Feasibility of using technology to disseminate evidence to rural nurses and improve patient outcomes

Background: Rural African American women receive less frequent mammography screening and die of breast cancer at a higher rate than is seen in the general population. To overcome this disparity, it is necessary to assist rural providers in their efforts to influence women to obtain screening. Method: This study examined the feasibility of using distance education to disseminate knowledge about timely and appropriate mammography screening to rural nurses, using patient outcome data to evaluate the effectiveness of this intervention. Results: Overall, there was a decline in referrals and mammography screening, but the intervention group centers showed a smaller decline after the educational intervention than did the control group. Conclusion: The findings show the effect of dissemination of information and the feasibility of using patient outcome data for educational evaluation. Neighboring academic health centers and nursing schools should include in their mission the provision of educational programs for relatively isolated rural nurses.

Socio-economic vulnerability of African Americans in the Gulf coast counties

The states bordering the Gulf of Mexico i.e. Texas, Louisiana, Mississippi, Alabama, and Florida have been historically devastated by hurricanes and tropical storms. A large number of African Americans live in these southern Gulf States which have high percentages of minorities in terms of total population. According to the U.S. Census, the total black population in the United States is about 40.7 million and about one-fourth of them live in these five Gulf States (U.S. Census, 2008). As evidenced from Hurricane Katrina and other major hurricanes, lowincome and under-served communities are usually the hardest hit during these disasters. The aim of this study is to identify and visualize socio-economic vulnerability of the African American population at the county level living in the hurricane risk areas of these five Gulf States. (PDF contains 5 pages)

The Sunday-school : its origin, mission, methods, and auxiliaries / by H. Clay Trumbull.

http://www.archive.org/details/thesundayschooli00trumuoft

Variability in frontotemporal brain structure: the importance of recruitment of African Americans in neuroscience research.

BACKGROUND: Variation in brain structure is both genetically and environmentally influenced. The question about potential differences in brain anatomy across populations of differing race and ethnicity remains a controversial issue. There are few studies specifically examining racial or ethnic differences and also few studies that test for race-related differences in context of other neuropsychiatric research, possibly due to the underrepresentation of ethnic minorities in clinical research. It is within this context that we conducted a secondary data analysis examining volumetric MRI data from healthy participants and compared the volumes of the amygdala, hippocampus, lateral ventricles, caudate nucleus, orbitofrontal cortex (OFC) and total cerebral volume between Caucasian and African-American participants. We discuss the importance of this finding in context of neuroimaging methodology, but also the need for improved recruitment of African Americans in clinical research and its broader implications for a better understanding of the neural basis of neuropsychiatric disorders. METHODOLOGY/PRINCIPAL FINDINGS: This was a case control study in the setting of an academic medical center outpatient service. Participants consisted of 44 Caucasians and 33 ethnic minorities. The following volumetric data were obtained: amygdala, hippocampus, lateral ventricles, caudate nucleus, orbitofrontal cortex (OFC) and total cerebrum. Each participant completed a 1.5 T magnetic resonance imaging (MRI). Our primary finding in analyses of brain subregions was that when compared to Caucasians, African Americans exhibited larger left OFC volumes (F (1,68) = 7.50, p = 0.008). CONCLUSIONS: The biological implications of our findings are unclear as we do not know what factors may be contributing to these observed differences. However, this study raises several questions that have important implications for the future of neuropsychiatric research.

Genetic variants in IGF-I, IGF-II, IGFBP-3, and adiponectin genes and colon cancer risk in African Americans and Whites.

PURPOSE: Evaluating genetic susceptibility may clarify effects of known environmental factors and also identify individuals at high risk. We evaluated the association of four insulin-related pathway gene polymorphisms in insulin-like growth factor-1 (IGF-I) (CA)( n ) repeat, insulin-like growth factor-2 (IGF-II) (rs680), insulin-like growth factor-binding protein-3 (IGFBP-3) (rs2854744), and adiponectin (APM1 rs1501299) with colon cancer risk, as well as relationships with circulating IGF-I, IGF-II, IGFBP-3, and C-peptide in a population-based study. METHODS: Participants were African Americans (231 cases and 306 controls) and Whites (297 cases, 530 controls). Consenting subjects provided blood specimens and lifestyle/diet information. Genotyping for all genes except IGF-I was performed by the 5'-exonuclease (Taqman) assay. The IGF-I (CA)(n) repeat was assayed by PCR and fragment analysis. Circulating proteins were measured by enzyme immunoassays. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated by logistic regression. RESULTS: The IGF-I (CA)( 19 ) repeat was higher in White controls (50 %) than African American controls (31 %). Whites homozygous for the IGF-I (CA)(19) repeat had a nearly twofold increase in risk of colon cancer (OR = 1.77; 95 % CI = 1.15-2.73), but not African Americans (OR = 0.73, 95 % CI 0.50-1.51). We observed an inverse association between the IGF-II Apa1 A-variant and colon cancer risk (OR = 0.49, 95 % CI 0.28-0.88) in Whites only. Carrying the IGFBP-3 variant alleles was associated with lower IGFBP-3 protein levels, a difference most pronounced in Whites (p-trend <0.05). CONCLUSIONS: These results support an association between insulin pathway-related genes and elevated colon cancer risk in Whites but not in African Americans.

Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members.

INTRODUCTION: We aimed to inform the design of behavioral interventions by identifying patients' and their family members' perceived facilitators and barriers to hypertension self-management. MATERIALS AND METHODS: We conducted focus groups of African American patients with hypertension and their family members to elicit their views about factors influencing patients' hypertension self-management. We recruited African American patients with hypertension (n = 18) and their family members (n = 12) from an urban, community-based clinical practice in Baltimore, Maryland. We conducted four separate 90-minute focus groups among patients with controlled (one group) and uncontrolled (one group) hypertension, as well as their family members (two groups). Trained moderators used open-ended questions to assess participants' perceptions regarding patient, family, clinic, and community-level factors influencing patients' effective hypertension self-management. RESULTS: Patient participants identified several facilitators (including family members' support and positive relationships with doctors) and barriers (including competing health priorities, lack of knowledge about hypertension, and poor access to community resources) that influence their hypertension self-management. Family members also identified several facilitators (including their participation in patients' doctor's visits and discussions with patients' doctors outside of visits) and barriers (including their own limited health knowledge and patients' lack of motivation to sustain hypertension self-management behaviors) that affect their efforts to support patients' hypertension self-management. CONCLUSION: African American patients with hypertension and their family members reported numerous patient, family, clinic, and community-level facilitators and barriers to patients' hypertension self-management. Patients' and their family members' views may help guide efforts to tailor behavioral interventions designed to improve hypertension self-management behaviors and hypertension control in minority populations.

Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. METHODS AND RESULTS: We analyzed data from 5146 African Americans in the Jackson Heart Study stratified by QRS duration on baseline 12-lead ECG. We defined QRS prolongation as QRS≥100 ms. We assessed the association between QRS duration and all-cause mortality using Cox proportional hazards models and reported the cumulative incidence of heart failure hospitalization. We identified factors associated with the development of QRS prolongation in patients with normal baseline QRS. At baseline, 30% (n=1528) of participants had QRS prolongation. The cumulative incidences of mortality and heart failure hospitalization were greater with versus without baseline QRS prolongation: 12.6% (95% confidence interval [CI], 11.0-14.4) versus 7.1% (95% CI, 6.3-8.0) and 8.2% (95% CI, 6.9-9.7) versus 4.4% (95% CI, 3.7-5.1), respectively. After risk adjustment, QRS prolongation was associated with increased mortality (hazard ratio, 1.27; 95% CI, 1.03-1.56; P=0.02). There was a linear relationship between QRS duration and mortality (hazard ratio per 10 ms increase, 1.06; 95% CI, 1.01-1.12). Older age, male sex, prior myocardial infarction, lower ejection fraction, left ventricular hypertrophy, and left ventricular dilatation were associated with the development of QRS prolongation. CONCLUSIONS: QRS prolongation in African Americans was associated with increased mortality and heart failure hospitalization. Factors associated with developing QRS prolongation included age, male sex, prior myocardial infarction, and left ventricular structural abnormalities.

Site Report for Phase III Archaeological Investigations at Reynolds Tavern (18AP23), 4 Church Circle, Annapolis, Maryland. 1982-1984

This report details the archaeology completed at Reynolds Tavern in the years 1982,1983, and 1984. It was completed in 2013, nearly 30 years after the excavation took place, using archival materials such as the draft interim reports, unit summary forms, original notes and photographs which are currently stored in the University Archives at Hornbake Library, at the University of Maryland, College Park. This report has been a collaboration across time and space, drawing from preliminary reports written by Anne Yenstch and Susan Mira in 1982 and Joe Dent and Beth Ford in 1983, as well as original notes from students of the field schools held there during those years, various analyses by scholars from many universities (including the University of Maryland, University of Georgia, and the College of William and Mary), and historical research by Nancy Baker. Thomas Cuddy began the writing of this report in 2002, completing the first three chapters in addition to the artifact analysis that led to the postexcavation identification of the African bundles in the Reynolds Tavern basement. This remarkable discovery was made along with Mark Leone of the University of Maryland, founder and director of Archaeology in Annapolis, who also served as the Principle Investigator during all three years of the Reynolds Tavern excavations. Dr. Leone contributed the fifth and final chapter to this report, the Conclusions and Recommendations, during its final compilation in 2013. The final report, including the fourth chapter on the archaeology itself, was written in part and compiled by Patricia Markert of the University of Maryland in the spring of 2013. Reynolds Tavern has been part of the landscape of Annapolis for two-hundred and fifty five years (at the time of the publication of this report). It sits on Church Circle facing St. Anne’s Church, and is a beautiful example of 18th century Georgian architecture as well one of the defining features of Historic Annapolis today. It currently operates as a popular restaurant and pub, but has served variously as a hat shop, a tavern, an inn, a library and a bank over time, among other things. Its long history contributes to its significance as an archaeological site, and also as a historic marker in present day Annapolis. The archaeology conducted at Reynolds Tavern shed light on life in 18th and 19th century Annapolis, illuminating details of the occupants’ lives through the material traces they left behind. These include an 18th century cobblestone road that ran diagonally through the Tavern’s yard, telling of the movement through early Annapolis; a large and intact well, which was found ii to contain a 19 foot wooden pipe; a large, ovular privy containing many of the objects used on a day to day basis at the Tavern or the structures around it; a subterranean brick storage feature in the basement of the Tavern, which may have been used by Reynolds during his days operating a hat shop; and also in the basement, two African caches of objects, providing a glimpse into West African spiritual practices alive in historic Annapolis and the presence of African American individuals at the Tavern in the 18th and 19th centuries. The purpose of this report is to detail these archaeological investigations and their findings, so that a public record will be available and the archaeology completed at Reynolds Tavern can continue to contribute to the history of Annapolis.

Short reflections on the history of African communication

This article aims to propose a chronological subdivision in the history of African communication. African communication today is one of the most important axes for implementing development strategies, sustaining education, health, and schooling programmes, and so on. However, many of these programmes fail due to a lack of or ineffective communication between international organisations, local elite and lay people. The reasons for this situation must be found in Africa’s history of communication, which has undergone radical transformations in its different phases. Using the functionalist analysis drawn up by Jakobson, this article proposes a new chronological subdivision of Africa’s history of communication, reflecting on the current contradictions in contemporary communication in Africa.

Cabinet Card of African Canadian by Photographer W. J. Rea, of Windsor [n.d.]

An unidentified African Canadian man is featured in this cabinet card by W. J. Rea, photographer, of Windsor, Ontario. The man appears to be in official dress, possibly of a religious or legal nature. This cabinet card bears the stamp of the photographer, W. J. Rea, in black ink along the bottom of the card and on the reverse. While it is undated, it is likely from the 1870s or 1880s. This cabinet card was in the possession of Iris Sloman Bell, of St. Catharines, Ontario. The Sloman - Bell family descendants include African American slaves from the United States who settled in Canada."Cabinet card photographs were first introduced in 1866. They were initially employed for landscapes rather than portraitures. Cabinet cards replaced Carte de visite photographs as the popular mode of photography. Cabinet cards became the standard for photographic portraits in 1870. Cabinet cards experienced their peak in popularity in the 1880's. Cabinet cards were still being produced in the United States until the early 1900's and continued to be produced in Europe even longer. The best way to describe a cabinet card is that it is a thin photograph that is mounted on a card that measures 4 1/4″ by 6 1/2″. Cabinet cards frequently have artistic logos and information on the bottom or the reverse of the card which advertised the photographer or the photography studio's services." Source: http://cabinetcardgallery.wordpress.com/category/cabinet-card-history/

Cabinet Card of Young African Canadian by The Dominion Photo Studio, Toronto [n.d.]

This unidentified African Canadian man is photographed at the Dominion Photo Studio, located at 388 Queen St. West in Toronto. The photographer's name is not known. No date is provided, however, the Dominion Studio is listed as operating from 1893-1894. The reverse of the card displays the Dominion Photo Studio stamp in gold lettering (image also attached). The gentleman in this cabinet card is possibly a relative of the Sloman - Bell family, who settled in the London and St. Catharines areas of Ontario. This cabinet card was among the family memorabilia in the possession of Iris Sloman Bell, of St. Catharines. Relatives of the Sloman - Bell family include former African American slaves who came to Canada.The Dominion Portait Co. is listed as operating from 1893-1894 in Toronto. There is an additional listing for the Dominion Portrait Co. (Gourlay and Clark props.) for 1894. Source: Phillips, Glen C. The Ontario photographers list (1851-1900). Sarnia: Iron Gate Publishing Co., 1990. "Cabinet card photographs were first introduced in 1866. They were initially employed for landscapes rather than portraitures. Cabinet cards replaced Carte de visite photographs as the popular mode of photography. Cabinet cards became the standard for photographic portraits in 1870. Cabinet cards experienced their peak in popularity in the 1880's. Cabinet cards were still being produced in the United States until the early 1900's and continued to be produced in Europe even longer. The best way to describe a cabinet card is that it is a thin photograph that is mounted on a card that measures 4 1/4″ by 6 1/2″. Cabinet cards frequently have artistic logos and information on the bottom or the reverse of the card which advertised the photographer or the photography studio's services." Source: http://cabinetcardgallery.wordpress.com/category/cabinet-card-history/

Pre-school contributions to future achievements

This paper provides recent evidence about the beneÖts of attending preschool on future performance. A non-parametric matching procedure is used over two outcomes: math and verbal scores at a national mandatory test (Saber11) in Colombia. It is found that students who had the chance of attending preschool obtain higher scores in math (6.7%) and verbal (5.4%) than those who did not. A considerable fraction of these gaps comes from the upper quintiles of studentís performance, suggesting that preschool matters when is done at high quality institutions. When we include the number of years at the preschool, the gap rises up to 12% in verbal and 17% in math.

Sexual blinging of women : Alice Walker's african character tashi and issue of female genital cutting

This thesis provides a reading of the different forms of representation that can be attributed to the character Tashi, the protagonist of the novel Possessing the Secret of Joy (1992), written by the African American writer Alice Walker. Before this work Tashi had already appeared in two previous novels by Walker, first, in The Color Purple (1982) and then, as a mention, in The Temple of My Familiar (1989). With Tashi, the author introduces the issue of female circumcision, a ritual Tashi submits herself to at the beginning of her adult life. The focus of observation lies in the ways in which the author’s anger is transformed into a means of creative representation. Walker uses her novel Possessing the Secret of Joy openly as a political instrument so that the expression “female mutilation” (term used by the author) receives ample attention from the media and critics in general. The aim of this investigation is to evaluate to what extent Walker’s social engagement contributes to the development of her work and to what extent it undermines it. For the analysis of the different issues related to “female genital cutting”, the term I use in this thesis, the works of feminist critics and writers such as Ellen Gruenbaum, Lightfoot-Klein, Nancy Hartsock, Linda Nicholson, Efrat Tseëlon and the Egyptian writer and doctor Nawal El Saadawi will be consulted. I hope that this thesis can contribute as an observation about Alice Walker’s use of her social engagement in the creation of her fictional world.

Ensino de história e cultura afro-brasileira: uma análise do caderno do professor de história do ensino médio público paulista

Pós-graduação em Educação - FFC

Characteristics of a spina bifida population including North American Caucasian and Hispanic individuals.

BACKGROUND: Meningomyelocele (MM) is a common human birth defect. MM is a disorder of neural development caused by contributions from genes and environmental factors that result in the NTD and lead to a spectrum of physical and neurocognitive phenotypes. METHODS: A multidisciplinary approach has been taken to develop a comprehensive understanding of MM through collaborative efforts from investigators specializing in genetics, development, brain imaging, and neurocognitive outcome. Patients have been recruited from five different sites: Houston and the Texas-Mexico border area; Toronto, Canada; Los Angeles, California; and Lexington, Kentucky. Genetic risk factors for MM have been assessed by genotyping and association testing using the transmission disequilibrium test. RESULTS: A total of 509 affected child/parent trios and 309 affected child/parent duos have been enrolled to date for genetic association studies. Subsets of the patients have also been enrolled for studies assessing development, brain imaging, and neurocognitive outcomes. The study recruited two major ethnic groups, with 45.9% Hispanics of Mexican descent and 36.2% North American Caucasians of European descent. The remaining patients are African-American, South and Central American, Native American, and Asian. Studies of this group of patients have already discovered distinct corpus callosum morphology and neurocognitive deficits that associate with MM. We have identified maternal MTHFR 667T allele as a risk factor for MM. In addition, we also found that several genes for glucose transport and metabolism are potential risk factors for MM. CONCLUSIONS: The enrolled patient population provides a valuable resource for elucidating the disease characteristics and mechanisms for MM development.