Dietary Quality and Comorbidities of Adults at Medical Risk for Diabetes

Background and aims: The current study evaluates following a special diet with diet quality and comorbidities (hypertension, hypercholesterolemia, and obesity) in four racial/ethnic groups diagnosed with prediabetes or “at risk for diabetes”. Methods and results: This is a cross-sectional analysis of data from the National Health and Nutrition Examination Surveys (NHANES), 2007- 2008 and 2009-2010. Sample weights were used to achieve a representative sample. Data were available for N = 2666 adults, aged ≥20 years (508 Mexican American, 294, Other Hispanic, 616 Black non-Hispanic, and 1248 White non-Hispanic) who were medically diagnosed with either prediabetes or “at risk for diabetes”. Those reporting following a special diet had greater odds of meeting saturated fat guidelines (

Dietary Intake Of Flavonoids And HDL- And LDL- Cholesterol In Two Black Ethnicities With And Without Type 2 Diabetes

Flavonoids are a class of over 6,500 plant metabolites that have been associated with reduced mortality from cardiovascular disease. A cross-sectional analysis of dietary flavonoids and serum cholesterol in 507 Blacks with and without type 2 diabetes (258 Haitian-Americans and 249 African-Americans) showed differences by ethnicity and diabetes status. Haitian-Americans consumed more of most flavonoids as compared to African-Americans. Individuals with type 2 diabetes consumed less of most flavonoids as compared to those without diabetes. Flavonoids were differentially associated with low-density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL) by diabetes status. Flavanones were associated with lower LDL for participants without diabetes and higher LDL for those with diabetes, independent of ethnicity and adjusted for age, gender, cholesterol medications, daily energy, dietary fat, body mass index (BMI), and smoking. Flavan-3-ols were positively related to LDL while polyflavonoids (theaflavin and polymers, proanthocyanidins) were inversely related to LDL for the group without diabetes only. Higher anthocyanidins and flavan-3-ols and lower polyflavonoids were associated with higher HDL (same adjustments) for those without diabetes, whereas no flavonoids were associated with HDL for individuals with type 2 diabetes.

Parent involvement on school advisory councils: a process evaluation at the middle school level

Increasing parental involvement was made an important goal for all Florida schools in educational reform legislation in the 1990's. A forum for this input was established and became known as the School Advisory Council (SAC). To demonstrate the importance of process and inclusion, a south Florida school district and its local teacher's union agreed on the following five goals for SACs: (a) to foster an environment of professional collaboration among all stakeholders, (b) to assist in the preparation and evaluation of the school improvement plan, (c) to address all state and district goals, (d) to serve as the avenue for authentic and representative input from all stakeholders, and (e) to ensure the continued existence of the consensus-building process on all issues related to the school's instructional program. The purpose of this study was to determine to what extent and in what ways the parent members of one south Florida middle school's SAC achieved the five district goals during its first three years of implementation. The primary participants were 16 parents who served as members of the SAC, while 16 non-parent members provided perspective on parent involvement as "outside sources." Being qualitative by design, factors such as school climate, leadership styles, and the quality of parental input were described from data collected from four sources: parent interviews, a questionnaire of non-parents, researcher observations, and relevant documents. A cross-case analysis of all data informed a process evaluation that described the similarities and differences of intended and observed outcomes of parent involvement from each source using Stake's descriptive matrix model. A formative evaluation of the process compared the observed outcomes with standards set for successful SACs, such as the district's five goals. The findings indicated that parents elected to the SACs did not meet the intended goals set by the state and district. The school leadership did not foster an environment of professional collaboration and authentic decision-making for parents and other stakeholders. The overall process did not include consensus-building, and there was little if any input by parents on school improvement and other important issues relating to the instructional program. Only two parents gave the SAC a successful rating for involving parents in the decision-making process. Although compliance was met in many of the procedural transactions of the SAC, the reactions of parents to their perceived role and influence often reflected feelings of powerlessness and frustration with a process that many thought lacked meaningfulness and productivity. Two conclusions made from this study are as follows: (a) that the role of the principal in the collaborative process is pivotal, and (b) that the normative-re-educative approach to change would be most appropriate for SACs.

Syndemic Health Disparities and Resilience Processes Related to HIV Transmission Risk among African American/Black Men in South Florida

Rates of HIV infection continue to climb among minority populations and men who have sex with men (MSM), with African American/Black MSM being especially impacted. Numerous studies have found HIV transmission risk to be associated with many health and social disparities resulting from larger environmental and structural forces. Using anthropological and social environment-based theories of resilience that focus on individual agency and larger social and environmental structures, this dissertation employed a mixed methods design to investigate resilience processes among African American/Black MSM. Quantitative analyses compared African American/Black (N=108) and Caucasian/White (N=250) MSM who participated in a previously conducted randomized controlled trial (RCT) of sexual and substance use risk reduction interventions. At RCT study entry, using past 90 day recall periods, there were no differences in unprotected sex frequency, however African American/Black MSM reported higher frequencies of days high (P Qualitative data collected among a sub-sample of African American/Black MSM from the RCT (N=21) described the men’s experiences of living with multiple health and social disparities and the importance of RCT study assessments in facilitating reductions in risk behaviors. A cross-case analysis showed different resilience processes undertaken by men who experienced low socioeconomic status, little family support, and homophobia (N=16) compared to those who did not (N=5). The dissertation concludes that resilience processes to HIV transmission risk and related health and social disparities among African American/Black MSM varies and are dependent on specific social environmental factors, including social relationships, structural homophobia, and access to social, economic, and cultural capital. Men define for themselves what it means to be resilient within their social environment. These conclusions suggest that both individual and structural-level resilience-based HIV prevention interventions are needed.

The importance of marine subsidies for terrestrial consumers in coastal Peru

The Peruvian coast is one the best examples of cross-ecosystem food web exchanges, in which resources from one of the richest marine ecosystems subsidize consumers in one of the driest deserts on Earth. Marine subsidies are resources that originate in the marine ecosystem, and that contribute to increase the density of consumers in the recipient ecosystem. I examined the effects of marine subsidies on animal populations in the Peruvian coastal desert. I combined several approaches to study the linkages between marine resources and terrestrial consumers, such as surveying the spatial distribution and estimating the relative abundance of terrestrial consumers, studying the diet of geckos and lizards through stomach content analyses, and examining the desert food web with carbon and nitrogen stable isotope analyses. I found that the distribution and diet of desert consumers were tightly coupled to the availability of marine subsidies. I revealed linkages along two pathways of nutrient fluxes: tidal action that washes ashore macroalgae and cadavers of marine organisms, and animal transport in places where pinnipeds and seabirds congregate for reproduction. In the first pathway, intertidal algivivores made marine resources available to terrestrial consumers by moving between the intertidal and supratidal zone. The relative contribution of terrestrial and algal carbon sources varied among terrestrial consumers, because scorpions assimilated a lower proportion of energy from macroalgae than did geckos and solifuges. In the second pathway, I found that pinniped colonies influenced the diet of desert consumers, and contributed to support large populations of lizards and geckos. By combining field observations, and stomach and stable isotope analyses, I constructed a simplified food web for a large sea lion colony, showing the number of trophic levels that originate from pinniped-derived nutrients. My study demonstrates the enormous importance of marine resources for the diet of desert consumers. The near absence of rainfall along the Peruvian coast promotes an extreme dependence of terrestrial consumers on marine resources, and causes permanent food web effects that are affected by temporal variability in marine productivity, rather then temporal patterns of desert plant growth.

Towards the formation of a sustainable South Florida: An analysis of conflict resolution and consensus building in the South Florida Everglades Ecosystem Restoration Initiative

This dissertation examines the sociological process of conflict resolution and consensus building in South Florida Everglades Ecosystem Restoration through what I define as a Network Management Coordinative Interstitial Group (NetMIG). The process of conflict resolution can be summarized as the participation of interested and affected parties (stakeholders) in a forum of negotiation. I study the case of the Governor's Commission for a Sustainable South Florida (GCSSF) that was established to reduce social conflict. Such conflict originated from environmental disputes about the Everglades and was manifested in the form of gridlock among regulatory (government) agencies, Indian tribes, as well as agricultural, environmental conservationist and urban development interests. The purpose of the participatory forum is to reduce conflicts of interest and to achieve consensus, with the ultimate goal of restoration of the original Everglades ecosystem, while cultivating the economic and cultural bases of the communities in the area. Further, the forum aim to formulate consensus through envisioning a common sustainable community by providing means to achieve a balance between human and natural systems. ^ Data were gathered using participant observation and document analysis techniques to conduct a theoretically based analysis of the role of the Network Management Coordinative Interstitial Group (NetMIG). I use conflict resolution theory, environmental conflict theory, stakeholder analysis, systems theory, differentiation and social change theory, and strategic management and planning theory. ^ The purpose of this study is to substantiate the role of the Governor's Commission for a Sustainable South Florida (GCSSF) as a consortium of organizations in an effort to resolve conflict rather than an ethnographic study of this organization. Environmental restoration of the Everglades is a vehicle for recognizing the significance of a Network Management Coordinative Interstitial Group (NetMIG), namely the Governor's Commission for a Sustainable South Florida (GCSSF), as a structural mechanism for stakeholder participation in the process of social conflict resolution through the creation of new cultural paradigms for a sustainable community. ^