To explore factors related to youths’ delay in seeking care after an HIV diagnosis. Multivariate ... more To explore factors related to youths’ delay in seeking care after an HIV diagnosis. Multivariate analyses were performed on 347 participants who were selected from a sample of 351 adolescents participating in a 1994-1996 survey among youth in four U.S. metropolitan cities. Key findings were that participants with prosocial peer behaviors took longer (34 days) to seek care than youth with poorer social engagement and excessive fibbing delayed seeking care (23 days). Potentially important findings suggest being female, older, having close peer networks, conduct problems, and certain housing settings may delay seeking care. Multivariate regression analyses indicate that later entry into medical care was observed among those with close social networks and behavioral characteristics related to delinquency.
Glucocorticoid receptor (GR) is emerging as a key driver of prostate cancer (PCa) progression and... more 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...
African American (AA)/Black men are more likely to develop aggressive prostate cancer (PCa), yet ... more 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-pat...
Increasing demand for accountability in health care requires that we understand how nurses contin... more 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. 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. Cross-sectional, descriptive, correlational study design was used. A purposive sample of RNs from one large, Midwestern teaching hospital was surveyed. 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. This study provides empirical evidence for the relationship of deliberat...
Prostate cancer (PCa) is the most commonly diagnosed cancer and second leading cause of cancer-re... more Prostate cancer (PCa) is the most commonly diagnosed cancer and second leading cause of cancer-related deaths in American men. African American (AA) men are more likely to be diagnosed with aggressive PCa at a younger age and twice as likely to die from the disease as European American (EA) men. In order to reduce PCa mortality and its associated racial disparities, there is a critical need to identify and target pathways responsible for PCa aggressiveness. An unexplored target is the plasminogen system, which is key to cancer cell migration and tissue invasion during metastasis. During inflammation, activation of the plasminogen pathway degrades extracellular fibrin networks; however, in the context of cancer, this activation promotes cancer tissue invasion and metastasis. Mounting evidence shows that the glycolytic enzyme alpha-enolase (ENO1) plays a vital role in both increased energy metabolism and plasminogen activation during cancer progression and metastasis. Using immunosero...
The context of the lives of physicians has unique and challenging features for those in dual-care... more The context of the lives of physicians has unique and challenging features for those in dual-career marriages. The empirical investigation of this phenomenon has remained relatively sparse. This study assesses dual-career couples that include a physician nurture marriage and family relationships while managing the heavy demands of their career. Using a sample of 15 dual-career couples with a key informant physician, a qualitative phenomenological lens investigated how these intimate relationships are nurtured as they manage the other demands of work and life. Two major themes evolved that were associated with intentionality to grow and maintain their relationship before having children and negotiating the demands of life and work after children come into the family. This study discusses important implications for theory, research, and practice as family counselors, therapists, and educators as they focus on adjustment to the unique experience of physicians in dual-career relationships.
In the United Kingdom, the morbidity and mortality associated with hypertension is much higher in... more 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-eff...
Using qualitative research methods, a culturally diverse group of 22 graduated master&amp... more Using qualitative research methods, a culturally diverse group of 22 graduated master's level marriage and family therapist interns were interviewed about their approach to relationship-building with a cross-cultural client. Interviews were conducted in southern California. Results indicate that participants rely on heightened efforts of self-supervision to manage the influences of their culturally informed beliefs and preconceptions of cross-cultural clients. Also,
Prostate cancer (PCa) presents the greatest US cancer health disparity in terms of incidence and ... more Prostate cancer (PCa) presents the greatest US cancer health disparity in terms of incidence and mortality, disproportionately affecting African American (AA) men. The biological characteristics of prostate tumors are exaggerated in AA men compared to European American (EA) men at time of diagnosis. The mechanisms underlying increased PCa aggressiveness in AA men are not fully understood; therefore, there is a critical need to identify biological determinants contributing to PCa mortality disparities. Glucocorticoids—a type of stress hormone—have been implicated as driving factors in PCa progression. The underlying mechanism involves endogenous glucocorticoid (cortisol) binding to its glucocorticoid receptor (GR) and activating genes that promote tumor aggressiveness and therapy resistance. A clinical dilemma exists as glucocorticoids, important in the palliative care of PCa patients, are now emerging as accelerators of disease progression and shortened survival. Chronically elevate...
Human flourishing has been defined as a subjective and holistic sentiment related to growth, pros... more Human flourishing has been defined as a subjective and holistic sentiment related to growth, prosperity, fulfillment, and sense of life completeness. This definition may lead to think that human flourishing is unique to people living under privileged circumstances of health and well-being, whereas people with life limiting illnesses are deprived from this possibility.In this paper, we reflect on the idea of human flourishing in the context of palliative care. Although people with advanced illnesses experience in a special manner the limits of human life and vulnerability, and the final stages may inevitably imply considerable suffering, we argue that it is also possible to experience this final stage as an opportunity for personal growth, to live it in full accordance with one's beliefs and values, and to reestablish a profound connection to oneself and to others. In sum, the end of life may also be a time of human flourishing.
Background. Most studies that involve Black Seventh-Day Adventists (SDAs) have been conducted in ... more 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 ( β = .16, p =.003), importance of the health principles ( β = .17, p = .003), and acceptance of health principles ( β = .65, p = .00001) si...
Religion and its practice have been found to significantly influence marital satisfaction and qua... more Religion and its practice have been found to significantly influence marital satisfaction and quality. However, there is a paucity of research that has explored these relationships among married adults living in the Caribbean and Latin America. This study examines the influence of prayer and family worship on relationship satisfaction, emotional attunement, conflict resolution and belief in traditional gender roles among Christian Caribbean and Latin American married adults. Data were gathered from 3997 Seventh-day Adventist (SDA) adults in the Caribbean and Latin America. Hierarchical multiple regression (HMR) analyses were conducted to evaluate the associations between religious practices (personal prayer, family worship, church attendance, and bible study) and relationship outcomes (relationship satisfaction, emotional attunement, conflict resolution, beliefs in traditional roles) independent of gender and level of education. The results suggest that married adults who spend more...
International Journal of Health Sciences and Research, 2017
Background: Self-reported diagnosis of high blood pressure is frequently used to study representa... more Background: Self-reported diagnosis of high blood pressure is frequently used to study representative samples of a population. Objective: Using a cross-sectional design, we examined the relationship between self-reported high blood pressure and clinical evidence for the disease, such as use of antihypertensive medications. Methods: A community-based sample of older Seventh-day Adventist adults aged 50 years and older (n = 457) was recruited from a prospective cohort study. Confirmed high blood pressure was defined as using an antihypertensive medication, having a systolic blood pressure ≥ 140 mmHg, or a diastolic blood pressure ≥ 90 mmHg. Results: There were 236 (52.0%) out of 457 participants with self-reported high blood pressure. Blacks (n = 118, 64.8%) reported higher rates of high blood pressure compared to Whites (n = 118, 42.9%). Based on the diagnostic criteria 13.6% (n = 62) were undiagnosed with high blood pressure. Blacks (49.7%) were more likely to report a true positive diagnosis and Whites (50.2%) were more likely to report a true negative diagnosis of high blood pressure. Sensitivity was 72% and specificity 80%. Sensitivity was significantly higher for Blacks (80%) than for Whites (62%). Agreement between self-report and diagnostic criteria for high blood pressure was substantial (kappa 0.68) across all participants. Conclusions: Our findings add to the evidence that self-report is usually a valid method for assessing high blood pressure, at least for studies with large sample sizes. The greater sensitivity rate for Blacks than Whites suggests that self-report of high blood pressure is more accurate for Blacks.
Based on the theory of planned behavior the research aims were to: (a) ascertain how attitude, su... more Based on the theory of planned behavior the research aims were to: (a) ascertain how attitude, subjective norm, and perceived control predict intentions to engage in sexual intercourse among Black, African-born adolescents in Southern California; and (b) determine how behavioral beliefs, normative beliefs, and control beliefs predict attitude, subjective norm and perceived control. A questionnaire was developed based on focus group findings. One hundred and thirty-five adolescents aged 15 to 19 years completed the questionnaire. The strongest predictor of intention was attitude, then subjective norm. Enjoying sex, “wanting to be a parent” and to “keep sexual partners” predicted attitude. Educative, informative, cultural and faith based programs, if initiated may help African adolescents in Southern California.
To explore factors related to youths’ delay in seeking care after an HIV diagnosis. Multivariate ... more To explore factors related to youths’ delay in seeking care after an HIV diagnosis. Multivariate analyses were performed on 347 participants who were selected from a sample of 351 adolescents participating in a 1994-1996 survey among youth in four U.S. metropolitan cities. Key findings were that participants with prosocial peer behaviors took longer (34 days) to seek care than youth with poorer social engagement and excessive fibbing delayed seeking care (23 days). Potentially important findings suggest being female, older, having close peer networks, conduct problems, and certain housing settings may delay seeking care. Multivariate regression analyses indicate that later entry into medical care was observed among those with close social networks and behavioral characteristics related to delinquency.
Glucocorticoid receptor (GR) is emerging as a key driver of prostate cancer (PCa) progression and... more 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...
African American (AA)/Black men are more likely to develop aggressive prostate cancer (PCa), yet ... more 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-pat...
Increasing demand for accountability in health care requires that we understand how nurses contin... more 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. 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. Cross-sectional, descriptive, correlational study design was used. A purposive sample of RNs from one large, Midwestern teaching hospital was surveyed. 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. This study provides empirical evidence for the relationship of deliberat...
Prostate cancer (PCa) is the most commonly diagnosed cancer and second leading cause of cancer-re... more Prostate cancer (PCa) is the most commonly diagnosed cancer and second leading cause of cancer-related deaths in American men. African American (AA) men are more likely to be diagnosed with aggressive PCa at a younger age and twice as likely to die from the disease as European American (EA) men. In order to reduce PCa mortality and its associated racial disparities, there is a critical need to identify and target pathways responsible for PCa aggressiveness. An unexplored target is the plasminogen system, which is key to cancer cell migration and tissue invasion during metastasis. During inflammation, activation of the plasminogen pathway degrades extracellular fibrin networks; however, in the context of cancer, this activation promotes cancer tissue invasion and metastasis. Mounting evidence shows that the glycolytic enzyme alpha-enolase (ENO1) plays a vital role in both increased energy metabolism and plasminogen activation during cancer progression and metastasis. Using immunosero...
The context of the lives of physicians has unique and challenging features for those in dual-care... more The context of the lives of physicians has unique and challenging features for those in dual-career marriages. The empirical investigation of this phenomenon has remained relatively sparse. This study assesses dual-career couples that include a physician nurture marriage and family relationships while managing the heavy demands of their career. Using a sample of 15 dual-career couples with a key informant physician, a qualitative phenomenological lens investigated how these intimate relationships are nurtured as they manage the other demands of work and life. Two major themes evolved that were associated with intentionality to grow and maintain their relationship before having children and negotiating the demands of life and work after children come into the family. This study discusses important implications for theory, research, and practice as family counselors, therapists, and educators as they focus on adjustment to the unique experience of physicians in dual-career relationships.
In the United Kingdom, the morbidity and mortality associated with hypertension is much higher in... more 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-eff...
Using qualitative research methods, a culturally diverse group of 22 graduated master&amp;amp... more Using qualitative research methods, a culturally diverse group of 22 graduated master&amp;amp;#x27;s level marriage and family therapist interns were interviewed about their approach to relationship-building with a cross-cultural client. Interviews were conducted in southern California. Results indicate that participants rely on heightened efforts of self-supervision to manage the influences of their culturally informed beliefs and preconceptions of cross-cultural clients. Also,
Prostate cancer (PCa) presents the greatest US cancer health disparity in terms of incidence and ... more Prostate cancer (PCa) presents the greatest US cancer health disparity in terms of incidence and mortality, disproportionately affecting African American (AA) men. The biological characteristics of prostate tumors are exaggerated in AA men compared to European American (EA) men at time of diagnosis. The mechanisms underlying increased PCa aggressiveness in AA men are not fully understood; therefore, there is a critical need to identify biological determinants contributing to PCa mortality disparities. Glucocorticoids—a type of stress hormone—have been implicated as driving factors in PCa progression. The underlying mechanism involves endogenous glucocorticoid (cortisol) binding to its glucocorticoid receptor (GR) and activating genes that promote tumor aggressiveness and therapy resistance. A clinical dilemma exists as glucocorticoids, important in the palliative care of PCa patients, are now emerging as accelerators of disease progression and shortened survival. Chronically elevate...
Human flourishing has been defined as a subjective and holistic sentiment related to growth, pros... more Human flourishing has been defined as a subjective and holistic sentiment related to growth, prosperity, fulfillment, and sense of life completeness. This definition may lead to think that human flourishing is unique to people living under privileged circumstances of health and well-being, whereas people with life limiting illnesses are deprived from this possibility.In this paper, we reflect on the idea of human flourishing in the context of palliative care. Although people with advanced illnesses experience in a special manner the limits of human life and vulnerability, and the final stages may inevitably imply considerable suffering, we argue that it is also possible to experience this final stage as an opportunity for personal growth, to live it in full accordance with one's beliefs and values, and to reestablish a profound connection to oneself and to others. In sum, the end of life may also be a time of human flourishing.
Background. Most studies that involve Black Seventh-Day Adventists (SDAs) have been conducted in ... more 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 ( β = .16, p =.003), importance of the health principles ( β = .17, p = .003), and acceptance of health principles ( β = .65, p = .00001) si...
Religion and its practice have been found to significantly influence marital satisfaction and qua... more Religion and its practice have been found to significantly influence marital satisfaction and quality. However, there is a paucity of research that has explored these relationships among married adults living in the Caribbean and Latin America. This study examines the influence of prayer and family worship on relationship satisfaction, emotional attunement, conflict resolution and belief in traditional gender roles among Christian Caribbean and Latin American married adults. Data were gathered from 3997 Seventh-day Adventist (SDA) adults in the Caribbean and Latin America. Hierarchical multiple regression (HMR) analyses were conducted to evaluate the associations between religious practices (personal prayer, family worship, church attendance, and bible study) and relationship outcomes (relationship satisfaction, emotional attunement, conflict resolution, beliefs in traditional roles) independent of gender and level of education. The results suggest that married adults who spend more...
International Journal of Health Sciences and Research, 2017
Background: Self-reported diagnosis of high blood pressure is frequently used to study representa... more Background: Self-reported diagnosis of high blood pressure is frequently used to study representative samples of a population. Objective: Using a cross-sectional design, we examined the relationship between self-reported high blood pressure and clinical evidence for the disease, such as use of antihypertensive medications. Methods: A community-based sample of older Seventh-day Adventist adults aged 50 years and older (n = 457) was recruited from a prospective cohort study. Confirmed high blood pressure was defined as using an antihypertensive medication, having a systolic blood pressure ≥ 140 mmHg, or a diastolic blood pressure ≥ 90 mmHg. Results: There were 236 (52.0%) out of 457 participants with self-reported high blood pressure. Blacks (n = 118, 64.8%) reported higher rates of high blood pressure compared to Whites (n = 118, 42.9%). Based on the diagnostic criteria 13.6% (n = 62) were undiagnosed with high blood pressure. Blacks (49.7%) were more likely to report a true positive diagnosis and Whites (50.2%) were more likely to report a true negative diagnosis of high blood pressure. Sensitivity was 72% and specificity 80%. Sensitivity was significantly higher for Blacks (80%) than for Whites (62%). Agreement between self-report and diagnostic criteria for high blood pressure was substantial (kappa 0.68) across all participants. Conclusions: Our findings add to the evidence that self-report is usually a valid method for assessing high blood pressure, at least for studies with large sample sizes. The greater sensitivity rate for Blacks than Whites suggests that self-report of high blood pressure is more accurate for Blacks.
Based on the theory of planned behavior the research aims were to: (a) ascertain how attitude, su... more Based on the theory of planned behavior the research aims were to: (a) ascertain how attitude, subjective norm, and perceived control predict intentions to engage in sexual intercourse among Black, African-born adolescents in Southern California; and (b) determine how behavioral beliefs, normative beliefs, and control beliefs predict attitude, subjective norm and perceived control. A questionnaire was developed based on focus group findings. One hundred and thirty-five adolescents aged 15 to 19 years completed the questionnaire. The strongest predictor of intention was attitude, then subjective norm. Enjoying sex, “wanting to be a parent” and to “keep sexual partners” predicted attitude. Educative, informative, cultural and faith based programs, if initiated may help African adolescents in Southern California.
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Papers by Colwick Wilson