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Background: Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Method: Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p < 0.05), more likely to report low health self-efficacy. When unmet medical need due to cost was added to the model, the association between financial hardship and low health self-efficacy was no longer statistically significant. Conclusion: Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy.

Synthetic peptide and peptido-mimetic filaments and tubes represent a diverse class of nanomaterials with a broad range of potential applications, such as drug delivery, vaccine development, synthetic catalyst design, encapsulation, and energy transduction. The structures of these filaments comprise supramolecular polymers based on helical arrangements of subunits that can be derived from self-assembly of monomers based on diverse structural motifs. In recent years, structural analyses of these materials at near-atomic resolution (NAR) have yielded critical insights into the relationship between sequence, local conformation, and higher-order structure and morphology. This structural information offers the opportunity for development of new tools to facilitate the predictable and reproducible de novo design of synthetic helical filaments. However, these studies have also revealed several significant impediments to the latter process – most notably, the common occurrence of structural polymorphism due to the lability of helical symmetry in structural space. This article summarizes the current state of knowledge on the structures of designed peptide and peptido-mimetic filamentous assemblies, with a focus on structures that have been solved to NAR for which reliable atomic models are available. [ABSTRACT FROM AUTHOR]

Background: African American (AA) male survivors of strokes or transient ischemic attacks (TIA) have the highest risk of recurrent stroke when compared to other racial-ethnic men. However, there is a paucity of evidence-based strategies, including organizational, educational, or behavioral interventions, that targets secondary stroke risk reduction in AA men. Methods: Targeted Management for Reducing Stroke Risk (TEAM) is an ongoing, 6-month prospective, randomized controlled trial that will determine whether a curriculum-guided self-management approach, using peer dyads (men who had a stroke or TIA and their care partners) will improve post-stroke care in AA men. Results: The study sample will consist of 160 AA men who have experienced a stroke or TIA within 5 years, randomized to TEAM or Wait-list control group. The primary outcome changes in systolic blood pressure (BP) and high-density lipoprotein (HDL), while secondary outcomes include diastolic BP, total cholesterol, low-density lipoprotein, triglycerides, and glycemic control for diabetics. We hypothesize that AA men in TEAM will have significantly lower systolic BP and higher HDL when compared to AA men in the Wait-list control group at 6-month. Conclusion: Persistent disparities for stroke burden in AA men highlight the need for novel interventions to promote secondary stroke-risk reduction. Building on promising pilot data, TEAM uses a group format, with a nurse and patient co-led intervention focused on AA men and family needs, practice in problem-solving, and attention to emotional and role management. In addition, the TEAM approach may help reduce stroke risk factors and health disparities in AA men. Clinicaltrials.gov Identifier: NCT04402125. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQOL) measures among the African American populations have previously been inadequately studied. This study sought to further analyze the quality of life of African American men at the Cleveland Clinic Minority Men’s Health Center and Cleveland Clinic Minority Men’s Health Fair. Subjects were randomly selected at the Minority Health Fair and Minority Men’s Health Center clinics over the duration of 2 weeks to participate in the anonymous survey with the help of independent surveyors. Convenience sampling was done at the Minority Men’s Health Fair and at the Minority Men’s Health Clinics. Participants were administered in-person Short Form-36 (SF-36v2). A total of 83 participants were surveyed, and the response rate from the surveyed population was 100%. The only exclusion criterion for the study was the refusal to participate (n = 0). As compared with healthy U.S. norms, African American men reported lower HRQOL across six health domains: physical functioning (60.69 ± 2.82 vs. 84.2), general health (57.56 ± 2.41 vs. 72), social functioning (72.65 ± 3.17 vs. 83.3), role-emotional (55.89 ± 3.02 vs. 81.3), mental health (61.23 ± 2.34 vs. 74.7), and role-physical (62.5 ± 2.88 vs. 81). The largest difference between the health domains was reported in role limitations due to emotional problems (55.89 ± 3.02 vs. 81.3, 25.4). Marital analysis revealed clinically significant lower HRQOL in married African Americans as compared with nonmarried, statistically significant in physical functioning and physical health component (p < .05). African Americans disproportionally face pervasive disparities in health, as supported by extensive quality of life impairment. No other study, to our knowledge, has used quality of life assessment in African Americans to quantitate how such disparities are affecting important domains in their lives. [ABSTRACT FROM AUTHOR]

Health self-efficacy, a measure of one’s self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, “Overall, how confident are you in your ability to take good care of your health?” Responses ranged from 1 (not confident at all) to 5 (completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated. [ABSTRACT FROM AUTHOR]

Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients. Our experience demonstrated a safe and positive outcome for both the recipient and donor, and is consistent with other reported outcomes in the literature. [ABSTRACT FROM AUTHOR]

Objective: To report a single-center 10-year experience of outcomes of kidney transplantation in African Americans (AAs) vs Caucasian Americans (CA) and to propose ways in which to improve kidney transplant outcomes in AAs, increased access to kidney transplantation, prevention of kidney disease, and acceptance of organ donor registration rates in AAs. Methods: We compared outcomes of deceased donor (DD) and living donor (LD) renal transplantation in AAs vs CAs in 772 recipients of first allografts at our transplant center from January 1995 to March 2004. For DD and LD transplants, no significant differences in gender, age, body mass index, or transplant panel reactive antibody (PRA) existed between AA and CA recipients. Results: Primary diagnosis of hypertension was more common in AA, DD, and LD recipients. Significant differences for DD transplants included Medicaid insurance in 23% AA compared with 7.0% CA (P <.0001) and more frequent diabetes mellitus type 2 in AAs (15% vs 4.1%, P = .0009). Eighty-three percent of AAs had received hemodialysis compared with 72% of CAs (P = .02). AAs endured significantly longer pretransplant dialysis (911 ± 618 vs 682 ± 526 days CA, P = .0006) and greater time on the waiting list (972 ± 575 vs 637 ± 466 days CA, P <.0001). In DD renal transplants, AAs had more human leukocyte antigen (HLA) mismatches than CAs (4.1 ± 1.4 vs 2.7 ± 2.1, P <.0001). Mean follow-up for survivors was 7.1 ± 2.5 years. Among LD transplants, graft survival and graft function were comparable for AAs and CAs; however, among DD transplants, graft function and survival were substantially worse for AAs (P = .0003). In both LD and DD transplants, patient survival was similar for AAs and CAs. Conclusion: Our data show that AAs receiving allografts from LDs have equivalent short- and long-term outcomes to CAs, but AAs have worse short- and long-term outcomes after DD transplantation. As such, we conclude that AAs should be educated about prevention of kidney disease, the importance of organ donor registration, the merits of LD over DD, and encouraged to seek LD options. [ABSTRACT FROM AUTHOR]