined English proficiency and peer interethnic relations as predictors of mathematics achievement among Latino and Asian high school students, postulating an interaction between the predictors and mediation by academic motivation. A multilevel moderated-mediation model was used to analyze data from a national sample of 2113 non-native English speaking Latino and Asian students attending high school in the U.S. We found that higher academic motivation mediated the relationship between English proficiency during their sophomore year and gains in senior math achievement scores for both Asian and Latino students. For Latino students however, this indirect path was only significant for students whose perceptions of positive peer interethnic relations at school were average or above average.