The association of depression and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes

Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta cell dysfunction and diabetes. The purpose of this study was to assess associations between depression symptoms and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes. Participants and Methods: Informed consent and data were available for 462 participants (231 African Americans and 231 Haitian Americans) for this cross-sectional study. A demographic questionnaire developed by the Primary Investigator was used to collect information regarding age, gender, smoking, and ethnicity. Diabetes status was determined by self-report and confirmed by fasting blood glucose. Anthropometrics (weight, and height and waist circumference) and vital signs (blood pressure) were taken. Blood samples were drawn after 8 10 hours over-night fasting to measure lipid panel, fasting plasma glucose and serum insulin concentrations. The homeostatic model assessment, version 2 (HOMA2) computer model was used to calculate beta cell function. Depression was assessed using the Beck Depression Inventory-II (BDI-II) and stress levels were assessed using the Perceived Stress Scale (PSS). Results: Moderate to severe depressive symptoms were more likely for persons with diabetes (p = 0.030). There were no differences in perceived stress between ethnicity and diabetes status (p = 0.283). General linear models for participants with and without type 2 diabetes using beta cell function as the dependent variable showed no association with depressive symptoms and perceived stress; however, Haitian Americans had significantly lower beta cell function than African Americans both with and without diabetes and adjusting for age, gender, waist circumference and smoking. Further research is needed to compare these risk factors in other race/ethnic groups.

Perceived Stress and Self‑rated Health of Haitian and African Americans with and without Type 2 Diabetes

Background: Blacks have a higher incidence of diabetes and its related complications. Self-rated health (SRH) and perceived stress indicators are associated with chronic diseases. The aim of this study was to examine the associations between SRH, perceived stress and diabetes status among two Black ethnicities. Materials and Methods: The cross-sectional study included 258 Haitian Americans and 249 African Americans with (n = 240) and without type 2 diabetes (n = 267) (N = 507). Recruitment was performed by community outreach. Results: Haitian-Americans were less likely to report ‘fair to poor’ health as compared to African Americans [OR=0.58 (95% CI: 0.35, 0.95), P = 0.032]; yet, Haitian Americans had greater perceived stress than African Americans (P = 0.002). Having diabetes was associated with ‘fair to poor’ SRH [OR=3.14 (95% CI: 2.09, 4.72),P < 0.001] but not perceived stress (P = 0.072). Haitian-Americans (P = 0.023), females (P = 0.003) and those participants having ‘poor or fair’ SRH (P < 0.001) were positively associated with perceived stress (Nagelkerke R2=0.151). Conclusion: Perceived stress associated with ‘poor or fair’ SRH suggests that screening for perceived stress should be considered part of routine medical care; albeit, further studies are required to confirm our results. The findings support the need for treatment plans that are patient-centered and culturally relevant and that address psychosocial issues.

Psychosocial barriers to self -care among Hispanic women with type 2 diabetes mellitus

This cross-sectional survey-designed study investigated the presence and influence of psychosocial barriers to diabetes self-management practices among Hispanic women with type 2 diabetes mellitus. Women (n = 128) who were diagnosed and being treated for type 2 diabetes were recruited from the Miami-Dade area in South Florida. A Beck Depression Inventory-II, Diabetes Care Profile, Diabetes Knowledge Test, Diabetes Empowerment, Multidimensional Health Locus of Control, and Perceived Stress Scales were administered, along with assessment of diet through a 24-hour recall and anthropometric evaluation by body composition analysis and body mass index computation. ^ Mean (± SD) age for subjects was 50.15 ± 15.93 and age at diagnosis was 42.46 ± 14.69. Mean glycosylated hemoglobin (A 1C) was 8.55 ± 1.39. Diabetes education had not been received by 46.9% of subjects. Psychosocial status had previously been evaluated in only 4 participants. Forty percent of participants were assessed as depressed and 17% moderately to severely so. Depression correlated significantly (p < 0.01) with A1C (r = 0.242), perceived stress (r = 0.566), and self-rated health (r = −0.523). Perceived stress correlated significantly (p < 0.01) with A1C (r = 0.388), understanding of diabetes (r = 0.282), self-rated health (r = −0.372) and diabetes empowerment (r = −0.366). For Cuban women, perceived stress (β = 0.418, p = 0.033) was the only significant predictor of A1C, while among non-Cuban Hispanic women, self-reported health (β = −0.418, p = 0.003) and empowerment (β = 0.432, p = 0.004) were better predictors. The most desirable DM status among the women surveyed (high diet adherence, low exercise barriers, and A1C ≤ 7) was associated with superior self-rated health, more support from family and friends, and greater empowerment. ^ This study revealed the error in considering Hispanics a homogenous entity in treating disease, as their cultural backgrounds and concentration in a community can greatly influence management of a chronic disease like diabetes. The strong correlations found between diabetes-related health indicators and psychosocial factors such as depression and perceived stress suggest that psychosocial assessment of patients must be more strongly advocated in diabetes care. Psychosocial assessment of ethnically diverse diabetic populations is especially vital if greater knowledge is to be gained about their barriers to self-care so that diabetes treatment and thus outcomes are enhanced. ^

Implications of a theoretical framework on stress and burnout for the development of graduate nursing education curricula

This study had two purposes: (a) to develop a theoretical framework integrating and synthesizing findings of prior research regarding stress and burnout among critical care nurses (CCRNs), and (b) to validate the theoretical framework with an empirical study to assure a theory/research based teaching-learning process for graduate courses preparing nursing clinical specialists and administrators.^ The methods used to test the theoretical framework included: (a) adopting instruments with reported validity, (b) conducting a pilot study, (c) revising instruments using results of the pilot study and following concurrence of a panel of experts, and (d) establishing correlations within predetermined parameters. The reliability of the tool was determined through the use of Cronbach's Alpha Coefficient with a resulting range from.68 to.88 for all measures.^ The findings supported all the research hypotheses. Correlations were established at r =.23 for statistically significant alphas at the.01 level and r =.16 for alphas.05. The conclusions indicated three areas of strong correlation among the theoretical variables: (a) work environment stressor antecedents and specific stressor events were correlated significantly with subjective work stress and burnout; (b) subjective work stress (perceived work related stress) was a function of the work environment stressor antecedents and specific stressor events, and (c) emotional exhaustion, the first phase of burnout, was confirmed to be related to stressor antecedents and specific stressor events. This dimension was found to be a function of the work environment stressor antecedents, modified by the individual characteristics of work and non-work related social support, non-work daily stress, and the number of hours worked per week. The implications of the study for nursing graduate curricula, nursing practice and nursing education were discussed. Recommendations for further research were enumerated. ^

Characteristics of effective clinical and theory instructors as perceived by LPN to RN versus generic students in an associate degree nursing program

The purpose of this study was to compare the characteristics of effective clinical and theory instructors as perceived by LPN/RN versus generic students in an associate degree nursing program.^ Data were collected from 508 students during the 1996-7 academic year from three NLN accredited associate degree nursing programs. The researcher developed instrument consisted of three parts: (a) Whitehead Characteristics of Effective Clinical Instructor Rating Scale, (b) Whitehead Characteristics of Effective Theory Instructor Rating Scale, and (c) Demographic Data Sheet. The items were listed under five major categories identified in the review of the literature: (a) interpersonal relationships, (b) personality traits, (c) teaching practices, (d) knowledge and experience, and (e) evaluation procedures. The instrument was administered to LPN/RN students in their first semester and to generic students in the third semester of an associate degree nursing program.^ Data was analyzed using a one factor mutivariate analysis of variance (MANOVA). Further t tests were carried out to explore for possible differences between type of student and by group. Crosstabulations of the demographic data were analyzed.^ There were no significant differences found between the LPN/RN versus generic students on their perceptions of either effective theory or effective clinical instructor characteristics. There were significant differences between groups on several of the individual items. There was no significant interaction between group and ethnicity or group and age on the five major categories for either of the two instruments. There was a significant main effect of ethnicity on several of the individual items.^ The differences between the means and standard deviations on both instruments were small, suggesting that all of the characteristics listed for effective theory and clinical instructors were important to both groups of students. Effective teaching behaviors, as indicated on the survey instruments, should be taught to students in graduate teacher education programs. These behaviors should also be discussed by faculty coordinators supervising adjunct faculty. Nursing educators in associate degree nursing programs should understand theories of adult learning and implement instructional strategies to enhance minority student success. ^

A multi-scale assessment of physiological processes in arctic tundra plants under natural and simulated climate change scenarios

Climate warming is predicted to cause an increase in the growing season by as much as 30% for regions of the arctic tundra. This will have a significant effect on the physiological activity of the vascular plant species and the ecosystem as a whole. The need to understand the possible physiological change within this ecosystem is confounded by the fact that research in this extreme environment has been limited to periods when conditions are most favorable, mid June–mid August. This study attempted to develop the most comprehensive understanding to date of the physiological activity of seven tundra plant species in the Alaskan Arctic under natural and lengthened growing season conditions. Four interrelated lines of research, scaling from cellular signals to ecosystem processes, set the foundation for this study. ^ I established an experiment looking at the physiological response of arctic sedges to soil temperature stress with emphasis on the role of the hormone abscisic acid (ABA). A manipulation was also developed where the growing season was lengthened and soils were warmed in an attempt to determine the maximum physiological capacity of these seven vascular species. Additionally, the physiological capacities of four evergreens were tested in the subnivean environment along with the potential role anthocyanins play in their activity. The measurements were scaled up to determine the physiological role of these evergreens in maintaining ecosystem carbon fluxes. ^ These studies determined that soil temperature differentials significantly affect vascular plant physiology. ABA appears to be a physiological modifier that limits stomatal processes when root temperatures are low. Photosynthetic capacity was limited by internal plant physiological mechanisms in the face of a lengthened growing season. Therefore shifts in ecosystem carbon dynamics are driven by changes in species composition and biomass production on a per/unit area basis. These studies also found that changes in soil temperatures will have a greater effect of physiological processes than would the same magnitude of change in air temperature. The subnivean environment exhibits conditions that are favorable for photosynthetic activity in evergreen species. These measurements when scaled to the ecosystem have a significant role in limiting the system's carbon source capacity. ^

Predicting posttraumatic stress reactions in children prior to traumatic exposure

The present study examined the relations among previously identified risk and protective variables associated with traumatic exposure and evaluated a model of resilience to traumatic events among Latino youth prior to traumatic exposure using structural equation modeling. Model tests were pursued in the context of Full Information Maximum Likelihood (FIML) methods as implemented in Mplus. The model evaluated the role of the following variables: (a) intervening life events; (b) child characteristics; (c) social support from significant others; and (d) children's coping. Data were collected from 181 Latino youth (M age = 9.22, SD = 1.38; 49.0% female) participants. Data analyses revealed that children's perceived available social support and use of coping strategies predicted low state anxiety following exposure to cues of disaster. Life events and preexisting depression symptoms did not significantly predict social support and coping, whereas preexisting anxiety was a significant predictor of perceived social support. This study represents an important initial step towards establishing and empirically evaluating a resilience model. Implications for preparedness interventions and a framework for the etiology of resilient reactions to disaster exposure are discussed.

Determinants of Mid-scale Hotel Brand Equity

The traditional brand management in the hotel industry is facing a great challenge as numerous brands provide many choices to hotel guests. In such competitive environments, hotel firms realize that capitalizing on one of the most important assests they own- the brand- is critical to achieve a premier growth goal not only rapidly but also in a cost- effective way. THe purpose of this study is to examine the determinants of cutsomer-based hotel brand equity for the mid-priced U.S. lodging segment by assessing the impacts of four-widely accepted brand equity dimensions: brand awareness, brand associations, percieved quality and customer loyalty. 277 travelers participated in this study at the airport in a Midwestern city. Perceived quality, brand loyalty, brand associations were found to be the core components of brand equity, while brand awareness, a seemingly important source of brand equity, did not exert a significant influence on building brand equity of mid-priced hotels. The result of this study sheds insight about how to create, manage, and evaluate a distinctive and successful hotel brand.

A comparison of the effects of classroom and Multi-User Virtual Environments on the perceived speaking anxiety of adult post-secondary English Language Learners

The population of English Language Learners (ELLs) globally has been increasing substantially every year. In the United States alone, adult ELLs are the fastest growing portion of learners in adult education programs (Yang, 2005). There is a significant need to improve the teaching of English to ELLs in the United States and other English-speaking dominant countries. However, for many ELLs, speaking, especially to Native English Speakers (NESs), causes considerable language anxiety, which in turn plays a vital role in hindering their language development and academic progress (Pichette, 2009; Woodrow, 2006). ^ Task-based Language Teaching (TBLT), such as simulation activities, has long been viewed as an effective approach for second-language development. The current advances in technology and rapid emergence of Multi-User Virtual Environments (MUVEs) have provided an opportunity for educators to consider conducting simulations online for ELLs to practice speaking English to NESs. Yet to date, empirical research on the effects of MUVEs on ELLs' language development and speaking is limited (Garcia-Ruiz, Edwards, & Aquino-Santos, 2007). ^ This study used a true experimental treatment control group repeated measures design to compare the perceived speaking anxiety levels (as measured by an anxiety scale administered per simulation activity) of 11 ELLs (5 in the control group, 6 in the experimental group) when speaking to Native English Speakers (NESs) during 10 simulation activities. Simulations in the control group were done face-to-face, while those in the experimental group were done in the MUVE of Second Life. ^ The results of the repeated measures ANOVA revealed after the Huynh-Feldt epsilon correction, demonstrated for both groups a significant decrease in anxiety levels over time from the first simulation to the tenth and final simulation. When comparing the two groups, the results revealed a statistically significant difference, with the experimental group demonstrating a greater anxiety reduction. These results suggests that language instructors should consider including face-to-face and MUVE simulations with ELLs paired with NESs as part of their language instruction. Future investigations should investigate the use of other multi-user virtual environments and/or measure other dimensions of the ELL/NES interactions.^

Perceived Risk of Predation Affects Reproductive Life - History Traits in Gambusia holbrooki, but Not in Heterandria formosa

Key to predicting impacts of predation is understanding the mechanisms through which predators impact prey populations. While consumptive effects are well-known, non-consumptive predator effects (risk effects) are increasingly being recognized as important. Studies of risk effects, however, have focused largely on how trade-offs between food and safety affect fitness. Less documented, and appreciated, is the potential for predator presence to directly suppress prey reproduction and affect life-history characteristics. For the first time, we tested the effects of visual predator cues on reproduction of two prey species with different reproductive modes, lecithotrophy (i.e. embryonic development primarily fueled by yolk) and matrotrophy (i.e. energy for embryonic development directly supplied by the mother to the embryo through a vascular connection). Predation risk suppressed reproduction in the lecithotrophic prey (Gambusia holbrokii) but not the matrotroph (Heterandria formosa). Predator stress caused G. holbrooki to reduce clutch size by 43%, and to produce larger and heavier offspring compared to control females. H. formosa, however, did not show any such difference. In G. holbrooki we also found a significantly high percentage (14%) of stillbirths in predator-exposed treatments compared to controls (2%). To the best of our knowledge, this is the first direct empirical evidence of predation stress affecting stillbirths in prey. Our results suggest that matrotrophy, superfetation (clutch overlap), or both decrease the sensitivity of mothers to environmental fluctuation in resource (food) and stress (predation risk) levels compared to lecithotrophy. These mechanisms should be considered both when modeling consequences of perceived risk of predation on prey-predator population dynamics and when seeking to understand the evolution of reproductive modes.

Managing small-scale commercial fisheries for adaptive capacity: Insights from dynamic social-ecological drivers of change in Monterey Bay

Globally, small-scale fisheries (SSFs) are driven by climate, governance, and market factors of social-ecological change, presenting both challenges and opportunities. The ability of small-scale fishermen and buyers to adapt to changing conditions allows participants to survive economic or environmental disturbances and to benefit from optimal conditions. This study presented here identifies key large-scale factors that drive SSFs in California to shift focus among targets and that dictate long-term trends in landings. We use Elinor Ostrom’s Social-Ecological System (SES) framework to apply an interdisciplinary approach when identifying potential factors and when understanding the complex dynamics of these fisheries. We analyzed the interactions among Monterey Bay SSFs over the past four decades since the passage of the Magnuson Stevens Fisheries Conservation and Management Act of 1976. In this region, the Pacific sardine (Sardinops sagax), northern anchovy (Engraulis mordax), and market squid (Loligo opalescens) fisheries comprise a tightly linked system where shifting focus among fisheries is a key element to adaptive capacity and reduced social and ecological vulnerability. Using a cluster analysis of landings, we identified four modes from 1974 to 2012 that were dominated by squid, sardine, anchovy, or lacked any dominance, enabling us to identify external drivers attributed to a change in fishery dominance during seven distinct transition points. Overall, we show that market and climate factors drive the transitions among dominance modes. Governance phases most dictated long-term trends in landings and are best viewed as a response to changes in perceived biomass and thus a proxy for biomass. Our findings suggest that globally, small-scale fishery managers should consider enabling shifts in effort among fisheries and retaining existing flexibility, as adaptive capacity is a critical determinant for social and ecological resilience.

A Comparison of the Effects of Classroom and Multi-User Virtual Environments on the Perceived Speaking Anxiety of Adult Post-Secondary English Language Learners

The population of English Language Learners (ELLs) globally has been increasing substantially every year. In the United States alone, adult ELLs are the fastest growing portion of learners in adult education programs (Yang, 2005). There is a significant need to improve the teaching of English to ELLs in the United States and other English-speaking dominant countries. However, for many ELLs, speaking, especially to Native English Speakers (NESs), causes considerable language anxiety, which in turn plays a vital role in hindering their language development and academic progress (Pichette, 2009; Woodrow, 2006). Task-based Language Teaching (TBLT), such as simulation activities, has long been viewed as an effective approach for second-language development. The current advances in technology and rapid emergence of Multi-User Virtual Environments (MUVEs) have provided an opportunity for educators to consider conducting simulations online for ELLs to practice speaking English to NESs. Yet to date, empirical research on the effects of MUVEs on ELLs’ language development and speaking is limited (Garcia-Ruiz, Edwards, & Aquino-Santos, 2007). This study used a true experimental treatment control group repeated measures design to compare the perceived speaking anxiety levels (as measured by an anxiety scale administered per simulation activity) of 11 ELLs (5 in the control group, 6 in the experimental group) when speaking to Native English Speakers (NESs) during 10 simulation activities. Simulations in the control group were done face-to-face, while those in the experimental group were done in the MUVE of Second Life. The results of the repeated measures ANOVA revealed after the Huynh-Feldt epsilon correction, demonstrated for both groups a significant decrease in anxiety levels over time from the first simulation to the tenth and final simulation. When comparing the two groups, the results revealed a statistically significant difference, with the experimental group demonstrating a greater anxiety reduction. These results suggests that language instructors should consider including face-to-face and MUVE simulations with ELLs paired with NESs as part of their language instruction. Future investigations should investigate the use of other multi-user virtual environments and/or measure other dimensions of the ELL/NES interactions.