State legislative term limits and the law of unintended consequences: An examination of member behavior, power structures, and legislative organization in Florida

The implementation of term limits on state legislators has provided a wealth of data for study. Florida, the second largest state in the Union with term limits, has not been comprehensively studied. This research examines the effects of term limits on electoral competition, member composition, legislator career paths, legislative leadership, and intra- and inter-governmental influences on Florida's legislature. This study looks at the Florida legislature from 1992 when term limits were enacted through 2004, three electoral cycles in which term limits have been in effect. This study uses both quantitative and qualitative data where appropriate. Electoral data is used to assess electoral and demographic effects, as well as member career trajectories. Interview data with current and former legislators, lobbyists, and executive branch officials is used to analyze both changes in legislative organization and intra- and inter-governmental influences on the legislative process. Term limits has only created greater competition when a legislative seat opens and has actually created a greater advantage for incumbents. Women and minorities have only made minimal gains in winning seats post-term limits. Newly elected legislators are not political novices with a vast majority having previous elective experience. Leadership is more centralized under term limits and the Senate has gained an advantage over the more inexperienced House. Lastly, the influence of staff, lobbyists, and most importantly, the governor has greatly increased under term limits. This research finds that term limits have not produced the consequences that proponents had envisioned.^

The influence of gender and ethnic diversity on team effectiveness

Organizations are becoming increasingly diverse as a growing number of women and ethnic minorities enter the workforce. Understanding the influence of diversity is particularly important for organizations that rely on team-based work structures, where individuals must engage in face-to-face interactions more frequently than in other organizational settings. The purpose of this research was to examine the effects of gender and ethnic diversity on team member interactions when performing a highly interdependent task that is both cognitively and behaviorally challenging. Participants were composed of 264 undergraduate students who enrolled in psychology courses at Florida International University and formed 66, 4-person teams. Teams participated in a low fidelity F-22 flight simulation consisting of two aircraft that had to interact in order to be successful. A 2 x 2 design was utilized in which the gender and ethnicity composition of each team was manipulated to form four experimental conditions (same gender/same ethnicity, same gender/mixed ethnicity, mixed gender/same ethnicity, mixed gender/mixed ethnicity). Both ethnic and gender homogeneity in teams resulted in increased interpersonal cohesion. Moreover, coordination fully mediated the relationship between interpersonal cohesion and team performance. Higher levels of interpersonal cohesion enhanced coordination between team members, which ultimately improved performance. Implications of these findings are discussed, as are limitations of the study and suggestions for future research. ^

Ethnic groups and institutions: A study of institutional engineering in four Central and Eastern European countries

The issue of institutional engineering has gained a renewed interest with the democratic transitions of the Central and Eastern European countries, as for some states it has become a matter of state survival. The four countries examined in the study – Macedonia, Slovakia, Romania and Bulgaria – exemplify the difficulty in establishing a stable democratic society in the context of the resurgence of national identity. The success of ethnonational minorities in achieving the desired policies affirming or expanding their rights as a group was conditioned upon the cohesion of the minority as well as the permissiveness of state institutions in terms of participation and representation of minority members. The Hungarian minorities in Slovakia and Romania, the Turkish minority in Bulgaria, and the Albanian minority in Macedonia, formed their political organizations to represent their interests. However, in some cases the divergence of strategies or goals between factions of the minority group seriously impeded its ability to obtain the desired concessions from the majority. The difficulty in the pursuit of policies favoring the expansion of minority rights was further exacerbated in some of the cases by the impermissiveness of political institutions. The political parties representing the interest of ethnonational minorities were allowed to participate in elections, although not without suspicions about their intent and even strong opposition from majority groups, but participation in elections and subsequent representation in legislative bodies did not translate into adoption of the desired policies. The ethnonational minorities' inability to effectively influence the decision-making process was the result of the inadequacy of democratic institutions to process these demands and channel them through the normal political process in the absence of majority desire to accommodate them. Despite the promise of democratic institutions to bring about a major overhaul of the policies of forceful assimilation and disregard for minority rights, the four cases analyzed in the study demonstrate that in effect ethnonational minorities continued to be at the mercy of the majority, especially if the minority was unable to position itself as a balancing actor.

The role of the health care organization in supporting nurses in the delivery of culturally competent care

This study was designed to explore ways in which health care organizations (HCOs) can support nurses in their delivery of culturally competent care. While cultural competence has become a priority for the federal government as well as the major health professional organizations, its integration into care delivery has not yet been realized. Health professionals cite a lack of educational preparation, time, and organizational resources as barriers. Most experts in the field agree that the cultural and linguistic needs of ethnic minorities pose challenges that individual care providers are unable to manage without the support of the health care organizations within which they practice. While several studies have identified implications for HCOs, there is a paucity of research on their role in this aspect of care delivery. Using a qualitative design with a case study approach, data collection included face-to-face interviews with 23 registered nurses, document analysis, and reports of critical incidents. The site chosen was a large health care system in South Florida that serves a culturally diverse population. Major findings from the study included language barriers, lack of training, difficulty with cultural differences, lack of organizational support, and reliance on culturally diverse staff members. Most nurses thought the ethnic mix was adequate, but rated other supports such as language services, training, and patient education materials as inadequate. Some of the recommendations for organizational performance were to provide the expectations and support for culturally competent care. Implications and recommendations for practice include nurses using trained interpreters instead of relying on coworkers or trying to "wing it", pursuing training, and advocating for organizational supports for culturally competent care. Implications and recommendations for theory included a blended model that combines both models in the conceptual framework. Recommendations for future research were for studies on the impact of language bathers on care delivery, develop and test a quantitative instrument, and to incorporate Gilbert's model into nursing research.

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.^

Minority Workforce Issues in Athletic Training

Certified Athletic Trainers belonging to ethnic minority groups have many issues in the profession. This paper addresses workforce issues including distribution of minorities, recruitment and retention of minority Certified Athletic Trainers, and support systems for minority Certified Athletic Trainers.

Critical Race Theory and Adult Education: Critique of the Literature in Adult Education Quarterly

This paper examines the assumptions and paradigms used to discuss diversity and equity in adult education literature using critical race theory as a lens. Five themes emerged from the critique that may initiate an innovative dialogue about the realities and subjectivities singling out racial and ethnic minorities in the USA.

From Bilingualism to Interlinguistics: The Case Against the Deficit Model of Language Acquisition

The article argues against an ahistorical deficit model of Spanish/English bilingualism in educational practice based on interlinguistic research. The bidirectional facilitative effects of Hispanic bilingualism allow Spanish-speaking minorities to exploit their language background while learning academic English and integrating their language and culture into the American mainstream.

Bondage and Discipline, Dominance and Submission, and Sadism and Masochism (BDSM) Identity Development

Identity shapes how people make sense of the world. Sexual minorities’ sexual orientations and gender identities fall outside of heteronormative categorizations. Adults engage in diverse relationships: many of them fall outside of heteronormative boundaries. As an instrument of social justice, Adult Education can be a site for BDSM identity development.

Ethnic identification: Impact on HIV/AIDS risk among migrant and seasonal workers in South Florida

Migrant workers are one of the most rapidly growing populations in the United States (U.S.) and have been significantly affected by HIV/AIDS. More than 9 million people in the U.S., primarily concentrated in Texas, Florida, Washington, California, Oregon, and North Carolina, are migrant farm workers. High prevalence rates are also suspected among migrant worker communities where risky health behaviors appear to be common. Constant mobility, isolation, limited education, substandard housing, and poverty are some of the factors that migrant workers experience and in many cases increases their HIV risk. Recent studies have suggested that ethnic identity or the level of attachment with one's ethnic group may influence engagement in HIV risk behaviors, a fact that may be important in the development of interventions among ethnic minorities. This study assesses the relationship between ethnic identity and HIV risk behaviors in two different samples; one assesses this relationship at baseline with a total of 431 African American migrant and seasonal workers in Immokalee, Florida. The second analyzes changes in ethnic identity and HIV behaviors in a sample of 270 Hispanic and African American migrant and seasonal workers in Immokalee, Florida. Data from baseline and 6-month follow-up were used in the analyses presented. The results suggest that individuals with higher levels of ethnic identity report lower levels of engagement in some, but not all, of the risky behaviors examined. These findings point to a potentially protective role for ethnic identity among this sample.

Monounsaturated fatty acid, carbohydrate intake, and diabetes status are associated with arterial pulse pressure

Background Diabetes is a global epidemic. Cardiovascular disease (CVD) is one of the most prevalent consequences of diabetes. Nutrition is considered a modifiable risk factor for CVD, particularly for individuals with diabetes; albeit, there is little consensus on the role of carbohydrates, proteins and fats for arterial health for persons with or without diabetes. In this study, we examined the association of macronutrients with arterial pulse pressure (APP), a surrogate measure of arterial health by diabetes status and race. Methods Participants were 892 Mexican Americans (MA), 1059 Black, non-Hispanics (BNH) and 2473 White, non-Hispanics (WNH) with and without diabetes of a weighted sample from the National Nutrition and Health Examination Survey (NHANES) 2007-2008. The cross-sectional analysis was performed with IBM-SPSS version 18 with the complex sample analysis module. The two-year sample weight for the sub-sample with laboratory values was applied to reduce bias and approximate a nationally, representative sample. Arterial stiffness was assessed by arterial pulse pressure (APP). Results APP was higher for MA [B = 0.063 (95% CI 0.015 to 0.111), p = 0.013] and BNH [B = 0.044 (95% CI 0.006 to 0.082), p = 0.018] than WNH, controlling for diabetes, age, gender, body mass index (BMI), fiber intake, energy intake (Kcal) and smoking. A two-way interaction of diabetes by carbohydrate intake (grams) was inversely associated with APP [B = -1.18 (95% CI -0.178 to -0.058), p = 0.001], controlling for race, age, gender, BMI, Kcal and smoking. BNH with diabetes who consumed more mono-unsaturated fatty acids (MUFA) than WNH with diabetes had lower APP [B = -0.112 (95%CI-0.179 to -0.045), p = 0.003] adjusting for saturated fatty acids, Kcal, age, gender, BMI and smoking. Conclusion Higher MUFA and carbohydrate intake for persons with diabetes reflecting lower APP may be due to replacement of saturated fats with CHO and MUFA. The associations of APP with diabetes, race and dietary intake need to be confirmed with intervention and prospective studies. Confirmation of these results would suggest that dietary interventions for minorities with diabetes may improve arterial health.

Television Watching, Diet Quality, and Physical Activity and Diabetes among Three Ethnicities in the United States

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 diabetes were more likely to watch more than 4 hours of TV per day as compared to their counterparts. Diet quality was inversely associated with physical activity level. Future studies are needed to establish the risk factors of prolonged TV watching in adult populations for the development of diabetes or diabetes-related complications. Although strategies to reduce TV watching have been proven effective among children, few trials have been conducted in adults. Intervention trials aimed at reducing TV viewing targeting people with type 2 diabetes may be beneficial to improve dietary quality and physical activity, which may reduce diabetes complications.

Relationship of Lifestyle Medical Advice and Non-HDL Cholesterol Control of a Nationally Representative US Sample with Hypercholesterolemia by Race/Ethnicity

Objective. The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods. Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results. Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion. The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.

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.