Adventures in black and white /

An account of the author's travels in sixty countries.

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.

Beyond Black and White: The grisaille exterior of the Netherlandish triptych

This thesis is a study of fifteenth- to mid sixteenth-century Netherlandish triptych exteriors, focusing on the so-called ‘grisaille’ technique. During this period, altarpieces produced in the Low Countries were typically constructed in a tripartite format with folding wings. This arrangement created the opportunity for pictorial representations on both sides of the hinged panels. Painters emphasized the distinction between the triptych’s two faces by executing the exteriors in a strikingly more subdued palette than the interiors. Particular iconographic subject matter was favoured for grisailles, which often depict the Annunciation or saints that reflect the triptych’s patronage or intended location. Jan van Eyck was notable for his emphasis on imitating stone statuary and created three important grisailles, one of which would influence triptych exteriors for years to come. Hieronymus Bosch, an artist working at the turn of the sixteenth century, also brought innovation to his grisailles, further expanding the potential of these reduced-palette paintings. This thesis examines the creative process involved in the production of grisailles and compares the underdrawings of triptych exteriors to those of the corresponding polychromatic interiors. In this study, grisailles are situated in their context as part of multifaceted artworks as well as within the broader church environment. New infrared reflectograms were generated using Queen’s OSIRIS infrared camera to document works in Belgium and the Netherlands. While some aspects of underdrawings could indicate that the figure was meant to imitate statuary, this distinction was not directly linked to triptych exteriors and was related instead to efforts at a trompe-l’oeil effect. Such attempts at mimicry can also be found on triptych interiors. Through a close examination of the underdrawing stage of these paintings it appears that this part of the creative process was not distinguished in any significant way from the underdrawings of triptych interiors.

Ledroit Park, A Portrait In Black And White: A Study Of Historic Districts, Social Change, And The Process Of Neighborhood Placemaking

This research examines the process of placemaking in LeDroit Park, a residential Washington, DC, neighborhood with a historic district at its core. Unpacking the entwined physical and social evolution of the small community within the context of the Nation’s Capital, this analysis provides insight into the role of urban design and development as well as historic designation on shaping collective identity. Initially planned and designed in 1873 as a gated suburb just beyond the formal L’Enfant-designed city boundary, LeDroit Park was intended as a retreat for middle and upper-class European Americans from the growing density and social diversity of the city. With a mixture of large romantic revival mansions and smaller frame cottages set on grassy plots evocative of an idealized rural village, the physical design was intentionally inwardly-focused. This feeling of refuge was underscored with a physical fence that surrounded the development, intended to prevent African Americans from nearby Howard University and the surrounding neighborhood, from using the community’s private streets to access the City of Washington. Within two decades of its founding, LeDroit Park was incorporated into the District of Columbia, the surrounding fence was demolished, and the neighborhood was racially integrated. Due to increasingly stringent segregation laws and customs in the city, this period of integration lasted less than twenty years, and LeDroit Park developed into an elite African American enclave, using the urban design as a bulwark against the indignities of a segregated city. Throughout the 20th century housing infill and construction increased density, yet the neighborhood never lost the feeling of security derived from the neighborhood plan. Highlighting the architecture and street design, neighbors successfully received historic district designation in 1974 in order to halt campus expansion. After a stalemate that lasted two decades, the neighborhood began another period of transformation, both racial and socio-economic, catalyzed by a multi-pronged investment program led by Howard University. Through interviews with long-term and new community members, this investigation asserts that the 140-year development history, including recent physical interventions, is integral to placemaking, shaping the material character as well as the social identity of residents.

ABLE-BODIED WOMANHOOD: DISABILITY AND CORPOREALLY EXCLUSIONARY NARRATIVES IN BLACK AND WHITE WOMEN’S RIGHTS DISCOURSES, 1832-1932

This project is a feminist disability rhetorical analysis of US black and white women’s rights movements from 1832-1932. Guided by Disability and Feminist Theory, it works to identify the presence and use of patterns of disability tropes in women’s rights discourses. From Lucretia Coffin Mott to Sojourner Truth, Elizabeth Cady Stanton to Mary Church Terrell, and Charlotte Perkins Gilman to Addie Hunton, this project interrogates the rhetorical work of dominant narratives and lesser known voices in women’s rights discourses. I argue that early black and white women’s rights advocates often utilized and repeated a disability rhetoric that relied on disability metaphor, narrative prosthesis, and corporeally exclusionary narratives in order to construct definitions of womanhood. Their insistence on cognitive ability as a marker of “fitness” and “ability” provided the foundation for rights arguments based on ableist assumptions of autonomy and citizenship. I also argue that this use of disability rhetoric relied on and furthered a pervasive ableist ideology present not only in many of these movements, but in US society. In the process, US black and white women’s rights discourses have continually elided women with disabilities from women’s rights discourses because their bodies (physically, cognitively, and/or psychologically) did not meet the ableist prerequisites set for claiming women’s rights during this time period.

Synthesis and evaluation of N1-substituted-3-propyl-1,4-benzodiazepine-2-ones as cholecystokinin (CCK2) receptor ligands

A novel synthetic approach towards N1-alkylated 3-propyl-1,4-benzodiazepines was developed in five synthetic steps from 2-amino-4-chlorobenzophenone, in which the N-oxide 4 served as a key intermediate. The structure-activity relationship optimization of this 3-prophyl-1,4-benzodiazepine template was carried out on the N1-position by selective alkylation reactions and resulted in a ligand with an improved affinity on the cholecystokinin (CCK2) receptor. The N-allyl-3-propyl-benzodiazepine 6d displayed an affinity towards the CCK2 (CCK-B) receptor of 170 nM in a radiolabelled receptor-binding assay. The anxiolytic activity of this allyl-3-propyl-1,4-benzodiazepine 6d was subsequently determined in in-vivo psychotropic assays. This novel ligand had ED50 values of 4.7 and 5.2 mg kg-1 in the black and white box test and the x-maze, respectively, and no significant sedation/muscle relaxation was observed.

Effects of the essential oil from Citrus aurantium L. in experimental anxiety models in mice

Citrus aurantium L. is popularly used to treat anxiety, among other indications suggesting central nervous system action. Previous studies showed anxiolytic effect in the essential oil from peel in mice evaluated on the elevated plus maze [Carvalho-Freitas, M.I.R., Costa, M., 2002. Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium L. Biological and Pharmaceutical Bulletin 25, 1629-1633.]. In order to better characterize the activity of the essential oil, it was evaluated in two other experimental models: the light-dark box and the marble-burying test, respectively related to generalized anxiety disorder and to obsessive compulsive disorder. Mice were treated acutely by oral route 30 min (single dose) or once a day for 15 days (repeated doses) before experimental procedures. In light-dark box test, single treatment with essential oil augmented the time spent by mice in the light chamber and the number of transitions between the two compartments. There were no observed alterations in the parameters evaluated in light-dark box after repeated treatment. Otherwise, single and repeated treatments with essential oil were able to suppress marble-burying behavior. At effective doses in the behavioral tests, mice showed no impairment on rotarod procedure after both single and repeated treatments with essential oil, denoting absence of motor deficit. Results observed in marble-burying test, related to obsessive compulsive disorder, appear more consistent than those observed in light-dark box. (c) 2005 Elsevier B.V. All rights reserved.