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1
Green, Vernard Darrell. "Completion Characteristics of Non-Hispanic Blacks with Tuberculosis and HIV". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/6568.
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Tuberculosis (TB) and human immunodeficiency virus (HIV) are difficult conditions to manage, in tandem they pose even more challenges to public health programs in identifying coinfection to ensure that all TB cases are treated to completion of therapy (COT). The purpose of this study was to test variables that predicted COT among the HIV/TB coinfected population of non-Hispanic, U.S.-born Blacks alive at the time of diagnosis. Social determinants of health were the theoretical foundation used to guide the study based on data from the Report of Verified Cases of TB (RVCT) between 2009 and 2014. Relationships were tested between ethnic/racial group membership and the likelihood of COT, and whether any association to COT was moderated by COT eligibility; a Centers for Disease Control and Prevention calculated algorithm considering disease severity, site, age, and disease complexity. The research design was a longitudinal quantitative approach using binary logistic regression to identify correlated variables associated with COT in the final model. The results showed no statistically significant differences among racial/ethnic groups, age, and gender for COT. COT was moderated by COT eligibility; odds ratio (5.4 - 11.6) times more likely to complete therapy. This study supports positive social change for programs by providing data driven outcomes to providers that support outreach, patient education, and disease prevention. In addition, this research describes an evaluation metric based on performance to set a foundation for collaboration among partners who manage other comorbidities in the United States.
2
Roker, Rosalyn. "Perspectives of older Blacks and Whites living with serious mental illness about outpatient mental health services". Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7708.
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In the United States, over three million adults, age 50 and older, reported a diagnosis of serious mental illness (SMI) in the past year. Most of them live in community-settings and are less likely than younger adults to utilize mental health treatment. Lack of and insufficient treatment for SMI places them at increased risk of morbidity, earlier mortality, cognitive decline, and diminished quality of life. The current study aimed to: (1) examine the factors that influence Black and White older adults, who live with SMI, to seek and engage in outpatient mental health treatment; (2) identify the perspectives of Black and White older adults, who live with SMI, on the issues of accessibility, affordability, appropriateness, and availability of outpatient mental health services; and (3) determine whether the perspectives of Blacks and Whites are different on the issues of accessibility, affordability, appropriateness, and availability of outpatient mental health services.
I developed a qualitative, interview-based study using the health belief model (HBM) as the theoretical framework. Individual semi-structured interviews were conducted with 19 participants, between the ages of 50-70 years (mean age 58.9), who had a clinical diagnosis of bipolar disorder, schizoaffective disorder, and schizophrenia. The interviews were audiotaped, transcribed verbatim, coded and analyzed using thematic analysis.
Data themes related to factors that influenced outpatient mental health treatment and services were identified and organized based on the six HBM constructs. Perceived barriers to mental health treatment engagement included lack of knowledge about available treatment and services in the community, poor mental health literacy, and stigma. Improved sense of well-being and increased socialization were perceived benefits of mental health treatment engagement. Risk of homelessness emerged from the data as the main influence for Black and White older adults, who live with SMI, to seek and engage in outpatient mental health treatment. For all participants, access to and availability of mental health services were not current issues. All except one participant had some type of medical coverage for their treatment and most of them felt that their current treatment was appropriate. There were no differences between Black and White older adults on the issues of accessibility, affordability, appropriateness, and availability of outpatient mental health services. In addition, Black participants did not feel a need for mental health services to be specifically tailored to Black older adults, and instead indicated they saw no differences in Blacks and Whites related to mental health services. These findings are contrary to existing research and may be indicative of the gravity of mental illness-related stigma, compared to racial stigma.
Better promotion of available mental health services in the community, mental health outreach, and community education about mental illness may be helpful for earlier identification of symptoms related to mental illness, earlier treatment and intervention, stigma reduction, and improved health and quality of life for community-residing older adults who live with SMI.
3
Kahn, Marc Simon. "The interface between Western mental health care and indigenous healing in South Africa: Xhosa psychiatric nurses' views on traditional healers". Thesis, Rhodes University, 1996. http://hdl.handle.net/10962/d1002508.
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Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.
4
Crowder, Steve. "Black folk medicine in southern Appalachia". [Johnson City, Tenn. : East Tennessee State University], 2001. http://etd-submit.etsu.edu/etd/theses/available/etd-0322101-181118/unrestricted/crowder0416.pdf.
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Tabane, Elizabeth Mamatle. "Opinions of African caretakers of children at Red Cross War Memorial Children's Hospital regarding the linking of traditional healers to western health settings". Master's thesis, University of Cape Town, 1995. http://hdl.handle.net/11427/21772.
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Bibliography: leave 85-90.Health care systems play an important role in maintaining good health in communities. In South Africa, Africans are continually faced with the dilemma of choosing western or traditional values. The literature has shown that African people use both western and traditional systems simultaneously. The South African government is also considering to include traditional healers in the national health policy .This study examines the opinions of African parents or caretakers of children at Red Cross War Memorial Children' s Hospital regarding their use of western and traditional health systems and their opinion regarding their linkage. The research method for this exploratory study was a focus group and structured interview. The results indicated that in the communities from which the respondents were drawn there are many Africans who consult traditional healers. The results further indicated that many Africans consult both western doctors and traditional healers for the same medical problem. The results also indicated that the respondents considered it necessary to link traditional healers to western health settings. Recommendations for future research are included.
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Campano, Erik. "Artificially Intelligent Black Boxes in Emergency Medicine : An Ethical Analysis". Thesis, Umeå universitet, Institutionen för psykologi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-160696.
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Det blir allt vanligare att föreslå att icke-transparant artificiell intelligens, s.k. black boxes, används inom akutmedicinen. I denna uppsats används etisk analys för att härleda sju riktlinjer för utveckling och användning av black boxes i akutmedicin. Analysen är grundad på sju variationer av ett tankeexperiment som involverar en läkare, en black box och en patient med bröstsmärta på en akutavdelning. Grundläggande begrepp, inklusive artificiell intelligens, black boxes, metoder för transparens, akutmedicin och etisk analys behandlas detaljerat. Tre viktiga områden av etisk vikt identifieras: samtycke; kultur, agentskap och privatliv; och skyldigheter. Dessa områden ger upphov till de sju variationerna. För varje variation urskiljs en viktig etisk fråga som identifieras och analyseras. En riktlinje formuleras och dess etiska rimlighet testas utifrån konsekventialistiska och deontologiska metoder. Tillämpningen av riktlinjerna på medicin i allmänhet, och angelägenheten av fortsatt etiska analys av black boxes och artificiell intelligens inom akutmedicin klargörs.Artificially intelligent black boxes are increasingly being proposed for emergency medicine settings; this paper uses ethical analysis to develop seven practical guidelines for emergency medicine black box creation and use. The analysis is built around seven variations of a thought experiment involving a doctor, a black box, and a patient presenting chest pain in an emergency department. Foundational concepts, including artificial intelligence, black boxes, transparency methods, emergency medicine, and ethical analysis are expanded upon. Three major areas of ethical concern are identified, namely consent; culture, agency, and privacy; and fault. These areas give rise to the seven variations. For each, a key ethical question it illustrates is identified and analyzed. A practical guideline is then stated, and its ethical acceptability tested using consequentialist and deontological approaches. The applicability of the guidelines to medicine more generally, and the urgency of continued ethical analysis of black box artificial intelligence in emergency medicine, are clarified.
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Lutfi, Khaleeq J. "Examining the Association between Racial Residential Segregation, Risky Sexual Behaviors, and Sexually Transmitted Infections". FIU Digital Commons, 2017. http://digitalcommons.fiu.edu/etd/3481.
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Sexually transmitted infections (STIs) disproportionately impact non-Hispanic blacks in the United States. Racial differences in sexual networks can contribute to these disparities. Racial residential segregation, the separation of racial groups in a residential context, is a community factor known to influence sexual networks and has been associated with negative health outcomes. Our objective was to examine the association between racial residential segregation (henceforth, referred to as segregation), risky sexual behavior, concurrent partnerships, and STI diagnoses among non-Hispanic blacks. Demographic, sexual behavior, and STI diagnosis data for non-Hispanic blacks 15–44 years of age were obtained from the 2006–2010 National Survey of Family Growth. Segregation and community poverty data were obtained from the U.S. Census. Five distinct dimensions measured segregation, each with a representative index. Multilevel logistic regressions were conducted to test how each of the five indices were associated with risky sexual behavior, concurrent partnerships, and STI diagnoses. Risky sexual behavior results showed 16.1% (n=588) of participants engaged in risky sexual behavior. The association was stronger for the absolute centralization (adjusted odds ratio [aOR] 2.07; 95% confidence interval [CI] 2.05 – 2.08) and relative concentration indices (aOR 2.05; 95% CI 2.03 – 2.07). This suggests risky sexual behavior is most strongly associated with segregation in neighborhoods with a high density of non-Hispanic blacks and accumulation of non-Hispanic blacks in an urban core. STI diagnosis results showed 7.4% (n=305) of participants reported a STI diagnosis, and segregation was associated with STI diagnosis. The association was strongest measured with the dissimilarity index (aOR 2.41; 95% CI 2.38 – 2.43) and stronger for males. Concurrent partnerships results showed 15.6% (n=645) of participants reported concurrent partnerships. Multilevel analyses showed segregation to be associated with concurrent partnerships with the association strongest measured with the dissimilarity index. Segregation acted as a risk and a protective factor with risky sexual behavior, concurrent partnerships, and STI diagnosis, depending on the segregation measure. Additional work is needed to understand the mechanisms of how specific segregation dimensions influence risky sexual behaviors and sexually transmitted infections.
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Jefferson, Lowest. "Primary Factors Affecting Breastfeeding in African American Communities". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1266.
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Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful sampling took part in the study. Data were largely collected through interviews utilizing open-ended semi-structured questions, which were used as the level-1 priori codes for data analysis. Inductive codes were developed from additional information provided by subjects during interviews. Sublevels were developed as needed. Codes with 2 or more responses from subjects were utilized in the analysis. Findings were based on the data and solely on the experiences and information shared by the subjects. The findings revealed that, among this sample of women, breastfeeding figured prominently in the African American culture. Most participants indicated they would breastfeed regardless of any support. Barriers to breastfeeding included the stigma that only the poor breastfeed, perceived inconsistency in information and assistance provided by health care personnel to African Americans as compared to other groups, and mothers not being aware of available resources. These results can be used to enhance social change initiatives, laws, and policies on breastfeeding for African Americans.
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Williams, Sarah. "Authentication and investigation of potential hepatotoxicity of Black Cohosh". Thesis, De Montfort University, 2017. http://hdl.handle.net/2086/16145.
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Black Cohosh (Actaea racemosa) is one of the highest selling medicinal plants, ranking as the sixth best seller in the US in 2015 (Smith et al., 2016). However, this popularity has been tarnished by claims of hepatotoxicity. The investigation of these reports has determined that implicated products did not contain Black Cohosh plant material. Other reports were shown to be incomplete or had other factors contributing. This has led to the suspicion that cases of adverse reactions may in fact be linked to cases of substitution or adulterations with Asian species of Actaea, rather than to A. racemosa. (Jordan et al., 2010). This shows the need for authentication of Black Cohosh products. In this study various DNA based authentication methods were developed. The first, PlantID is capable of discriminating between Actaea racemosa and four potential adulterant species; Actaea cimicifuga, Actaea cordifolia, Actaea podocarpa and Caulophyllum thalictroides, in a single PCR reaction. The resulting fragments are scrutinized using gel electrophoresis. Other platforms of analysis were trialled with little success. The second was a qPCR based method. These assays are competent in detecting A. racemosa, A. cimicifuga and A. dahurica species and are compared to a generic primer capable of amplification of ten Actaea species. This enables the user to detect specific species in comparison to how much Actaea species are present as a whole. This assay was extensively tested on many materials and products available in the UK and the USA. Out of 34 products assessed it was possible to extract DNA from 32. From the UK market it was found that five products contained undeclared species. From the US market it was found that six products contained undeclared species. All of the THR registered products were found to contain only the authentic species Actaea racemosa. This was a reassuring result from the analysis and adds further value to the scheme of THR. Sequence data from GenBank was used to assist in assigning species to sequenced DNA samples. The data contained on GenBank was scrutinised using various bioinformatics tools. Sequences were organised into molecular taxonomic units using tree diagram software. This showed efficiently and iii visually which sequence entries were reliable to use based upon grouping. This analysis showed that the nuclear internal transcribed spacer (nrITS) was an ideal barcoding region and that maturase K (MatK) was a poor choice for Actaea species. To address the issue of hepatotoxicity claims, cultured human hepatocyte derived cells were treated with 60% ethanol extracts of Actaea racemosa and Asian Actaea. A qPCR array was utilised to assess 84 genes associated with hepatotoxicity across various concentrations of extract. The collective array output gave a plethora of data which was analysed using bespoke online software from the manufacturer. Stringent quality controls were included on the arrays which gave confidence of results. There were small changes noted for Actaea racemosa and some activity for the Asian Actaea treated cells was also seen. An LDH and MTT assay were used to assess cell viability and toxicity in two human hepatocyte derived cell lines. Actaea racemosa showed no significant effects whereas the Asian Actaea extract showed a notable decrease in cell viability and significant release of LDH indicating toxicity. The Asian Actaea material used to manufacture extracts was of questionable species origin but determined to be either A. dahurica or A. cimicifuga. The results from these experiments were unfortunately not as conclusive as hoped, but did show some evidence of a more likely culprit of toxicity originating from Asian Actaea species.
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Price, Suzanne Phillips. "The black student medical school experience /". Access Digital Full Text version, 1992. http://pocketknowledge.tc.columbia.edu/home.php/bybib/1106299x.
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Thesis (Ed.D)--Teachers College, Columbia University, 1992.Typescript; issued also on microfilm. Sponsor: Ellen Condliffe Lagemann. Dissertation Committee: Gary Natriello. Includes bibliographical references (p. 113-117).
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Peer, Nasheeta. "Cardiovascular disease risk factors in the urban black population in Cape Town". Doctoral thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/3449.
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Okpechi, Ikechi Gareth. "Metabolic syndrome, the leptin gene and kidney disease in non-diabetic black South Africans". Doctoral thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/3446.
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Includes abstract.Includes bibliographical references (leaves 226-256).
Obesity is a worldwide problem and is a factor in the pathogenesis of the metabolic syndrome and kidney disease through the development of obesity-related hypertension and neurohormonal mechanisms that include the action of leptin. As there appear to be no focussed studies that have looked at the association of the LEP gene with kidney disease phenotypes or cardiovascular disease markers like hypertension, the metabolic syndrome and obesity, and especially so in native black Africans, this study sought to establish an association between the obesity gene (LEP) and kidney disease phenotypes (independent of diabetes and hypertension) in a homogenous black African population.
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Moholisa, Retsilisitsoe Raymond. "Genetic and biochemical analysis of ACE inhibitor-induced angioedema in black and coloured South Africans". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/11480.
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Angiotensin converting enzyme inhibitors (ACEi) are routinely used as first line treatment for hypertensive patients because of their protective effects against heart and kidney disease. Despite their clinical benefits, ACEi used is associated with adverse side effects such as life threatening angioedema (ACEi-AE) and persistent dry cough (ACEi-cough)
14
Onder, Sylvia Wing. "Women and the dynamic interaction of traditional and clinical medicine on the Black Sea coast of Turkey /". The Ohio State University, 1998. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487951907958023.
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Tuffour, Isaac. "Black African service users experiences of recovery from mental illness in England". Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/18096/.
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Background: Recovery is a complex and contested concept. Many studies have explored the meaning of the concept from the perspectives of service users suffering from mental illness. However, too little attention has been paid to the experiences of Black African service users (BASUs) living in England. At the time of writing this work there were no studies that have explored recovery from the perspectives of BASUs in England. Aims of the study: The aim of the present study is to explore experiences of recovery from mental illness of BASUs in England. Methodology and methods: Semi-structured interviews were conducted with twelve BASUs. The interviews were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Five superordinate themes were derived from the analysis: (1) it is different in Africa; (2) it all started in England; (3) shattered; 4) ‘freaked out’; and (5) focus on recovery. An in-depth explanation of these superordinate themes and the related subordinate themes is presented. The findings highlight the multifaceted ways in which BASUs understand their experiences of mental illness and recovery. Discussion: The insight gained from these findings provided rich information about the complexities of the participants’ experiences of recovery from mental illness. Participants’ explanatory models of mental illness included the complexities of migration, African-centred worldviews and negative life experiences. Participants conceptualised recovery in the context of their social and cultural backgrounds, remission or eradication of symptoms, spirituality, resourcefulness, resilience and unique personal identities. An emerging conceptual model of recovery is formed (Figure 3). Findings are discussed considering existing theory and literature. Implications for clinical practice in relation to the provision of care and promoting recovery for BASUs in England are considered.
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Hildreth, Valencia L. Beckley. "Human Immunodeficiency Virus Disparity in Black Men who Have Sex With Men". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5629.
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The HIV/AIDS epidemic continues to be a challenge in the men who have sex with men (MSM) population. Initiatives to decrease rates of new HIV infections have proven less than optimal. Despite evidence-based interventions to curtail the prevalence and incidence rates of HIV infection, Black MSM have been most impacted with increased HIV incidence. The purpose of this quantitative correlational study was to explore the relationship, if any, between age, online and physical venues attended by participants within the last thirty days, neighborhood's perceived social environment, and HIV incidence in the non-Hispanic Black MSM population in a metropolitan statistical area (MSA) in Southern U.S. Social cognitive theory was used to frame this study. Secondary datasets from the Involve[MEN]t database were used in this study and included 810 Black and White MSM living in a MSA. Ages of the participants ranged between 18 and 39. Original data were collected through online questionnaires. Chi-square, independent samples t test, and logistic regression model were used to analyze data. Chi-square analysis showed a significant main effect (p = 0.006) for online venue Facebook and HIV incidence but no significance differences identified between age, online venues CraigsList and Black Gay Chat, physical venues (including bars and restaurants, gyms, and bath houses), and neighborhood's perceived social environment (including neighborhood attachment, self-esteem/morale, and personal safety). Positive social implications of the study findings could include tailoring existing interventions with strategies to address self-esteem and morale, explore selected online and physical venues, and develop social and behavioral structured policies in the Black MSM population.
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Parmar, Beena. "Working with black minority ethnic children and adults". Thesis, University of Warwick, 2010. http://wrap.warwick.ac.uk/36756/.
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Research has indicated that working with black minority ethnic clients, is an area that creates some uncertainty for health and social care staff. Although, policies and practices are changing and developing there continues to be some ambiguity and ambivalence around working with individuals from different ethnic groups. This thesis considers two situations on a clinical level in which working with minority ethnic clients might raise additional dilemmas and challenges. These include working therapeutically with an ethnically dissimilar adult in therapy and working with black minority ethnic children in domestic violence situations. The first paper is a review of literature on addressing race in cross-racial therapy. In particular this paper focuses on how clinicians might bring up the issue of race in therapy, the factors which influence a therapist in discussing race and outcome studies in which race has been addressed in cross-racial therapy. The second paper is an empirical study exploring health and social care professionals’ perceptions and experiences of working with black minority ethnic children who are in domestic violence situations. This paper examines professionals’ perceptions of these children's family and of the wider professional system and considers how these two factors result in ongoing challenges for professionals working in this field. The paper also examines how these perceptions and dilemmas influence practice. The final paper is a reflective account of the hidden stories that were uncovered within me as researcher, participants and children throughout my research journey. In summary, the three papers demonstrate the important of remaining open in working with black minority ethnic clients, taking the time to understand the multiple influences within their lives and considering them as individuals rather than labelling. The papers also indicated the importance of having the confidence to ask questions about racial difference and in domestic violence situations where stories may remain hidden.
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Teanpaisan, Rawee. "Phenotypic and genotypic characterisation of oral black-pigmented anaerobes isolated from periodontitis patients and healthy subjects". Thesis, University of Sheffield, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319444.
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Lähteelä, Heli Maria Mirjami. "Order and meaning from the chaos of plague: doctors writing about the plague in fifteenth- and sixteenth-century Italy". Thesis, The University of Sydney, 2010. http://hdl.handle.net/2123/7112.
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This thesis discusses in detail four Italian vernacular plague tracts written by doctors in the fifteenth and sixteenth centuries. These doctors used the popular genre of plague tracts to promote their views on how to improve the physical and spiritual well-being of the people in their communities. The plague tracts illustrate their concerns about the expertise and status of doctors, apprehensions about the behaviour of communities during plague epidemics, and the ever-present fears that the plague was both a symptom of and a catalyst for immoral behaviour. This thesis particularly focuses on the connections early modern doctors perceived between spiritual and physical health and the varied solutions they suggested for the improvement of the societies the lived in.
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Marsh, Julia Anne. "Effect of black cohosh on MCF-7 human breast cancer cell growth and response to treatment with doxorubicin and paclitaxel". [New Haven, Conn. : s.n.], 2008. http://ymtdl.med.yale.edu/theses/available/etd-12092008-134138/.
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Downing, Christopher. "Black populations in epidemiological Alzheimer's disease case-control and cohort studies : a discussion and review". Honors in the Major Thesis, University of Central Florida, 2008. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1076.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Medicine
Molecular Biology and Microbiology
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Garner, Erin E. "Not just black and white : an investigation of overuse injuries among university pianists /". Lynchburg, VA : Liberty University, 2007. http://digitalcommons.liberty.edu.
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Rice, Brian. "How is the epidemiology of heterosexually-acquired HIV infection evolving, particularly among black Africans, in England, Wales and Northern Ireland?" Thesis, City University London, 2016. http://openaccess.city.ac.uk/14936/.
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In the United Kingdom (UK), an estimated 107,800 people were living with HIV in 2013, of whom 55% were heterosexual men and women. Black African men and women accounted for the majority of heterosexuals living with HIV in the UK in 2013. In this PhD by prospective publication my research question is “How is the epidemiology of heterosexually-acquired HIV infection evolving, particularly among black Africans, in England, Wales and Northern Ireland?”. I conducted a quantitative analysis of national surveillance datasets and undertook literature searches. Most of my analysis was based on data from the three national HIV surveillance systems which constitute the HIV and AIDS Reporting System (New HIV Diagnoses database; Survey of Prevalent HIV Infections Diagnosed; CD4 Surveillance Scheme). I published the results of my analyses in six peer-reviewed papers between 2007 and 2014. My key findings were as follows: over the last decade an increasing proportion of black African heterosexuals born abroad but diagnosed with HIV in the UK acquired HIV whilst living in the UK; outward migration from the UK may explain why some black African heterosexuals were lost to follow-up from HIV care; the proportion of black African heterosexuals diagnosed late with HIV has not changed substantially; the uptake of HIV testing among black African heterosexuals has increased over time but remains low compared with that among MSM. To minimize the risk of HIV transmission and to maximise the benefits of earlier detection my key recommendation is to promote regular HIV testing among black African women and men in a range of healthcare and community settings in E,W&NI, particularly in primary care.
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Brown, Luke Jonathan. "Understanding excessive rates of compulsory hospital admission amongst Black-Caribbean patients, during first episode psychosis (FEP)". Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/66881/.
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Introduction: It has been consistently found that Black-Caribbean patients experience disproportionate rates of compulsory hospital admission during First Episode Psychosis (FEP). Existing research can only partially explain this phenomenon, which suggests that other more comprehensive explanations must exist. This thesis aims to address this limitation and develop both an empirical and theoretical understanding that explains ethnic variation in detention rates specific to FEP. Thesis Aim: To identify new variables that account for excessive rates of detention amongst Black-Caribbean patients during FEP, which can help develop a theoretical explanatory model. Method: A mixed method pathways to care study was conducted consisting of two parts. In the quantitative part, a multi-ethnic cohort of FEP patients was recruited at the point of entry into an Early Intervention Service (EIS) where socio-demographic, clinical, help seeking behaviours and symptom attributions during the pathway to care were collected. In a separate qualitative design, carers’ narrative accounts of the processes leading to detention were also explored, comparing and contrasting ethnic difference between Black-Caribbean and other groups. Results: From the quantitative arm, 122 FEP patients were recruited of which 46 were White-British (37.7%), 44 Black-Caribbean (36.06%) and 32 Asian-Pakistani (26.22%). Through the logistic regression analysis conducted, eight variables were found to attenuate the association between the Black-Caribbean sample and elevated rates of compulsory detention. In the qualitative work, 17 interviews were conducted and revealed many unique features in the process of detention for Black-Caribbean patients, such as; a lack of awareness of the early signs of psychosis, the influence of patients fragment living status and the importance of a psychotic episode manifesting itself through a crisis event. Discussion: Through an iterative process, a theory is developed that married well key explanatory finding from both arms of the study, in accounting for ethnic differences in detention rates. This theory is named the ‘crisis hypothesis’, and is discussed in detail within.
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Dickie, Kasha Elizabeth. "Relationships between physical activity, cardiorespiratory fitness and sedentary behaviour, and risk factors for cardiovascular disease and type 2 diabetes, in black South African women". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2749.
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Includes abstract.Includes bibliographical references.
Non-communicable diseases (NCDs), including cardiovascular disease (CVD) and type 2 diabetes (T2D), constitute the second highest cause of mortality in South Africa (SA) and seem to be exacerbated by the high prevalence of obesity, particularly amongst black SA women. Although the aetiology of obesity is complex, common antecedents for its development include a sedentary lifestyle and poor nutrition. The overall aim of this thesis was to examine the association between physical activity (PA) and risk factors for CVD and T2D in a sample of apparently healthy black SA women. The aims of this thesis were addressed in two separate studies with the following objectives: Study 1: i) to compare body composition and metabolic risk factors for CVD and T2D between active and inactive groups classified according to international PA recommendations for health (Part 1, crosssectional analysis) and ii) to determine whether PA level predicts changes in body composition and metabolic risk factors for CVD and T2D over a 5.5-year follow-up period (Part 2, longitudinal analysis); Study 2: to examine the independent effects of PA, cardiorespiratory fitness (CRF) and sedentary time on body composition and metabolic risk factors for CVD and T2D (cross-sectional analysis). In part 1 of study 1, a sample of 240 apparently healthy black SA women(26±7 years) underwent the following measurements in 2005/6: PA (Global PhysicalActivity Questionnaire (GPAQ)), body composition (dual-energy x-ray absorptiometry and computerised tomography), blood pressure, fasting glucose, insulin and lipid concentrations. Thereafter (part 2), a sub-sample of women (n=57) underwent follow-up testing after a 5.5-year follow period (2010/11), which included additional measurements of objective PA (accelerometry) and CRF (VO2max, ml/kg/min) measured during a submaximal step-test. Study 2 included women from the follow-up subsample and 19 additional women (n=76). Cross-sectional comparisons of objective PA, CRF and sedentary time with body composition and metabolic risk factors for CVD and T2D were examined. Study 1: Using the GPAQ, the majority (61%) of women were sufficiently active, meeting the guidelines for moderate- to vigorous-intensity physical activity (MVPA) according to international criteria. Women who were active had significantly lower body weight (p<0.001), measures of body fat (BMI, fat mass, %body fat, waist circumference, central and appendicular fat mass, p<0.001), and measures of insulin resistance (fasting serum insulin, p=0.010 and HOMA-IR, p=0.010, respectively), and higher high-density lipoprotein cholesterol (HDL-C, p=0.041) compared to the inactive group. At follow-up, bodyweight increased from 82.0±19.6 kg to 89.5±19.2 kg (p<0.001) in the active group, and from 91.0±15.6 kg to 98.3±13.2 kg (p<0.001) in the inactive group, whereas serum lipid concentrations remained unchanged (p>0.05), and diastolic blood pressure decreased significantly in those who were active (78±7 vs. 74±14 mmHg, p=0.039). Study 2: Using accelerometry as an objective measure of PA, more than half (51.3%) of the women met international MVPA criteria and the goal of ≥10 000 steps per day (55.3%). Greater light PA and steps per day, but not MVPA, were associated with lower trunk (central) fat mass (r=-0.25, p=0.03, r=-0.31, p=0.01 and r=-0.09, p=0.42, respectively). Conversely, greater sedentary time was associated with higher TG and TG/HDL-C (r=0.36, p=0.01 and r=0.34, p=0.04, respectively), and these relationships were independent of body fat. In addition, higher CRF was associated with reduced body fat% (r=-0.34, p=0.02) and central fat mass (r=-0.31, p=0.03), as well as reduced insulin resistance (HOMA-IR; r=-0.41, p=0.01). These associations were independent of body fat and PA, but not VAT. CRF was inversely associated with sedentary time (r=-0.31, p=0.03) and not with any of the PA variables (p>0.05). Both PA and CRF level were associated with reduced total and central fat mass, and reduced metabolic risk for CVD and T2D amongst a sample of apparently healthy black SA women. Promotion of increasing daily PA, including light-intensity and MVPA, whilst reducing sedentary time, and increasing CRF should be encouraged to reduce levels of obesity and risk factors for CVD and T2D.
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Charlton, Karen Elizabeth. "The development of a dietary intervention to modify cation content of foods and the evaluation of its effects on blood pressure in hypertensive black South Africans". Doctoral thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/3373.
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Includes bibliographical references.Black South Africans are at high risk of hypertension, stroke and blood pressure-related target-organ damage. In South Africa, the limited resources at primary health care level allocated to the prevention, early diagnosis and management of hypertension necessitate a non-pharmacological population-based approach to curb the escalating burden of cardiovascular disease, for which raised blood pressure is an important major contributory risk factor. The series of five studies included in the thesis provide a systematic approach to developing an appropriate nutritional population-based approach to lowering blood pressure in a high risk population. Firstly, valid, reliable, and updated information was obtained to identify habitual intake of sodium, potassium, magnesium and calcium in the target population, using the gold standard method of assessing sodium intake, namely 24-hour urinary excretion collections (Chapter 3). This information was necessary to inform the levels of sodium and other cation modification required in order to obtain a physioligically relevant change in blood pressure. As well as quantitative data on levels of sodium intake, the food sources that are the most important contributors to overall non-discretionary salt intake, and the pattern of intake of these foods, is described (Chapter 4). This data allowed identification of commonly consumed foods that could be targeted for modification on their cation content.
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Robinson, Sabrina. "The experience of depression among Black and Minority Ethnic women in the United Kingdom : an interpretative phenomenological study". Thesis, London Metropolitan University, 2016. http://repository.londonmet.ac.uk/1157/.
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Background: Identity and health status have been linked in the extant literature, but the lived experience of depression in Black and Minority Ethnic (BME) women in the UK is an under researched phenomenon. This study therefore aimed to gain an in-depth understanding of the experience of depression in a small group of UK based BME women using Interpretative Phenomenological Analysis (IPA), affording the ability to describe, explore and provide an idiographic analysis of this lived experience. Method: Semi-structured interviews were conducted with a purposive sample of five BME women with experience of depression. Participants provided detailed accounts of how they made sense of their experience. Interviews were audio-recorded and verbatim transcripts of the interviews were analysed using IPA. In keeping with the underpinnings of IPA the researcher’s personal and epistemological reflexivity is embedded throughout to demonstrate greater transparency and demonstrate how IPA was applied in practice. Results: The analysis produced two master themes; ‘Cultural Expectations and Depression: “I just need to be me”’ and ‘The Nature of Depression: Agency, Façades and Coping’. The first theme captures how identity conflicts led to isolation for the participants, heightened stress and exacerbated or brought on depression. The experience of being a minority was considered and how this can cause stress, impacting on the ability to cope with adversity and influence perceptions of mental health. The second theme explored perceptions of the nature of depression and the stress of managing physical complaints. Participants adopted a range of coping strategies such as presenting with façades and resilience which impacted on help-seeking behaviours, diagnosis and management of their depression. Discussions around experiences of taking antidepressants served to highlight the importance of the understanding of medication for lay individuals and their implications for treatment adherence. Conclusion: The central finding of this research is that the experience of depression for BME women in the UK is heavily influenced by identity, cultural factors, minority status and pressures of societal norms. This research expands on the extant literature on the relationships between stress, coping and health, illuminating the essence of the lived experience of depression. The recommendations of this research include the need for health practitioners to better understand variabilities in the experience of depression among BME women in the UK (considering ethnic identity and culture) and the need for them to seek to work with individuals in a co-productive way. There is a need for the development of high quality, personalised services which engage with harder to reach communities along with health promotion campaigns and health services to support enhancing the health literacy of BME women with depression.
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Adinkrah, Joycelyn. "First generation Ghanaian migrants in the UK : dietary intake, anthropometric indices and nutrition intervention through the black churches". Thesis, London Metropolitan University, 2013. http://repository.londonmet.ac.uk/696/.
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Background: Black Africans in developed countries have a higher prevalence of diet-related chronic diseases. However, dietary and anthropometry data is limited, particularly on sub-groups such as Ghanaians in the UK. Objectives: To determine the habitual diet and body composition of first generation Ghanaian migrants, to validate a food frequency questionnaire specific for Ghanaians, find the ideal body image of Ghanaians and the body size most attractive to Ghanaian males and to conduct a nutrition intervention programme using the Black Churches as a setting. Methodology: Cross-sectional survey. Participants were volunteers and first generation Ghanaian migrant who were congregants of Black Churches in London (n=288). Information on dietary intake was obtained from multiple repeated 24-hour recalls in a sub-sample (n=68) of the survey participants. The food frequency questionnaire was developed using the most commonly reported foods and portion sizes, field tested, shortened and then validated with multiple 24hr recalls (n=68). Information was also collected on height, weight, waist circumference, waist to hip ratio and percentage body fat which was measured using a portable bioelectric impedance analyzer (n=212). Participants from London (n=45) and Ghana (n=79) completed questionnaires to collect information on their ideal size and other body-shape related questions using the Figure Rating Scale (FRS). The nutrition intervention programme (n=76) was developed with input from participants through focus groups and the Obesity Clinic at the London Metropolitan University. Participants were assigned to either the intervention or control group and information on socio-demography, dietary intake and anthropometric measurements were taken at baseline, 6 weeks and at 3 months to evaluate the effectiveness of the intervention programme. Results: Energy and the percentage energy from fat intake of Ghanaian migrants (1987 kcal, fat 35.3%) was similar to that of the host population (1972kcal, fat 35.4%) but carbohydrate and fibre intake was different (carbohydrate 50.1%, fibre 16.4g vs 48.1%, 13.9g) for migrant Ghanaians and host population respectively. Energy under-reporting was 31% for this survey and was associated with gender and body mass index. The food frequency questionnaire performed well relative to 7 multiple 24-hour recalls with correlations increasing after adjusting for energy (protein r= 0.71, fat r=0.69, carbohydrate r=0.54, fibre r=0.69). Participants were correctly classified in the same (34%) or adjacent quartile (54%) for most nutrients with only 3% to 9% of participants mis-classified into opposite quartiles. Bland-Altman plots were within limits of agreement for all the macro-nutrients. The prevalence of overweight and obesity was higher in female migrant Ghanaians using body mass index (67%) compared to the host population (58%) but prevalence was lower when percentage body fat was used (female 40%). There was a cultural shift in acceptability of overweight and obese body sizes and shapes among Ghanaians with 60% of Ghanaian males preferring Ghanaian females with a normal body size. The nutrition intervention programme was conducted over 6 weeks and changes were observed in energy (intervention - 250kcal vs -135kcal (NS)) and fat intake (intervention -3.8g (p=0.04) vs control -2.1g (NS). Waist circumference decreased by 2.2cm (p=0.05) for the intervention group after 6 weeks. After 3 months fat intake decreased by 7.3g (p=0.000) for the intervention group and 10.4g (p=0.04) for the control group. Changes in anthropometry still persisted after 3 months for body weight (-2.3kg, p=0.001), body mass index (-1.4kg/m², p=0.001) waist circumference (-3.3cm, p=0.04) and % body fat (-2.0%, p=0.01) for the intervention group. Changes in anthropometry were also observed in the control group for weight (-0.9kg, p=0.05), waist circumference (-1.9cm, p=0.006) and waist-hip ratio (-0.1, p=0.03). Conclusion: The dietary intake of Ghanaian migrants in the UK is similar to the host population. The food frequency questionnaire developed specifically for this population is an adequate dietary assessment tool. Ghanaian males preferred females with normal body sizes. The prevalence of overweight and obesity is higher in female migrant Ghanaians compared to the host population and the Black Churches are an effective setting for the delivery of nutrition intervention programmes.
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Fortuin-De, Smidt Melony. "The effect of an exercise intervention on insulin sensitivity, insulin secretion and insulin clearance in black obese South African women". Doctoral thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32674.
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Introduction: Black African populations present with low insulin sensitivity (SI) and hyperinsulinemia, the latter due to high insulin secretion and reduced clearance. In addition, they exhibit lower levels of central and ectopic fat, compared to their white counterparts, contradicting the known correlates of SI typically reported in white populations. Moreover, in black African women hyperinsulinemia is in excess of the level needed to compensate for low SI, with a corresponding high disposition index (DI), a marker of insulin response that accounts for the level of SI. Further, obese, black African women have a high risk for type 2 diabetes (T2D), but the correlates of hyperinsulinemia have not been fully elucidated, especially the role of ectopic fat and body fat distribution. Exercise training is beneficial to improve SI and DI, however, whether these effects are mediated by changes in ectopic fat in skeletal muscle, liver and pancreatic depots is unknown. Accordingly, exercise training can be used as a model to assess the correlates of hyperinsulinemia and SI in cohorts at high risk for developing T2D, such as obese black African women. This thesis therefore aims to describe the correlates of hyperinsulinemia and SI and to evaluate the effect of exercise training on these components with emphasis on the role of body fat distribution and ectopic fat in mediating these changes. Methods: Firstly, a cross-sectional analysis of 45 obese (BMI 30-40 kg/m2 ) black South African women (age 20-35 years) without T2D was conducted. Thereafter the women were block randomized into an exercise training (n=23) or no exercise (control, n=22) group. The exercise training group participated in a 12-week combined aerobic and resistance training programme (40-60 min session, 4 days/week) supervised by a biokineticist. Pre and post-intervention testing included assessment of acute insulin response to glucose (AIRg), SI, DI (AIRg x SI), insulin secretion rate (ISR), hepatic insulin extraction (HIE) and peripheral insulin clearance (CLp) (frequently sampled intravenous glucose tolerance test); body fat mass and regional adiposity (dual-energy X-ray absorptiometry); hepatic, pancreatic and skeletal muscle fat and abdominal subcutaneous (aSAT) and visceral adipose tissue (VAT) (magnetic resonance imaging); intramyocellular (IMCL) and extramyocellular fat content (EMCL) (magnetic resonance spectroscopy). Results: The baseline results showed that a high DI was associated with low VAT (r0.565, p< 0.001), pancreatic fat, soleus IMCL and EMCL with VAT explaining most of the variance in DI (32%). SI was inversely associated with VAT (rho -0.417, p=0.007) and AIRg was inversely and HIE was positively associated with VAT-aSAT ratio (rho - 0.345, p=0.029 and rho 0.510, p=0.011, respectively). DI was positively associated with CLp (rho 0.528, p=0.006), while its components (SI and AIRg) were not. Results from the intervention showed that exercise training increased DI (median (interquartile range): 6.1 (3.6-7.1) to 6.5 (5.6-9.2) x103 arbitrary units, p=0.028), SI (2.0 (1.2-2.8) to 2.2 (1.5-3.7) (mU/l) -1 min -1 , p=0.005) and VO2peak (mean ± standard deviation: 24.9±2.42 to 27.6±3.39 ml/kg/min, p< 0.001), with no changes in control group. Exercise training decreased body weight (84.1±8.7 to 83.3±.9.7 kg, p=0.038) and gynoid fat mass (18.5±1.7 to 18.2±1.6%, p< 0.001). AIRg, ISR, HIE, CLp, aSAT, VAT and ectopic fat were unchanged after exercise training. However, the control group increased body weight and aSAT. The increase in SI and DI were not associated with changes in body composition, body fat distribution or ectopic fat. Conclusion: Novel results from our cross-sectional analysis showed that, in obese black South African women, DI was positively associated with peripheral insulin clearance, probably due to higher SI of peripheral tissue. Moreover, the most important correlate of a high DI was low VAT independent of ectopic fat accumulation in other sites. Further, we showed that low AIRg and high HIE correlated with a high VAT-aSAT ratio, while low SI was associated with high VAT. These associations require further exploration to determine direction of causality. Findings from our exercise intervention study extend on previous research by showing that moderate-to-high intensity combined aerobic and resistance exercise training increased SI and improved cardiovascular fitness, but insulin secretion, hepatic insulin clearance, ectopic and central fat depots did not change. Our results suggest that hyperinsulinemia may not occur solely as a compensatory mechanism for low SI and that ectopic and central fat might not be the primary correlates of insulin resistance in this cohort. Rather, intrinsic factors within muscle and adipose tissue may be putative mediators for observed improvements in the metabolic outcomes but will require further elucidation. Further research is required to confirm the causal role of VAT on low DI and to determine whether a long-term exercise training program and/or a low carbohydrate/glycemic index diet will reduce AIRg in those with hyperinsulinemia.
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Kilbride, Cherry Bridget. "Inside the black box : creating excellence in stroke care through a community of practice". Thesis, City, University of London, 2007. http://openaccess.city.ac.uk/17605/.
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This thesis looked inside the black box of stroke care, so called because its contents are not clearly defined. This case study of success illustrated how a new inpatient stroke unit (SU) was created in an inner London teaching hospital, transforming treatment for patients with stroke. Whilst it is known that good stroke care results in improved patient outcomes, it is not fully understood how or why. As stroke is the second major cause of death in adults worldwide, and a leading cause of adult disability in the UK, it is essential more is known about how evidence translates into practical knowledge for use in mainstream practice. This action research study, through the systematic documentation and evaluation of the processes and outcomes, has unpacked and illuminated factors that enabled development of success, and provides the first empirical account of its kind. This study adds to the knowledge of knowing how. A variety of qualitative and quantitative methods were used to generate data between January 2001 and November 2002. Findings were analysed using Immersion I Crystallization and descriptive statistics. When the black box of stroke unit care was opened, four key interrelated themes emerged from the process findings: building a multidisciplinary stroke team; developing practice based knowledge and skills in stroke; valuing the central role of the nurse in stroke care and creating an organisational climate for supporting improvement. Analyses of findings suggest the creation of excellence in stroke care was linked to the development of a Community of Practice (CoP), which combines three elements; domain, community and practice, into a conceptual framework of learning that fundamentally places the acquisition of knowledge into a social process of learning. Whilst improvement initiatives have recently been linked in the literature to CoPs, no guidance is available on how this should be done. This thesis makes an original contribution to the body of knowledge by providing the first empirical evidence of not only on how a CoP was created, but shows how it developed into a functional multidisciplinary CoP, a concept identified in the literature as difficult to accomplish. In concluding, issues related to practice, research, education and policy are raised for future considerations.
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Roberts, Max T. "Contributors to Wisconsin’s Persistent Black-White Gap in Life Expectancy". DigitalCommons@USU, 2017. https://digitalcommons.usu.edu/etd/6756.
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For decades, blacks have faced shorter life expectancy than their white counterparts. This persistent disparity has led to a gap in life expectancy between the two groups. Nationally, this gap has decreased over the last 40 years. However, this is not the case at the state-level as some states have experienced little or no improvement in the life expectancy gap. Such is the case in Wisconsin, where the life expectancy gap is the largest in the nation for males, and the gap actually has grown for females over the last two decades. This study seeks to examine this persistent gap in Wisconsin by looking at different causes of death and the ages when they contribute most to the gap. Additionally, this study will examine how the contribution of certain causes of death have changed over time, both between blacks and whites, and also within each group. Using 1999-2001 and 2009-2011 data from the National Center for Health Statistics, this study found that heart disease and malignant neoplasms (cancer) contributed most to the life expectancy gap between blacks and whites and also over time within each group. For females, diabetes and perinatal conditions were found to be top contributors to the black-white gap. Diabetes contributed most after the age of 50. For males, homicide was found to be a top contributor to the black-white gap, particularly among youth aged 15 to 29. Homicide among males frequently ranked near heart disease and malignant neoplasms as a leading contributor to the gap. These findings tell us that by reducing death rates from these causes at particular moments in the life course, the life expectancy gap between blacks and whites can be reduced. This study provides important evidence that health policy makers can use to address racial disparities in life expectancy.
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Kuehnl, Nathan. "Establishing Professional Legitimacy: Black Physicians and the Journal of the National Medical Association". Bowling Green State University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1382115117.
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Richey-Abbey, Laurel Rhea. "Bush Medicine in the Family Islands: The Medical Ethnobotany of Cat Island and Long Island, Bahamas". Miami University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=miami1335445242.
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Krishnappa, Shankar. "Do Black MSM Have More IDU and HIV Positive Partners Compared to White Men Having Sex with Men ?" VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1662.
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Objectives: This study estimates the proportion of intravenous drug use (IDU) partners and HIV positive sexual partners among black and white and examine the association between repeat HIV testing and sex with high risk partners. Methods: A cross-sectional study of MSM was conducted by using pooled data from counseling, Testing, Referral services in Virginia, USA 2002-2007. Results: We obtained a sample of 19679 MSM out of which 10924(56%) and 6739(34%) were white and black MSM respectively. The proportion of IDU partners and HIV positive partners were among white MSM (5% and 11%) and black MSM (3% and 9%) respectively. Age rather than race was significantly associated with having more IDU and HIV positive partners. MSM in 30 - 39 age groups were thrice likely to have sex with HIV partners compared to young MSM. 79% and 74% of the white MSM and black MSM had undergone previous HIV testing. Previously tested MSM were twice likely to report to have sex with HIV positive partners compared to first time testers. Discussion: These findings suggest that fewer black MSM compared with white MSM report having HIV positive sex partners. HIV test repeaters continue to engage in sex with high risk individuals. Further study is needed to compare high risk behaviors between HIV positive repeaters and HIV negative repeaters. Identifying the epidemiological dynamics driving HIV infection among black MSM that go beyond individual level risk behaviors may be warranted.
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Johnson, Verena D. "Program for Healthcare Personnel to Improve Anti-hypertensive Medication Adherence in Black Adults". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/265.
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Medication nonadherence is a healthcare problem that costs the United States billions of dollars annually. The purpose of this project was to propose an evidence-based program for healthcare personnel to increase the rate of medication adherence in hypertensive Black adults who require daily, oral medication. The transtheoretical model of change was used to explain the process of change and to identify approaches to changing non-adherent behaviors related to medications. Motivational interviewing was used to explain the process that nurse-educators would use to guide patients through the stages of change. In the initial step of this quality improvement program, a convenience sample of 9 healthcare personnel were given an overview of the proposed program and asked to provide feedback on the relevance and meaningfulness of the proposed program using a program development evaluation form. Numerical data collected from the evaluation form were gathered using a 5-point Likert-type, scale. The data results were analyzed to determine the relevance and meaningfulness of the proposed program. The analyzed data were reported in frequency and percentages. Descriptive statistics were used. According to the findings, all 9 healthcare personnel supported the use of the proposed program and believed that its content was relevant and meaningful to clinical practice. The findings also revealed that 8 out of the 9 healthcare personnel believed that patients who qualified for the proposed program would be likely to participate. Adoption of this evidence-based program would facilitate social change by improving the rate of medication adherence in hypertensive Black adults and potentially improving their overall health.
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Mulugeta, Betselot. "The influence of culture on the views of Black African/African-Caribbean men living in the UK towards cancer". Thesis, University of Central Lancashire, 2014. http://clok.uclan.ac.uk/12880/.
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In the United Kingdom (UK), men face a significantly higher risk of contracting and dying from cancer. Prostate, lung and colorectal cancer are the most common cancers diagnosed in men; with prostate cancer disproportionately affecting black men. Little is known about black African (BA) and black African-Caribbean (BAC) men’s view towards cancer; yet culture and acculturation determine the way in which people understand, explain and develop their attitudes towards cancer. Hence, cancer prevention and early detection strategies may not be sensitive to UK-based black men views, affecting their awareness of risk factors and early detection services. An evidence based understanding about black men’s views towards cancer is needed to effectively target cancer prevention strategies. This qualitative study explored the influence of culture on the views of UK based BA and BAC men towards cancer. In collaboration with black community organisations based in Leeds, Manchester, Birmingham, and London, 27 participants were recruited. Convenience and theoretical sampling methods were used. Data were collected from June 2013-February 2014 using semi-structured one-to-one interviews. Data were analysed using the grounded theory analytical method. BA and BAC men have their own distinct beliefs concerning the causes of cancer, which influence how they view cancer as a whole. Seven categories: ‘Cultural views’; ‘Religious beliefs’; ‘Avoiding Babylon’; ‘Alienation’; ‘Suspicious mind’; ‘Advertisements and information influence very little’, and ‘Gap in service provision (Bridging the gap)’ were identified as sub-categories revolving around the core category: ‘Cancer through black eyes’. Cancer was not viewed as a purely medical condition through black eyes. Black men’s views towards cancer were closely linked to socially constructed perspectives of themselves, linked with their cultural and religious beliefs; what being black male means in society, the meanings of historical phenomena like slavery, and the meanings they ascribed to social systems and establishments, such as healthcare systems. Clinical risk factors such as smoking and obesity had different meanings and symbolisation through black eyes. There were macro- and micro-level similarities and differences between BA and BAC men. Cancer-related services, such as public-health campaigns, aimed at black men need to be sensitive enough to understand cancer through black eyes. Public health campaigns based on only the clinical meaning of cancer mismatch with black men’s understandings of cancer. Accordingly, the effort made to increase public awareness of cancer and to reduce health inequality in this regard may continue to be ineffective. Findings from this study can be used to inform public health policy makers, and healthcare professionals more broadly, including professionals involved in health promotion, as well as charitable organisations aiming to provide services that will be utilised by BA and BAC men.
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Johl, Nicholas. "Support needs and service provision for family carers from Black and minority ethnic communities within the United Kingdom". Thesis, University of Warwick, 2013. http://wrap.warwick.ac.uk/58611/.
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Chapter one is a literature review of the experiences of carers from Black and ethnic minority communities caring for someone with dementia in the United Kingdom. Critical analysis of eight articles revealed that carers viewed symptoms of dementia as a normal process of ageing. Furthermore, the carers perceived their role as an extension of an existing responsibility to provide care and support for their family member. The literature review highlighted the majority of carers being female and stigma of a family member having a mental health issue still influenced carers’ willingness to engage in formal health services. Chapter two is an exploration of the experiences that staff within alcohol services have had whilst providing support to relatives of alcohol dependent individuals from the Sikh community. Ten staff members were recruited to take part in semi-structured interviews. Thematic analysis was conducted on the derived data, eliciting a number of themes illustrating the nature of familial support provided for someone who is alcohol dependent, the pro-social attitude towards alcohol held by Sikh family members, a lack of understanding regarding addiction and the confidential nature of alcohol services. This article provided evidence of inter-generational differences between Sikh family member’s knowledge of addiction and the expectation of alcohol services. Lastly, the present study identified variations in how alcohol services target and tailor their services in specific ways to meet the needs of Sikh family members of someone with alcohol dependence. Chapter three is a reflective article on the process of conducting the empirical research. The article addressed reasons why the lead researcher conducted research in this area and considers the effects of participant experiences of working with Sikh family members of someone with alcohol dependence. This chapter also discusses the lead researcher’s relationship with participants and how the research process impacted on the lead researcher’s personal life.
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Jalil, Abbe Maleyki Mhd. "Development of functional bread with beta glucan and black tea and effects on appetite regulation, glucose and insulin responses in healthy volunteers". Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7956/.
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In the UK, dietary fibre intake is below the recommended level of 30 g/day. The manipulation of behavioural change is challenging, hence finding alternative ways to improve diet is important. The development of functional foods such as bread with added functional ingredients such as β-glucan and black tea may be more feasible and acceptable than changing to a new eating pattern. β-Glucan and black tea are often eaten separately, however there may be a food-matrix interaction between starch, protein (gluten), tea (poly)phenols and β-glucan when added together in a bread. We hypothesise that β-glucan and black tea will be digested slowly and display a blunted postprandial glycaemia. Some undigested residues will reach the colon, where it will be metabolised to short chain fatty acids (SCFA). SCFA, particularly propionate, have the potential to increase satiety by stimulating G protein receptors, however the effects on food intake need to be tested. This project described: i) development of a functional bread containing black tea, BT; β- glucan, βG; β-Glucan and black tea, βGBT) and compare it to normal white bread (WB) (study 1); ii) determination of bread palatability, perceived satiety and subsequent energy intake following ingestion (study 2); iii) determination of postprandial glucose and insulin responses, and appetite hormones (CCK, PYY and GLP-1) among healthy volunteers (study 3 – in vivo study). In study 1, the breads were developed and tested for starch functionality, antioxidant potential and in vitro fermentability mimicking human colonic fermentation. βG and βGBT breads reduced early (10-min) in vitro starch hydrolysis and this could be due to action of β-glucan that ‘protected’ some of the starch granules (microscopic study) against amylolysis. Digestion with α-amylase increased antioxidant potential and total (poly)phenols content of BT and βGBT breads compared with WB. In vitro propionate concentration did not increase significantly when fermented with β-glucan. High inter- individual variation was observed for individual SCFA production. The addition of black tea had no apparent effect on SCFA production. Study 2 is a randomised, crossover study design conducted in healthy volunteers. Breads were given as breakfast and perceived satiety (perceived fullness, hunger, satiety, desire to eat and prospective food intake) was measured postprandially for 3 h. Ad libitum lunch was given after 3 h and energy intake estimated. BT bread was the most acceptable among all breads. βG and βGBT breads showed adverse taste, texture and palatability but showed similar overall acceptability as WB and BT breads. Female subjects showed lower preference for taste, texture and palatability of βG and βGBT compared with WB. βG and βGBT had positive effects on perceived satiety as follows: 1) decreased hunger; 2) increased fullness; and 3) decreased desire to eat. However, eating βG and βGBT at breakfast did not reduce energy intake at lunch compared with WB. Study 3 was similar to study 2. Only βG bread showed significantly lower glucose TAUC0-180 min compared with BT and βGBT but has no apparent effect on insulin response. No significant changes were observed for CCK and GLP-1 responses for all breads. However, βG and βGBT showed lower PYY TAUC0-180 min compared with BT. In vitro starch hydrolysis did not correlate with in vivo postprandial glycaemic responses. In conclusion, these studies suggest that breads with β-glucan and/or black tea have positive effects on perceived satiety in vivo and show good overall acceptability. However, there is no clear evidence that they affect appetite regulation. Breads containing 7 g β- glucan per 50 g of available carbohydrate reduced in vivo glucose response without altering insulin responses. There was no additional effect of adding black tea together with β-glucan to bread on the in vivo postprandial glycaemic response. It is too early to generalise the results from in vitro batch fermentation and starch hydrolysis and this needs to be considered when planning future dietary interventions looking at both in vitro and in vivo studies. Overall this study concluded that adding soluble dietary fibre to bread is feasible in controlling glycaemic responses and may help increase daily dietary fibre intake.
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Sardina, Angela. "Pain and Physical Function in a Socioeconomically Diverse Sample of Black and White Adults". Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6948.
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Musculoskeletal pain alters physiological function and these changes may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for chronic pain and report functional limitations similar to older adults. However, few studies have explored the unique individual factors (e.g., sociodemographic, health, and psychosocial characteristics) that may drive the pain experience; and more research is needed that examines the relationships between musculoskeletal pain and physical function, using objective performance measures, in a sample of racially and socioeconomically diverse adults.
Data from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study (HANDLS) were analyzed across two cross-sectional studies. The first study examined the association between subjective (self-reported) and objective measures of pain (passive range of motion) of the hands, neck and low back. Additionally, this study explored the unique predictors that may be associated with inconsistency between subjective and objective measurements of pain. Results indicated weak but significant correlations between subjective and objective hand- pain measurements. However, there were no significant correlations identified between subjective and objective neck-pain measurements, or subjective and objective low back pain measurements.
Three binary logistic regression models were conducted to explore the relationship between sociodemographic (Model 1), health (Model 2), and psychosocial characteristics (Model 3) of consistent and inconsistent pain measurements for each pain site. There were no significant relationships between sociodemographic, health, or psychosocial characteristics and consistent and inconsistent hand pain measurements. However, individuals who reported a history of depressive symptoms were nearly 1.8 times more likely to report inconsistent neck pain. Follow-up analyses to explore two-way interactions across unique predictors identified that individuals with a history of depressive symptoms, who were below poverty status, were nearly 3 times more likely to report inconsistent neck pain. Additionally, females, individuals with a greater number of comorbidities, and those with a history of depressive symptoms tended to demonstrate inconsistent low back pain. Follow-up analyses identified that those who identified a history of depressive symptoms, and reported the quality of their neighborhood as “poor” to “fair”, were 3.3 times more likely to demonstrate inconsistent low back pain measurements.
The second study examined the relationship between pain, pain interference and a global measure of physical function. Additionally, the study investigated whether relationships between pain, pain interference, and global physical function were moderated by sociodemographic characteristics (e.g., age, sex, race, and measures of socioeconomic status). In multivariable regression analyses, musculoskeletal pain was significantly associated with physical function, particularly among middle-aged and older individuals. Additionally, pain interference was significantly associated with physical function, particularly among older adults.
This dissertation strives to further our understanding of the unique factors that contribute to individualized pain experiences among under-represented populations, and to identify functional deficits that may be evidenced earlier in the life course. Furthermore, this dissertation is intended to motivate further research that explores appropriately timed non-pharmacological interventions that are tailored to the needs of diverse groups, in efforts to reduce musculoskeletal pain, pain interference, and sustain functional independence in later life.
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Conradie, Magda. "A comparative study of the determinants of bone strength and the propensity to falls in black and white South African women". Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/1151.
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Thesis (DMed)--Stellenbosch University, 2008.The comparative study presented in this dissertation specifically aimed to assess fracture risk in black (Xhosa) and white South African women by evaluating known determinants of bone strength as well as the propensity to falls. We thus compared the prevalence of clinical (historic) risk factors for osteoporosis, measured and compared vertebral and femoral bone mineral density (BMD) employing dual energy X-ray absorptiometry (DEXA), ultrasound variables using the Sahara sonometer, serum parathyroid hormone (PTH) and 25-OH Vitamin D, mineral homeostasis and modern biochemical markers of bone turnover, bone geometry and the propensity to falls. Finally, we determined the prevalence of vertebral fractures in these black and white South African females. 1. Significant ethnic differences were noted in the presence and frequency of historical clinical and lifestyle risk factors for osteoporosis. Blacks were heavier and shorter, they consumed less calcium, were more inactive, preferred depot-medroxyprogesterone acetate as contraceptive agent and were of higher parity. Whites smoked more, preferred oral oestrogen containing contraceptive tablets and were more likely to have a positive family history of osteoporosis. Hormone therapy was used almost exclusively by postmenopausal whites. Inter-ethnic differences in weight, physical activity and high parity was most marked in the older subjects. 2. We found that peak spinal BMD was lower, but peak femoral BMD similar or higher (depending on the specific proximal femoral site measured) in black South-African females compared with whites. The lower peak spinal BMD was mainly attributed to lower BMD’s in the subgroup of black females with normal to low body weight, indicating that obesity either protected black females against a low spinal BMD or enhanced optimal attainment of bone mineral. An apparent slower rate of decline in both spinal- and femoral BMD with ageing was noted in the black females compared with whites in this cross-sectional study – an observation which will require confirmation in longitudinal, follow-up studies. This resulted in similar spinal BMD values in postmenopausal blacks and whites, but significantly higher femoral BMD measurements in blacks. The volumetric calculation of bone mineral apparent density (BMAD) at the lumbar spine and femoral neck yielded similar results to that of BMD. Spinal BMAD was similar in blacks and whites and femoral neck BMAD was consistently higher in all the menopausal subgroups studied. Weight significantly correlated with peak- and postmenopausal BMD at all sites in the black and white female cohorts. Greater and better maintained body weight may be partially responsible for slower rates of bone loss observed in black postmenopausal females. Most of the observed ethnic difference in BMD was, in fact, explained by differences in body weight between the two cohorts and not by ethnicity per se. 3. A low body weight and advanced age was identified as by far the most informative individual clinical risk factors for osteopenia in our black and white females, whereas physical inactivity was also identified as an important individual risk factor in blacks only. Risk assessment tools, developed and validated in Asian and European populations, demonstrated poor sensitivity for identification of South African women at increased risk of osteopenia. The osteoporosis risk assessment instrument (ORAI) showed the best results, with sensitivities to identify osteopenic whites at most skeletal sites approaching 80% (78% - 81%). The risk assessment tool scores appear to be inappropriate for our larger sized study cohort, especially our black subjects, thus resulting in incorrect risk stratification and poor test sensitivity. General discriminant analysis identified certain risk factor subsets for combined prediction of osteopenia in blacks and whites. These risk factor subsets were more sensitive to identify osteopenia in blacks at all skeletal sites, compared with the risk assessment tools described in the literature. 4. Higher ultrasonographically measured broadband ultrasound attenuation (BUA) and speed of sound (SOS) values were documented in our elderly blacks compared with whites, even after correction for differences in DEXA determined BMD at the spine and proximal femoral sites. BUA and SOS showed no decline with ageing in blacks, in contrast to an apparent significant deterioration in both parameters in ageing whites. If these quantitative ultrasound (QUS) parameters do measure qualitative properties of bone in our black population, independent of BMD as has been suggested in previous work in Caucasian populations, the higher values documented in elderly blacks imply better preservation of bone quality in ageing blacks compared with whites. The correlation between QUS calcaneal BMD and DEXA measured BMD at the hip and spine was modest at best. QUS calcaneal BMD was therefore unable to predict DEXA measured BMD at clinically important fracture sites in our study population. 5. Bone turnover, as assessed biochemically, was similar in the total pre- and postmenopausal black and white cohorts, but bone turnover rates appeared to differ with ageing between the two racial groups. A lower bone turnover rate was noted in blacks at the time of the menopausal transition and is consistent with the finding of a lower percentage bone loss at femoral sites at this time in blacks compared with whites. Bone turnover only increased in ageing postmenopausal blacks, and this could be ascribed, at least in part, to the observed negative calcium balance and the more pronounced secondary hyperparathyroidism noted in blacks. Deleterious effects of secondary hyperparathyroidism on bone mineral density at the proximal femoral sites were demonstrated in our postmenopausal blacks and contest the idea of an absolute skeletal resistance to the action of PTH in blacks. The increase in bone turnover and the presence of secondary hyperparathyroidism due to a negative calcium balance may thus potentially aggravate bone loss in ageing blacks, especially at proximal femoral sites. 6. Shorter, adult black women have a significantly shorter hip axis length (HAL) than whites. This geometric feature has been documented to protect against hip fracture. The approximately one standard deviation (SD) difference in HAL between our blacks and whites may therefore significantly contribute to the lower hip fracture rate previously reported in South African black females compared with whites. Average vertebral size was, however, smaller in black females and fail to explain the apparent lower vertebral fracture risk previously reported in this population. Racial differences in vertebral dimensions (height, width) and/or other qualitative bone properties as suggested by our QUS data may, however, account for different vertebral fracture rates in white and black women – that is, if such a difference in fact exists. 7. The number of women with a history of falls was similar in our black and white cohorts, and in both ethnic groups the risk of falling increased with age. There is a suggestion that the nature of falls in our black and white postmenopausal females may differ, but this will have to be confirmed in a larger study. Fallers in our postmenopausal study population were more likely to have osteoporosis than non-fallers. Postmenopausal blacks in our study demonstrated poorer outcomes regarding neuromuscular function, Vitamin D status and visual contrast testing and were shown to be more inactive with ageing compared with whites. An increased fall tendency amongst the black females could not however be documented in this small study. Quadriceps weakness and slower reaction time indicated an increased fall risk amongst whites, but were unable to distinguish black female fallers from non-fallers. 8. Vertebral fractures occurred in a similar percentage of postmenopausal blacks (11.5%) and whites (8.1%) in our study. Proximal femoral BMD best identified black and white vertebral fracture cases in this study. Quite a number of other risk factors i.e. physical inactivity, alcohol-intake, poorer physical performance test results and a longer HAL were more frequent in the white fracture cases and could therefore serve as markers of increased fracture risk, although not necessarily implicated in the pathophysiology of OP or falls. However, in blacks, only femoral BMD served as risk factor. Similar risk factors for blacks and whites cannot therefore be assumed and is deserving of further study. White fracture cases did not fall more despite lower 25-OH-Vitamin D, poorer physical performance and lower activity levels than non-fracture cases. Calcaneal ultrasonography and biochemical parameters of bone turnover were similar in fracture and non-fracture cases in both ethnic groups. Our study data on vertebral fractures in this cohort of urbanized blacks thus cautions against the belief that blacks are not at risk of sustaining vertebral compression fractures and emphasize the need for further studies to better define fracture prevalence in the different ethnic populations of South Africa. 9. In our study, hormone therapy in postmenopausal white women improved bone strength parameters and reduced fall risk. In hormone treated whites compared with non-hormone users, a higher BMD at the spine and proximal femur as determined by DEXA were documented and all QUS measurements were also significantly higher. The biochemically determined bone turnover rate, as reflected by serum osteocalcin levels, was lower in hormone users. Fall frequency was lower in the older hormone treated women (≥ 60yrs) and greater quadriceps strength and reduced lateral sway was noted. Only one patient amongst the hormone users (2%) had radiological evidence of vertebral fractures compared with four patients (6%) amongst the never-users. As hormone therapy was used almost exclusively by whites in this study population, the impact of hormone therapy on postmenopausal black study subjects could not be assessed.
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Gantt, Antrelise. "Differences in sources of assistance with activities of daily living between Black and white non-Hispanic elderly in South Florida". FIU Digital Commons, 1999. http://digitalcommons.fiu.edu/etd/3453.
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Rungarara-Keenan, Margareth. "Culture and diet : food choice among Black African and African-Caribbean women with Type 2 Diabetes". Thesis, University of Essex, 2016. http://repository.essex.ac.uk/16866/.
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People of Black African heritage in the UK have increased susceptibility of being diagnosed with Type 2 Diabetes Mellitus (T2DM) compared to the general White population. Nutrition is central in halting T2DM and the progression of complications such as cardiovascular diseases. However, little is known about the factors influencing the diet of women of Black African heritage with T2DM. In addition, clinical and public health conceptions of the problem tend to be individualistic in orientation. This study is an exploratory and in-depth inquiry into food choice and the implications of dietary change for women of Black African heritage who self-manage T2DM by diet alone. Eight participants were recruited using purposive sampling. Recruitment sites included Black and Minority Ethnic charities in Norfolk and Suffolk. Data was derived from direct observation using the ‘Accompanied Shopping Task’, combined with a ‘Think Aloud Technique’ called a ‘Product Choice Reasoning Task’. In-depth interviews were undertaken and transcribed verbatim. Framework Analysis was used to provide a procedure to manage data analysis, which was informed by the PEN-3 public health cultural model which moves beyond overly individualistic conceptions of the issues. The study showed that six participants prioritised the disease and used what I have called a ‘Disease Focused Approach’ to self-manage T2DM. Two used a ‘Family Focused Approach’, as family played a crucial role in T2DM self-management. All participants undertook T2DM self-care by following a culturally appropriate diet. Their least preferred options for managing T2DM were medical therapy and physical activity. The study showed that although food choice is influenced by many factors, culture was particularly important. Moreover, participants showed greater knowledge than had been anticipated about the role of nutrition to prevent progression of T2DM. Results are explored and presented for three main domains of experience for the participants: first, food shopping and decision-making; second, diet choice and lifestyle; and third, the interface with health services. For each of these the culture was found to be of paramount importance. The implications of the findings are presented in relation to the importance of culturally appropriate advice; culturally sensitive service provision; and the significance of household composition in managing the illness, especially for people with T2DM who have young children living at home.
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Owuor, John. "Disclosure, concealment and exposure : how black immigrant men from East Africa living in the UK and their families manage communication about HIV-positive status". Thesis, University of Huddersfield, 2014. http://eprints.hud.ac.uk/id/eprint/23321/.
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The aim of this study was to explore what it means for London-based, immigrant Black East-African men and their female partners to live with HIV. Few studies have been conducted on this issue with the present study population. The main thrust of existing research has been on preventing new infections, and work on living with HIV has mostly focused on groups in which the disease has a higher prevalence in developed societies, for example men who have sex with men. A modified grounded theory methodology underpinned by a symbolic interactionist theoretical framework was adopted. Data collection involved in-depth interviews with 23 participants, including: one HIV-negative man in a sero-discordant relationship; 11 HIV-positive men; six HIV-positive women, five of whom were partners of an HIV-positive research participant; and five workers from London-based community organisations offering HIV-related services accessed by Black Africans. Most (13/17) of the HIV-positive research participants opted to partially conceal their condition. In consequence, they faced an ongoing dilemma regarding whether to reveal their HIV-positive status to particular individuals. Disclosure could potentially unlock sources of social support, but also created the risk of stigmatization. But concealment meant forfeiting potential social support sources, and created risks of exposure. Four of the 18 research participants had eventually decided to ‘come out’ publicly in order to challenge stereotypes about HIV. They demonstrated that open communication about HIV-positive status can be a viable alternative to selective concealment and disclosure. The findings are used to develop practice and policy recommendations based on recognising social sensitivities around communicating HIV-positive status and other stigmatized attributes. Proposals are offered for developing further research, particularly comparative work which can help to clarify the impact of culture on disclosure of potentially stigmatizing personal information.
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Sriharan, Abiramy. "Using realist approach to open the black box of global continuing medical education partnerships". Thesis, University of Oxford, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.669702.
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McCummings, Carolyn. "Social Influences of Suburban Black Residents Food Purchasing Decisions Using SNAP Benefits". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4936.
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In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that children in the household had a great deal of influence over food purchases. This was followed by health issues and concerns of those in the household and, the SNAP benefit amount. The study results shed light on multiple issues faced not just with buying food, but with trying to buy healthy food on a SNAP budget. The findings are consistent with previous studies which suggest food choices are often influenced by personal and cultural ideals, and controlled by present income, family structure, and the health of family members. The study findings also support Bandura's conceptual framework which believes before changes in behavior can take place, factors that can possibly influence behavior must be considered. In conclusion, providing guidance for both public health and social service providers on the influences that effect behavior among specific populations may impact social change and lead to greater success in the prevention of diet-related chronic illnesses.
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Iyokho, Wilson Osaro. "Psycho-social Resilience and Risky HIV Behaviors among Black Males who have Sex with Males". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/225.
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The incidence rate of HIV among Black males having sex with Black males (BMSM) is high compared to that of other racial groups. Researchers have established the association between inappropriate sexual practices, age, income, and environmental determinants and HIV positive status among BMSM. Guided by resilience theory, the purpose of this study was to examine the relationship between HIV risk behavior and resiliency with the goal of identifying a new intervention to mitigate the HIV infection rate in the BMSM community. The theoretical framework used for this study was the resilience theory. This theory is concern with the phenomenon of why some people thrive after period of catastrophic adversity while others do not. A quantitative research design was used to test for a correlation between psychosocial resilience and HIV risk behavior. Fifty seven respondents were included in the study, 28 who were HIV positive, and 29 who were HIV negative. The Risky Behavior Questionnaire and the Resilience Survey were used to collect study data. The main study finding was a significant correlation between resilience and sex-related HIV risk behaviors, including unprotected sex, a lack of awareness of HIV status, multiple male sexual partners, and alcohol and drug use during sex. According to study findings, BMSM with higher resilience might be less likely to engage in sex-related HIV risk behaviors than those with low resilience. Strategies to mitigate HIV transmission could include resilience training. The benefit to the society would be reduced HIV infections transmission due to reduced risky HIV behaviors. The population social change would be the importance of the resiliency practice among BMSM in an effort to dispel the fear about the disease.
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Mosley, Marie Oleatha Pitts. "A history of Black leaders in nursing : the influence of four Black community health nurses on the establishment, growth, and practice of public health nursing in New York City, 1900-1930 /". Access Digital Full Text version, 1992. http://pocketknowledge.tc.columbia.edu/home.php/bybib/1106402x.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1992.Includes tables. Typescript; issued also on microfilm. Sponsor: Elizabeth Tucker. Dissertation Committee: Douglas S. Sloan. Includes bibliographical references (leaves 157-175).
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Burkett, Tonia Marie. "Black Women's Health: A Content Analysis of the Journal of the American Medical Association, the American Journal of Public Health, and the New England Journal of Medicine (1989-1998)". PDXScholar, 2003. https://pdxscholar.library.pdx.edu/open_access_etds/3042.
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According to the National Vital Statistics Report (1998), Black women age 45-64 are ten times more likely than white women of the same age to die from diseases of the heart. They are five times more likely to die from diabetes. The goal of this study was to examine how articles published in leading medical journals between 1989 and 1998 accounted for such differences in health outcomes among Black and white women.
The explanatory content of the articles was analyzed and coded according to four types of attributions: genetic/biological, cultural/behavioral, structural/socioeconomic and alternative. Each type of explanation derives from different assumptions and operates with different models for understanding why health outcomes vary among groups. Alternative explanations are those that focus on the direct effect of race/gender oppression on Black women's health. Genetic/biological attributions occurred less frequently than structural/socioeconomic and cultural behavioral but were more likely to occur than alternative attributions, which were the least often employed. While alternative attributions are considered in some of the articles about Black women's health and mortality, they are overall rarely employed. The finding that explanations that most directly explore the impact of racism and sexism on Black women's health occur least often has important implications. Articles published in these three journals inform medical practitioners and affect the ability of such practitioners to adequately address the needs of Black women in their care.
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Simmons, Tiffany McIntyre. "The Associated Risk Factors That Lead To The Onset Of Sarcoidosis In Black American Women". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3208.
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Sarcoidosis is a disease characterized as noncaseation granulomas. Granulomas are clusters of cells that form a discrete nodule. This research was important because Black American women develop saroidosis at a higher rate than any other race. The purpose of this phenomenological qualitative study was to examine the impact of sarcoidosis in the lives of Black American women diagnosed with the disease and to consider how occupational experiences may have contributed to participants' development of sarcoidosis. Research states that domestic work such as cleaning, when performed on a daily basis or as an occupation, can contribute to adverse health effects. The framework of this study utilized the transtheoretical model of behavior change while the overall research questions centered on the effects of sarcoidosis on the quality of life of Black American women. This qualitative research included interviews with thirteen Black American women diagnosed and living with sarcoidosis at various stages. Data were collected using the software tool HyperRESEARCH. Both purposive sampling and snowball sampling technique was used for this research. Data were gathered using a general profile of the lived experiences of women with sarcoidosis. The findings revealed that the common lived experience that has potentially put Black American women at risk for developing sarcoidosis is bleach. My recommendations for further research would be to expand the locations of participants to across the United States. The implications for positive social change may result from broader knowledge of the disease through education, even for those who are not at risk for developing it. Chronic sarcoidosis can be fatal if untreated.
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Kwak, Jung. "Predictors and outcomes of hospice use among Medicare and Medicaid dual-eligible nursing home residents in Florida: a comparison of non-Hispanic Blacks and non-Hispanic Whites". [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001665.
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