Bishop Sedgwick Daniels's legacy extends beyond the pulpit, deeply impacting community health and well-being. His work, particularly through the C.H. Mason Health Clinic, aimed to address critical health issues and empower individuals to lead healthier lives. This article explores the initiatives inspired by Bishop Daniels, focusing on the clinic's role in providing accessible healthcare and promoting wellness within the community.
The C.H. Mason Health Clinic: A Beacon of Hope
Prior to covid, Holy Redeemer Church of God in Christ, under the late Bishop Sedgwick Daniels, relaunched the C.H. Mason Health Clinic. The C. H. Mason Clinic is free to the community and is open Monday through Friday. Through a partnership with now-defunct St. Michael’s Hospital, parish nurses primarily ran the clinic. The clinic is staffed by a nurse practitioner, nurses and clinical support staff. Dr. Kemba Banyard, a Psychiatric Mental Health Nurse Practitioner and Family Practice Nurse Practitioner, also runs a weight loss management program at the clinic. The clinic addresses important health topics such as diabetes, obesity, and depression.
Accessible and Comprehensive Care
The C.H. Mason Health Clinic stands as a testament to Bishop Daniels's vision of a healthier community. The clinic offers free services to the community, operating from Monday through Friday. A nurse practitioner, nurses, and clinical support staff, staff the clinic. Dr. Kemba Banyard, a Psychiatric Mental Health Nurse Practitioner and Family Practice Nurse Practitioner, also runs a weight loss management program at the clinic. The clinic addresses important health topics such as diabetes, obesity, and depression.
A Holistic Approach to Health
The clinic's approach extends beyond treating illnesses; it focuses on preventive care and education. "Health is the key to success. If we have a healthier community, we will have healthier families". The clinic's services encompass a range of health concerns, including weight management.
Community Engagement and Education
Registration for the “Lunch and Learn” session is encouraged. Visit www.chmasonhealthclinic.com/ for more information. While walk-in patients are accepted, appointments can also be scheduled by calling (414) 249-4613. The clinic actively engages the community through educational initiatives.
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Addressing Obesity and Promoting Weight Loss
Obesity is a significant health concern, and the C.H. Mason Health Clinic directly addresses this issue through its weight loss management program. The program, run by Dr. Kemba Banyard, offers a supportive environment for individuals seeking to achieve a healthier weight.
Weight Loss Management Program
The weight loss management program at the clinic offers a structured approach to weight loss, incorporating medical expertise and personalized guidance. This program reflects a commitment to addressing the multifaceted challenges of obesity and promoting sustainable lifestyle changes.
The Importance of Community Health Initiatives
Bishop Daniels's emphasis on health underscores the importance of community-based initiatives in promoting overall well-being. These initiatives play a vital role in addressing health disparities and empowering individuals to take control of their health.
Strengthening Families and Communities
"If we have a healthier community, we will have healthier families". This statement encapsulates the interconnectedness of individual and community health, highlighting the far-reaching impact of initiatives like the C.H. Mason Health Clinic.
Tanisha Collins-Johnson: A Champion of Community Health
Tanisha Collins-Johnson has spent most of her life working in health care in some capacity. She is currently employed by Anthem Blue Cross/Blue Shield, in partnership with C. H. Tanisha attended Shalom High School and Waukesha County Technical College, where she earned an Associate’s degree in Human Services. After completing training as a pharmacy technician, Tanisha transferred to St. Joseph’s Hospital.
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A Career Dedicated to Healthcare
Tanisha's journey reflects a deep commitment to serving others and improving community health. Her experiences in various healthcare settings have equipped her with a comprehensive understanding of the challenges and opportunities in the field.
Echoing Bishop Daniels's Vision
"My mother always told me to go after my dreams, believe in myself and always trust God and trust the process. At the end of the day, it’s not about me; it’s about others. As Bishop Daniels always said, “If God can do anything, God can do everything". Tanisha's words resonate with the spirit of Bishop Daniels's teachings, emphasizing the importance of faith, perseverance, and service to others.
The Broader Impact of Health Initiatives
The work inspired by Bishop Daniels extends beyond the C.H. Mason Health Clinic, encompassing a range of initiatives aimed at promoting health and well-being within the community. These efforts contribute to creating a culture of health, where individuals are empowered to make informed decisions and lead healthier lives.
Addressing Health Disparities
Community health initiatives play a crucial role in addressing health disparities, ensuring that all individuals have access to quality care and resources. By focusing on underserved populations, these initiatives help to level the playing field and promote health equity.
Promoting Preventive Care
Preventive care is a cornerstone of community health initiatives, empowering individuals to take proactive steps to protect their health. Through education, screenings, and early intervention, these initiatives help to prevent chronic diseases and improve overall health outcomes.
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Ataxia-Telangiectasia (A-T): A Case Study in Health Challenges
BackgroundAtaxia-telangiectasia (A-T) or Louis-Bar Syndrome (ORPHA:100, OMIM #208,900) is a rare, inherited form of autosomal recessive neurodegenerative ataxia with onset in early childhood [1,2,3]. According to the 2022 classification of inborn errors of immunity, patients with A-T are included in the group of genetic syndromes associated with immune abnormalities [4]. A-T has a variable incidence of 1:40,000 to 1:100,000, with both sexes affected equally [5]. It is caused by mutations in the ATM (Ataxia-Telangiectasia, Mutated) gene located on chromosome 11q22-23, whose translated protein (ATM) belongs to the phosphatidylinositol 3-kinase family and is involved in mitogenic signal transduction, intracellular protein transport, and regulation of the DNA repair machinery [6]. Failure of these processes results in chromosomal instability, increased production of reactive oxygen species (ROS), mitochondrial dysfunction with concomitant oxidative stress, cell cycle arrest, and cell apoptosis.A-T is characterized by progressive neurodegeneration, oculocutaneous telangiectasia, increased susceptibility to infections, radiosensitivity, cancer predisposition, malnutrition, metabolic and cardiovascular disorders, dysphagia, and more recently described, chronic liver disease [7,8,9]. Clinical and biochemical changes that have been associated with the classic A-T phenotype include reduced lean body mass, premature aging, insulin resistance, type 2 diabetes, and increased risk of developing cardiovascular disease [10].Liver disease associated with A-T typically appears during the second decade of life, with more than 90% of older individuals showing liver abnormalities [11, 12]. Liver involvement belongs to the complex premature aging component of the syndrome, which also includes insulin resistance, type 2 diabetes, and dyslipidemia, thus causing incomplete metabolic syndrome [13, 14]. However, hepatopathy is usually mild and does not limit the synthesis and detoxification functions of the liver [11].A-T is classified as classic or atypical depending on the homozygous or heterozygous mutation in the ATM gene, respectively. The clinical phenotype and severity of A-T depend on the presence of residual ATM kinase activity as determined by the genotype [15]. Mutations that result in an almost complete loss of functional ATM protein kinase lead to the classic form of the disease. Residual ATM kinase activity can reduce oxidative stress to maintain mitochondrial function or to compensate for the absence of functional ATM protein (eg, gene modification and environmental factors), which may be responsible for the mild clinical manifestations of atypical cases of A-T [16].Patients with classic A-T tend to be shorter and often experience lower-than-expected height and weight gain, which can start during the intrauterine period and persist throughout life. Even if the child appears to have a good growth rate during the first 2 years of life, the poor weight and height gain starts early and becomes persistent [17]. Malnutrition in children is particularly worrying because it negatively affects normal height and weight gain and may have a detrimental impact on lung development. Cross-sectional studies have shown that patients with A-T have high rates of malnutrition, short stature, and reduced lean body mass [18, 19]. In addition, changes in nutritional status increase infection-related morbidity and mortality [20]. Children, adolescents and young adults with A-T have a high mortality rate, with an average age at death of 14 years due to various complications such as neoplasms, infections, and nutritional complications, among others [21].Managing A-T poses significant challenges because of the disease’s complexity. Current treatments primarily focus on alleviating symptoms as effectively as possible. Recent studies have explored therapies such as N-acetyl-DL-leucine for ataxia symptoms, bone marrow transplant therapy to restore immune competence, and gene therapy to correct defective alleles in the ATM gene-potentially restoring ATM protein function and reducing DNA damage. Additionally, the use of dexamethasone in modified erythrocytes (EryDex) and growth hormone have shown promising results, demonstrating improvements in locomotor behavior and immunity with few adverse effects [22].Assessing malnutrition and biomarkers of metabolic syndrome is essential for the clinical management of A-T. However, there is a paucity of literature on the topic mainly due to the rarity of the disease. Epidemiological research is needed to expand knowledge of the natural history and improve the care of individuals with A-T in daily practice. Information from the participating centers was reviewed retrospectively and the data were entered in a semi-structured survey through an online questionnaire by the principal investigator. The following data were analyzed from medical records: weight, height, fasting glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-c), triglycerides, alpha-fetoprotein (AFP), aspartate aminotransferase (AST), and alanine transaminase (ALT).Age- and sex-specific body mass index (BMI) z-scores were calculated using the World Health Organization criteria to assess nutritional status in individuals aged 2 to 20 years (severe thinness if z-score < − 3; thinness if z-score between − 3 and − 2; normal weight if z-score between − 2 and + 1) [23, 24]. Cases where the z-score was > + 1 were grouped together as patients at risk of overweight, obesity, or severe obesity.Abnormal total cholesterol levels were ≥ 170 mg/dL for children/adolescents and ≥ 200 mg/dL for adults, abnormal LDL-c levels were ≥ 110 mg/dL for children/adolescents and > 129 mg/dL for adults, and abnormal triglyceride levels were ≥ 100 mg/dL for children/adolescents and ≥ 150 mg/dL for adults [25, 26]. Blood glucose was considered abnormal if serum levels were ≥ 100 mg/dL. AST was considered abnormal if ≥ 60 (U/L) in children/adolescents, ≥ 40 (U/L) in adult men, and ≥ 32 (U/L) in adult women. ALT was considered abnormal if ≥ 40 (U/L). AFP was considered abnormal if > 20 ng/mL [27].Upon analyzing the medical records, we observed that both the first and last patient assessments were duly documented, starting from the initial consultation at their respective health centers through the end of data collection in 2018. However, we could not accurately determine the exact time interval between these assessments due to multiple biomarker collections performed for each patient over the study period. Therefore, to analyze the biomarker trends throughout the study, we decided to compare each variable based on the first and last records available in the medical records.This research is part of a recently published larger study analyzing the metabolic, immunological, and mortality profile of patients with A-T in Latin America [21]. For the present analysis, we adopted the classification into 3 categories, according to the European Society for Immunodeficiencies (ESID) criteria [28], for the diagnosis of A-T and composition of our sample, as follows: Definitive diagnosis: defined as the presence of pathogenic variants in both alleles of the ATM gene and either increased radiation-induced chromosomal breakage in cultured cells or progressive cerebellar ataxia; Probable diagnosis: defined as the presence of progressive cerebellar ataxia and at least 3 of the following 4 abnormalities - (1) ocular or facial telangiectasia, (2) AFP at least 2 SD above normal for age, (3) serum IgA at least 2 SD below normal for age, or (4) increased radiation-induced chromosomal breakage; and Possible diagnosis: defined as the presence of progressive cerebellar ataxia and at least 1 of the 4 abnormalities described above.
Nutritional Status and Metabolic Profiles in A-T Patients
The data were analyzed descriptively and expressed as absolute and relative frequencies. Associations between variables were examined using the chi-square test or Fisher’s exact test. If statistical differences occurred in the distributions, standardized adjusted residual analysis was used to identify local differences, where absolute values above 1.96 indicated evidence of (local) associations between the relative categories. Percentages at 2 or 3 assessment points (related samples) were compared using the McNemar test and Cochran Q test, respectively.This study was approved by the research ethics committees of the participating centers (CAAE: 61,257,916.3.1001.5505) and conducted in accordance with the provisions of the Declaration of Helsinki. Furthermore, informed consent for data collection and use was obtained from each patient and/or family member.Data from 218 patients with A-T from 46 health centers located in 9 Latin American countries were collected between July 2015 and February 2018. These patients had a mean age of 13.7 years at the time of the survey. According to the ESID criteria, 90 patients (41.5%) had a probable A-T diagnosis, 59 patients (27.2%) had a possible A-T diagnosis, and 69 patients (31.8%) had a definitive A-T diagnosis. Overall, 123 patients were from Brazil, 34 were from Mexico, 32 were from Argentina, 13 were from Colombia, 5 were from Chile, 4 were from Peru, 3 were from Uruguay, 3 were from Paraguay, and 1 was from Honduras. A total of 111 patients (51.0%) were female and 107 (49.0%) were male. Ataxia occurred in all patients and was the initial presenting symptom in 159 patients (72.9%), dysarthria in 156 patients (85.2%), postural changes in 144 (75.4%), and ocular apraxia in 133 (74.7%); 112 patients used a wheelchair (56.3%).Higher proportions of severe thinness were observed among older individuals: 9.1% in patients aged 2 to 6 years; 19.0% in patients aged 7 to 10 years; 39.1% in patients aged 11 to 19 years; and 50.0% in patients aged ≥ 20 years. Data from patients who had more than one anthropometric assessment over time were paired to assess the over-time evolution of the z-scores individually. The proportion of patients with A-T with severe thinness increased with increasing age (p = 0.016).
Laboratory Results and Trends
In patients with more than one AST and ALT measurement, paired analyses showed a tendency for liver enzymes to increase over time. High glucose and triglyceride levels were observed in 9.5% and 23.6% of patients, respectively. Total cholesterol was high in 31.7, and 34.0% had abnormal LDL-c levels. In the analysis of paired samples, a progressive increase in aspartate aminotransferase was observed over time.
Discussion of A-T Study Findings
This multicenter study evaluated 218 patients with A-T in Latin America and showed a high rate of thinness, changes in hepatic inflammatory markers, atherogenic lipid profile, and glucose abnormalities in this population, as well as a significant decline in BMI z-scores over time. This is consistent with the findings of Krauthammer et al., who reported a drop in BMI z-scores over time despite regular follow-up in a multidisciplinary A-T center, where 61.4% of patients had severe thinness and 22.7% had thinness during the follow-up period [29]. Stewart et al. also described a significant decline in z-scores despite optimal nutritional therapy, where approximately 25% of patients were classified as thin (z-score < − 2) at some point during the study [30].Problems with eating, swallowing and nutrition are common in patients with A-T. In our series, 50% of patients had dysphagia and 8.3% had undergone gastrostomy. Gastrostomy has been associated with an improvement in nutritional status or at least a decline in the progression of malnutrition, suggesting that malnutrition is not an inevitable consequence of A-T but rather a complication that can be successfully managed with early intervention [30]. However, the benefits of gastrostomy are still controversial in the literature. Natale et al. showed no benefit of gastrostomy for nutritional status, indicating …