Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Medical Advice and Diabetes Self-Management Reported by Mexican-American, Black- and White-Non-Hispanic Adults Across the United States

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 MexicanAmericans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with ‘undiagnosed diabetes’ [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants’ diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately onethird of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Politics and prayer in West Perrine, Florida: Civic social capital and the black church

This thesis traces the mechanisms and sources responsible for the generation of civic social capital (a set of shared norms and values that promote cooperation between groups, enabling them to participate in the political process) by black churches in West Perrine, Florida. Data for this thesis includes over fifty interviews and participant observations, archival records, newspaper articles, and scholarly journals. ^ Despite the institutional racism of the first half of the twentieth century, many blacks and whites in Perrine developed levels of trust significant enough to form an integrated local governing body, evidence of high levels of csc. At mid-century, when black and white interactions ceased, Perrine's csc decreased, leading to the deterioration of Perrine's social and physical conditions. Perrine's csc increased in the 1980s by way of broad-based coalitions as Perrine's churches invested their csc in an effort to eradicate crime, clean up its neighborhood, and win back its youth. ^

Authority and stratification in the Bahamas: The quest for legitimacy

This longitudinal study provides a detailed description of the transition in the Bahamas from British colony to independent country. It analyzes the ongoing process of legitimation and delegitimation of Bahamian political parties and of the transfer of authority from the white minority to the black majority. It is a story of social and political struggles that take place within the quarter century following World War II. These struggles are analyzed within a theoretical framework which focuses on the meaning of symbols used to support claims to authority, and/or which function to delegitimize alternative claims. Specifically, this study looks at the delegitimization of the institutions of colonialism and the concurrent profession of symbols to support both independence and a fully enfranchised democracy in the Bahamas. ^ The research methodology includes an extensive analysis of official British colonial documents, private governmental dispatches, and contemporaneous newspaper articles. The sources were primarily the Public Records Office of Great Britain; the Archives of the Bahamas; and the Institute for Social and Economic Research, University of the West Indies. Secondary literature on civil rights, political science, religion, Black Nationalism, corruption, social theory, and popular culture was studied. Two hundred days of participant observation, spread over seven years of study, resulted in notes from which information was gleaned. During that time, seventeen open-ended interviews with a cross section of Bahamians (male and female, black and white) who lived through this period were recorded, information from which was also incorporated. ^ A detailed description of the socio-historical process, and an analysis of data, demonstrates how the black majority's desire for political representation, and future independence, pressured Great Britain to come into line with the desires of the majority of Bahamians. The symbolic universe that had historically divided white from black now urged dramatic social and political change. ^ The documents and testimonials studied demonstrate how symbols and symbolic events supported and/or undercut the claims to legitimacy proffered by different groups in the Bahamas in their respective attempts to solidify their social and political position within the society. ^

Expression of the Myod and T-Box Families of Transcription Factors in the Developing Purkinje Fiber

The coordinated beating of the heart depends on a group ofhighly specialized cells that constitute the cardiac conduction system. Among these cells, the Purkinje fibers are responsible for propagation of the electric impulse into the ventricles. In early stages of development, Purkinje fibers and skeletal muscle fibers originate from similar but separate populations of myocytes. The role of the MyoD family of transcription factors in the development of the myotube is well known, but the role of these factors in the development of the Purkinje fiber is not. Members of the T-Box family of transcription.The coordinated beating of the heart depends on a group ofhighly specialized cells that constitute the cardiac conduction system. Among these cells, the Purkinje fibers are responsible for propagation of the electric impulse into the ventricles. In early stages of development, Purkinje fibers and skeletal muscle fibers originate from similar but separate populations of myocytes. The role of the MyoD family of transcription factors in the development of the myotube is well known, but the role of these factors in the development of the Purkinje fiber is not. Members of the T-Box family of transcription factors are also involved in the development of various cardiac tissues, including the conduction system but little is known about their role in the development of the Purkinje fiber. We explored the expression of members of the MyoD and T-Box families in the developing cardiac conduction system in vivo and in vitro. We showed that the expression of these factors changes as the myocyte differentiates into the Purkinje fiber. We also showed that NRG-1, a secreted protein involved in the development of the Purkinje fiber, features a dose-dependent response in the differentiation of cultured ventricular myocytes.