Facing a paradigm shift in professional credentialing: Preparedness of registered dietitians for Professional Development 2001

In the year 2001, the Commission on Dietetic Registration (CDR) will begin a new process of recertifying Registered Dietitians (RD) using a self-directed lifelong learning portfolio model. The model, entitled Professional Development 2001 (PD 2001), is designed to increase competency through targeted learning. This portfolio consists of five steps: reflection, learning needs assessment, formulation of a learning plan, maintenance of a learning log, and evaluation of the learning plan. By targeting learning, PD 2001 is predicted to foster more up-to-date practitioners than the current method that requires only a quantity of continuing education hours. This is the first major change in the credentialing system since 1975. The success or failure of the new system will impact the future of approximately 60,000 practitioners. The purpose of this study was to determine the readiness of RDs to change to the new system. Since the model is dependent on setting goals and developing learning plans, this study examined the methods dietitians use to determine their five-year goals and direction in practice. It also determined RD's attitudes towards PD 2001 and identified some of the factors that influenced their beliefs. A dual methodological design using focus groups and questionnaires was utilized. Sixteen focus groups were held during state dietetic association meetings. Demographic data was collected on the 132 registered dietitians who participated in the focus groups using a self-administered questionnaire. The audiotaped sessions were transcribed into 643 pages of text and analyzed using Non-numerical Unstructured Data - Indexing Searching and Theorizing (NUD*IST version 4). Thirty-four of the 132 participants (26%) had formal five-year goals. Fifty-four participants (41%) performed annual self-assessments. In general, dietitians did not currently have professional goals nor conduct self-assessments and they claimed they did not have the skills or confidence to perform these tasks. Major barriers to successful implementation of PD 2001 are uncertainty, misinterpretation, and misinformation about the process and purpose, which in turn contribute to negative impressions. Renewed vigor to provide a positive, accurate message along with presenting goal-setting strategies will be necessary for better acceptance of this professional development process. ^

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.^

Personal and institutional factors: Relationship to self-efficacy of persistence to the senior year in college among self-identified Black undergraduate students in a Hispanic serving institution

While undergraduate enrollment of all racial groups in United States higher education institutions has increased, 6-year graduation rates of Blacks (39%) remain low compared to other races; Asians (69%), Whites (62%), and Hispanics (50%; NCES, 2010). Women's graduation rate is higher than men's; 58% compared to men's at 53% in public institutions (IPEDS, 2011). Retention literature does not address the perceptions of Black ethnic groups' experiences in college, particularly in Hispanic serving institutions. Informed by Tinto's (1975, 1987, 1993) student academic and social integration model, Guiffrida's (2003, 2004, 2005, 2006) model of relationships while at college, and ex-post facto research design, the study investigated personal and institutional factors that relate to Black students' self-efficacy and persistence to the senior year in college. Data about Black ethnic undergraduate seniors' (N = 236) academic and social experiences in college were collected using the Student Institutional Integration Survey (SIIS), an online questionnaire. Descriptive statistics were used to collect background information about the sample, correlation was calculated to indicate the degree of relationship between the variables, and multiple linear regressions were used to identify variables that are predictors of self-efficacy of persistence. Independent samples t-test and analyses of variance were computed to determine whether differences in perceptions of personal and institutional factors that relate to self-efficacy of persistence to the senior year in college could be identified between gender and ethnicity. Frequency was summarized to identify themes of participants' primary motivation for finishing undergraduate degree programs. These themes were: (a) self-pride/personal goal, (b) professional aspiration/career (c) motivation to support family, (d) desire to have financial independence/better job, (e) to serve community, (f) opportunity to go to college, (g) being first-generation college student, and (h) prove to family the value of higher education. The research findings support the tenets of academic and social integration theories which suggest that students' interaction with peer and faculty, relationships with family and friends, and involvement in institutional activities and organizations influence their persistence in college. Implications based on the findings affect institutional policy, curriculum, and program improvements that relate to Black undergraduate students' academic and social support.

Personal and Institutional Factors: Relationship to Self-Efficacy of Persistence to the Senior Year in College among Self-Identified Black Undergraduate Students in a Hispanic Serving Institution

While undergraduate enrollment of all racial groups in United States higher education institutions has increased, 6-year graduation rates of Blacks (39%) remain low compared to other races; Asians (69%), Whites (62%), and Hispanics (50%; NCES, 2010). Women’s graduation rate is higher than men’s; 58% compared to men’s at 53% in public institutions (IPEDS, 2011). Retention literature does not address the perceptions of Black ethnic groups’ experiences in college, particularly in Hispanic serving institutions. Informed by Tinto’s (1975, 1987, 1993) student academic and social integration model, Guiffrida’s (2003, 2004, 2005, 2006) model of relationships while at college, and ex-post facto research design, the study investigated personal and institutional factors that relate to Black students’ self-efficacy and persistence to the senior year in college. Data about Black ethnic undergraduate seniors’ (N = 236) academic and social experiences in college were collected using the Student Institutional Integration Survey (SIIS), an online questionnaire. Descriptive statistics were used to collect background information about the sample, correlation was calculated to indicate the degree of relationship between the variables, and multiple linear regressions were used to identify variables that are predictors of self-efficacy of persistence. Independent samples t-test and analyses of variance were computed to determine whether differences in perceptions of personal and institutional factors that relate to self-efficacy of persistence to the senior year in college could be identified between gender and ethnicity. Frequency was summarized to identify themes of participants’ primary motivation for finishing undergraduate degree programs. These themes were: (a) self-pride/personal goal, (b) professional aspiration/career (c) motivation to support family, (d) desire to have financial independence/better job, (e) to serve community, (f) opportunity to go to college, (g) being first-generation college student, and (h) prove to family the value of higher education. The research findings support the tenets of academic and social integration theories which suggest that students’ interaction with peer and faculty, relationships with family and friends, and involvement in institutional activities and organizations influence their persistence in college. Implications based on the findings affect institutional policy, curriculum, and program improvements that relate to Black undergraduate students’ academic and social support.

Intra -organizational turnover in a self -selective team environment

Four-hundred twenty-seven firefighter/paramedics and firefighter/emergency medical technicians completed questionnaires regarding past and current turnover decisions. The employees, who work in teams of either three or four, have a collective bargaining benefit that allows them to "bid for" (request) new positions/teams every six months; positions are awarded on the basis of seniority. Because employees are leaving neither the organization nor their job, the "bid" process creates intra-organizational turnover on a regular basis. It was hypothesized that those individuals higher in teamwork/social cohesion expectations, higher in interpersonal orientation, and lower in conflict tolerance would report placing greater importance on interpersonal reasons (teamwork/social cohesion) in past bid/assignment decisions. Creation of a conflict tolerance scale was the goal of a preliminary study. It was further hypothesized that current bid/assignment satisfaction would predict the current turnover decision (during the cycle in which the study was conducted), and that past individual turnover frequency would also predict current turnover. All hypotheses were supported. ^

Self -regulated learning: The role of a journal in the learning process for students and teachers

A fundamental goal of education is to equip students with self-regulatory capabilities that enable them to educate themselves. Self directedness not only contributes to success in formal instruction but also promotes lifelong learning (Bandura, 1997). The area of research on self-regulated learning is well grounded within the framework of psychological literature attributed to motivation, metacognition, strategy use and learning. This study explored past research and established the purpose of teaching students to self-regulate their learning and highlighted the fact that teachers are expected to assume a major role in the learning process. A student reflective writing journal activity was sustained for a period of two semesters in two fourth-grade mathematics classrooms. The reflective writing journal was analyzed in search of identifying strategies reported by students. Research questions were analyzed using descriptive statistics, frequency counts, cross-tabs and chi-square analyses. ^ Results based on student-use of the journals and teacher interviews indicated that the use of a reflective writing journal does promote self-regulated learning strategies to the extent which the student is engaged in the journaling process. Those students identified as highly self-regulated learners on the basis of their strategy use, were shown to consistently claim to learn math “as well or better than planned” on a weekly basis. Furthermore, good self-regulators were able to recognize specific strategies that helped them do well and change their strategies across time based on the planned learning objectives. The perspectives of the participating teachers were examined in order to establish the context in which the students were working. The effect of “planned change” and/or the resistance to change as established in previous research, from the teachers point of view, was also explored. The analysis of the journal data did establish a significant difference between students who utilized homework as a strategy. ^ Based on the journals and interviews, this study finds that the systematic use of metacognitive, motivational and/or learning strategies can have a positive effect on student's responsiveness to their learning environment. Furthermore, it reflects that teaching students “how to learn” can be a vital part of the effectiveness of any curriculum. ^

Health changes in Hispanic older adults in a Spanish arthritis self -management education program

Arthritis is the most common chronic condition affecting older people and is a major cause of limited activity. Arthritis education programs in English have demonstrated a positive impact on health but these programs have not reached the Hispanic communities where arthritis is the leading cause of disability. Minorities, such as Hispanics, have traditionally been reluctant to pursue self-help programs, and have been identified as an under-served population in terms of medical care. This study examined the effectiveness of one community health adult education program targeting Hispanic older adults with arthritis, the Spanish Arthritis Self Management Education Program (SASMEP), by evaluating changes in the participants' general health, pain, disability, self-efficacy, health perceptions, frequency of physician visits, and exercise. A pre and post control group experimental design and analyses of covariance were used to determine the pre and post differences in health status and health behaviors for a group participating in the SASMEP and a group who did not using gender and age as covariates. A repeated measures design was also used, and repeated measures analyses of variance and post hoc tests were done on health status and health behavior data collected pre, post and one-year post education to determine long-term differences. ^ Results indicated the participants' health status significantly improved in general health, significantly decreased in pain, and significantly decreased in arthritic disability immediately following the education. Self-efficacy and health perceptions increased for both groups but not significantly. The participants' health behaviors showed significantly fewer physician visits and significantly increased time spent performing stretching and strengthening exercise and time spent performing aerobic exercise. No group differences were found in the frequency of arthritis physician visits. ^ The improvements seen immediately after the SASMEP participation were not reflected in the post one-year scores. No significant differences were found for the participants' health status or health behaviors one year following the education. Health status and health behaviors did not return below baseline scores after one year suggesting the participants' health, although not improved, did not deteriorate. Therefore, the SASMEP education provided short-term health benefits for older Hispanic adults with arthritis, but not long-term health benefits. ^

Effects of computer self efficacy and positive mood in business -to -business service encounters

Attempts to improve the level of customer service delivered have resulted in an increased use of technology in the customer service environment. Customer-contact employees are expected to use computers to help them in providing better service encounters for customers. This research study done in a business-to-business environment explored the effects of customer-contact employees' computer self efficacy and positive mood on in-role customer service, extra-role customer service and organization citizenship. It also examined the relationship of customer service to customer satisfaction and customer delight. ^ Research questions were analyzed using descriptive statistics, frequency distributions, correlation analysis, and regression analysis. Results indicated that computer self efficacy had a greater impact on extra-role customer service than it did on in-role customer service. Positive mood had a positive moderating influence on extra-role customer service but not on in-role customer service. ^ There was a significant relationship between in-role customer service and customer satisfaction but not between extra-role customer service and customer satisfaction. There was no significant relationship between in-role customer service and customer delight nor between extra-role customer service and customer delight. There was a statistically greater positive relationship between joy experienced by clients and customer delight than between pleasant surprise and customer delight. ^ This study demonstrated the importance of facilitating customer-contact employee positive mood on the job in order to improve the level of extra-role customer service delivered. It also showed that increasing the level of customer service does not necessarily lead to higher levels of customer satisfaction. ^

Hybrid Power System Intelligent Operation and Protection Involving Plug-in Electric Vehicles

Two key solutions to reduce the greenhouse gas emissions and increase the overall energy efficiency are to maximize the utilization of renewable energy resources (RERs) to generate energy for load consumption and to shift to low or zero emission plug-in electric vehicles (PEVs) for transportation. The present U.S. aging and overburdened power grid infrastructure is under a tremendous pressure to handle the issues involved in penetration of RERS and PEVs. The future power grid should be designed with for the effective utilization of distributed RERs and distributed generations to intelligently respond to varying customer demand including PEVs with high level of security, stability and reliability. This dissertation develops and verifies such a hybrid AC-DC power system. The system will operate in a distributed manner incorporating multiple components in both AC and DC styles and work in both grid-connected and islanding modes. The verification was performed on a laboratory-based hybrid AC-DC power system testbed as hardware/software platform. In this system, RERs emulators together with their maximum power point tracking technology and power electronics converters were designed to test different energy harvesting algorithms. The Energy storage devices including lithium-ion batteries and ultra-capacitors were used to optimize the performance of the hybrid power system. A lithium-ion battery smart energy management system with thermal and state of charge self-balancing was proposed to protect the energy storage system. A grid connected DC PEVs parking garage emulator, with five lithium-ion batteries was also designed with the smart charging functions that can emulate the future vehicle-to-grid (V2G), vehicle-to-vehicle (V2V) and vehicle-to-house (V2H) services. This includes grid voltage and frequency regulations, spinning reserves, micro grid islanding detection and energy resource support. The results show successful integration of the developed techniques for control and energy management of future hybrid AC-DC power systems with high penetration of RERs and PEVs.

Hybrid power system intelligent operation and protection involving plug-in electric vehicles

Two key solutions to reduce the greenhouse gas emissions and increase the overall energy efficiency are to maximize the utilization of renewable energy resources (RERs) to generate energy for load consumption and to shift to low or zero emission plug-in electric vehicles (PEVs) for transportation. The present U.S. aging and overburdened power grid infrastructure is under a tremendous pressure to handle the issues involved in penetration of RERS and PEVs. The future power grid should be designed with for the effective utilization of distributed RERs and distributed generations to intelligently respond to varying customer demand including PEVs with high level of security, stability and reliability. This dissertation develops and verifies such a hybrid AC-DC power system. The system will operate in a distributed manner incorporating multiple components in both AC and DC styles and work in both grid-connected and islanding modes. ^ The verification was performed on a laboratory-based hybrid AC-DC power system testbed as hardware/software platform. In this system, RERs emulators together with their maximum power point tracking technology and power electronics converters were designed to test different energy harvesting algorithms. The Energy storage devices including lithium-ion batteries and ultra-capacitors were used to optimize the performance of the hybrid power system. A lithium-ion battery smart energy management system with thermal and state of charge self-balancing was proposed to protect the energy storage system. A grid connected DC PEVs parking garage emulator, with five lithium-ion batteries was also designed with the smart charging functions that can emulate the future vehicle-to-grid (V2G), vehicle-to-vehicle (V2V) and vehicle-to-house (V2H) services. This includes grid voltage and frequency regulations, spinning reserves, micro grid islanding detection and energy resource support. ^ The results show successful integration of the developed techniques for control and energy management of future hybrid AC-DC power systems with high penetration of RERs and PEVs.^