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 Mexican-Americans; 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 one-third 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.

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.

Rastafarianism and the Nation of Islam as institutions for group-identity formation among blacks in the United States: A case study comparing their approaches

This dissertation explores the Rastafari movement and the Nation of Islam as institutions that provide a group-identity for their adherents. The study seeks to determine the characteristics of the identity that is institutionalized by each movement, and the nature of the institutionalization process. The research was conducted primarily in South Florida where both movements exist. An extensive literature review in conjunction with in-depth field interviews were used as the primary research methodologies. What was of particular interest were the reasons that the members of the movements chose one movement over the other, also the similarities and dissimilarities between the movements in their role as institutions for group-identity formation. The research showed that both movements imbued their members with a sense of pride, high self-esteem and a strong sense of race consciousness. In addition, it showed that there was significant variation in identity orientation within the Rastafari Movement, which contrasted with the Nation of Islam where the identity variations within the movement were negligible. This was due largely to the difference in structure between the movements, the Nation of Islam being a centrally organized movement with one leader while the Rastafari movement is a decentralized polycephalous one. ^ Both movements were found to be millenarian in nature, essentially because of the significant utility of the concept that their members would rise to prominence through God's grace. Additionally, both movements were identified as expressive social movements, since they were determined as being primarily concerned with changing the attitudes of their members rather than effecting structural social change. ^

The state of emergency management 2000: The process of emergency management professionalization in the United States and Florida

This dissertation analyzes the current status of emergency management professionalization in the United States and Florida using a qualitative case study. I investigate the efforts of various organizations at the national and state levels in the private and public sectors to organize emergency management as a profession. I conceptualize emergency management professionalization as occurring in two phases: the indirect institutionalization of the occupation of emergency management and the formal advancement toward an emergency management profession. The legislative, organizational, and procedural developments that occurred between approximately 1900 and the late 1970s became the indirect institutionalization of the occupation of emergency management. Over time, as our society developed and became increasingly complex, more disasters affect the security of the population. In order to adapt to increasing risks and vulnerabilities the emergency management system emerged and with it the necessary elements upon which a future profession could be established providing the basis for the formal advancement toward an emergency management profession. ^ During approximately the last twenty years, the formal advancement toward an emergency management profession has encompassed two primary strategies—certification and accreditation—motivated by the objective to organize a profession. Certification applies to individual emergency managers and includes all training and education. Accreditation of state and local emergency management agencies is reached by complying to a minimum level of proficiency with established standards of performance. Certification and accreditation are the mechanisms used to create an emergency management profession and thus act as axes around which the field of emergency management is organizing. ^ The purpose of this research is to provide a frame of reference for whether or not the field of emergency management is a profession. Based on sociology of professions literature, emergency management can be considered to be professionalizing. The current emergency management professionalization efforts may or may not be sufficient to achieve the ultimate goal of becoming a legitimate profession based on legal and public support for the exclusive right to perform emergency management tasks (monopoly) as well as self-regulation of those tasks (autonomy). ^

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.