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. ^

Comparative analysis of a moderating and mediating model of stress, appraisal, and coping in Hispanic and non-Hispanic Alzheimer's disease caregivers

This dissertation utilizes a cross-sectional study to examine the phenomenon of caregiving within a theoretically grounded stress, appraisal, and coping model. Hispanic and non-Hispanic caregivers were studied to examine the factors associated with variance in caregiver appraisal, coping, and outcomes of caregiving strain (depression and somatic complaints) and caregiving gain (life satisfaction, mastery, and personal gain). A purposive sampling strategy was used to recruit 204 Alzheimer's disease caregivers in South Florida. A self-report questionnaire was used to collect demographic data, and to measure stress, appraisal, coping, and psychological well-being of caregivers. Regression equations were developed to compare moderating and mediating models of appraisal and coping. Emotion-focused coping skills were found to significantly moderate the effects of stress (F [1,195] = 4.62, p < .05), explaining approximately 21% of the variance in satisfaction was found to moderate the effects of stress (F [1,195] = 7.09; p < .05), explaining approximately 27% of the variance in personal gain and approximately 8% of the variance in life satisfaction (F [1,195] = 4.14; p < .05). Appraisal of Burden was found to significantly mediate the effects of stress, explaining approximately 30% of the variance in somatic complaints (F [1,196] = 31.60; p < .001) and 32% of the variance in depression (F [1,196] = 38.18; p < .001). The results of the analyses indicate that appraisal and coping skills are important variables in the stress process. The results of this study underscore the importance of accounting for positive and negative outcomes in providing a fuller understanding of the stress, appraisal and coping process of Alzheimer's Disease caregivers. ^

A study of learners' perceived value and satisfaction for implied effectiveness of online learning systems

Online learning systems (OLS) have become center stage for corporations and educational institutions as a competitive tool in the knowledge economy. The satisfaction construct has received extensive coverage in information systems literature as an indicator of effectiveness but has been criticized for lack of validity; yet, the value construct has been largely ignored, although it has a long history in psychology, sociology, and behavioral science. The purpose of this dissertation is to investigate the value and satisfaction constructs in the context of OLS, and their perceived by learners relationship for implied effectiveness of OLS. ^ First, a qualitative phase is employed to gather OLS values from learners' focus groups, followed by a pilot phase to refine a proposed instrument, and a main phase to validate the survey. Responses were received from 75 students in four focus groups, 141 in the pilot, and 207 the main survey. Extensive data cleaning and exploratory factor analysis were done to identify factors of learners' perceived value and satisfaction of OLS. Then, Value-Satisfaction grids and the Learners' Value Index of Satisfaction (LeVIS) were developed as benchmarking tools of OLS. Moreover, Multicriteria Decision Analysis (MCDA) techniques were employed to impute value from satisfaction scores in order to reduce survey response time. ^ The results provided four satisfaction and four value factors with high reliability (Cronbach's α). Moreover, value and satisfaction were found to have low linear and nonlinear correlations, indicating that they are two distinct uncorrelated constructs. This is consistent with the literature. Value-Satisfaction grids and the LeVIS index indicated relatively high effectiveness for technology and support characteristics, relatively low effectiveness for professor's characteristics, while course and learner characteristics indicated average effectiveness. ^ The main contributions of this study include identifying, defining, and articulating the relationship between value and satisfaction constructs as assessment of users' implied IS effectiveness, as well as assessing the accuracy of MCDA procedures to predict value scores, thus reducing by half the survey questionnaire size. ^

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.

Relations between acculturation and alcohol use among international students

In the current study, 226 international students attending Florida International University responded to an Web-based questionnaire that assessed self-reported scores for: acculturation, acculturative stress, alcohol use patterns, perceived peer alcohol use, and perceived injunctive social norms for alcohol use. The purpose of the study was to evaluate structural relations among this set of variables using Structural Equation Modeling (SEM) via AMOS 17.0. The results of SEM analyses documented acceptable fit of a model which hypothesized that relations between acculturation and alcohol use variables are mediated partially by acculturative stress, perceived peer alcohol use, and perceived injunctive social norms. While significant path coefficients were documented for paths between (a) acculturation and acculturative stress and (b) acculturative stress and alcohol use, the coefficients had negative signs, contrary to existing studies investigating these relations among immigrant youth. While paths between (a) perceived peer alcohol use or (b) perceived injunctive social norms and participants’ alcohol use were significant, path coefficients between acculturation and either (a) perceived peer alcohol use or (b) perceived injunctive social norms were not statistically significant. In addition, multiple-group comparisons suggested that social support had a significant moderating influence on several significant paths in the structural model. Specifically, international students reporting higher social support reported lower scores for acculturative stress and alcohol use, in contrast to their counterparts who reported lower scores for social support.

A study of the differences among African -American, Hispanic, and Anglo women on the perceived barriers and strategies to career advancement in public school administration

Women have been traditionally excluded from the ranks of principals and district administrators in public school systems throughout the country. Traditionally, Anglo women have been more successful than African American and Hispanic women in breaking down the barriers that impede their ascension to the top. The purpose of this study was to ascertain how African American, Hispanic, and Anglo higher-level female administrators perceive the barriers that hinder their progress, the effects of the barriers, and the strategies to overcome the barriers. ^ Two hundred, sixty female administrators employed with Miami-Dade County Public Schools and serving in the role of principal or higher were mailed a questionnaire consisting of 49 questions centering on personal and professional characteristics, perceptions of barriers, perceived effects of barriers, and strategies to overcome the barriers. One hundred, seventy-five questionnaires were returned. To analyze the respondents' personal and professional characteristics, cross tabulations were conducted on the demographic information and on the strategies. ANOVA was conducted on the barriers and the effects of the barriers by ethnic groups. Tukey's test for post-hoc comparisons was utilized to identify groups with means significantly divergent from those of other ethnicities. ^ The data revealed that Hispanic female higher-level administrators who returned the questionnaire were more likely to be married and have children as compared to Anglo and African American female administrators. When addressing the barriers to career success, African American females had a higher mean score on 14 of the 17 barriers to career success as compared to the other ethnic groups. Hispanic female administrators proved to be more successful in utilizing the strategies to overcome career barriers. The strategy, forming a “New Girl Network,” was the least utilized with 79 of the respondents reporting that they had never used it. ^ It is concluded that there is strong need for female administrators to network, mentor, and support one another. Also, it is imperative that the success of particular groups in certain areas is shared with others. ^

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.

Social determinants of fruit and vegetable intake and validation of Pro-Children Eating Habits Questionnaire for 3rd and 5th grade children

BACKGROUND: The Pro Children Eating Habits Questionnaire has been evaluated as a valid and reliable tool in Europe to measure determinants of fruit and vegetable intake for children; however, it has not been validation for United States populations. The purpose of this study was to (1) assess the reliability and discrimination validity of fruit and vegetable correlates for the Pro Children Eating Habits Questionnaire; (2) investigate the predictive validity of determinants of fruit and vegetable consumption for multi-ethnic elementary school children; and, (3) to assess the association of social determinants with fruit and vegetable consumption. METHODS: One hundred and thirty elementary school students from the 3rd and 5th grades completed this cross-sectional study. RESULTS: Fruit and vegetable determinants, had satisfactory internal consistencies. No differences were found between the test and the retest for the individual questions with the exception of the question for mean perceived vegetable intake. The discriminatory validity indicated the questionnaire could show differences across grade and gender levels for barriers of fruit and vegetables but not for other factors. Grade together with gender explained barriers to eating fruit and vegetables. Greater availability of fruit in the home and school was associated with higher frequency of consumption. CONCLUSIONS: The results of this study indicate the Pro-Children Eating Habits Questionnaire may be a reliable and valid tool for assessing fruit and vegetable consumption of children in the United States.

Relations Between Acculturation And Alcohol Use Among International Students

In the current study, 226 international students attending Florida International University responded to an Web-based questionnaire that assessed self-reported scores for: acculturation, acculturative stress, alcohol use patterns, perceived peer alcohol use, and perceived injunctive social norms for alcohol use. The purpose of the study was to evaluate structural relations among this set of variables using Structural Equation Modeling (SEM) via AMOS 17.0. The results of SEM analyses documented acceptable fit of a model which hypothesized that relations between acculturation and alcohol use variables are mediated partially by acculturative stress, perceived peer alcohol use, and perceived injunctive social norms. While significant path coefficients were documented for paths between (a) acculturation and acculturative stress and (b) acculturative stress and alcohol use, the coefficients had negative signs, contrary to existing studies investigating these relations among immigrant youth. While paths between (a) perceived peer alcohol use or (b) perceived injunctive social norms and participants’ alcohol use were significant, path coefficients between acculturation and either (a) perceived peer alcohol use or (b) perceived injunctive social norms were not statistically significant. In addition, multiple-group comparisons suggested that social support had a significant moderating influence on several significant paths in the structural model. Specifically, international students reporting higher social support reported lower scores for acculturative stress and alcohol use, in contrast to their counterparts who reported lower scores for social support.

Perceived and actual sex differences in attributional style for affiliative behavior

The objectives of this thesis were threefold: (1) to review the concept of attributional style, (2) to demonstrate its applicability to affiliative behavior, and (3) to document the existence of actual and perceived sex differences in attributional style for affiliative behavior. To fulfill the first two objectives the development of attributional theory was traced from the Abramson, Seligman, and Teasdale (1978) presentation of the reformulated learned helplessness model through Weiner's (1979) examination of attributional style as a motivational feature of achievement behavior to the application of attribution theory to affiliative behavior. To fulfill the third objective the evidence detailing the sex differences in achievement and affiliative attributional styles was reviewed within the framework of perceptions of sex appropriate behavior. A study was then designed to assess both actual and perceived affiliative attributional sex differences. The Escovar, Brown, and Rodriguez Attributional Style Questionnaire for Affiliative Behavior was administered to 107 male and female University of Miami and Florida International University students. Each subject answered the questionnaire twice, once for themselves and once as if they were a member of the opposite sex. The results indicated that the EBR-ASQ maintained previous levels of internal consistency and reliability. Analyses performed on the covariate of the order of perspective presentation were negative; all further analyses were performed without a covariate. The data were analyzed using a 2(Sex) X 2(Perspective) X 2(Outcome) factorial, multivariate, repeated measures design with the three attributional dimensions serving as the dependent variable repeated measures. As expected all multivariate tests revealed that each of the three factors was a significant influence over all three of the dependent variables. Of the 21 univariate tests 12 of the main effect and two-way interactions were significant and one approached significance. Examination of the means revealed that of the eight significant main effects six were in the expected direction; of the four significant two-way interactions three were in the expected direction. Although the results were not totally supportive of the hypotheses they did support the thesis that affiliation is the female sex-role appropriate analogue to male achievement behavior.