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Against the backdrop of today's increasingly multicultural society, are America's elite colleges admitting and successfully educating a diverse student body? No Longer Separate, Not Yet Equal pulls back the curtain on the selective college experience and takes a rigorous and comprehensive look at how race and social class impact each stage--from application and admission, to enrollment and student life on campus. Arguing that elite higher education contributes to both social mobility and inequality, the authors investigate such areas as admission advantages for minorities, academic achievement gaps tied to race and class, unequal burdens in paying for tuition, and satisfaction with college experiences. The book's analysis is based on data provided by the National Survey of College Experience, collected from more than nine thousand students who applied to one of ten selective colleges between the early 1980s and late 1990s. The authors explore the composition of applicant pools, factoring in background and \"selective admission enhancement strategies\"--including AP classes, test-prep courses, and extracurriculars--to assess how these strengthen applications. On campus, the authors examine roommate choices, friendship circles, and degrees of social interaction, and discover that while students from different racial and class circumstances are not separate in college, they do not mix as much as one might expect. The book encourages greater interaction among student groups and calls on educational institutions to improve access for students of lower socioeconomic status.

This mixed-methods study used open-response survey data, focus groups, and an experimental simulation to explore how 311 admissions officers defined and used concepts of holistic review in selective college admissions. We found that 3 distinct definitions of holistic review predominate in the field: whole file, whole person, and whole context. We explored these concepts qualitatively and used the coded data to predict decision making in an experimental simulation. We found that admissions officers with a \"whole context\" view of holistic review were disproportionately likely to admit a low socioeconomic-status applicant in our simulation. Inconsistent definitions of a core admissions concept make it more difficult for the public to comprehend the \"black box\" of college admissions, and a more consistently contextualized view of holistic review may also have real-world implications for the representation of low-income students at selective colleges.

Higher education institutions increasingly aim to implement equity in admissions. However, there is no one-size-fits-all solution to determine which equitable admissions procedures are suitable in a specific context, nor which groups should be its beneficiaries. Therefore, we applied the Formal Consensus Method (FCM) to investigate the support amongst experts and stakeholders for different equitable admissions policies and target groups within the context of Health Professions Education in The Netherlands. We found majority support (median of ratings ≥ 7 on a scale of 1 to 9) in both groups for the target groups ‘applicants with a low or average socio-economic status’ and ‘applicants with an underrepresented migration background’. The majority of participants was also in favor of Contextualized Admissions, especially when used to increase enrolment of applicants with a low or average socio-economic status, with an underrepresented migration background, and asylum status holders. Lastly, both groups supported lottery with extra tickets for applicants with an underrepresented migration background. However, as the range of ratings fell outside the FCM prescribed range of 5-9, no case in which there was majority support could be defined as a ‘consensus’. The expert group proposed the use of Bonded Medical Places for applicants from the Caribbean parts of the Dutch Kingdom. The policies and target groups for which broad support was found, could contribute to equitable admissions, improved student diversity, and enhanced quality of health education and future care. Our application of the FCM in the area of equitable admissions policies may be useful for researchers in other countries where equity principles are not (widely) used in admissions decisions.

The higher education regulator for England has set challenging new widening access targets requiring universities to rethink how merit is judged in admissions. Universities are being encouraged to move away from the traditional meritocratic equality of opportunity model of fair access, which holds that university places should go to the most highly qualified candidates irrespective of social background, in accordance with the principles of procedural fairness. Instead, they are being asked to move towards what we term the meritocratic equity of opportunity model, which holds that prospective students’ qualifications should be judged in light of the socioeconomic circumstances in which these were obtained to enhance distributive fairness, a practice known in the UK as contextualised admissions. In this paper, we critically discuss the theoretical underpinnings of these two competing perspectives on fair access and review the existing empirical evidence base, drawing together for the first time insights from our ESRC and Nuffield Foundation funded studies of fair access to highly academically selective universities in England. We argue that reconceptualising fair access in terms of distributive fairness rather than procedural fairness offers a more socially just set of principles on which to allocate valuable but scarce places at the most academically selective universities in England, unless or until such time as the vertical stratification of higher education institutions is reduced or eliminated entirely.

IntroductionBased on the collective evidence from previous trials, the American Diabetes Association consensus report recommends considering screening asymptomatic adults with diabetes for the development of cardiac structural or functional abnormalities (stage B heart failure) by measurement of natriuretic peptides (BNP).PurposeIn our retrospective study, we aim to describe the predictive value of elevated BNP for clinical events.MethodsPatients with diabetes mellitus and cardiovascular risk factors, without symptomatic HF, were identified from the STOP-HF follow-up study and included in this report. The population was divided into patients with a normal BNP (defined as BNP <50) and elevated BNP and the number of downstream clinical events were compared between the 2 groups over a follow up period of 3 years. We examined the relationship between normal and elevated BNP to hospital admissions (characterised by HF hospitalisations, non-HF, cardiovascular hospitalisations and non – cardiovascular hospitalisations) and non-hospitalisation events.ResultsA total of 868 patients met the inclusion criteria. 208 (24%) of patients had an elevated BNP at baseline. At a follow up of 3 years we observed a significant difference in emergent HF hospitalisations between the 2 groups (3/660 (0.5%) vs 8/208 (3.8%) p < 0.001). There was a trend towards increase in emergent non HF, cardiovascular hospital admissions 56/660 (8.5%) vs 30/208 (14.4%) p=0.018. The elevated BNP group had an overall higher number of non-cardiac hospitalisations (177/660 (26.8%) vs 70/208 (33.7%) p = 0.069.ConclusionPrevious randomized controlled trials have shown that more intensive treatment of risk factors in people with increased levels of BNP reduces the risk for symptomatic HF and HF hospitalizations. Our data supports the use of BNP as a screening tool in a high risk diabetic population to predict clinical events over a short follow up period.

The increasing concentration of wealthy students at highly selective colleges is widely perceived, but few analyses examine the underlying dynamics of higher education stratification over time. To examine these dynamics, the authors build an analysis data set of four cohorts from 1972 to 2004. They find that low-income students have made substantial gains in their academic course achievements since the 1970s. Nonetheless, wealthier students have made even stronger gains in achievement over the same period, in both courses and test scores, ensuring a competitive advantage in the market for selective college admissions. Thus, even if low-income students were \"perfectly matched\" to institutions consistent with their academic achievements, the stratification order would remain largely unchanged. The authors consider organizational and policy interventions that may reverse these trends.

Medical-school applicants learn from many sources that they must stand out to fit in. Many construct self-presentations intended to appeal to medical-school admissions committees from the raw materials of work and volunteer experiences, in order to demonstrate that they will succeed in a demanding profession to which access is tightly controlled. Borrowing from the field of architecture the lens of construction ecology, which considers buildings in relation to the global effects of the resources required for their construction, we reframe medical-school admissions as a social phenomenon that has far-reaching harmful unintended consequences, not just for medicine but for the broader world. Illustrating with discussion of three common pathways to experiences that applicants widely believe will help them gain admission, we describe how the construction ecology of medical school admissions can recast privilege as merit, reinforce colonizing narratives, and lead to exploitation of people who are already disadvantaged.