The gendered behaviors displayed by Disney protagonists.

Previous research suggests that the portrayal of male and female protagonists in Disney animations may be changing over time. The current study examined the portrayal of gendered behaviors displayed within some of Disney's most successful animated feature length films, including those beyond the Disney princess franchise. Extending the scope of the Disney animated films analyzed was important because both young girls and young boys report little personal interest in male characters within the Disney princess animations. This suggests that it is important to look beyond the Disney princess franchise to understand the gendered behaviors displayed by potentially influential male Disney protagonists. The current study also considered a greater number of masculine and feminine behaviors as well as some gender-neutral traits which had yet to be incorporated. A quantitative content analysis of 39 Disney protagonists from films released between 1937 and 2021 was conducted. The results revealed that male and female protagonists were statistically higher in feminine than masculine traits. Female protagonists from the earliest animations were the most feminine. However, there was no statistical difference in the gendered portrayals of females in the animations released in the 1990s and those released from 2009 to 2021 suggesting some continued stereotyping in females' profiles. Alternatively, male characters were more feminine relatively consistently across time-points. This study concludes that Disney is persistently portraying stereotyped female protagonists, and this could have implications on young females' behavioral profiles. However, the extent to which feminine traits are being celebrated when displayed by male protagonists needs to be examined, as well as the potential relationship between such messages and boys' behaviors and children's conceptualizations of gender more broadly.

Patterns of Gender Development Across Intersections of Age, Gender, and Ethnicity-Race.

Two components of gender identity are gender similarity, how one's self-concept relates to the major gender collectives (i.e., female, male), and felt pressure to conform to gender norms. The development of these components across ages and contexts has been understudied. The focus of this study was to examine variations in gender similarity and felt pressure across multiple intersecting contexts: developmental stage, gender, and ethnic-racial group. Six data sets were harmonized and means were compared across 2628 participants (51% girls, 49% boys) from four different developmental cohorts (childhood n = 678, early adolescence n = 1322, adolescence n = 415, and young adulthood n = 213) from diverse ethnic-racial backgrounds (45% White, 23% Latinx/Hispanic, 11% Black/African-American, 7% Asian-American, 5% American Indian, and 5% Multiracial). Results revealed nuanced patterns: Gender intensification was supported in early adolescence, primarily for boys. Young adult men reported lower levels of pressure and gender typicality than younger boys, but young adult women's levels were generally not different than younger girls. Surprisingly, young adult women's levels of own-gender similarity and pressure from parents were higher than adolescent girls. Expectations of gender differences in gender typicality and felt pressure were supported for all ages except young adults, with higher levels for boys. Finally, there were more similarities than differences across ethnic-racial groups, though when there were differences, minoritized participants reported heightened gender typicality and pressure (largely accounted for by higher scores for Black and Latinx participants and lower scores for White and Multiracial participants). These results add to what is understood about contextually dependent gender development.

Quantifying gender norm resistance.

INTRODUCTION: Qualitative and mixed-methods researchers have described the experience of gender norm resistance in adolescence and identified potential types of resistance including indirect resistance (motivated by a preference for gender-atypicality) and direct resistance (motivated by dislike of gender norms and a desire to change them). Building on this work, we developed the Gender Norm Resistance measure to operationalize indirect and direct gender norm resistance. We explored how gender norm resistance aligns with and differs from other gender self-concepts (e.g., felt pressure to conform to gender norms) and peer relations (e.g., contact with peers) and tested for gender differences. METHODS: Participants included 484 early adolescents (girls = 234; Mage = 11.44 years, SD = 0.56). Analyses included factor analyses (EFA, CFA) and bivariate correlations to gather validity evidence, and ANOVAs to determine mean level differences. RESULTS: Evidence that validated using the proposed measure as intended was found including confirmation of the two types of gender norm resistance (indirect and direct). Mean differences were found across participant gender as well as across types of gender norm resistance. CONCLUSIONS: The findings highlight the strengths and weaknesses of the Gender Norm Resistance measure, the different ways adolescents experience indirect and direct gender norm resistance, and the limited role of felt pressure in gender norm resistance.

Improving water quality in a dialysis unit using root cause analysis.

BACKGROUND: Water quality levels from hemodialysis (HD) and reverse osmosis (RO) machines in dialysis units must meet standards set by the American Association of Medical Instrumentation. Researchers used a root cause analysis (RCA) approach to identify and address factors affecting water quality in the HD and portable RO machines at our institution. METHODS: A multidisciplinary team reviewed processes, interviewed staff members, and identified opportunities to improve the current sampling and machine disinfection processes. The RCA team identified and implemented 5 interventions, of which 3 were process (changes in water sampling technique, machine disinfection processes, and allocation of machine maintenance duties) and 2 were structural (regular cleaning of water sampling tubes and spigots and addition of new water sampling sites in the system) measures. RESULTS: Postimplementation of new protocols, 100% of water cultures of HD and RO machines consistently met the required regulatory standards as recorded over a period of 8 months. CONCLUSIONS: RCA approach helped improve patient safety, quality of care, streamlined processes, and improved efficiencies of work for staff within the HD program.

A Dual Identity Approach for Conceptualizing and Measuring Children's Gender Identity.

The goal was to test a new dual identity perspective on gender identity by asking children (n = 467) in three grades (Mage  = 5.7, 7.6, 9.5) to consider the relation of the self to both boys and girls. This change shifted the conceptualization of gender identity from one to two dimensions, provided insights into the meaning and measurement of gender identity, and allowed for revisiting ideas about the roles of gender identity in adjustment. Using a graphical measure to allow assessment of identity in young children and cluster analyses to determine types of identity, it was found that individual and developmental differences in how similar children feel to both genders, and these variations matter for many important personal and social outcomes.

Practical toolkit for monitoring endoscope reprocessing effectiveness: Identification of viable bacteria on gastroscopes, colonoscopes, and bronchoscopes.

BACKGROUND: Experts have recommended microbiologic surveillance by external reference laboratories for certain flexible endoscopes. There is currently insufficient evidence on the feasibility and utility of cultures. Researchers evaluated a preassembled toolkit for collecting and processing samples from endoscopes. METHODS: A pilot study was performed in a large academic medical center. A toolkit was used to aseptically sample biopsy ports and suction/biopsy channels of 5 gastroscopes, 5 colonoscopes, and 5 bronchoscopes after full reprocessing. Blinded specimens were packaged and transported on icepacks to a reference laboratory that used standard methodologies for microbial cultures. RESULTS: The laboratory detected bacteria in samples from 60% of patient-ready endoscopes, including gram-positive and gram-negative species. Viable microbes (<10 CFU) were recovered from 2 gastroscopes, 3 colonoscopes, and 4 bronchoscopes. Stenotrophomonas maltophilia and Delftia acidovorans were recovered from all 3 endoscope types. Subsequent environmental testing detected S maltophilia in the reprocessing rinse water. CONCLUSIONS: A preassembled toolkit facilitated the aseptic collection of samples for culturing by a reference laboratory that detected viable microbes on fully reprocessed endoscopes. Speciation allowed identification of potential pathogens and a possible common contamination source, demonstrating that microbial cultures may have value even when colony counts are low.

Integrating Quality Improvement and Continuing Professional Development at an Academic Medical Center: A Partnership Between Practice Plan, Hospital, and Medical School.

INTRODUCTION: While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts. This article provides a case example describing our organizational context, what was done, and with what effect and makes our example and lessons learned available to others. METHODS: We developed a new educational QI program that was jointly planned and implemented by a group comprising major QI stakeholders. This project was intended to create horizontal organizational linkages between continuing professional development, clinicians, the hospital, and QI department and produce QI activities that aligned with the strategic objectives of senior management. RESULTS: The group developed and implemented a curriculum based on Lean methodology and concepts from the Institute for Health Care Improvement Model for Improvement. Two cohorts (27 teams) completed the training and planned and implemented QI projects. All projects were aligned with organizational quality, safety, and patient experience goals. The majority of projects met their aim statements. DISCUSSION: This case description provides an example of successful horizontal integration of an AMCs' QI functions to disseminate knowledge and implement meaningful QI aligned with strategic objectives (vertical integration).

Gender-based relationship efficacy: children's self-perceptions in intergroup contexts.

This research introduces a new construct, gender-based relationship efficacy, which refers to beliefs about one's ability to relate to own- and other-gender peers. Study 1 investigated 204 fourth graders (M age = 9.56) and confirmed that own-gender and other-gender relationship efficacy represent distinguishable aspects of preadolescents' social competency beliefs that are differentially related to outcomes with own- and other-gender peers, including outcome expectancies and friendships with own- and other-gender peers. Study 2 provided further evidence of the distinctiveness of relationship efficacy for own- and other-gender peers among 403 seventh (M age = 12.48) and 453 eighth (M age = 13.50) graders and found gender and age differences. Developmental changes and implications for research on intergroup relationships are discussed.

'It's not that we hate you': understanding children's gender attitudes and expectancies about peer relationships.

Widespread gender segregation, evident throughout elementary school, seems to imply that girls and boys have negative feelings and thoughts about one another, and classic theories of inter-group processes support this idea. However, research has generally overlooked children's feelings and perceptions about gender-related interpersonal interactions. This paper investigates the nature of children's attitudes about same- and other-gender peers, and explores how those attitudes relate to the expectancies and beliefs children hold about same- and other-gender peer interactions. Children (N= 98 fifth graders) completed questionnaires assessing their global liking of own- and other-gender peers (Yee & Brown, 1994), positive and negative attitudes about own- and other-gender peers, and outcome expectancies related to interacting with own- and other-gender peers. Results indicated that rather than being characterized by out-group negativity, children's inter-group gender attitudes are best characterized by an in-group positivity bias. Children's positive and negative affective attitudes were also significantly associated with outcome expectancies. In contrast, global liking of own- and other-gender peers was less predictive of outcome expectancies. Thus, the greater specificity of the affective attitude measures appeared to be a more predictive and potentially fruitful gauge of children's feelings about own- and other-gender peers. Results are discussed in terms of the need for finer grained and more extensive studies of children's gender-related feelings and cognitions about own- and other-gender peers.

H1N1 pandemic: life span considerations.

In March 2009, a child in Mexico was infected with novel influenza A (H1N1), otherwise known as swine flu. Otherwise healthy children in that small town came down with it shortly after, as well as others from other countries who had visited Mexico or been visited by someone from Mexico, as was the case in the United States. The Centers for Disease Control and Prevention confirmed the first 2 cases in April 2009 and has been working together with local health departments to do syndromic surveillance. In June 2009, the World Health Organization raised the pandemic alert to level 6. Pandemic H1N1, as it is now called, has infected otherwise healthy people younger than 25 years. Most patients present with fever, sore throat, and cough. Transmission is via droplets; therefore, appropriate precautions should be taken. Antiviral care is usually recommended for those who are hospitalized, and the virus has been found to be susceptible to oseltamivir (Tamiflu) and zanamivir (Relenza). Hospitals should work with local health departments for confirmation of the flu and implement pandemic plans as necessary.