Lessons from dietary studies in Adventists and questions for the future.
Comparisons of diets and disease rates between Adventists and non-Adventists, and prospective cohort studies among Adventists, have contributed greatly to our general understanding of nutrition and health. The most fundamental conclusion drawn from the Adventist Health Studies has been that maintaining a lean body weight throughout life is central for optimal health. Other contributions have included the value of nut consumption for prevention of coronary artery disease, and the roles of red meat and dairy products in the etiologies of cardiovascular disease and cancer. Although much progress has been made, many issues remain unresolved. In particular, rates of breast and prostate cancers remain high among Adventist populations despite an overall healthy lifestyle and long life expectancy. There is even some suggestion that risk of breast cancer may increase with duration of being a vegetarian. One topic that may be uniquely studied among an Adventist population is the effect of soy phytoestrogens in disease prevention. Although soy consumption has been hypothesized to contribute to the low rates of breast cancer in Asian populations, several intervention studies using high doses of soy estrogens have shown changes in breast nipple fluid that would predict higher rates of breast cancer. Also, high dairy product consumption has been associated with risk of prostate and ovarian cancers in some but not all studies. The unusually wide range of milk consumption in Adventists will be particularly informative with regard to these relations. Resolution of these issues is needed to provide optimal guidance regarding healthy diets, and the newly funded Adventist Health Study will contribute importantly in this effort. (+info)
Maspardin is mutated in mast syndrome, a complicated form of hereditary spastic paraplegia associated with dementia.
Mast syndrome is an autosomal recessive, complicated form of hereditary spastic paraplegia with dementia that is present at high frequency among the Old Order Amish. Subtle childhood abnormalities may be present, but the main features develop in early adulthood. The disease is slowly progressive, and cerebellar and extrapyramidal signs are also found in patients with advanced disease. Patients have a thin corpus callosum and white-matter abnormalities, as seen on magnetic resonance imaging. Using an extensive Amish pedigree, we have mapped the Mast syndrome locus (SPG21) to a small interval of chromosome 15q22.31 that encompasses just three genes. Sequence analysis of the three transcripts revealed that all 14 affected cases were homozygous for a single base-pair insertion (601insA) in the acid-cluster protein of 33 kDa (ACP33) gene. This frameshift results in the premature termination (fs201-212X213) of the encoded product, which is designated "maspardin" (Mast syndrome, spastic paraplegia, autosomal recessive with dementia), and has been shown elsewhere to localize to intracellular endosomal/trans-Golgi transportation vesicles and may function in protein transport and sorting. (+info)
"Street medicine": Collaborating with a faith-based organization to screen at-risk youths for sexually transmitted diseases.
Chlamydia and gonorrhea rates among African American youths in San Francisco are far higher than those among young people of the city's other racial and ethnic groups. A geographically targeted sexually transmitted disease education and screening intervention performed in collaboration with a local faith-based organization was able to screen hundreds of at-risk youths. The screened individuals included friends and sex partners from an extensive social-sexual network that transcended the boundaries of the target population. The intervention also provided an excellent opportunity to practice "street medicine," in which all screening and treatment was effectively conducted in the field. (+info)
Therapeutic perspectives of human embryonic stem cell research versus the moral status of a human embryo--does one have to be compromised for the other?
Stem cells are unspecialized cells able to divide and produce copies of themselves and having the potential to differentiate, i.e. to produce other cell types in the body. Because of the latter ability, the scientists investigate their possible use in regenerative medicine. Especially embryonic stem cells have huge therapeutic potential because they can give rise to every cell type in the body as compared to stem cells from certain adult tissues which can only differentiate into a limited range of cell types. For this reason scientists stress the importance of embryonic stem cell research. However, this research raises sensitive ethical and religious arguments, which are balanced against possible great benefit of such research for the patients suffering from so far incurable diseases. The objective of this literature review is to present the main arguments in favor and against human embryonic stem cell research. Since the sensitivity of the latter issue to a large extent stems from the position of predominant religions in a given society, the positions of the main religions regarding embryo research are also presented. CONCLUSION: There is no consensus regarding ethical aspects of human embryonic stem cell research. The article presents both the arguments supporting human embryonic stem cell research and the arguments opposing it. (+info)
Understanding physical activity participation in members of an African American church: a qualitative study.
Faith-based interventions hold promise for increasing physical activity (PA) and thereby reducing health disparities. This paper examines the perceived influences on PA participation, the link between spirituality and health behaviors and the role of the church in promoting PA in African Americans. Participants (n = 44) were adult members of African American churches in South Carolina. In preparation for a faith-based intervention, eight focus groups were conducted with sedentary or underactive participants. Groups were stratified by age (<55 years versus >or=55 years), geography and gender. Four general categories were determined from the focus groups: spirituality, barriers, enablers and desired PA programs. Personal, social, community and environmental barriers and enablers were described by both men and women, with no apparent differences by age. Additionally, both men and women mentioned aerobics, walking programs, sports and classes specifically for older adults as PA programs they would like available at church. This study provides useful information for understanding the attitudes and experiences with exercise among African Americans, and provides a foundation for promoting PA through interventions with this population by incorporating spirituality, culturally specific activities and social support within the church. (+info)
Using IT to improve quality at NewYork-Presybterian Hospital: a requirements-driven strategic planning process.
At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality. (+info)
The association of health and functional status with private and public religious practice among rural, ethnically diverse, older adults with diabetes.
PURPOSE: This analysis describes the association of health and functional status with private and public religious practice among ethnically diverse (African American, Native American, white) rural older adults with diabetes. METHODS: Data were collected using a population-based, cross-sectional, stratified, random sample survey of 701 community-dwelling elders with diabetes in two rural North Carolina counties. Outcome measures were private religious practice, church attendance, religious support provided, and religious support received. Correlates included religiosity, health and functional status, and personal characteristics. Statistical significance was assessed using multiple linear regression and logistic regression models. FINDINGS: These rural elders had high levels of religious belief, and private and public religious practice. Religiosity was associated with private and public religious practice. Health and functional status were not associated with private religious practice, but they were associated with public religious practice, such that those with limited functional status participated less in public religious practice. Ethnicity was associated with private religious practice: African Americans had higher levels of private religious practice than Native Americans or whites, while Native Americans had higher levels than whites. CONCLUSIONS: Variation in private religious practice among rural older adults is related to personal characteristics and religiosity, while public religious practice is related to physical health, functional status, and religiosity. Declining health may affect the social integration of rural older adults by limiting their ability to participate in a dominant social institution. (+info)
Comparing self-reported disease outcomes, diet, and lifestyles in a national cohort of black and white Seventh-day Adventists.
INTRODUCTION: Few epidemiologic cohort studies on the etiology of chronic disease are powerful enough to distinguish racial and ethnic determinants from socioeconomic determinants of health behaviors and observed disease patterns. The Adventist Health Study-2 (AHS-2), with its large number of respondents and the variation in lifestyles of its target populations, promises to shed light on these issues. This paper focuses on some preliminary baseline analyses of responses from the first group of participants recruited for AHS-2. METHODS: We administered a validated and pilot-tested questionnaire on various lifestyle practices and health outcomes to 56,754 respondents to AHS-2, comprising 14,376 non-Hispanic blacks and 42,378 non-Hispanic whites. We analyzed cross-sectional baseline data adjusted for age and sex and performed logistic regressions to test differences between responses from the two racial groups. RESULTS: In this Seventh-day Adventist (Adventist) cohort, blacks were less likely than whites to be lifelong vegetarians and more likely to be overweight or obese. Exercise levels were lower for blacks than for whites, but blacks were as likely as whites not to currently smoke or drink. Blacks reported higher rates of hypertension and diabetes than did whites but lower rates of high serum cholesterol, myocardial infarction, emphysema, and all cancers. After we eliminated skin cancer from the analysis, the age-adjusted prevalence of cancer remained significantly lower for black than for white women. The prevalence of prostate cancer was 47% higher for black men than for white men. CONCLUSION: The profile of health habits for black Adventists is better than that for blacks nationally. Given the intractable nature of many other contributors to health disparities, including racism, housing segregation, employment discrimination, limited educational opportunity, and poorer health care, the relative advantage for blacks of the Adventist lifestyle may hold promise for helping to close the gap in health status between blacks and whites nationally. (+info)