Self -management factors, influences, and conditions for type 2 diabetes among Black ethnic groups in Miami, Florida and Abidjan, Cote d'Ivoire

The Dahlgren and Whitehead ecological theory provides the framework for a cross-sectional design to compare socio-demographic characteristics, living and working conditions, and lifestyle daily habits as well as cultural and ecological factors among six diabetic multiethnic Black groups in Miami and Abidjan. Approximately 180 Black Americans (African-, Caribbean-, and Haitian-) and 180 Black Africans (Akan, Malinke, and Krou) aged 20 years and older were surveyed. During the preliminary of this study participants' attitudes and behaviors were qualitatively assessed (N=60) and a tool was developed to describe, in the main study (N=360), differences in participants' strength of commitment to diabetes lifestyle self-management. Despite similarities found in terms of age and gender, statistically significant differences were also found within and among groups in terms of living and working conditions, education level, and religion. African American groups were more likely to participate in more diabetes classes than Haitian Americans and Caribbean Americans. However, African Americans were less likely to adhere to daily dietary and weight control regimens. Although, Black African groups reported limited access to equipment, facilities, and financial support they were more likely to follow dietary and weight control recommendations than Black American groups. Overall, African American participants showed the poorest attitudes towards recommended foods, Caribbean American respondents reported the best attitudes and behaviors towards weight control regimens, and the Malinke group had significantly more strength of commitment to successful weight control. Furthermore, Black African groups had significantly more strength of commitment to successful dietary adherence and significantly less support for weight control than Black American groups. ^ Significant differences found within Black groups suggest that understanding each patient's conditions may help healthcare professionals in initiating individualized appropriate counseling before goal setting, and in developing culturally relevant type 2 diabetes management programs. Moreover, significant differences exist in strength of commitment to lifestyle adherence among Black groups in Miami and Abidjan. Cultural, socio-demographic factors and self-management habits may explain differences in participants' outcomes. At the policy level, Black groups should not be approached as a homogenous group and assessment of the vulnerability of each ethnic group may be necessary in the decision-making process.^

Ethnic groups and institutions: A study of institutional engineering in four Central and Eastern European countries

The issue of institutional engineering has gained a renewed interest with the democratic transitions of the Central and Eastern European countries, as for some states it has become a matter of state survival. The four countries examined in the study – Macedonia, Slovakia, Romania and Bulgaria – exemplify the difficulty in establishing a stable democratic society in the context of the resurgence of national identity. The success of ethnonational minorities in achieving the desired policies affirming or expanding their rights as a group was conditioned upon the cohesion of the minority as well as the permissiveness of state institutions in terms of participation and representation of minority members. The Hungarian minorities in Slovakia and Romania, the Turkish minority in Bulgaria, and the Albanian minority in Macedonia, formed their political organizations to represent their interests. However, in some cases the divergence of strategies or goals between factions of the minority group seriously impeded its ability to obtain the desired concessions from the majority. The difficulty in the pursuit of policies favoring the expansion of minority rights was further exacerbated in some of the cases by the impermissiveness of political institutions. The political parties representing the interest of ethnonational minorities were allowed to participate in elections, although not without suspicions about their intent and even strong opposition from majority groups, but participation in elections and subsequent representation in legislative bodies did not translate into adoption of the desired policies. The ethnonational minorities' inability to effectively influence the decision-making process was the result of the inadequacy of democratic institutions to process these demands and channel them through the normal political process in the absence of majority desire to accommodate them. Despite the promise of democratic institutions to bring about a major overhaul of the policies of forceful assimilation and disregard for minority rights, the four cases analyzed in the study demonstrate that in effect ethnonational minorities continued to be at the mercy of the majority, especially if the minority was unable to position itself as a balancing actor.

Novel NR5A1 Missense Mutation in Premature Ovarian Failure: Detection in Han Chinese Indicates Causation in Different Ethnic Groups

Background The etiology of most premature ovarian failure (POF) cases is usually elusive. Although genetic causes clearly exist and a likely susceptible region of 8q22.3 has been discovered, no predominant explanation exists for POF. More recently, evidences have indicated that mutations in NR5A1 gene could be causative for POF. We therefore screened for mutations in the NR5A1 gene in a large cohort of Chinese women with non-syndromic POF. Methods Mutation screening of NR5A1 gene was performed in 400 Han Chinese women with well-defined 46,XX idiopathic non-syndromic POF and 400 controls. Subsequently, functional characterization of the novel mutation identified was evaluated in vitro. Results A novel heterozygous missense mutation [c.13T>G (p.Tyr5Asp)] in NR5A1 was identified in 1 of 384 patients (0.26%). This mutation impaired transcriptional activation on Amh, Inhibin-a, Cyp11a1and Cyp19a1 gene, as shown by transactivation assays. However, no dominant negative effect was observed, nor was there impact on protein expression and nuclear localization. Conclusions This novel mutation p.Tyr5Asp, in a novel non-domain region, is presumed to result in haploinsufficiency. Irrespectively, perturbation in NR5A1 is not a common explanation for POF in Chinese.

Health beliefs and health care options of disparate black communities in the United States

According to the 1999 U.S. Census, there were approximately thirty-three million African Americans and approximately 1.8 million non-Hispanic black immigrants in the United States. The 1997 U.S. Census estimated that there were as many as 554,000 foreign-born Haitians and 505,000 foreign-born Jamaicans living in the United States, mainly residing in Florida and New York. The U.S. Census claims that blacks are one of the largest emerging ethnic groups in America constituting at least twelve percent of this country's population. Because of this increase, their specific health beliefs and health care options are increasingly nationally significant. ^ In the present intra-black and inter-ethnic study, two hundred seventy African Americans, Haitian immigrants, and Jamaican immigrants residing in South Florida were quantitatively and qualitatively surveyed in order to investigate their health beliefs and health care options. According to the reviewed literature, the three black ethnic groups researched in this study have not been compared or contrasted before in relation to these beliefs and health care choices. ^ As was discovered by the present research, differing health beliefs and health care options were the cultural products of the ethnic differences of the researched communities. It was expected that differing health beliefs among the researched black groups might indicate disparate patterns of health care utilization of either western or non-western models. Additionally, it was projected that by investigating the health beliefs and the health care options of these emerging black ethnic groups, western health care providers in the United States could become better versed in medically servicing growing ethnically-disparate black populations. The study yielded results about the researched groups that supported major findings in the reviewed literature. The data were reported and examined, and theoretical generalizations from the data were discussed. The most important of these findings was that, within a race, health beliefs and health care options were determined by specific ethno-cultural variables dependent on national origins. ^

Intra-racial relations among blacks in the United States: dissimilarities, partnerships, and common identities

In the wake of a steadily increasing diversity in ethnicity among Blacks in the United States, efforts need to be made to analyze and understand the dynamics of the relations among the various Black ethnic groups in the United States. This thesis explores the present state of relations among these groups by utilizing an extensive literature review on the topic in conjunction with in-depth interviews. What is of particular interest here are the differing and similar intergroup perspectives on self-identity, as well as any cultural similarities and dissimilarities that exist. We find that the cultural dissimilarities create barriers to harmonious relations among the groups, while particular ideologies such as Pan-Africanism and Black nationalism provide the basis for strong unified fronts and partnerships for those who embrace them.

The will to write: Students' and teachers' perceptions of writing

This study investigated the perceptions of writing among secondary and post-secondary students and their teachers. The focus was on students' writing philosophy and influences, perceptions of the writing process, and perceptions of student writing skills, high stakes assessment tests, and writing across the curriculum. ^ An ethnographic case study was used to investigate the perceptions of writing among ten students and their English teachers in two high schools, a community college, and a university. To establish balance and ethnic plurality, seven females and three males representing the four large ethnic groups in South Florida—African American, Haitian American, European American and Latino—participated. During one four-month term, data from written samples of students' writing, formal and informal interviews, a student focus group, field notes, classroom observations, and a “think-aloud” protocol were collected. ^ Four themes emerged. First, Florida's writing assessment test has a negative influence on students' perceptions of writing. Students' motivation and attitudes as well as their confidence in their abilities were affected by practice and preparation in “recital writing.” Second, writing is a vehicle of social and personal transformation. Students believed that writing is a mean to connect to others and to create change in schools and communities. Third, students lacked the ability to connect writing, thinking and learning. Although students and teachers agree with statements about this connection, students failed to see the relevance of thinking and learning through writing in current or future courses, or in their future careers. Finally, writing context, teachers, schools, peers and gender influenced writing perceptions. Students believed that their writing philosophy, writing process, and perceptions of writing in academia and in the workplace are connected to these five factors. ^ The effect of the Florida writing test pervades students' and teachers' writing perceptions, making a stronger case for writing across the curriculum than previous research. Writing should help students see knowledge as interrelated, honor students' interests and values, and build relationships between and among students, schools and communities. In designing and implementing methods that support and sustain student writing, teachers should provide students with multiple opportunities to expand knowledge, learning, and connection through writing. ^

Island diasporas: Perceptions of Indo-Caribbean protégés regarding the effects of their cross-cultural mentoring experiences in the United States

Mentoring is defined as an "intense caring relationship in which persons with more experience work with less experienced persons to promote both professional and personal development" (Caffarella, 1992, p. 38). It is "a powerful emotional, and passionate interaction whereby the mentor and protégé experience...intellectual growth and development" (Galbraith & Zelenak, 1991, p. 126). In cross-cultural mentoring, mentors and protégés from different cultures confront social and cultural identities, goals, expectations, values, and beliefs (Cross & Lincoln, 2005) to "achieve a higher level of potency in education and society" (Mullen, 2005, p. 6). Cross-cultural mentoring research explores attitudes, behaviors, linguistics and motivators of the more visible racial and ethnic groups in the U.S. (Elmer, 1986, Ulmer, 2008). The cross-cultural mentoring experiences of Indo-Caribbeans in the U.S. are obscured from the research despite their rich socio-historic culture. The purpose of this phenomenological study was to explore the perceptions of Indo-Caribbean protégés regarding the effects of their cross-cultural mentoring experiences in the United States. Phenomenology is "the systematic attempt to uncover and describe...the internal meaning structures, of lived experience [by studying the] particulars or instances as they are encountered" (Van Manen, 1990, p. 10). Criterion and snowball sampling were used to recruit 15 participants. A semi-structured interview guide was used to gather data and Creswell's (2007) simplified version of Moustakas's (1994) Modification of the Stevick-Colaizzi-Keen Method of Analysis of Phenomenological Data was used to analyze the data. Three themes emerged: (a) "Sitting at the feet of gurus" taught protégés how to accept guidance, (b) Guru-Shishya: Learning and Discipleship, ways that protégés perceived mentors' guidance related to work, skill acquisition, and social or emotional support, and (c) Samavartan sanskar: Building Coherence, helped protégés understand, manage and find meaning. Protégés' goals and professional expectations determined what they wanted from cross-cultural mentoring relationships and what they were willing to endure within those relationships. Since participants valued achievement and continuous improvement, mentor support was integral to making meaning and developing a sense of coherence in their lives. Implications regarding cross-cultural mentoring relationships together with recommendations for future research conclude the study.

Ethnic Differences in Insulin Resistance, Adiponectin Levels and Abdominal Obesity: Haitian Americans and African Americans, with and without Type 2 Diabetes Mellitus

Background: Metabolic outcomes of obesity and its associated disorders may not be equivalent across ethnicity and diabetes status. Aim: In this paper, we examined the association of abdominal obesity, by ethnicity and diabetes status, for indicators of glucose metabolism in Blacks. Methods: A cross sectional study was conducted in Haitian Americans (n= 186) and African Americans (n= 148) with and without type 2 diabetes mellitus (T2DM). Student’s t-test and Chi-squared test were used to assess differences in mean and proportion values between ethnicities with and without type 2 diabetes mellitus. Relationship between insulin resistance, ethnicity, diabetes status, abdominal obesity, and adiponectin levels were analyzed by analysis of covariance while controlling for confounding variables. Results:Haitian American participants were older (P = .032), had higher fasting plasma glucose (P = .036), and A1C (P = .016), but had lower levels of Hs-CRP (P < .001), insulin and HOMA2-IR and lower abdominal obesity (P = .030), than African Americans. Haitian Americans had significantly lower HOMA2-IR (P = .008) than African Americans when comparing both ethnicities with T2DM, high abdominal obesity, and adiponectin levels lower than the median ( Conclusion: The clinical significance of observed differences in insulin resistance, abdominal obesity, and adiponectin levels between Haitian Americans and African Americans could assist in forming public health policies that are ethnic specific.

A comparative study of perceptions about social relations between black Caribbean nationals and African Americans in a black institution

The present study researched how first-generation black national Caribbean groups and native born black Americans perceived each other socially within an African American institution. Each group rated the other group on items dealing with perceived social relations. Two black ethnically-distinct communities totaling 151 participants were studied. Chi-square ($\chi\sp2$) and one-way analyses of variances (ANOVAs) were employed to test the collected data. The study yielded results about the researched groups that supported both the major findings in the review literature and the thesis's hypothesis; namely, that black Caribbean nationals tend to perceive that they relate socially more with their own group than with African Americans even as mutual participants in a monoracial institution. The present study was unique, as it incorporated a multinational Caribbean group and an African American group that the literature has not previously researched together, and especially as it surveyed these two groups in the context of a black-owned institution. ^

Health care utilization behavior of elders in a multicultural urban environment

The objective of this research is to determine the influences of social, environmental, behavioral, and economic forces on the health care service utilization of four racial/ethnic groups of non-institutionalized elders in a multicultural urban environment. To address these issues this dissertation examines three intertwined themes of culture, aging, and health, using a sample of elders residing in Miami-Dade County, FL in four racial/ethnic groups: white non-Hispanic; black non-Hispanic English speakers; Cuban; and non-Cuban Hispanic. ^ The research questions were analyzed using both quantitative and qualitative data. Data for the quantitative component uses telephone survey data from the Dade County Needs Assessment. The purpose of this component is to develop a more comprehensive model of elder health care utilization behavior. The qualitative component uses data from focus groups from Dade County Needs Assessment, archival data and a literature review of previous ethnographic research. The purpose of this component is to gain a better understanding of the social construction of the terms “age”' and “aging,” as well as to place issues of health and health care in the lives of elders. ^ The findings raised several important issues. First, just because people share a common chronological age does not mean that they are the same in every other respect. Examining elders as a homogeneous group of users of formal health care services in a community is simplistic. Placing “aging” and “health” in a cultural context is important. My findings confirm that the meaning of “aging” and “old” are socially constructed. Further, the term “aging” is NOT synonymous with ill health or frailty. This was a consistent finding in both the quantitative and qualitative results. ^ While all aging individuals share a mutual orientation toward aging (i.e., biological process), they do not age the same way (i.e., social construction of “aging”). Thus, policymakers and others serving the elder population must be aware of the particular cultural context, as well as the previous life experiences of the individuals that they serve. This analysis documents the importance of culture and geographic community in understanding health care service utilization of elders. ^

Differences in learning style preference among students of diverse ethnicities, gender, academic placement level, and academic achievement

This investigation studied the differences in learning styles among ethnically diverse secondary science students from a multicultural urban high school. It examined whether there were learning style differences among samples based on ethnicity, gender, academic grouping, and academic achievement. The learning style elements were based on scores of the Dunn, Dunn, and Price Learning Style Inventory (LSI) (1997). The sample (n = 476) consisted of students enrolled in Life Science courses. The analyses of data were made by one way analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA). ^ Significant differences were found among students for three of the four groups tested. The largest numbers of differences in learning style element preference were in academic grouping, with eight significant differences showing small or medium effect sizes. There were four significant differences between genders and one significant difference among ethnic groups. Effect size was small. The data analyses showed that individual differences have a much bigger effect than group differences on learning style, and that proportions in learning style element categories reveal more information than means of groups. ^ This study implied the need to increase awareness of differences in learning styles among students and help educators to understand them. Other predictors of learning styles might account for a large amount of the unexplained variation. Overall, this study reinforces the body of existing literature. ^

Personal and institutional factors: Relationship to self-efficacy of persistence to the senior year in college among self-identified Black undergraduate students in a Hispanic serving institution

While undergraduate enrollment of all racial groups in United States higher education institutions has increased, 6-year graduation rates of Blacks (39%) remain low compared to other races; Asians (69%), Whites (62%), and Hispanics (50%; NCES, 2010). Women's graduation rate is higher than men's; 58% compared to men's at 53% in public institutions (IPEDS, 2011). Retention literature does not address the perceptions of Black ethnic groups' experiences in college, particularly in Hispanic serving institutions. Informed by Tinto's (1975, 1987, 1993) student academic and social integration model, Guiffrida's (2003, 2004, 2005, 2006) model of relationships while at college, and ex-post facto research design, the study investigated personal and institutional factors that relate to Black students' self-efficacy and persistence to the senior year in college. Data about Black ethnic undergraduate seniors' (N = 236) academic and social experiences in college were collected using the Student Institutional Integration Survey (SIIS), an online questionnaire. Descriptive statistics were used to collect background information about the sample, correlation was calculated to indicate the degree of relationship between the variables, and multiple linear regressions were used to identify variables that are predictors of self-efficacy of persistence. Independent samples t-test and analyses of variance were computed to determine whether differences in perceptions of personal and institutional factors that relate to self-efficacy of persistence to the senior year in college could be identified between gender and ethnicity. Frequency was summarized to identify themes of participants' primary motivation for finishing undergraduate degree programs. These themes were: (a) self-pride/personal goal, (b) professional aspiration/career (c) motivation to support family, (d) desire to have financial independence/better job, (e) to serve community, (f) opportunity to go to college, (g) being first-generation college student, and (h) prove to family the value of higher education. The research findings support the tenets of academic and social integration theories which suggest that students' interaction with peer and faculty, relationships with family and friends, and involvement in institutional activities and organizations influence their persistence in college. Implications based on the findings affect institutional policy, curriculum, and program improvements that relate to Black undergraduate students' academic and social support.

Critical Race Theory and Adult Education: Critique of the Literature in Adult Education Quarterly

This paper examines the assumptions and paradigms used to discuss diversity and equity in adult education literature using critical race theory as a lens. Five themes emerged from the critique that may initiate an innovative dialogue about the realities and subjectivities singling out racial and ethnic minorities in the USA.

Personal and Institutional Factors: Relationship to Self-Efficacy of Persistence to the Senior Year in College among Self-Identified Black Undergraduate Students in a Hispanic Serving Institution

While undergraduate enrollment of all racial groups in United States higher education institutions has increased, 6-year graduation rates of Blacks (39%) remain low compared to other races; Asians (69%), Whites (62%), and Hispanics (50%; NCES, 2010). Women’s graduation rate is higher than men’s; 58% compared to men’s at 53% in public institutions (IPEDS, 2011). Retention literature does not address the perceptions of Black ethnic groups’ experiences in college, particularly in Hispanic serving institutions. Informed by Tinto’s (1975, 1987, 1993) student academic and social integration model, Guiffrida’s (2003, 2004, 2005, 2006) model of relationships while at college, and ex-post facto research design, the study investigated personal and institutional factors that relate to Black students’ self-efficacy and persistence to the senior year in college. Data about Black ethnic undergraduate seniors’ (N = 236) academic and social experiences in college were collected using the Student Institutional Integration Survey (SIIS), an online questionnaire. Descriptive statistics were used to collect background information about the sample, correlation was calculated to indicate the degree of relationship between the variables, and multiple linear regressions were used to identify variables that are predictors of self-efficacy of persistence. Independent samples t-test and analyses of variance were computed to determine whether differences in perceptions of personal and institutional factors that relate to self-efficacy of persistence to the senior year in college could be identified between gender and ethnicity. Frequency was summarized to identify themes of participants’ primary motivation for finishing undergraduate degree programs. These themes were: (a) self-pride/personal goal, (b) professional aspiration/career (c) motivation to support family, (d) desire to have financial independence/better job, (e) to serve community, (f) opportunity to go to college, (g) being first-generation college student, and (h) prove to family the value of higher education. The research findings support the tenets of academic and social integration theories which suggest that students’ interaction with peer and faculty, relationships with family and friends, and involvement in institutional activities and organizations influence their persistence in college. Implications based on the findings affect institutional policy, curriculum, and program improvements that relate to Black undergraduate students’ academic and social support.

Not getting by: Poverty management and homelessness in Miami

Urban inequality has emerged as one of the dominant themes of modern life and globalization. More than three million people experienced homelessness in the United States last year; in Miami-Dade, more than 15,000 individuals were homeless. Surviving extreme poverty, and exiting or avoiding homelessness, involves negotiating a complex mix of public and private assistance. However, a range of factors influence what types of help are available and how they can be accessed. Frequently, larger social structures determine which resource are available, leaving many choices entirely out of the individual's control. For single men, who are ineligible for many benefits, homelessness can be difficult to avoid and even harder to exit. My study seeks to better understand how adult, minority men living in extreme poverty in Miami-Dade negotiate their daily survival. Specific research questions address: Do black and Hispanic men who are homeless or at risk of homelessness have different personal characteristics and different experiences in avoiding or exiting homelessness? How does Miami's response to extreme poverty/homelessness, including availability of public benefits and public and private service organizations, either maximize or constrain the choices available to this population? And, what is the actual experience of single, adult men who are homeless or at risk of homelessness, in negotiating their daily survival? A mixed methods approach combines quantitative survey data from 7,605 homeless men, with qualitative data from 54 semi-structured interviews incorporating the visual ethnography techniques of Photo Elicitation Interviewing. Results show the differences experienced by black and Hispanic men who are poor and homeless in Miami. Findings also highlight how the community's official and unofficial responses to homelessness intersect with the actual experiences of the persons targeted by the policies and programs, challenging preconceived notions regarding the lives of persons living in extreme poverty. It adds to the existing body of literature by focusing on the urban Miami context, emphasizing disparities amongst racial and ethnic groups. Findings are intended to provide an empirically grounded thesis that humanizes the subjects and illuminates their personal experiences, helping to inform public policy around the needs of extremely poor populations.