Risk factors of coronary heart disease and correlates of type 2 diabetes among Cuban Americans

Cuban Americans, a minority Hispanic subgroup, have a high prevalence of type 2 diabetes. Persons with diabetes experience a higher rate of coronary heart disease (CHD) compared to those without diabetes. The objectives of the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) are to investigate the risk factors of CHD and the etiology of diabetes among diabetics of minority ethnic populations. No information is available on the etiology of CHD risks for Cuban Americans. ^ This cross-sectional study compared Cuban Americans with (N = 79) and without (N = 80) type 2 diabetes residing in South Florida. Data on risk factors of CHD and type 2 diabetes were collected using sociodemographics, smoking habit, Rose Angina, Modifiable Activity, and Willet's food frequency questionnaires. Anthropometrics and blood pressure (BP) were recorded. Glucose, glycated hemoglobin, lipid profile, homocysteine, and C-reactive protein were assessed in fasting blood. ^ Diabetics reported a significantly higher rate of angina symptoms than non-diabetics (P = 0.008). After adjusting for age and gender, diabetics had significantly (P < 0.001) larger waist circumference and higher systolic BP than non-diabetics. There was no significant difference in major nutrient intakes between the groups. One quarter of subjects, both diabetics and non-diabetics, exceeded the intake of percent calories from total fat and almost 60% had cholesterol intake >200 mg/d and more than 60% had fiber intake <20 gm/d. The pattern of physical activity did not differ between groups though, it was much below the recommended level. After adjusting for age and gender, diabetics had significantly (P < 0.001) higher levels of blood glucose, glycated hemoglobin, triglycerides, and homocysteine than non-diabetics. In contrast, diabetics had significantly (P < 0.01) lower levels of high-density lipoprotein cholesterol (HDL-C). ^ Multivariate logistic regression analyses showed that increasing age, male gender, large waist circumference, lack of acculturation, and high levels of triglycerides were independent risk factors of type 2 diabetes. In contrast, moderate alcohol consumption conferred protection against diabetes. ^ The study identified several risk factors of CHD and diabetes among Cuban Americans. Health care providers are encouraged to practice ethno-specific preventive measures to lower the burden of CHD and diabetes in Cuban Americans. ^

The drivers of perception: Identifying the driving factors of resident perceptions of municipal service quality in cities of South Florida

The idea of comparative performance assessment is crucial. Recent study findings show that in South Florida the use by most municipalities of external benchmarks for performance comparison is virtually non-existent. On one level this study sought to identify the factors impacting resident perceptions of municipal service quality. On a different and more practical level, this study sought to identify a core set of measures that could serve for multi jurisdictional comparisons of performance. ^ This study empirically tested three groups of hypotheses. Data were collected via custom designed survey instruments from multiple jurisdictions, representing diverse socioeconomic backgrounds, and across two counties. A second layer of analysis was conducted on municipal budget documents for the presence of performance measures. A third layer of analysis was conducted via face-to-face interviews with residents at the point of service delivery. Research questions were analyzed using descriptive and inferential statistic methodologies. ^ Results of survey data yielded inconsistent findings. In absolute aggregated terms, the use of sociological determinants to guide inquiry failed to yield conclusive answers regarding the factors impacting resident perceptions of municipal service quality. At disaggregated community levels, however, definite differences emerged but these had weak predictive ability. More useful were the findings of performance measures reporting via municipal budget documents and analyses of interviews with residents at the point of service delivery. Regardless of socio-economic profile, neighborhood characteristics, level of civic engagement or type of community, the same aspects were important to citizens when making assessments of service quality. For parks and recreation, respondents most frequently cited maintenance, facility amenities, and program offerings as important while for garbage collection services timely and consistent service delivery mattered most. Surprisingly municipalities participating in the study track performance data on items indicated as important by citizen assessments but regular feed back from residents or reporting to the same is rarely done. ^ The implications of these findings suggest that endeavors, such as the one undertaken in this study, can assist in determining a core set of measures for cross jurisdictional comparisons of municipal service quality, improving municipal delivery of services, and to communicate with the public. ^

Risk factors of type 2 diabetes and cardiovascular diseases among Jamaican adolescents

Purpose. The purpose of the study was to examine Jamaican adolescents in a school setting, for risk factors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). Methods. A descriptive epidemiological cross-sectional study of 276 Jamaican adolescents (112 males and 164 females) ages 14-19 years (15.6±1.2), randomly selected from grades 9-12 from ten high schools on the island. Thirteen risk factors were examined. Risk factors were compared with BMI levels and demographics. A sub-study validated finger prick testing of fasting blood glucose, total cholesterol, and HbA1c versus venous testing in 59 subjects. Results. Prevalence of overweight was 33.0% (n=91) with mean BMI of 23.74±7.74. Approximately 66.7% of subjects reported ≥ 3 risk factors. The number of T2DM and CVDs risk factors increased for subjects with BMI above 25. One third of the overweight subjects were classified with the metabolic syndrome. High BMI was associated with high waist circumference (r = .767, p < .01), high waist-to-hip ratio (r = .180, p < .01), presence of Acanthosis Nigricans (r = .657, p < .01), high total cholesterol (r = .158, p < .01), family history of T2DM (r = .157, p < .01), and hypertension (r = .422, p < .01). Regression analyses significantly predicted gender and physical activity (p < .001), and total number of risk factors for T2DM and CVDs (p < .001). Paired samples t-tests revealed no significant differences between methods of testing for TC and HbA1c (p < .01) but not for FBG (p > .05). Percentage bias for the methods of blood testing met the reference standards for fasting blood glucose but not for total cholesterol and HbA1c. Bland Altman tests of agreement between the two methods indicated good agreement for all three tests. Conclusion. Jamaican adolescents are at high risk for T2DM and CVDs as seen in other study populations. Effective programs to prevent T2DM and CVDs are needed. Family history of diseases, anthropometric measures, and gender identified more subjects at risk than did the biochemical measures. Comparison between finger prick and venous blood methods suggested that finger prick is an adequate method to screen for risk factors in children and adolescents.

A Study of Satisfaction Level of Hong Kong Tourists with Hot Springs Hotels and Resorts in Guangdong, China

The research reported here aimed at examining Hong Kong tourists’ level of satisfaction with hot springs hotels and resorts in Guangdong, China. Primary data were collected and service quality and tourist satisfaction levels were measured using the SERVQUAL model. The empirical findings indicate that most tourists are satisfied with the service quality of these hotels and resorts. Among the different dimensions of service quality, empathy receives the highest score. Overall satisfaction receives a score only slightly better than average. The results also reveal significant relationships among customer satisfaction level, loyalty, and recommendation.

Risk factors of type 2 diabetes and cardiovascular diseases among Jamaican adolescents

Purpose: The purpose of the study was to examine Jamaican adolescents in a school setting, for risk factors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). Methods: A descriptive epidemiological cross-sectional study of 276 Jamaican adolescents (112 males and 164 females) ages 14-19 years (15.6±1.2), randomly selected from grades 9-12 from ten high schools on the island. Thirteen risk factors were examined. Risk factors were compared with BMI levels and demographics. A sub-study validated finger prick testing of fasting blood glucose, total cholesterol, and HbAlc versus venous testing in 59 subjects. Results: Prevalence of overweight was 33.0% (n=91) with mean BMI of 23.74±7.74. Approximately 66.7% of subjects reported > 3 risk factors. The number of T2DM and CVDs risk factors increased for subjects with BMI above 25. One third of the overweight subjects were classified with the metabolic syndrome. High BMI was associated with high waist circumference (r =.767, p (r = .180, p.05). Percentage bias for the methods of blood testing met the reference standards for fasting blood glucose but not for total cholesterol and HbAlc. Bland Altman tests of agreement between the two methods indicated good agreement for all three tests. Conclusion: Jamaican adolescents are at high risk for T2DM and CVDs as seen in other study populations. Effective programs to prevent T2DM and CVDs are needed. Family history of diseases, anthropometric measures, and gender identified more subjects at risk than did the biochemical measures. Comparison between finger prick and venous blood methods suggested that finger prick is an adequate method to screen for risk factors in children and adolescents.

Factors of Inflammation in Haitian Americans and African Americans with and without Type 2 Diabetes

Chronic low-grade inflammation has been implicated in the processes leading to the development of type 2 diabetes (T2D) and its progression. Non-Hispanic Blacks bear a disproportionate burden of T2D and are highly susceptible to inflammation. This cross-sectional study assessed and compared the serum levels of established adipocytokines; interleukin-6 (IL-6), C-reactive protein (CRP), leptin, and novel adipocytokines; chemerin and omentin in Haitian and African Americans with and without T2D. The relationships of these adipocytokines with metabolic syndrome (MetS), anthropometric and HOMA2 measures by ethnicity and diabetes status were also assessed. Serum levels of IL-6, CRP, leptin, chemerin and omentin were determined by the ELISA method. HOMA2 measures were calculated for insulin sensitivity (HOMA2-IS) and insulin resistance (HOMA2-IR). Analyses of available data for 230 Haitian Americans and 241 African Americans (240 with and 231 without T2D) for the first study showed that Haitian Americans with and without MetS had lower levels of IL-6 and CRP compared to African Americans with and without MetS (P Ethnic-specific diabetes intervention and treatment programs must be designed to target Haitian Americans and African Americans as separate unique groups, in order to reduce the burden of T2D among the non-Hispanic Black community. Further research is needed to gain better understanding of the role of inflammation and T2D in this population.

Factors associated with social work student satisfaction with field placements in child welfare

This study was conducted during the 1994-1995 academic year. Seven social work education programs in the state of Florida, all accredited by the Council on Social Work Education, participated in this study. Graduate and undergraduate social work students in child welfare field placements, and their field instructors, were surveyed during the Spring 1995 semester to assess their satisfaction with field placements in this area and the relationship of this satisfaction to employment interests and field placement recommendations.^ The majority of social work students responding to this survey were generally satisfied with several aspects of their field placements--the learning, field work program, field instructor, child welfare agency, and overall field experience. The field instructors were generally more satisfied than the students, but only statistically different from the students in the areas of satisfaction with the field work program and the child welfare agency. Multiple regression analysis revealed that learning assignment opportunities, field instructor relationship characteristics, placement preference, and pre-placement interview contributed to the prediction of student satisfaction.^ Student satisfaction in field placement was significantly related to the acceptance of employment, if offered, and the recommendation of the field placement to other students. Logistic regression analysis revealed that satisfaction with the child welfare agency was the greatest contributor to the prediction of acceptance of employment, and satisfaction with the field work program was the greatest contributor to the prediction of field placement recommendation. ^

A study of learners' perceived value and satisfaction for implied effectiveness of online learning systems

Online learning systems (OLS) have become center stage for corporations and educational institutions as a competitive tool in the knowledge economy. The satisfaction construct has received extensive coverage in information systems literature as an indicator of effectiveness but has been criticized for lack of validity; yet, the value construct has been largely ignored, although it has a long history in psychology, sociology, and behavioral science. The purpose of this dissertation is to investigate the value and satisfaction constructs in the context of OLS, and their perceived by learners relationship for implied effectiveness of OLS. ^ First, a qualitative phase is employed to gather OLS values from learners' focus groups, followed by a pilot phase to refine a proposed instrument, and a main phase to validate the survey. Responses were received from 75 students in four focus groups, 141 in the pilot, and 207 the main survey. Extensive data cleaning and exploratory factor analysis were done to identify factors of learners' perceived value and satisfaction of OLS. Then, Value-Satisfaction grids and the Learners' Value Index of Satisfaction (LeVIS) were developed as benchmarking tools of OLS. Moreover, Multicriteria Decision Analysis (MCDA) techniques were employed to impute value from satisfaction scores in order to reduce survey response time. ^ The results provided four satisfaction and four value factors with high reliability (Cronbach's α). Moreover, value and satisfaction were found to have low linear and nonlinear correlations, indicating that they are two distinct uncorrelated constructs. This is consistent with the literature. Value-Satisfaction grids and the LeVIS index indicated relatively high effectiveness for technology and support characteristics, relatively low effectiveness for professor's characteristics, while course and learner characteristics indicated average effectiveness. ^ The main contributions of this study include identifying, defining, and articulating the relationship between value and satisfaction constructs as assessment of users' implied IS effectiveness, as well as assessing the accuracy of MCDA procedures to predict value scores, thus reducing by half the survey questionnaire size. ^

Factors associated with social work student satisfaction with field placements in child welfare by Diane Elias Alperin.

This study was conducted during the 1994-1995 academic year. Seven social work education programs in the state of Florida, all accredited by the Council on Social Work Education, participated in this study. Graduate and undergraduate social work students in child welfare field placements, and their field instructors, were surveyed during the Spring 1995 semester to assess their satisfaction with field placements ii this area and the relationship of this satisfaction to employment interests and field placement recommendations. The majority of social work students responding to this survey were generally satisfied with several aspects of their field placements--the learning, field work program, field instructor, child welfare agency, and overall field experience. The field instructors were generally more satisfied than the students, but only statistically different from the students in the areas of satisfaction with the field work program and the child welfare agency. Multiple regression analysis revealed that learning assignment opportunities, field instructor relationship characteristics, placement preference, and pre-placement interview contributed to the prediction of student satisfaction. Student satisfaction in field placement was significantly related to the acceptance of employment, if offered, and the recommendation of the field placement to other students. Logistic regression analysis revealed that satisfaction with the child welfare agency was the greatest contributor to the prediction of acceptance of employment, and satisfaction with the field work program was the greatest contributor to the prediction of field placement recommendation.

The clinical competency of practicing and nonpracticing faculty of associate degree schools of nursing

This study assesses and describes the perception of clinical competency and the relationship to clinical practice of full-time nursing faculty in the associate degree nursing programs in the state of Florida. The study was developed around one major hypothesis and four research questions. The Hygiene-Motivators Theory proposed by Herzberg, Mausner, and Snyderman (1959) provided the conceptual framework to explain factors that would motivate a person to expand workload and maintain job satisfaction.^ Data were collected from the 244 faculty members teaching full-time at the 15 associate degree schools of nursing accredited by the National League for Nursing in the state of Florida. A total of 186 faculty (76%) responded and 175 (72%) cases were used for data analysis.^ Two instruments were modified and combined for the investigation. The instruments were the Faculty Perception of Practice Questionnaire (Parascenzo, 1983) and a three-part Attributes Deemed Necessary for Faculty to Proclaim Clinical Competency (Smith, 1991) scale. Computer analyses employing descriptive and inferential statistics were performed.^ The findings revealed that faculty were closely divided as to practice activities with more faculty nonpracticing than practicing. Factors identified as impediments to increased clinical practice were identified as teaching load and personal/family responsibilities that lead to a lack of time and lack of opportunity. Those faculty who practice did so as moonlighters in positions that would not require advanced training. Both the practicing and nonpracticing faculty reported a high level of satisfaction with their activities as a means of maintaining clinical practice. While both groups reported a high level of expertise, those practicing faculty perceived themselves to be more clinically competent on the attributes of knowledge, skills, and on the total attribute scale. It was further revealed that perception of competency declined with the length of time spent out of practice. There was no difference in the two groups on the attributes of values/attitude. ^

The conflict resolution behaviors of occupational therapy students as a function of the personality types, demographic characteristics and contextual factors

Interpersonal conflicts have the potential for detrimental consequences if not managed successfully. Understanding the factors that contribute to conflict resolution has implications for interpersonal relationships and the workplace. Researchers have suggested that personality plays an important and predictable role in conflict resolution behaviors (Chanin & Schneer, 1984; Kilmann & Thomas, 1975; Mills, Robey & Smith, 1985). However, other investigators have contended that contextual factors are important contributors in triggering the behavioral responses (Shoda & Mischel, 2000; Mischel & Shoda, 1995). The purpose of this study was to investigate the relationships among personality types, demographic characteristics and contextual factors on the conflict resolution behaviors reported by graduate occupational therapy students (n = 125). ^ The study design was correlational. The Myers Briggs Type Indicator (MBTI) and the Thomas-Kilmann (MODE) Instrument were used to establish the personality types and the context independent conflict resolution behaviors respectively. The effects of contextual factors of task vs. relationship and power were measured with the Conflict Case Scenarios Questionnaire (CCSQ). One-way ANOVA and linear regression procedures were used to test the relationships between personality types and demographic characteristics with the context independent conflict behaviors. Chi-Square procedures of the personality types by contextual conditions ascertained the effects of contexts in modifying the resolution modes. Descriptive statistics established a profile of the sample. ^ The results of the hypotheses tests revealed significant relationships between the personality types of feeling-thinking and sensing-intuition with the conflict resolution behaviors. The contextual attributes of task vs. relationship orientation and of peer vs. supervisor relationships were shown to modify the conflict behaviors. Furthermore, demographic characteristics of age, gender, GPA and educational background were shown to have an effect on the conflict resolution behaviors. The knowledge gained has implications for students' training, specifically understanding their styles and use of effective conflict resolution strategies. It also contributes to the knowledge on management approaches and interpersonal competencies and how this might facilitate the students' transition to the clinical role. ^

Adolescent readers' self-perceptions of affective factors related to performance on standardized tests

The purpose of this study was to investigate which affective factors of adolescent high school readers were related to high-level readers, middle-level readers and low-level readers. The research problem was to determine the relationship between adolescent high school students' self-perceived reading self-efficacy factors and the students' reading performance on a standardized reading assessment considering demographic factors of age, gender and socio-economic status as covariates. The research design was ex post facto making inferences without direct intervention. The sample was obtained from one large, diverse, urban high school, consisting of 9th and 10th grade adolescent students (N = 176). Students voluntarily completed a self-report, reading self-efficacy survey. School records were used to obtain standardized reading level scores, age, gender, and socio-economic status data. An exploratory factor analysis of the self-efficacy survey responses resulted in the identification of 7 underlying factors. The striving (low-level) readers had significantly lower self-perceptions on 5 of the 7 affective factors than the middle-level readers, and strong (high-level) readers, p < .05. The 5 affective factors on which the striving readers had significantly lower self-perceptions were: (a) Observational Comparison, (b) Progress, (c) Lack of Progress, (d) Lack of Anxiety, and (e) Positive Social Feedback. The 2 affective factors which were not significantly different for reader level were Anxiety and Negative Social Feedback. Girls had significantly less anxiety than boys for both of the factors in the Anxiety category. Statistical results showed that none of the demographic covariates tested; age, gender, or socio-economic status, moderated the relationship between affective reader self-efficacy factors and reader level. This study concluded that there were distinguishable differences for striving, middle, and strong readers' self-efficacy factors. Determining affective factors related to reading can be used to create better instructional environments and instruction for adolescent students.

Development of a new student evaluation instrument of instructor effectiveness in online courses

The purpose of this study was to (a) develop an evaluation instrument capable of rating students' perceptions of the instructional quality of an online course and the instructor’s performance, and (b) validate the proposed instrument with a study conducted at a major public university. The instrument was based upon the Seven Principles of Good Practice for Undergraduate Education (Chickering & Gamson, 1987). The study examined four specific questions. 1. Is the underlying factor structure of the new instrument consistent with Chickering and Gamson's Seven Principles? 2. Is the factor structure of the new instrument invariant for male and female students? 3. Are the scores on the new instrument related students’ expected grades? 4. Are the scores on the new instrument related to the students' perceived course workload? ^ The instrument was designed to measure students’ levels of satisfaction with their instruction, and also gathered information concerning the students’ sex, the expected grade in the course, and the students’ perceptions of the amount of work required by the course. A cluster sample consisting of an array of online courses across the disciplines yielded a total 297 students who responded to the online survey. The students for each course selected were asked to rate their instructors with the newly developed instrument. ^ Question 1 was answered using exploratory factor analysis, and yielded a factor structure similar to the Seven Principles.^ Question 2 was answered by separately factor-analyzing the responses of male and female students and comparing the factor structures. The resulting factor structures for men and women were different. However, 14 items could be realigned under five factors that paralleled some of the Seven Principles. When the scores of only those 14 items were entered in two principal components factor analyses using only men and only women, respectively and restricting the factor structure to five factors, the factor structures were the same for men and women.^ A weak positive relationship between students’ expected grades and their scores on the instrument was found (Question 3). There was no relationship between students’ perceived workloads for the course and their scores on the instrument (Question 4).^

The Study of Clustering of Taiwanese Tourists' Motivations to Hong Kong

Abstract Driven by the political and economic forces of cross-strait, Taiwan has become one of the major source markets for Hong Kong tourism industry since 1987. The major purposes of this study were to investigate the following factors (1) The influential factors of travel motivation, (2) The clusters of travel motivations, (3) The marketing segmentation of clusters of Taiwanese tourists to visit Hong Kong. Through ten travel agents, self-report surveys were distributed to collect data from 366 Taiwanese travelers. Hence, four push factors and six pull factors were identified as travel motivations through the factor analysis. Combined with the cluster analysis; five new groups were founded. Finally, five clusters which process unique profiles (location difference, visiting frequency, travel satisfaction, and destination loyalty) were addressed. The suggestions of developing effective market strategies to attract Taiwanese tourists to Hong Kong were also provided.

The relationship between student characteristics, computer literacy,technology acceptance, and distance education student satisfaction

The purpose of this study is to identify the relationship between the characteristics of distance education students, their computer literacy and technology acceptance and distance education course satisfaction. The theoretical framework for this study will apply Rogers and Havelock's Innovation, Diffusion & Utilization theories to distance education. It is hypothesized that technology acceptance and computer competency will influence the student course satisfaction and explain the decision to adopt or reject distance education curriculum and technology. Distance education delivery, Institutional Support, Convenience, Interactivity and five distance education technologies were studied. The data were collected by a survey questionnaire sent to four Florida universities. Three hundred and nineteen and students returned the questionnaire. A factor and regression analysis on three measure of satisfaction revealed significant difference between the three main factors related to the overall satisfaction of distance education students and their adoption of distance education technology as medium of learning. Computer literacy is significantly related to greater overall student satisfaction. However, when competing with other factors such as delivery, support, interactivity, and convenience, computer literacy is not significant. Results indicate that age and status are the only two student characteristics to be significant. Distance education technology acceptance is positively related to higher overall satisfaction. Innovativeness is also positively related to student overall satisfaction. Finally, the technology used relates positively to greater satisfaction levels within the educational experience. Additional research questions were investigated and provided insights into the innovation decision process.