Exploring Cultural Experiences of African American Recipients of Healthcare

Culturally competent care is widely accepted as a strategy to address healthcare disparities based on the perceptions of the individual provider, yet this approach lacks the voice of the African American (AA) communities intended to benefit from the strategy. Individuals in AA communities have been shown to suffer higher incidence of disease, disproportionately poorer health outcomes, and inequitable healthcare treatment. Framed by Leininger’s culture care theory, the purpose of this interpretive phenomenological study was to explore the lived cultural experiences of AA recipients of care when interacting with the healthcare system in an effort to contribute evidence to improve the health of the AA community. For this qualitative study, seven AA participants, at least 18 years of age, were recruited to participate in semistructured interviews. Manual coding and thematic analysis revealed five major themes: (a) communication, (b) medical mistrust, (c) access to healthcare, (d) satisfaction with healthcare experience, and (e) dissatisfaction with healthcare experience. Thirteen subthemes were identified that supported the major themes. The results of this study provide a better understanding of the lived cultural experiences of the AA recipients of healthcare based on the shared perceptions of previous encounters. These findings have the potential to contribute to positive social change by providing better understanding of the experiences of members of a vulnerable population negatively impacted by healthcare disparities in an effort to support the development of initiatives to reduce these disparities. Future studies may use the identified themes as the basis for participatory research to develop system-level strategies that result in meaningful improvements to the healthcare experiences of AAs

Pessimistic Side of Robert Frost

Englis

Disabled adults in sheltered employment: an assessment of dental needs and costs.

In this dental survey of a multi-disability sheltered industry, 233 adults were examined. When compared to adjusted North Carolina values, the workers exhibited poorer oral hygiene with higher rates and severity of periodontal disease. DMF-T totals were equal to those statewide; however, workers had more decayed and fewer missing teeth. Significant unmet restorative and prosthodontic needs were found. Treatment cost estimates at 1983 fees were $421 per capita, with a median fee of$240

Meaningfulness in the Associative Stage of Paired-Associate Learning

An experiment employing seventy-two undergraduate students enrolled in introductory psychology courses was performed to test the hypothesis that the effect of meaningfulness on the stimulus and on the response will be equivalent in paired-associate learning with the elimination of the response-recall stage of associative learning. Dissyllables taken from Noble’s list (1960) were paired with single digit numbers to comprise the paired-associate terms. An attempt was made to eliminate the response-recall stage of paired-associate learning by making the correct responses available to the S at the time of stimulus presentation. Two control groups learned paired-associates in the usual manner. The effect of meaningfulness on stimulus versus response with the elimination of the response-recall stage of associative learning is not significant. This result may be viewed as confirming the hypothesis if the attempted elimination of the response-recall stage was successful. Significant results were obtained for the variable of meaningfulness, replicating the finding that terms of high meaningfulness are easier to learn than terms of low meaningfulness

Effects of Corticosteroids on Eosinophil Chemotaxis and Adherence

A B S T R A C T Therapeutic doses of corticosteroids frequently induce eosinopenia; however, the mechanism(s) involved remain obscure. To investigate this question, we studied the effects of corticosteroids on eosinophil adherence and migration. Eosinophils from normal donors were prepared by dextran sedimentation and Hypaque gradient centrifugation to 45-96% purity. Adherence was measured by filtration of whole blood and isolated eosinophils through nylon wool columns. Before prednisone administration, adherence was 83.8+3.2% for eosinophils in heparinized blood and 82.1±3.2% for isolated eosinophils. 4 h after oral prednisone administration whole blood eosinophil adherence was reduced to 53.9+10.7%; at 24 and 48 h adherence was normal. In contrast, isolated eosinophils showed no decrease in adherence 4, 24, or 48 h after corticosteroid administration. Similarly, in vitro addition of hydrocortisone to isolated eosinophils at 0.01 and 2.0 mg/ml did not reduce adherence. Eosinophil migration was tested in modified Boyden chambers by "lower-surface" and "leading-front" methods, using zymosan-activated serum and buffered saline to assess chemotactic and random migration, respectively. In vitro incubation of eosinophils with hydrocortisone or methylprednisolone produced a dose-dependent inhibition ofchemotaxis. Using lowersurface methods the minimal concentration effecting substantial inhibition was 0.01 mg/ml for both drugs. At 2.0 mglml hydrocortisone and methylprednisolone inhibited eosinophil chemotaxis 82.6±4.4% and 85.0±3.5%, respectively. Using leadiig-front chemotaxis techniques significant inhibition was detected at 0.001 mg/ml hydrocortisone. Eosinophils incubated and washed free of corticosteroids responded normally to chemoattractants, indicating that the inhibitory effect of these drugs was reversible. HydroAddress reprint requests to Dr. Altman. Received for publicatio