Medical Advice and Diabetes Self-Management Reported by Mexican-American, Black- and White-Non-Hispanic Adults Across the United States

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 MexicanAmericans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with ‘undiagnosed diabetes’ [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants’ diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately onethird of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Comparison of Linear Functions in Middle Grades Textbooks from Singapore and the United States

Many U.S. students do not perform well on mathematics assessments with respect to algebra topics such as linear functions, a building-block for other functions. Poor achievement of U.S. middle school students in this topic is a problem. U.S. eighth graders have had average mathematics scores on international comparison tests such as Third International Mathematics Science Study, later known as Trends in Mathematics and Science Study, (TIMSS)-1995, -99, -03, while Singapore students have had highest average scores. U.S. eighth grade average mathematics scores improved on TIMMS-2007 and held steady onTIMMS-2011. Results from national assessments, PISA 2009 and 2012 and National Assessment of Educational Progress of 2007, 2009, and 2013, showed a lack of proficiency in algebra. Results of curriculum studies involving nations in TIMSS suggest that elementary textbooks in high-scoring countries were different than elementary textbooks and middle grades texts were different with respect to general features in the U.S. The purpose of this study was to compare treatments of linear functions in Singapore and U.S. middle grades mathematics textbooks. Results revealed features currently in textbooks. Findings should be valuable to constituencies who wish to improve U.S. mathematics achievement. Portions of eight Singapore and nine U.S. middle school student texts pertaining to linear functions were compared with respect to 22 features in three categories: (a) background features, (b) general features of problems, and (c) specific characterizations of problem practices, problem-solving competency types, and transfer of representation. Features were coded using a codebook developed by the researcher. Tallies and percentages were reported. Welch's t-tests and chi-square tests were used, respectively, to determine whether texts differed significantly for the features and if codes were independent of country. U.S. and Singapore textbooks differed in page appearance and number of pages, problems, and images. Texts were similar in problem appearance. Differences in problems related to assessment of conceptual learning. U.S. texts contained more problems requiring (a) use of definitions, (b) single computation, (c) interpreting, and (d) multiple responses. These differences may stem from cultural differences seen in attitudes toward education. Future studies should focus on density of page, spiral approach, and multiple response problems.

A Comparative Analysis of Corporate Finance in the United States and Japan From 1880 to 1930

This study explained the diversity of corporate financial practices in two nations. Existing studies have emphasized the reliance on equity finance in U.S. firms and bank loans in Japanese firms. In fact, patterns of corporate finance were much more complex. Financial institutions, which were created by national economic policy and regulation, affected corporate financial practices, but corporate financial practices often differed from what policymakers expected. Differences in corporate financial practices between nations also reflected differences in the mixture of industries in each nation. Many factors such as the amount of fixed capital, the process of production, the level of risk, the degree of innovation, and the importance of the industry in the national economy affected corporate financial practices. In addition, corporate financial practices within each nation differed from firm to firm due to managers’ considerations about stock ownership, which would affect their control power; corporate finance was closely related to control over management through ownership. To explain these complexities of corporate financial practices, the study linked corporate finance with the development of financial institutions in the United States and in Japan. While financial institutions affected corporate financial practices, the response of the firms to financial institutions and opportunities were diverse. The study also attempted to grasp variations in corporate financial practices by dealing with companies in three sectors: railroads, public utilities, and manufacturing. Finally, the study examined the structure of firm ownership. Contradictory to the widely held belief that U.S. firms distributed securities more widely to the public than did Japanese firms, many large American firms remained closely held, while some Japanese counterparts built publicly-held corporations.

The Survival and Stock Performance of Emerging Country Firms in the United States

Many firms from emerging markets flocked to developed countries at high cost with hopes of acquiring strategic assets that are difficult to obtain in home countries. Adequate research has focused on the motivations and strategies of emerging country firms' (ECFs') internationalization, while limited studies have explored their survival in advanced economies years after their venturing abroad. Due to the imprinting effect of home country institutions that inhibit their development outside their home market, ECFs are inclined to hire executives with international background and affiliate to world-wide organizations for the purpose of linking up with the global market, embracing multiple perspectives for strategic decisions, and absorbing the knowledge of foreign markets. However, the effects of such orientation on survival are under limited exploration. Motivated by the discussion above, I explore ECFs’ survival and stock performance in a developed country (U.S.). Applying population ecology, signaling theory and institutional theory, the dissertation investigates the characteristics of ECFs that survived in the developed country (U.S.), tests the impacts of global orientation on their survival, and examines how global-oriented activities (i.e. joining United Nations Global Compact) affect their stock performance. The dissertation is structured in the form of three empirical essays. The first essay explores and compares different characteristics of ECFs and developed country firms (DCFs) that managed to survive in the U.S. The second essay proposes the concept of global orientation, and tests its influences on ECFs’ survival. Employing signaling theory and institutional theory, the third essay investigates stock market reactions to announcements of United Nation Global Compact (UNGC) participation. The dissertation serves to explore the survival of ECFs in the developed country (U.S.) by comparison with DCFs, enriching traditional theories by testing non-traditional arguments in the context of ECFs’ foreign operation, and better informing practitioners operating ECFs about ways of surviving in developed countries and improving stockholders’ confidence in their future growth.