Working Together with God: Religious Coping, Perceived Discrimination, and Hypertension.

This study examined the relationships of perceived discrimination and religious coping with hypertension in a sample of Black and White Seventh-day Adventists. Data come from a community-based sample of 6128 White American, 2253 African American and 927 Caribbean American adults (67% women; mean age = 62.9 years). Results indicate lifetime unfair treatment was significantly associated with hypertension regardless of race/ethnicity. Positive religious coping was associated with lower odds of hypertension and did not interact with unfair treatment. Both positive and negative religious coping were indirectly associated with increased hypertension risk through an increase in perceived discrimination.

Immunoseroproteomic Profiling in African American Men with Prostate Cancer: Evidence for an Autoantibody Response to Glycolysis and Plasminogen-Associated Proteins.

African American (AA) men suffer from a disproportionately high incidence and mortality of prostate cancer (PCa) compared with other racial/ethnic groups. Despite these disparities, African American men are underrepresented in clinical trials and in studies on PCa biology and biomarker discovery. We used immunoseroproteomics to profile antitumor autoantibody responses in AA and European American (EA) men with PCa, and explored differences in these responses. This minimally invasive approach detects autoantibodies to tumor-associated antigens that could serve as clinical biomarkers and immunotherapeutic agents. Sera from AA and EA men with PCa were probed by immunoblotting against PC3 cell proteins, with AA sera showing stronger immunoreactivity. Mass spectrometry analysis of immunoreactive protein spots revealed that several AA sera contained autoantibodies to a number of proteins associated with both the glycolysis and plasminogen pathways, particularly to alpha-enolase (ENO1). The proteomic data is deposited in ProteomeXchange with identifier PXD003968. Analysis of sera from 340 racially diverse men by enzyme-linked immunosorbent assays (ELISA) showed higher frequency of anti-ENO1 autoantibodies in PCa sera compared with control sera. We observed differences between AA-PCa and EA-PCa patients in their immunoreactivity against ENO1. Although EA-PCa sera reacted with higher frequency against purified ENO1 in ELISA and recognized by immunoblotting the endogenous cellular ENO1 across a panel of prostate cell lines, AA-PCa sera reacted weakly against this protein by ELISA but recognized it by immunoblotting preferentially in metastatic cell lines. These race-related differences in immunoreactivity to ENO1 could not be accounted by differential autoantibody recognition of phosphoepitopes within this antigen. Proteomic analysis revealed differences in the posttranslational modification profiles of ENO1 variants differentially recognized by AA-PCa and EA-PCa sera. These intriguing results suggest the possibility of race-related differences in the antitumor autoantibody response in PCa, and have implications for defining novel biological determinants of PCa health disparities.

Deliberate practice and nurse competence.

BACKGROUND: Increasing demand for accountability in health care requires that we understand how nurses continually increase their expertise. Development of expertise has been linked to deliberate practice in many domains but little is known about how deliberate practice impacts the expertise of registered nurses. OBJECTIVES: Evaluate the relationships among experience, education, deliberate practice, and competence as an empirical referent of expertise, and to identify which of the independent variables makes the highest contribution to competence. METHODS: Cross-sectional, descriptive, correlational study design was used. A purposive sample of RNs from one large, Midwestern teaching hospital was surveyed. RESULTS: After taking into consideration demographic variables, education and experience, deliberate practice made the greatest contribution to competence. No significant relationship was found between years of experience or education and competence. CONCLUSION: This study provides empirical evidence for the relationship of deliberate practice to competence, a promising concept for explaining the development of skill acquisition in nursing.

Prostate Cancer Screening among High-Risk Black Men.

We explored potential barriers and facilitators for prostate cancer screening choices among high-risk Black men. In our sample of 264 Black men over 45 years of age living in the U.S. who met the American Cancer Society criteria for screening, we found that only 49.6% had ever been screened. We investigated potential barriers including screening intention, access to care, medical mistrust, and fatalism. Potential facilitating factors investigated were provider-patient conversations encompassing the pros and cons of screening, ethnicity taken into account, insurance, and previous prostate cancer screening. Recommendations and resources are suggested to increase screening of high-risk Black men.

Religiousness and suicide in a nationally representative sample of Trinidad and Tobago adolescents and young adults.

PURPOSE: The present study examines religiousness and its connection to suicidal thoughts, plans, and attempts among Trinidad and Tobago adolescents and young adults. METHOD: Data are from Trend Research Empowering National Development on adolescents and young adults in Trinidad and Tobago (N = 4448). Religious affiliation, self-perceived religiousness, attendance at religious services, prayer frequency, socio-demographic variables, and suicidal thoughts, plans, and attempts were assessed. RESULTS: Compared to nonreligious, Catholics (OR 0.63, p < 0.05) and Seventh-day Adventists (OR 0.47, p < 0.01) were less likely to think about suicide, and hindus (OR 5.81, p < 0.05) and other affiliates (OR 7.28, p < 0.01) were more likely to be treated for suicide. Higher self-rated religiosity was related to lower likelihood of thinking about suicide (OR 0.86, p < 0.01) and lower likelihood of planning suicide (OR 0.78, p < 0.001). Attendance at religious services was related to lower likelihood of thinking about suicide (OR 0.94, p < 05) and fewer suicide attempts (ß = -0.11, p < 0.01). More frequent prayer was related to lower likelihood of thinking about suicide (OR 0.92, p < 0.01) and lower likelihood of planning suicide (OR 0.90, p < 0.001). CONCLUSIONS: Religiousness may offer benefits for adolescents and young adults in Trinidad and Tobago by reducing the likelihood that they engage in suicide thoughts and behaviors. Results may hold implications for counselors, clergy, teachers, and others working with adolescents and young adults in Trinidad and Tobago.

Religious involvement and health-related behaviors among Black Seventh-Day Adventists in Canada.

BACKGROUND: Most studies that involve Black Seventh-Day Adventists (SDAs) have been conducted in the United States. We sought to examine the association between religious involvement and lifestyle practices among Black SDAs in Canada. METHOD: A convenience sample of 509 Black SDA church members 18 years and older completed a self-administered questionnaire, assessing religious involvement and seven lifestyle practices promoted by the SDA church: diet, physical activity, water intake, exposure to sunlight, alcohol use, caffeine and tobacco use, and rest. RESULTS: Compliance with lifestyle practices ranged from a low of 10% meeting fitness guidelines to a high of 99% abstaining from tobacco products. Religious involvement and lifestyle were positively related (rs = .11, p < .05). Multivariate analyses indicated that private religious practice (ß = .16, p =.003), importance of the health principles (ß = .17, p = .003), and acceptance of health principles (ß = .65, p = .00001) significantly predicted the number of behaviors practiced. CONCLUSION: Greater religious involvement is associated with positive lifestyle practices but is not an independent predictor of lifestyle practices for Black Canadian SDAs.

"Deeply woven roots": health initiatives and community social services of faith-based organizations of the Hidalgo County, Texas.

Faith-based organizations (FBO) continue to play a significant role in the lives of individuals and communities in the United States. This study focused on the contributions of FBO to the health and well-being of residents of Rio Grande Valley, South Texas. Specifically, this study examined two main areas of involvement of FBO in Hidalgo County, Texas: health initiatives and community social services. Despite their influential and historical involvement, FBO partnership in the delivery of health and social services is not well accounted for. This study explores the characteristics of the clergy, parishioners, and FBO that are associated with community health initiatives and social services. Analyses revealed that FBO deliver a remarkably wide range of services. On a weekly basis, one in six or 17% of Hidalgo County residents were reported as receiving some form of health assistance or social services from county FBO. Variations exist depending on the characteristics of the clergy and the FBO. Policy and practice recommendations include engaging in additional networking, organizing resources, and strengthening FBO health initiatives.

Regional differences in attitudes that may affect health behavior and willingness to participate in research among Black Seventh-day Adventists.

OBJECTIVE: To identify the attitudes and perceptions of Black Seventh-day Adventists regarding health research and the healthcare system in two regions of the United States. DESIGN: Church members were selected from those who participated in the Adventist Health Study-2 (AHS-2) and those who chose not to participate. Participants were selected from two regions of the United States. SETTING: Participants were interviewed in their churches, in their homes, and in the research study office at Loma Linda University. Interviews were done in the Western and Southern regions of the United States. PARTICIPANTS: 384 Black Seventh-day Adventists, aged >30 years. MAIN OUTCOME MEASURES: Responses to the structured interviews from those in the Western region were compared to those in the Southern region. RESULTS: Those in the Southern region included more elderly subjects; they were more likely to own their home despite earning less; and were more likely to be married. Compared to the Western region participants, we found Southern participants to have greater participation in church activities, greater mistrust of the healthcare system and particular concerns about racial inequalities in care. In contrast, they also reported more positive experiences with their personal healthcare provider than Western participants. Southerners felt that they had greater control over their own health, perhaps in part due to a greater identification with the health teachings of the Adventist church. CONCLUSIONS: A number of clear differences were found between Black Adventist subjects living in either the Western or Southern regions of the United States. These factors should be considered carefully when planning the promotion for a research study.

Health beliefs and the prevention of hypertension in a black population living in London.

In the United Kingdom, the morbidity and mortality associated with hypertension is much higher in Blacks than in Whites. We studied a convenience sample of 312 persons aged 25-79 years from 17 predominantly Black Seventh-Day Adventist churches across London by using the health belief model to examine their beliefs about the prevention of hypertension. A questionnaire was used to collect demographic and anthropometric data, lifestyle practices, and perceptions toward hypertension by using the health belief model constructs of susceptibility, severity, benefits, barriers, and self-efficacy. A relative risk estimate score was developed to assess the presence of several risk factors of hypertension for each participant. Based on multiple regression analyses, the demographic variables were independent predictors of systolic blood pressure (R2 = .195), the combined behavioral variable (risk score) was an independent predictor of diastolic blood pressure (beta = .18, P = .02), and self-efficacy was the only independent variable significantly associated with risk scores (beta = -.21, P = .008). The perception of self-efficacy to perform behaviors that will decrease hypertension risk needs to be effectively harnessed by health educators to decrease the prevalence of hypertension in this population.

Exploring the Relationship Balance Assessment.

Assessments of power in couples' relationships often only survey one partner, but they do not take into consideration both partners' perceptions. Thus, many assumptions about power and equality in relationships have not been quantitatively tested due to a lack of dyadic measures of power. Therefore, the purpose of the Gender and Relationships Study was to develop and test a new scale of equality and relative power for couples, the Relationship Balance Assessment (RBA). The RBA may be useful for research and for clinical work with couples to help raise awareness of the balance of power in their relationship. A review of the literature has shown a shift away from focusing on monetary resources and decision-making dominance towards examining relationship processes and the connection between gender and power. This study prescreened a pool of process-oriented questions based on the qualitative literature. Then exploratory factor analysis of data from 268 individuals and 91 couples identified 12 consistent latent factors underlying relationship equality. These 12 subscales are summed up with the TREASURES acronym: Time Discretion, Relational Power, Emotional Power (Emotional Expression and Avoidance subscales), Accommodation, Spending and Saving subscales, Union or Sexual Dominance, Rational Power, Economic Role Power (Status and Childcare subscales), and Social Choices.

Religious Coping and Glycemic Control in Couples with Type 2 Diabetes.

This study examines the role of religious coping in couples' diabetes management processes. Eighty-seven couples where one spouse had type 2 diabetes were surveyed. The relationships between religious coping (positive and negative), shared glycemic control activities (e.g., planning a healthy diet), and glycemic control were examined using repeated measures ANOVA and SEM. Findings show spousal engagement in shared activities is significantly associated with glycemic control. Furthermore, the use of negative religious coping by the diabetic spouse, and positive religious coping by the nondiabetic spouse, related to lower levels and higher levels of shared glycemic control activities, respectively. Religious coping and shared glycemic control activities appear integral to couples managing type 2 diabetes and, may serve as useful points of intervention.

Physician Consultations, Prostate Cancer Knowledge, and PSA Screening of African American Men in the Era of Shared Decision-Making.

African American (AA)/Black men are more likely to develop aggressive prostate cancer (PCa), yet less likely to be screened despite guidelines espousing shared decision-making regarding PCa screening and prostate-specific antigen (PSA) testing. Given the documented racial disparities in PCa incidence and mortality, engaging interactions with physicians are especially important for AA/Black men. Thus, this study evaluated occurrence of physician-patient conversations among AA/Black men, and whether such conversations were associated with PCa knowledge. We also quantified the serum PSA values of participants who had, and had not, discussed testing with their physicians. Self-identified AA/Black men living in California and New York, ages 21-85, donated blood and completed a comprehensive sociodemographic and health survey ( n = 414). Less than half (45.2%) of participants had discussed PCa screening with their physicians. Multivariate analyses were used to assess whether physician-patient conversations predicted PCa knowledge after adjusting for key sociodemographic/economic and health-care variables. Increased PCa knowledge was correlated with younger age, higher income and education, and having discussed the pros and cons of PCa testing with a physician. Serum PSA values were measured by ELISA. Higher-than-normal PSA values were found in 38.5% of men who had discussed PCa screening with a physician and 29.1% who had not discussed PCa screening. Our results suggest that physician-AA/Black patient conversations regarding PCa risk need improvement. Encouraging more effective communication between physicians and AA/Black men concerning PCa screening and PSA testing has the potential to reduce PCa health disparities.

Glucocorticoids Induce Stress Oncoproteins Associated with Therapy-Resistance in African American and European American Prostate Cancer Cells.

Glucocorticoid receptor (GR) is emerging as a key driver of prostate cancer (PCa) progression and therapy resistance in the absence of androgen receptor (AR) signaling. Acting as a bypass mechanism, GR activates AR-regulated genes, although GR-target genes contributing to PCa therapy resistance remain to be identified. Emerging evidence also shows that African American (AA) men, who disproportionately develop aggressive PCa, have hypersensitive GR signaling linked to cumulative stressful life events. Using racially diverse PCa cell lines (MDA-PCa-2b, 22Rv1, PC3, and DU145) we examined the effects of glucocorticoids on the expression of two stress oncoproteins associated with PCa therapy resistance, Clusterin (CLU) and Lens Epithelium-Derived Growth Factor p75 (LEDGF/p75). We observed that glucocorticoids upregulated LEDGF/p75 and CLU in PCa cells. Blockade of GR activation abolished this upregulation. We also detected increased GR transcript expression in AA PCa tissues, compared to European American (EA) tissues, using Oncomine microarray datasets. These results demonstrate that glucocorticoids upregulate the therapy resistance-associated oncoproteins LEDGF/p75 and CLU, and suggest that this effect may be enhanced in AA PCa. This study provides an initial framework for understanding the contribution of glucocorticoid signaling to PCa health disparities.

Disparities in obesity prevalence and obesity-related behaviors among adolescents in Trinidad and Tobago.

Objective African Americans adolescents have disproportionately high rates of obesity compared to their Caucasian peers. Little is known about the rates of obesity among adolescents of African descent in countries with diverse populations. Therefore, we aimed to determine the prevalence of obesity and weight-related behaviors among adolescents in Trinidad and Tobago and to explore differences by race and gender. Methods In this cross-sectional study, students from a national stratified sample of high schools (n = 42) in Trinidad and Tobago completed a self-administered survey regarding their health habits. Body mass index (BMI) was calculated from measured height (via a portable stadiometer) and weight (via a digital scale), and BMI percentiles determined using Centers for Disease Control and Prevention (CDC) growth charts. Univariate calculations and χ2 analyses were performed to determine obesity prevalence and explore associations between obesity and self-reported demographic factors and weight-related behaviors. One-way analysis of variance (ANOVA) was used to test mean difference in weight status and multivariate analyses explored the role of gender and race after adjusting for covariates. Results Of the 3618 adolescents in the study, 56.3% were female. Race: 31.9% Black-Trinidadian, 33.7% Indo-Trinidadian and 33.4% Mixed-Race. Mean age was 17.6 years. The overall prevalence of obesity was 7%, but this differed by race (Black-Trinidadians 17%, Mixed-Trinidadians 2%, Indo-Trinidadians 1%). Black-Trinidadian girls were most likely to be obese (28.1%) and to engage in obesity related habits than their peers. Conclusion Black-Trinidadian girls have a significantly higher prevalence of obesity than their peers. Further work should explore culturally tailored interventions to address obesity prevention and treatment in this group.

Partner expressed emotion and diabetes management among spouses living with Type 2 diabetes.

INTRODUCTION: Expressed emotion has been consistently shown to be a significant predictor of relapse and poor disease management across numerous physical and mental health conditions, however very little research has been conducted on its relationship to the management practices of individuals living with Type 2 diabetes. This study examines the relationship between expressed emotion (EE) and diabetes management among couples where 1 spouse has Type 2 diabetes. METHODS: The authors surveyed 106 couples where 1 partner was diagnosed with Type 2 diabetes. Partners without diabetes completed questionnaires about their level of criticism, emotional involvement, and warmth toward their partners. Partners with diabetes completed questionnaires on diabetes control, diabetes management practices and attitude toward their diabetes. RESULTS: The authors found that, individuals living with diabetes who had partners with high EE reported significantly poorer diabetes management in all areas (diet, physical activity, and attitude toward diabetes). Diabetes management was found to mediate the relationship between EE and diabetes control. Results suggest that partners with high EE may have a significant influence on diabetes management practices in their partner. DISCUSSION: These findings highlight the important role couple interactions may play in diabetes management. Findings also emphasize the potential benefit of conceptualizing diabetes management from a systems/relational perspective. In addition, greater consideration should be given to using family-based approaches for diabetes management and treatment among coupled individuals living with Type 2 diabetes. (PsycINFO Database Record

Culture, black men, and prostate cancer: what is reality?

BACKGROUND: The worldwide incidence of prostate cancer is higher among American black men than any other male group. In the United States, lack of participation in screening for prostate cancer by black men is influenced by several cultural factors, including knowledge, health beliefs, barriers, and relationships with primary healthcare providers. METHODS: We used the qualitative and paralleling descriptive quantitative findings of a mixed-method longitudinal study exploring prostate cancer screening behaviors among 277 black men. RESULTS: Five themes were identified as critical elements affecting men's screening for prostate cancer: lack of knowledge, communication, social support, quality of care, and sexuality. These themes were associated with a sense of disconnectedness by black men from the healthcare system and contributed to nonparticipation in prostate cancer early detection activities. CONCLUSIONS: Lack of discussion about the decision to screen for prostate cancer and general lack of culturally appropriate communication with healthcare providers has engendered distrust, created fear, fostered disconnect, and increased the likelihood of nonparticipation in prostate cancer screening among black men.

Seven types of nonsexual romantic physical affection among Brigham young university students.

College students from Brigham Young University (N= 186; 68 men, 118 women, M age=22.7 yr., SD=3.5) completed a survey regarding nonsexual, romantic physical affection-defined as any touch intended to arouse feelings of love in the giver or the recipient. Respondents included both dating and married individuals, although this was not specified on the questionnaire. This descriptive study reports the mean, median, mode, and standard deviation for each of the seven physical affection types: backrubs/massages, caressing/stroking, cuddling/holding, holding hands, hugging, kissing on the face, and kissing on the lips. Grouped frequency distributions further describe the amounts of each type of physical affection. Although physical affection has been underrepresented in the literature, studies have shown it to be associated with relationship satisfaction, partner satisfaction, psychological intimacy, feeling understood, the development of attachment bonds, modulating cardiovascular arousal, and easier conflict resolution.

Couple's relationship with diabetes: means and meanings for management success.

Diabetes is a serious chronic illness that involves individuals, couples, and families in complex reciprocal interactions with the illness and other life dimensions. A major issue in diabetes management is how well the patient is able to follow the established medical regimen of selfcare. Situated within personal, physical, and social contexts, the meaning that a couple creates and the emotions they feel in their adaptation to living with diabetes and its demanding regimen can be viewed as the couple's relationship with diabetes.

Physician assistant: motivations and perceptions of the profession.

UNLABELLED: The purpose of this study was to explore factors associated with the current gender gap in the Physician Assistant (PA) profession. PARTICIPANTS: Sixty-six physician assistant students from three physician assistant programs in southern California. METHOD: We enrolled a focus group at each school. We used four open-ended questions to explore the participants' reasons for choosing the PA profession. In addition, participants completed a demographic questionnaire. Using qualitative analysis, we identified three themes among the participants' responses. RESULTS: Responses were grouped in the following categories: 1. Motivations for becoming a PA; 2. Flexibility and autonomy; and 3. Perceptions of a gender gap. CONCLUSIONS: There are several factors that contribute to the gender gap in the PA profession. Health professions with a gender gap may consider these factors to design a supportive environment for genders as well as re-examine marketing targets and educational awareness.