Medical advice, diabetes self-management, and health outcomes of a multi-ethnic population from the National Health and Nutrition Examination Survey 2007--2008

Diabetes self-management, an essential component of diabetes care, includes weight control practices and requires guidance from providers. Minorities are likely to have less access to quality health care than White non-Hispanics (WNH) (American College of Physicians-American Society of Internal Medicine, 2000). Medical advice received and understood may differ by race/ethnicity as a consequence of the patient-provider communication process; and, may affect diabetes self-management. ^ This study examined the relationships among participants’ report of: (1) medical advice given; (2) diabetes self-management, and; (3) health outcomes for Mexican-Americans (MA) and Black non-Hispanics (BNH) as compared to WNH (reference group) using data available through the National Health and Nutrition Examination Survey (NHANES) for the years 2007–2008. This study was a secondary, single point analysis. Approximately 30 datasets were merged; and, the quality and integrity was assured by analysis of frequency, range and quartiles. The subjects were extracted based on the following inclusion criteria: belonging to either the MA, BNH or WNH categories; 21 years or older; responded yes to being diagnosed with diabetes. A final sample size of 654 adults [MA (131); BNH (223); WNH (300)] was used for the analyses. The findings revealed significant statistical differences in medical advice reported given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), p<0.001]. There were differences among ethnicities for reporting receiving recent diabetes education. Black, non-Hispanics were twice as likely to report receiving diabetes education than WNH [OR = 2.29 (1.36, 3.85), p = 0.004]. Medical advice reported given and ethnicity/race, together, predicted several health outcomes. Having recent diabetes education increased the likelihood of performing several diabetes self-management behaviors, independent of race. ^ These findings indicate a need for patient-provider communication and care to be assessed for effectiveness and, the importance of ongoing diabetes education for persons with diabetes.^

The impact of institutional complexity and top management characteristics on executive compensation and firm performance

While most studies take a dyadic view when examining the environmental difference between the home country of a multinational enterprise (MNE) and a particular foreign country, they ignore that an MNE is managing a network of subsidiaries embedded in diverse environments. Additionally, neither the impacts of global environments on top executives nor the effects of top executives’ capabilities to handle institutional complexity are fully explored. Thus, using a three-essay format, this dissertation tried to fill these gaps by addressing the effects of institutional complexity and top management characteristics on top executive compensation and firm performance. ^ Essay 1 investigated the impact of an MNE’s institutional complexity, or the diversity of national institutions facing an MNE’s network of subsidiaries, on the top management team (TMT) compensation. This essay proposed that greater political and cultural complexity leads to not only greater TMT total compensation but also to a greater portion of TMT compensation linked with long-term performance. The arguments are supported in this essay by using an unbalanced panel dataset including 296 U.S. firms with 1,340 observations. ^ Essay 2 explored TMT social capital and its moderating role on value creation and appropriation by the chief executive officer (CEO). Using a sample with 548 U.S. firms and 2,010 observations, it found that greater TMT social capital does facilitate the effects of CEO intellectual capital and social capital on firm growth. Finally, essay 3 examined the performance implications for the fit between managerial information-processing capabilities and institutional complexity. It proposed that institutional complexity is associated with the needs of information-processing. On the other hand, smaller TMT turnover and larger TMT size reflect larger managerial information-processing capabilities. Consequently, superior performance is achieved by the match among institutional complexity, TMT turnover, and TMT size. All hypotheses in essay 3 are supported in a sample of 301 U.S. firms and 1,404 observations. ^ To conclude, this dissertation advances and extends our knowledge on the roles of institutional environments and top executives on firm performance and top executive compensation.^

Integrated assessment of water conservation practices for sustainable management strategies

Miami-Dade County implemented a series of water conservation programs, which included rebate/exchange incentives to encourage the use of high efficiency aerators (AR), showerheads (SH), toilets (HET) and clothes washers (HEW), to respond to the environmental sustainability issue in urban areas. This study first used panel data analysis of water consumption to evaluate the performance and actual water savings of individual programs. Integrated water demand model has also been developed for incorporating property’s physical characteristics into the water consumption profiles. Life cycle assessment (with emphasis on end-use stage in water system) of water intense appliances was conducted to determine the environmental impacts brought by each practice. Approximately 6 to 10 % of water has been saved in the first and second year of implementation of high efficiency appliances, and with continuing savings in the third and fourth years. Water savings (gallons per household per day) for water efficiency appliances were observed at 28 (11.1%) for SH, 34.7 (13.3%) for HET, and 39.7 (14.5%) for HEW. Furthermore, the estimated contributions of high efficiency appliances for reducing water demand in the integrated water demand model were between 5 and 19% (highest in the AR program). Results indicated that adoption of more than one type of water efficiency appliance could significantly reduce residential water demand. For the sustainable water management strategies, the appropriate water conservation rate was projected to be 1 to 2 million gallons per day (MGD) through 2030. With 2 MGD of water savings, the estimated per capita water use (GPCD) could be reduced from approximately 140 to 122 GPCD. Additional efforts are needed to reduce the water demand to US EPA’s “Water Sense” conservation levels of 70 GPCD by 2030. Life cycle assessment results showed that environmental impacts (water and energy demands and greenhouse gas emissions) from end-use and demand phases are most significant within the water system, particularly due to water heating (73% for clothes washer and 93% for showerhead). Estimations of optimal lifespan for appliances (8 to 21 years) implied that earlier replacement with efficiency models is encouraged in order to minimize the environmental impacts brought by current practice.

Investigating the outcomes of two chronic disease self-management programs and understanding the correlates of completion for each program

Chronic disease affects 80% of adults over the age of 65 and is expected to increase in prevalence. To address the burden of chronic disease, self-management programs have been developed to increase self-efficacy and improve quality of life by reducing or halting disease symptoms. Two programs that have been developed to address chronic disease are the Chronic Disease Self-Management Program (CDSMP) and Tomando Control de su Salud (TCDS). CDSMP and TCDS both focus on improving participant self-efficacy, but use different curricula, as TCDS is culturally tailored for the Hispanic population. Few studies have evaluated the effectiveness of CDSMP and TCDS when translated to community settings. In addition, little is known about the correlation between demographic, baseline health status, and psychosocial factors and completion of either CDSMP or TCDS. This study used secondary data collected by agencies of the Healthy Aging Regional Collaborative from 10/01/2008–12/31/2010. The aims of this study were to examine six week differences in self-efficacy, time spent performing physical activity, and social/role activity limitations, and to identify correlates of program completion using baseline demographic and psychosocial factors. To examine if differences existed a general linear model was used. Additionally, logistic regression was used to examine correlates of program completion. Study findings show that all measures showed improvement at week six. For CDSMP, self-efficacy to manage disease (p = .001), self-efficacy to manage emotions (p = .026), social/role activities limitations (p = .001), and time spent walking (p = .008) were statistically significant. For TCDS, self-efficacy to manage disease (p = .006), social/role activities limitations (p = .001), and time spent walking (p = .016) and performing other aerobic activity (p = .005) were significant. For CDSMP, no correlates predicting program completion were found to be significant. For TCDS, participants who were male (OR=2.3, 95%CI: 1.15–4.66), from Broward County (OR=2.3, 95%CI: 1.27–4.25), or living alone (OR=2.0, 95%CI: 1.29-–3.08) were more likely to complete the program. CDSMP and TCDS, when implemented through a collaborative effort, can result in improvements for participants. Effective chronic disease management can improve health, quality of life, and reduce health care expenditures among older adults.

Practical dynamic thermal management on Intel desktop computer

Fueled by increasing human appetite for high computing performance, semiconductor technology has now marched into the deep sub-micron era. As transistor size keeps shrinking, more and more transistors are integrated into a single chip. This has increased tremendously the power consumption and heat generation of IC chips. The rapidly growing heat dissipation greatly increases the packaging/cooling costs, and adversely affects the performance and reliability of a computing system. In addition, it also reduces the processor's life span and may even crash the entire computing system. Therefore, dynamic thermal management (DTM) is becoming a critical problem in modern computer system design. Extensive theoretical research has been conducted to study the DTM problem. However, most of them are based on theoretically idealized assumptions or simplified models. While these models and assumptions help to greatly simplify a complex problem and make it theoretically manageable, practical computer systems and applications must deal with many practical factors and details beyond these models or assumptions. The goal of our research was to develop a test platform that can be used to validate theoretical results on DTM under well-controlled conditions, to identify the limitations of existing theoretical results, and also to develop new and practical DTM techniques. This dissertation details the background and our research efforts in this endeavor. Specifically, in our research, we first developed a customized test platform based on an Intel desktop. We then tested a number of related theoretical works and examined their limitations under the practical hardware environment. With these limitations in mind, we developed a new reactive thermal management algorithm for single-core computing systems to optimize the throughput under a peak temperature constraint. We further extended our research to a multicore platform and developed an effective proactive DTM technique for throughput maximization on multicore processor based on task migration and dynamic voltage frequency scaling technique. The significance of our research lies in the fact that our research complements the current extensive theoretical research in dealing with increasingly critical thermal problems and enabling the continuous evolution of high performance computing systems.

Hydro-physical characterization of media used in agricultural systems to develop the best management practices for operation of an environmentally sustainable agricultural enterprise

Florida is the second leading horticulture state in the United States with a total annual industry sale of over $12 Billion. Due to its competitive nature, agricultural plant production represents an extremely intensive practice with large amounts of water and fertilizer usage. Agrochemical and water management are vital for efficient functioning of any agricultural enterprise, and the subsequent nutrient loading from such agricultural practices has been a concern for environmentalists. A thorough understanding of the agrochemical and the soil amendments used in these agricultural systems is of special interest as contamination of soils can cause surface and groundwater pollution leading to ecosystem toxicity. The presence of fragile ecosystems such as the Everglades, Biscayne Bay and Big Cypress near enterprises that use such agricultural systems makes the whole issue even more imminent. Although significant research has been conducted with soils and soil mix, there is no acceptable method for determining the hydraulic properties of mixtures that have been subjected to organic and inorganic soil amendments. Hydro-physical characterization of such mixtures can facilitate the understanding of water retention and permeation characteristics of the commonly used mix which can further allow modeling of soil water interactions. The objective of this study was to characterize some of the locally and commercially available plant growth mixtures for their hydro-physical properties and develop mathematical models to correlate these acquired basic properties to the hydraulic conductivity of the mixture. The objective was also to model the response patterns of soil amendments present in those mixtures to different water and fertilizer use scenarios using the characterized hydro-physical properties with the help of Everglades-Agro-Hydrology Model. The presence of organic amendments helps the mixtures retain more water while the inorganic amendments tend to adsorb more nutrients due to their high surface area. The results of these types of characterization can provide a scientific basis for understanding the non-point source water pollution from horticulture production systems and assist in the development of the best management practices for the operation of environmentally sustainable agricultural enterprise

Not getting by: Poverty management and homelessness in Miami

Urban inequality has emerged as one of the dominant themes of modern life and globalization. More than three million people experienced homelessness in the United States last year; in Miami-Dade, more than 15,000 individuals were homeless. Surviving extreme poverty, and exiting or avoiding homelessness, involves negotiating a complex mix of public and private assistance. However, a range of factors influence what types of help are available and how they can be accessed. Frequently, larger social structures determine which resource are available, leaving many choices entirely out of the individual's control. For single men, who are ineligible for many benefits, homelessness can be difficult to avoid and even harder to exit. My study seeks to better understand how adult, minority men living in extreme poverty in Miami-Dade negotiate their daily survival. Specific research questions address: Do black and Hispanic men who are homeless or at risk of homelessness have different personal characteristics and different experiences in avoiding or exiting homelessness? How does Miami's response to extreme poverty/homelessness, including availability of public benefits and public and private service organizations, either maximize or constrain the choices available to this population? And, what is the actual experience of single, adult men who are homeless or at risk of homelessness, in negotiating their daily survival? A mixed methods approach combines quantitative survey data from 7,605 homeless men, with qualitative data from 54 semi-structured interviews incorporating the visual ethnography techniques of Photo Elicitation Interviewing. Results show the differences experienced by black and Hispanic men who are poor and homeless in Miami. Findings also highlight how the community's official and unofficial responses to homelessness intersect with the actual experiences of the persons targeted by the policies and programs, challenging preconceived notions regarding the lives of persons living in extreme poverty. It adds to the existing body of literature by focusing on the urban Miami context, emphasizing disparities amongst racial and ethnic groups. Findings are intended to provide an empirically grounded thesis that humanizes the subjects and illuminates their personal experiences, helping to inform public policy around the needs of extremely poor populations.

The IRS Collection Division: Contacts and Settlements

In his study -The IRS Collection Division: Contacts and Settlements - by John M. Tarras, Assistant Professor School of Hotel, Restaurant and Institutional Management, Michigan State University, Tarras initially states: “The collection division of the internal revenue service is often the point of contact for many hospitality businesses. The author describes how the division operates, what the hospitality firm can expect when contacted by it, and what types of strategies firms might find helpful when negotiating a settlement with the IRS.” The author will have you know that even though most chance meetings with the IRS Collection Division are due to unfortunate tax payment circumstances, there are actually more benign reasons for close encounters of the IRS kind. This does not mean, however, that brushes with the IRS Collection Division will end on an ever friendlier note. “…the Tax Reform Act of 1986 with its added complexity will cause some hospitality firms to inadvertently fail to make proper payments on a timely basis,” Tarras affords in illustrating a perhaps less pugnacious side of IRS relations. Should a hospitality business owner represent himself/herself before the IRS? Never, says Tarras. “Too many taxpayers ruin their chances of a fair settlement by making what to them seem innocent remarks, but ones that turn out to be far different,” warns Professor Tarras. Tarras makes the distinction between IRS the Collection Division, and IRS the Audit Division. “While the Audit Division is interested in how the tax liability arose, the Collection Division is generally only interested in collecting the liability,” he informs you. Either sounds firmly in hostile territory. They don’t bluff. Tarras does want you to know that when the IRS threatens to levy on the assets of a hospitality business, they will do so. Those assets may extend to personal and real property as well, he says. The levy action is generally the final resort in an IRS collection effort. Professor Tarras explains the lien process and the due process attached to that IRS collection tactic. “The IRS can also levy a hospitality firm owner's wages. In this case, it is important to realize that you are allowed to exempt from levy $75 per week, along with $25 per week for each of your dependents (unless your spouse works),” Professor Tarras says with the appropriate citation. What are the options available to the hospitality business owner who finds himself on the wrong side of the IRS Collection Division? Negotiate in good faith says Professor Tarras. “In many cases, a visit to the IRS office will greatly reduce the chances that a simple problem will turn into a major one,” Tarras advises. He dedicates the last pages of the discussion to negotiation strategies.

Improving resource management in virtualized data centers using application performance models

The rapid growth of virtualized data centers and cloud hosting services is making the management of physical resources such as CPU, memory, and I/O bandwidth in data center servers increasingly important. Server management now involves dealing with multiple dissimilar applications with varying Service-Level-Agreements (SLAs) and multiple resource dimensions. The multiplicity and diversity of resources and applications are rendering administrative tasks more complex and challenging. This thesis aimed to develop a framework and techniques that would help substantially reduce data center management complexity.^ We specifically addressed two crucial data center operations. First, we precisely estimated capacity requirements of client virtual machines (VMs) while renting server space in cloud environment. Second, we proposed a systematic process to efficiently allocate physical resources to hosted VMs in a data center. To realize these dual objectives, accurately capturing the effects of resource allocations on application performance is vital. The benefits of accurate application performance modeling are multifold. Cloud users can size their VMs appropriately and pay only for the resources that they need; service providers can also offer a new charging model based on the VMs performance instead of their configured sizes. As a result, clients will pay exactly for the performance they are actually experiencing; on the other hand, administrators will be able to maximize their total revenue by utilizing application performance models and SLAs. ^ This thesis made the following contributions. First, we identified resource control parameters crucial for distributing physical resources and characterizing contention for virtualized applications in a shared hosting environment. Second, we explored several modeling techniques and confirmed the suitability of two machine learning tools, Artificial Neural Network and Support Vector Machine, to accurately model the performance of virtualized applications. Moreover, we suggested and evaluated modeling optimizations necessary to improve prediction accuracy when using these modeling tools. Third, we presented an approach to optimal VM sizing by employing the performance models we created. Finally, we proposed a revenue-driven resource allocation algorithm which maximizes the SLA-generated revenue for a data center.^

Casino Gambling is Hot: Gambling Debt Collection is Hot

Gambling on credit, considered a vice by some, is not judicially collectible based upon the Statute of Anne. This common law statute prevents the collection of gambling losses, unless expected by state statute. This article reviews and updates the findings of an unenforceability of gambling debt study conducted in 1989 just prior to the rapid expansion of gambling in the United States.

The Nevada Gaming Debt Collection Experience

In the discussion - The Nevada Gaming Debt Collection Experience - by Larry D. Strate, Assistant Professor, College of Business and Economics at the University of Nevada, Las Vegas, Assistant Professor Strate initially outlines the article by saying: “Even though Nevada has had over a century of legalized gaming experience, the evolution of gaming debt collection has been a recent phenomenon. The author traces that history and discusses implications of the current law.” The discussion opens with a comparison between the gaming industries of New Jersey/Atlantic City, and Las Vegas, Nevada. This contrast serves to point out the disparities in debt handling between the two. “There are major differences in the development of legalized gaming for both Nevada and Atlantic City. Nevada has had over a century of legalized gambling; Atlantic City, New Jersey, has completed a decade of its operation,” Strate informs you. “Nevada's gaming industry has been its primary economic base for many years; Atlantic City's entry into gaming served as a possible solution to a social problem. Nevada's processes of legalized gaming, credit play, and the collection of gaming debts were developed over a period of 125 years; Atlantic City's new industry began with gaming, gaming credit, and gaming debt collection simultaneously in 1976 [via the New Jersey Casino Control Act] .” The irony here is that Atlantic City, being the younger venue, had or has a better system for handling debt collection than do the historic and traditional Las Vegas properties. Many of these properties were duplicated in New Jersey, so the dichotomy existed whereby New Jersey casinos could recoup debt while their Nevada counterparts could not. “It would seem logical that a "territory" which permitted gambling in the early 1800’s would have allowed the Nevada industry to collect its debts as any other legal enterprise. But it did not,” Strate says. Of course, this situation could not be allowed to continue and Strate outlines the evolution. New Jersey tactfully benefitted from Nevada’s experience. “The fundamental change in gaming debt collection came through the legislature as the judicial decisions had declared gaming debts uncollectable by either a patron or a casino,” Strate informs you. “Nevada enacted its gaming debt collection act in 1983, six years after New Jersey,” Strate points out. One of the most noteworthy paragraphs in the entire article is this: “The fundamental change in 1983, and probably the most significant change in the history of gaming in Nevada since the enactment of the Open Gaming Law of 1931, was to allow non-restricted gaming licensees* to recover gaming debts evidenced by a credit instrument. The new law incorporated previously litigated terms with a new one, credit instrument.” The term is legally definable and gives Nevada courts an avenue of due process.

Algorithms for efficient transaction management and consistent queries in client -server semantic object-oriented parallel databases

Large read-only or read-write transactions with a large read set and a small write set constitute an important class of transactions used in such applications as data mining, data warehousing, statistical applications, and report generators. Such transactions are best supported with optimistic concurrency, because locking of large amounts of data for extended periods of time is not an acceptable solution. The abort rate in regular optimistic concurrency algorithms increases exponentially with the size of the transaction. The algorithm proposed in this dissertation solves this problem by using a new transaction scheduling technique that allows a large transaction to commit safely with significantly greater probability that can exceed several orders of magnitude versus regular optimistic concurrency algorithms. A performance simulation study and a formal proof of serializability and external consistency of the proposed algorithm are also presented.^ This dissertation also proposes a new query optimization technique (lazy queries). Lazy Queries is an adaptive query execution scheme which optimizes itself as the query runs. Lazy queries can be used to find an intersection of sub-queries in a very efficient way, which does not require full execution of large sub-queries nor does it require any statistical knowledge about the data.^ An efficient optimistic concurrency control algorithm used in a massively parallel B-tree with variable-length keys is introduced. B-trees with variable-length keys can be effectively used in a variety of database types. In particular, we show how such a B-tree was used in our implementation of a semantic object-oriented DBMS. The concurrency control algorithm uses semantically safe optimistic virtual "locks" that achieve very fine granularity in conflict detection. This algorithm ensures serializability and external consistency by using logical clocks and backward validation of transactional queries. A formal proof of correctness of the proposed algorithm is also presented. ^

The early development and pilot -testing of a case management intervention with victims of stalking: An evaluation study

This study evaluated the early development and pilot-testing of Project IMPACT, a case management intervention for victims of stalking. The Design and Development framework (Rothman & Thomas, 1994) was used as a guide for program development and evaluation. Nine research questions examined the processes and outcomes associated with program implementation. ^ The sample included all 36 clients who participated in Project IMPACT between February of 2000 and June of 2001, as well as the victim advocates who provided them with services. Quantitative and qualitative data were drawn from client case files, participant observation field notes and interview transcriptions. Quantitative data were entered into three databases where: (1) clients were the units of analysis (n = 36), (2) services were the units of analysis (n = 1146), and (3) goals were the units of analysis (n = 149). These data were analyzed using descriptive statistics, Pearson's Chi-square, Spearman's Rho, Phi, Cramer's V, Wilcoxon's Matched Pairs Signed-Ranked Test and McNemar's Test Statistic. Qualitative data were reduced via open, axial and selective coding methods. Grounded theory and case study frameworks were utilized to analyze these data. ^ Results showed that most clients noted an improved sense of well-being and safety, although residual symptoms of trauma remained for numerous individuals. Stalkers appeared to respond to criminal and civil justice-based interventions by reducing violent and threatening behaviors; however, covert behaviors continued. The study produced findings that provided preliminary support for the use of several intervention components including support services, psycho-education, safety planning, and boundary spanning. The psycho-education and safety planning in particular seemed to help clients cognitively reframe their perceptions of the stalking experience and gain a sense of increased safety and well-being. A 65% level of satisfactory goal achievement was observed overall, although goals involving justice-based organizations were associated with lower achievement. High service usage was related to low-income clients and those lacking in social support. Numerous inconsistencies in program implementation were found to be associated with the skills and experiences of victim advocates. Thus, recommendations were made to further refine, develop and evaluate the intervention. ^

Process of privatization: Benefits of *reform in management of public housing

The study of the private management of public housing is an important topic to be critically analyzed as the government search for ways to increase efficiency in providing housing for the poor. Public Housing Authorities must address the cost for repairing or replacing the deteriorating housing stock, the increase in the need for affordable housing, and the lack of supply. There is growing pressure on efficient use of public funds that has heightened the need for profound structural reform. An important strategy for carrying out such reform is through privatization. Although privatization does not work in every case, the majority position in the traditional privatization literature is that reliance on private organizations normally, but not always, results in cost savings. ^ The primary purpose of this dissertation is to determine whether a consensus exist among decision-makers on the efficiency of privatizing the management of public housing. A secondary purpose is to review the techniques (best practices) used by the private sector that results in cost-efficiencies in the management of public housing. The study employs the use of a triangulated research design utilizing cross-sectional survey methodology that included use of a survey instrument to solicit responses from the private managers. The study consists of qualitative methods using interviews from key informants of private-sector management firms and public housing agencies, case studies, focus groups, archival records and housing authorities documents. ^ Results indicated that important decision-makers perceive that private managers made a positive contribution to cost-efficiencies in the management of public housing. The performance of private contractors served as a yardstick for comparison of efficiency of services that are produced in-house. The study concluded that private managers made the benefits of their management techniques well known creating a sense of competition between public and private managers. Competition from private contractors spurred municipal worker and management productivity improvements creating better management results for the public housing authorities. The study results are in concert with a review of recent research and studies that also concluded private managers have some distinct advantages to controlling costs in the management of public housing. ^