Complicated Inclusion: Exploring the Reception of Nigerian Immigrants in the United States

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CARE Program: Compassionate and Rewarding Education for Expectant African American Mothers in Prince George’s County, Maryland: A Program Plan and Evaluation

A country’s success or progress is often marked by its health care status. One such marker of nationwide health status is infant mortality. Infant mortality rate is defined as the number of infants that pass away within one year of life for every 1000 live births. From the year 1980 to 2000, rates of infants born with low birth weight rose to 12 percent in the United States. However, over the same time period, improvements were seen in preventing infant deaths, with infant mortality rates declining by 46 percent. Whereas these improvements in maternal and child health are successes to the United States health care system, there are still wide racial disparities in infant mortality rates. The relative infant mortality rate for African American women increased from 2.04 times that of Caucasian women in the year 1980 to 2.46 in the year 2000. These statistics poignantly demonstrate an example of how health disparities in the United States dramatically affect Black Americans. In the year 2000, the five leading causes of infant deaths in the United States were: 1.) congenital malformations; 2.) complications of the cord, placenta, or membranes; 3.) sudden infant death syndrome, 4.) complications during the mother’s pregnancy; and 5. disorders associated with a short gestational period. When comparing African American and White American women, the greatest rate ratios were in the maternal pregnancy complications (3.1) and short gestational disorders (3.9). Therefore, greater education and social support during the pregnancy months might be a significant method to help lower these causes of infant death. Studies have also found that African American women with a college education and adequate prenatal care have greater than two times the likelihood of having a low birth weight infant than their Caucasian counterparts. This data shows that the problem of higher infant mortality rates in African American women is not solely attributable to socioeconomic status. Higher rates of infant mortality are also evident in African American women in my hometown of Prince George’s County, Maryland. It is a predominantly African-American county (64.5 percent African American) and has an infant mortality rate of 11.7 deaths per 1000 births. This rate is greater than the state average of 8 deaths per 1000 births. Therefore, there is a wide health disparity seen in African American women in regards to infant mortality. There is a great need to address infant mortality in African American women through public health programming, especially in places like Prince George’s County, Maryland. On systematic review, several articles were found containing different approaches to prenatal education programming. Some focused solely on education, such as proper nutrition or smoking abstinence during pregnancy. Others included social support sessions, prenatal care coordination, case management, education for fathers, and exploration of social determinants of health in the African American community. This masters paper will discuss an original program entitled, “Compassionate and Rewarding Education Program for Expectant African American Mothers (CARE).” The CARE Program will integrate some of the previously mentioned educational programs and add other new elements to bring a unique program to Prince George’s County, Maryland. Core components will include an educational curriculum, group therapy, mental support sessions, and Lamaze classes, free of charge. There are four primary sections of this paper on the CARE Program. First, the literature review will analyze research studies that look into the causes of the infant mortality health disparity in African Americans, and strategies and programs that target this population. The program plan will describe the goals, objectives, design, and overall plan for the intervention. Next, the evaluation plan will explain how I intend to examine and report the program’s progress, as well as detailing the evaluation methods and design. Lastly, the discussion section will provide conclusions, reflections, and future implications of this program plan and evaluation.Master of Public Healt

Clinico-Pathological Analysis of Osteomyelitis in Cancrum Oris (Noma) Patients Seen in Noma Children Hospital, Northwest Nigeria

Background: Cancrum oris is a rapid and devastating infectious disease of the orofacial region, which can be life threatening in its fulminant stage. Infection of bone (osteomyelitis) is a possible sequelae of Noma (cancrum oris) and is more likely due to late presentation especially in our environment. A literature search revealed scanty research describing osteomyelitis in Noma patients. Objective: To analyze the clinico–pathology of osteomyelitis in Noma patients diagnosed and treated at Noma Children Hospital, Sokoto. Methods: The design was a 2-year retrospective study of records of Thirty–two patients who had sequestrectomy secondary to osteomyelitis in Noma (Cancrum oris). Age, gender, jaws affected and side of involvement were analyzed Results: The age ranged from 2–11 years with mean ±standard deviation 5.47 ± 2.68 years was recorded. Osteomyelitis in Noma patients was found among 17 (53.10%) males compared to 15 (46.90%) females. In 20 (62. 50%) of the cases, anterior maxillary involvement was observed and the remaining 12 (37. 50%) was found at the mandibular posterior region and it is more common on the left side. Result of histopathology showed both acute and chronic inflammatory cells. Necrosis and bone hyperactivity was observed in most of the slides. Conclusion: Osteomyelitis is a common complication of Noma and its treatment is of paramount importance for adequate management of Noma patients. &nbsp

Cause and prevention of demyelination in a model multiple sclerosis lesion

OBJECTIVE: Demyelination is a cardinal feature of multiple sclerosis, but it remains unclear why new lesions form, and whether they can be prevented. Neuropathological evidence suggests that demyelination can occur in the relative absence of lymphocytes, and with distinctive characteristics suggestive of a tissue energy deficit. The objective was to examine an experimental model of the early multiple sclerosis lesion and identify pathogenic mechanisms and opportunities for therapy. METHODS: Demyelinating lesions were induced in the rat spinal dorsal column by microinjection of lipopolysaccharide, and examined immunohistochemically at different stages of development. The efficacy of treatment with inspired oxygen for 2 days following lesion induction was evaluated. RESULTS: Demyelinating lesions were not centered on the injection site, but rather formed 1 week later at the white-gray matter border, preferentially including the ventral dorsal column watershed. Lesion formation was preceded by a transient early period of hypoxia and increased production of superoxide and nitric oxide. Oligodendrocyte numbers decreased at the site shortly afterward, prior to demyelination. Lesions formed at a site of inherent susceptibility to hypoxia, as revealed by exposure of naive animals to a hypoxic environment. Notably, raising the inspired oxygen (80%, normobaric) during the hypoxic period significantly reduced or prevented the demyelination. INTERPRETATION: Demyelination characteristic of at least some early multiple sclerosis lesions can arise at a vascular watershed following activation of innate immune mechanisms that provoke hypoxia, and superoxide and nitric oxide formation, all of which can compromise cellular energy sufficiency. Demyelination can be reduced or eliminated by increasing inspired oxygen to alleviate the transient hypoxia. Ann Neurol 2016;79:591-604

Changes in oxygen partial pressure of brain tissue in an animal model of obstructive apnea

Background: Cognitive impairment is one of the main consequences of obstructive sleep apnea (OSA) and is usually attributed in part to the oxidative stress caused by intermittent hypoxia in cerebral tissues. The presence of oxygen-reactive species in the brain tissue should be produced by the deoxygenation-reoxygenation cycles which occur at tissue level during recurrent apneic events. However, how changes in arterial blood oxygen saturation (SpO2) during repetitive apneas translate into oxygen partial pressure (PtO2) in brain tissue has not been studied. The objective of this study was to assess whether brain tissue is partially protected from intermittently occurring interruption of O2 supply during recurrent swings in arterial SpO2 in an animal model of OSA. Methods: Twenty-four male Sprague-Dawley rats (300-350 g) were used. Sixteen rats were anesthetized and noninvasively subjected to recurrent obstructive apneas: 60 apneas/h, 15 s each, for 1 h. A control group of 8 rats was instrumented but not subjected to obstructive apneas. PtO2 in the cerebral cortex was measured using a fastresponse oxygen microelectrode. SpO2 was measured by pulse oximetry. The time dependence of arterial SpO2 and brain tissue PtO2 was carried out by Friedman repeated measures ANOVA. Results: Arterial SpO2 showed a stable periodic pattern (no significant changes in maximum [95.5 ± 0.5%; m ± SE] and minimum values [83.9 ± 1.3%]). By contrast, brain tissue PtO2 exhibited a different pattern from that of arterial SpO2. The minimum cerebral cortex PtO2 computed during the first apnea (29.6 ± 2.4 mmHg) was significantly lower than baseline PtO2 (39.7 ± 2.9 mmHg; p = 0.011). In contrast to SpO2, the minimum and maximum values of PtO2 gradually increased (p < 0.001) over the course of the 60 min studied. After 60 min, the maximum (51.9 ± 3.9 mmHg) and minimum (43.7 ± 3.8 mmHg) values of PtO2 were significantly greater relative to baseline and the first apnea dip, respectively. Conclusions: These data suggest that the cerebral cortex is partially protected from intermittently occurring interruption of O2 supply induced by obstructive apneas mimicking OSA

Dysregulation of neuronal iron homeostasis as an alternative unifying effect of mutations causing familial Alzheimer's disease

The overwhelming majority of dominant mutations causing early onset familial Alzheimer's disease (EOfAD) occur in only three genes, PSEN1, PSEN2, and APP. An effect-in-common of these mutations is alteration of production of the APP-derived peptide, amyloid ß (Aß). It is this key fact that underlies the authority of the Amyloid Hypothesis that has informed Alzheimer's disease research for over two decades. Any challenge to this authority must offer an alternative explanation for the relationship between the PSEN genes and APP. In this paper, we explore one possible alternative relationship - the dysregulation of cellular iron homeostasis as a common effect of EOfAD mutations in these genes. This idea is attractive since it provides clear connections between EOfAD mutations and major characteristics of Alzheimer's disease such as dysfunctional mitochondria, vascular risk factors/hypoxia, energy metabolism, and inflammation. We combine our ideas with observations by others to describe a "Stress Threshold Change of State" model of Alzheimer's disease that may begin to explain the existence of both EOfAD and late onset sporadic (LOsAD) forms of the disease. Directing research to investigate the role of dysregulation of iron homeostasis in EOfAD may be a profitable way forward in our struggle to understand this form of dementia

Review of The Good Immigrants: How the Yellow Peril Became the Model Minority (2015)

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Intertwined migration policies : citizenship, race, and quality of life as they affect Nigerian immigrants in the United States

In an era of heightened immigration restrictions in the United States, this study applies the conceptual framework of context of reception (Portes and Rumbaut, 2014) to examine how federal immigration policies affect the integration of Nigerian immigrants in the United States. Drawing upon the case analysis of the Houston Metropolitan Area, this study deploys two qualitative research methods; namely, ethnographic interviews and participant observation, to address the following questions: (i) How do Nigerian immigrants define American citizenship? (ii) How do federal immigration policies influence Nigerian immigrants’ understanding of race (blackness) and how it functions in the United States? (iii) Is there a relationship between the culmination of racialized experiences and the quality of life among Nigerians in the US? In answering these questions, I argue that the assigned racial status of Nigerians as Black renders their citizenship status and belonging in the United States as a precarious, fragile condition, despite their educational and occupational attainments. Chapter 1 details the push and pull factors that facilitated African immigration to the US post-1965 while also providing a sociodemographic profile of Nigerians in the US. Chapter 2 reveals how Nigerians characterize and exercise their ideas of American citizenship and argues that the concept of US citizenship continues to be predicated on racial and ethnic exclusion. Chapter 3 examines the racialization of Nigerians in the US and how they navigate US racial politics. Chapter 4 explores how the culmination of perceived racialized experiences affect the quality of life of Nigerians. Chapter 5 discusses the political incorporation of Nigerians in Houston and assesses their level of political mobilization to combat racial inequality. This study will compel us to seek new understandings of the nuanced relationship between immigration, racialization, citizenship, and quality of life. Ultimately, the project articulates the persistence of marginality of African immigrants and seeks to identify policies that will redress it.African and African Diaspora Studie

Where shall the monsters live? : low-income black women and the politics of urban disposability

My dissertation historically and ethnographically traces how low-income black women have been affected by recent changes in public and affordable housing policies and advocacy. This dissertation examines the contemporary landscape of affordable housing policy and politics to better understand why low-income black women remain vulnerable to eviction, displacement, and housing insecurity in cities like the District of Columbia. Feminist scholars have documented how low-income black mothers won tenant rights and greater access to public housing during the civil rights movement. Yet very little research has examined the post-1970s changes to affordable housing policy and black women’s tenant activism. To capture the empirical and theoretical complexity of low-income black women’s experiences in affordable housing policy and politics, I employ a new epistemological approach called black feminist materialism. Black feminist materialism combines black feminist theories including intersectionality, critical theory, and feminist theories on the welfare state. Black feminist materialism provides the theoretical perspective needed to conduct critical ethnography, critical discourse analysis, and historical materialism. Armed with my feminist-minded theoretical perspective and after conducting archival and primary source research, I discovered federal and local housing bureaucrats used negative stereotypes about low-income black mothers to advocate post-1970s market reforms of public and affordable housing. Borrowing a term originally coined by critical urbanist Ananya Roy, I called these stereotypes poverty truths because these negative narratives facilitated policy interventions that had disciplinary and carceral effects. Housing officials used poverty truths to reduce funding, conduct mass evictions, and advocate for character rehabilitation services (e.g., job readiness/parenting classes) in exchange for housing assistance. In order to understand tenant activists’ response to these policy reforms, I analyzed the District of Columbia’s affordable housing advocacy community. To examine this community, I conducted participant observation as a community organizer for 18 months, starting in late 2013 and ending in early 2015. Moreover, I conducted semi-structured interviews with thirty non-profit staffers and ten low-income black women living in public and affordable housing. Post-1970s market reforms to affordable housing led to D.C. non-profit developers and service providers leading affordable housing production and advocacy. No longer leading tenant campaigns, low-income black women are recruited into non-profit developers and service providers’ advocacy models. These non-profits’ advocacy efforts are limited to regulatory reform (i.e., small improvements to existing laws), often ignoring or reducing black women tenant activists’ demands for structural reforms, which included calls for massive state investment in living-wage work, public and affordable housing, and childcare supports. This dissertation concludes with reflections on how non-profit organizing groups and low-income black women tenant activists can help develop tenant solidarity and a political analysis to counter the negative consequences of market- and disciplinary-based housing reforms.Ph.D.Includes bibliographical referencesby Rosemary Nonye Ndubuiz