Examining Obesity Health Outcomes With African American Men in the Black Church

Obesity often increases the risk of developing other dependent characteristics that challenge health and well-being, such as hypertension, diabetes, heart disease, and other chronic illnesses. Each year, approximately one in three Americans is diagnosed with obesity based on national and public health body mass index standards. Obesity diagnoses among African Americans are historically elevated and have continued to trend upwards year over year. When compared to other populations, African Americans experience higher rates of chronic illness and obesity, which leads this population to experience higher rates of mortality. Although there are many programs, interventions, and evidence-based research studies on how obesity impacts African American women, research data on African American men remain minimal. The purpose of this quantitative research study was to examine African American men and their associations with obesity, diet, physical activity, health status predictors, the church, and mental health for 204 participants. The results of the study yielded significant relationships between vegetable consumption and BMI and physical activity and BMI. Health status indicators (defined as favorable and unfavorable) and weight change predictions were also significant. In this study, health factors examining correlations between obesity, the church environment, and mental health (depression) were not significant or attributable to improved health outcomes. The results of this study may enhance future positive social change research with African American men who seek alternative and perhaps nontraditional methods to manage obesity, improve nutritional habits, and increase their physical activity to prolong and enhance the lifespan

A Revised Model for Informed Consent in Predictive Genetic Testing

This dissertation develops a revised model of informed consent for PGT. The need for this model arises from distinguishing characteristics of PGT, which make it distinctive from other forms of health-related testing. These characteristics are: the difficulty in understanding genetic risks and probabilities; the problem of treatment options for diagnosed genetic traits; and the concern with family-related genetic information. The first chapter explains PGT to identify these characteristics that shape the revised model of consent. The second chapter explores the history of consent to identify the widely recognized components of consent (understanding, disclosure, and voluntariness) that represent the current model. The third chapter explains the revised model by aligning the three distinguishing characteristics of PGT with the three widely recognized components in the current model. At the end, the revised model is applied to direct-to-consumer and pleiotropic genetic testing. To explain the significance of the revised model of consent, the following main categories are discussed. First, PGT involves a risk analysis of the related probabilities that can be complicated for patients to comprehend. This point develops the importance of understanding in the current model. Risk assessment involves calculating probabilities to determine the likelihood of developing a disease. To accomplish this, the relation between autonomy and comprehension is crucial. The current model uses an approach to autonomy that is standardized and generic, focusing on consent by providing a signature to accept or reject a test. The revised model enhances patient involvement by adopting a more extensive approach, described as a process rather than as an event. Typically the current model does not offer a large amount of time to comprehending risk assessments. The additional time and complexity involved in comprehending the connection between risk and probability has significant implications for patient education by the doctor, thereby developing the meaning of the doctor-patient relationship. For example, the emergence of the so-called Nocebo Effect needs to be considered here. Second, there are complex treatment options, including no treatment for some diseases, that require genetic counseling to select an appropriate option. This point develops the importance of disclosure in the current model. Typically the current model emphasizes appropriate disclosure of information. The revised model takes this further and recognizes that this disclosure needs to be accompanied with genetic counseling both before and after testing to enhance decision making about a suitable option. Appropriate genetic counseling must include patient assessment and feedback mechanisms. Third, PGT involves family-related information with accompanying implications that can compromise voluntariness. This third point develops the importance of avoiding coercion of both the patient and the patient\u27s family when information is presented. The third distinctive characteristic of PGT is the relevance of genetic information for the patient\u27s family. In the current model, family-related coercion is often difficult to identify. The revised model ensures voluntary consent by establishing procedures to avoid two forms of coercion: pressure by the family for the patient to be tested (eg, if there is a family genetic trait already known, there can be pressure upon a child to be tested to ascertain if s/he is a carrier etc); and pressure upon the family regarding the testing outcome (eg, if a trait emerges that affects other siblings, a process needs to be undertaken to ascertain whether the sibling wants to know). The revised model of consent requires an additional component to the traditionally recognized three components (comprehension, disclosure, voluntariness): the culture of patient safety. That is, the revised model of consent enhances the traditional components of consent within a medical culture that emphasizes patient safety. This safety culture requires nationally established systems of accountability for PGT that implement the revised components of consent in a transparent manner to foster trust in the emerging system of genetic-related services

Generalizabiity and dependability of brief behavior rating scales for social skills

While there are appropriate tools to progress monitor academics, there is no universally accepted tool to progress monitor social behavior. The current study proposed the development of a series of brief behavior rating scales to correspond to important social skills domains on the Social Skills Rating Scale (Gresham & Elliott, 2008) and to evaluate the resulting psychometric features through generalizability theory. Data was collected in a preschool classroom in a 6 persons by 2 rater by 6-7 items by occasions mixed model design. Data was analyzed series of generalizability and decision studies to investigate sources of variability and to determine the assessment conditions required to make reliable decisions. Results indicated that large proportions of the total variance in these scales were attributed to rater-related effects. This affected generalizability and dependability coefficients to the extent that reliable decisions could not be made with the current scale using feasible assessment conditions. Furthermore, current results did not support the abbreviation of the current scales. These finding indicates the need to further understand and control for unwanted variability between raters. Implications for the assessment of social behavior and suggestions for scale development are reviewed

Educating for Civic-Mindedness: Examining Student Impacts of Academic Programs of Community and Civic Engagement in Higher Education

Within the last decade, colleges and universities in the United States have embraced the “community engagement” model to fulfill their public missions and prepare their students for work within increasingly complex and diverse communities. The number of academic majors and minors in community engagement-related fields has multiplied across the country, yet there is little literature that examines their impact on students, and whether or not they are producing uniquely engaged citizens upon graduation. This quasi-experimental, quantitative study explores the effects of one such program on students at Central Connecticut State University. Graduates who have completed a minor in Community and Civic Engagement were compared with a second group of graduates with similar majors on the Civic-Minded Graduate (CMG) Scale; it was found that those who had completed the Community and Civic Engagement minor showed significantly higher levels of civic-mindedness on all four CMG subscales than graduates who did not complete the minor. Sex was found to be a significant factor on three of the four subscales. The results of this study promise to inform university curriculum design and allocation of resources in the area of community engagement, as well as to fill a gap in the literature regarding outcomes assessment for academic community engagement programs. Areas for future research include assessment of community impact, more precise evaluations of program components, and the inclusion of global learning as an outcome for community and civic engagement programs

Metacognitive self-reflectivity moderates the relationship between distress tolerance and empathy in schizophrenia

Deficits in empathy seen in schizophrenia are thought to play a major role in the social dysfunction seen in the disorder. However, little work has investigated potential determinants of empathic deficits. This study aimed to fill that gap by examining the effects of two variables on empathy – distress tolerance and metacognitive self-reflectivity. Fifty-four people with schizophrenia-spectrum disorders receiving services at an urban VA or community mental health center were assessed for empathy, metacognition, and distress tolerance. Bivariate correlations and moderation methods were used to ascertain associations amongst these variables and examine interactions. Results revealed that, against hypotheses, empathy was not related at the bivariate level to either distress tolerance or metacognitive self-reflectivity. However, consistent with hypotheses, moderation analyses revealed that participants with higher self-reflectivity showed no relationship between distress tolerance and empathy, while those with lower self-reflectivity showed a relationship such that reduced ability to tolerate distress predicted reduced empathy. Taken together, results of this study suggest that lack of distress tolerance can negatively affect empathy in people with schizophrenia with lesser capacity for metacognitive self-reflection; thus, fostering self-reflectivity may help overcome that negative impact. Future work is needed investigating the impact of metacognitively-tailored interventions on empathy in this population

Bacterial Voltage-Gated Sodium Channels (BacNaVs) from the Soil, Sea, and Salt Lakes Enlighten Molecular Mechanisms of Electrical Signaling and Pharmacology in the Brain and Heart

AbstractVoltage-gated sodium channels (NaVs) provide the initial electrical signal that drives action potential generation in many excitable cells of the brain, heart, and nervous system. For more than 60years, functional studies of NaVs have occupied a central place in physiological and biophysical investigation of the molecular basis of excitability. Recently, structural studies of members of a large family of bacterial voltage-gated sodium channels (BacNaVs) prevalent in soil, marine, and salt lake environments that bear many of the core features of eukaryotic NaVs have reframed ideas for voltage-gated channel function, ion selectivity, and pharmacology. Here, we analyze the recent advances, unanswered questions, and potential of BacNaVs as templates for drug development efforts

Structure of the saxiphilin:saxitoxin (STX) complex reveals a convergent molecular recognition strategy for paralytic toxins.

Dinoflagelates and cyanobacteria produce saxitoxin (STX), a lethal bis-guanidinium neurotoxin causing paralytic shellfish poisoning. A number of metazoans have soluble STX-binding proteins that may prevent STX intoxication. However, their STX molecular recognition mechanisms remain unknown. Here, we present structures of saxiphilin (Sxph), a bullfrog high-affinity STX-binding protein, alone and bound to STX. The structures reveal a novel high-affinity STX-binding site built from a "proto-pocket" on a transferrin scaffold that also bears thyroglobulin domain protease inhibitor repeats. Comparison of Sxph and voltage-gated sodium channel STX-binding sites reveals a convergent toxin recognition strategy comprising a largely rigid binding site where acidic side chains and a cation-π interaction engage STX. These studies reveal molecular rules for STX recognition, outline how a toxin-binding site can be built on a naïve scaffold, and open a path to developing protein sensors for environmental STX monitoring and new biologics for STX intoxication mitigation